गर्भाशय (uterus)

Uterus ( गर्भाशय )
- Synonym
  - Hysteria , womb ,
- Definition
  - Child bearing organ in females
- Situation ( स्थिति )
  - In pelvis between bladder and rectum ( श्रोणि में )
  - Palpated bimanually during a per vaginal examination ( दो हाथों से छूकर पता लगाया जाता हैं )
  - Protects and provides nutrition to a fertilized ovum
- Size and shape
  - Pyriform
  - 7.5 cm long , 5 cm broad , 2.5 cm thick
  - Weighs 30- 40 grams
- Position and angulation
  - 90 with long axis of vagina ( योनि से 90 डिग्री )
  - Forward tilting of uterus relative to vagina ( आगे की ओर झुकना योनि के संबंध में )
    - Anteversion
  - Backward tilting of uterus relative to vagina
    - Retroversion
  - Slightly flexed at level of internal os of cervix ( गर्भग्रीवा )
    - Anteflexion
      - 125 degree
  - Long axis of uterus corresponds to
    - Axis of pelvic inlet
- Parts ( भाग )
  - Upper expanded part - body
  - Upper 2/3
  - Lower cylindrical part - cervix
  - Lower 1/3
  - Junction of these two parts
    - Isthmus
    - Part of uterus above opening of fallopian tube
      - Fundus
    - Superolateral angle of body projects out
      - Cornua
  - Fundus
    - Convex like a dome
    - Covered with peritoneum
    - Directed forward when bladder is empty ( मूत्रशय खाली रहने पर सामने की ओर रहता हैं )
    - Fertilized oocyte is usually
    - Implanted posterior wall of fundus
      - Or Upper part of body of uterus
  - Anterior / vesical surface ( अग्र और आशय स्तर )
    - Body is flat ( काय चिपटा हैं )
    - Related to urinary bladder
    - Covered with peritoneum
    - Forms
      - Posterior or superior wall of uterovesical pouch
  - Posterior / intestinal surface ( पश्च या आंत्र स्तर )
    - Convex
    - Related to coils of terminal ileum and to sigmoid colon
    - Covered with peritoneum and forms anterior wall of rectouterine pouch
  - Lateral border ( पार्श्व किनारा )
    - Convex and rounded ( गोल और उभाड़ )
    - Provides attachment to broad ligament of uterus ( चौड़ी स्नायूबंधन से जुड़ता हैं )
    - Connects to lateral pelvic wall ( पार्श्व श्रोणि दीवार से जोड़ता हैं )
    - Uterine tube opens in to uterus
      - At upper end of this border ( इस किनारे के ऊपरी छोर में
    - End of this border
      - Anteroinferior to tube
        
        Gives attachment to round ligament of uterus
      - Posteroinferior to tube
        
        Ligament of ovary
    - Uterine artery ascends along the lateral border of uterus between two layers of broad ligament
- Cavity of uterus
  - Sagittal section
    - It is a mere slit
    - Compressed anteroposterior
  - Coronal section
    - Triangular in shape
  - At Apex
    - Becomes continuous with canal of cervix
    - Junction called as internal os
- Cervix
  - Supravaginal part
- Relation
  - Anterior
    - Bladder
  - Posterior
    - Rectouterine pouch containing coils of intestine and rectum
  - Each side
    - Ureter and to uterine artery embedded in parametrium
- Vaginal part
  - Projects in to anterior wall of vagina
  - Space between it and vagina
    - Fornices
  - Communication
    - Externally by external os
      - Nulliparous women ( नई स्त्री में , कुमारी स्त्री में )
        
        Small and circular ( छोटा रहता हैं )
      - Multiparous women ( बहु गर्भधारण स्त्री में )
        
        Bounded by anterior and posterior lips
- Cervical canal ( गर्भ ग्रीवा )
  - Cavity of cervix.
    - Fusiform in shape
  - Internal os
    - Canal is flattened
      - Anterior wall
      - Posterior wall
      - Walls show
        
        Mucous folds
        
        Arbor vitae uteri
        
        Folds interlock with each other to close the canal
- Ligaments of uterus
  - Peritoneal ligaments
    - Anterior ligament ( अग्र स्नायू बंधन )
    - Uterovesical fold of peritoneum
    - Posterior ligament ( पश्च स्नायू बंधन)
    - Rectovaginal fold forming rectovaginal pouch of peritoneum
    - Broad ligaments ( right and left )
      - Bladder to lateral pelvic wall
        
        Surfaces
        
        Anterior , posterior
        
        Borders
        
        Upper , lower , medial , lateral
        
        Upper border is free
    - Mesoovarium
      - Attached to posterior later of braod ligament
    - Mesosalpinx
      - Suspensory ligament of ovary or infundibulopelvic ligament
    - Broad ligament consists of following structures
      - Uterine tube
    - Round ligament
    - Ligament of ovary
    - Uterine vessels
    - Ovarian vessels in infundibulopelvic ligament
    - Uterovaginal and ovarian nerve plexus
    - Epoophoron
    - Paraphooron
- Fibromuscular ligaments
  - Round ligament of uterus ( गोल
  - Transverse cervical ligament ( गर्भाशय ग्रीवा )
  - Uterosacral ligament ( गर्भशय त्रिक )
- Arterial supply
  - Uterine artery (
  - Division of internal iliac artery
  - Partly by ovarian artery
- Venous drainage
- Lymphatic drainage
- Nerve supply
- Supports of uterus
- Primary supports
  - Muscular or active supports
  - Pelvic diaphragm ( श्रोणि पट्ट )
  - Perineal body (कुंडलिनी काय )
  - Distal urethral sphincter mechanism
- Fibromuscular or mechanical support
  - Uterine axis
  - Pubocervical ligament
  - Transverse cervical ligament of mackenrodt
  - Uterosacral ligament
  - Round ligament of uterus
- Secondary support
  - Broad ligament
  - Vesicouterine pouch and fold of peritoneum
  - Rectovaginal pouch or rectouterine pouch and fold of peritoneum
- Role of individual supports
  - Pelvic diaphragm
  - Perineal body
  - Urethral sphincter mechanism
  - Uterine axis
  - Pubocervical ligaments
  - Transverse cervical ligaments of mackenrodt
  - Uterosacral ligaments
  - Round ligament of uterus

परिभाषा

आकार

स्थान और स्थिति कोण

भाग

fundus lateral border

स्तर

anterior or vesical surface posterior or intestinal surface

गर्भाशय के स्नायू

पर्युदर्या स्नायू

anterior ligament
posterior ligament
right and left broad ligament
infundibulopelvic ligament