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FUNCTIONAL ANATOMY OF ACCESSORY SEX ORGANS

Uterus

Uterus is otherwise known as womb. It lies in the pelvic cavity in between rectum on its anterior side and urinary bladder on its posterior side. Uterus is a hollow muscular organ with a thick wall. It has a central cavity which opens into vagina through cervix. On either side at its upper part, the fallopian tubes open. Uterus communicates with peritoneal cavity through fallopian tubes.

The virgin uterus is pyriform in shape and is flattened anteroposterior. It measures about 7.5 cm in length, 5 cm in breadth at its upper part and about 2.5 cm in thickness. There is a constriction almost at the middle of uterus called isthmus. It divides the uterus into two portions:

1. The portion above the isthmus called the body of uterus

2. Portion below the isthmus called cervix.

The dome shaped part of the body which lies above a plane passing through the points of entrance of the fallopian tubes is known as the fundus.

Structure of uterus

Uterus is made up of 3 layers:

1. Outer serous layer

2. Middle muscular layer or myometrium

3. Inner mucus layer or endometrium.

1. Outer serous layer

It is the covering of uterus derived from peritoneum. Anteriorly, it covers the uterus completely but posteriorly it covers only up to the isthmus.

2. Middle muscular layer or myometrium

This layer is the thickest of all layers. It is made up of smooth muscle fibers which are disposed into three different groups.

I. External myometrium in which the muscle fibers are arranged transversely

II. Middle myometrium in which the muscle fibers are arranged longitudinally, obliquely and transversely

III. Internal myometrium which is formed by cilcular muscle fibers.

The muscular layer is interdisposed with blood vessels, nerve fibers, lymphatic vessels and areolar tissues.

3. Inner mucus layer or endometrium

It is smooth and soft with pale red colour. It is made up of ciliated columnar epithelial cells. Minute orifices are found on the surface of the endometrium. The tubular follicles of endometrium open through these orifices. Endometrium also contains connective tissue in which the uterine glands are present. Uterine glands are lined by ciliated columnar epithelial cells.

Uterine changes

Uterus changes its size, structure and function in different phases of sexual life.

During menstruation, uterus is enlarged, becomes more vascular. The endometrium thickens with more blood supply. This layer is desquamated during menstruation and reformed after menstrual period.

During pregnancy, uterus is enlarged very much with increase in weight. After parturition (delivery), it comes back to its original size but the cavity remains larger. In old age uterus is atrophied.

Cervix

Cervix is the lower constricted part of uterus. It is divided into two portions:

1. Upper supravaginal portion

2. Lower vaginal portion

The supravaginal portion communicates with body of uterus through internal os (orifice) of cervix. The vaginal portion of cervix projects into the anterior wall of the vagina and it communicates with vagina through external os (orifice) of cervix.

The mucous membrane of supravaginal portion of cervix has many glandular follicles, which secrete mucus. The mucus membrane of vaginal portion is formed by stratified epithelial cells.

Vagina

Vagina is a short tubular organ. It is lined by mucous membrane which is formed by stratified epithpiig cells.

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