Blood-Vessels

The main blood-vessels of the pelvic genital organs are the uterine and ovarian arteries, described by some authors as the single utero-ovarian artery.

The uterine artery comes from the internal iliac and passes almost horizontally inward toward the lower portion of the cervix. As it approaches the cervix it gives off a cervicovaginal branch passing to the upper part of the vagina. At this point it has just crossed in front of the ureter and is about level with the external os. It then inclines upward, reaching the side of the uterus at its junction with the vagina. It passes up the side of the uterus, in nulliparae a short distance away from its side, but in multipara close to it, until it reaches the cornu above. It here is continuous with the ovarian artery.

The ovarian artery comes down from the aorta as does the spermatic artery in the male. It crosses the brim of the pelvis in front of the ureter, enters the infundibulo-pelvic or suspensory ligament of the ovary and runs horizontally towards the uterus in the broad ligament between the round ligament and the ovary. It gives branches to the ovary and tube and as it reaches the cornu of the uterus it crosses in front of the round ligament and joins the uterine artery. As the uterine and ovarian arteries are continuous with each other either one may be the larger and they vary considerably in size.

Fig. 461.   Lymphatics of uterus. (Cuneo and Marcille).

Fig. 461. - Lymphatics of uterus. (Cuneo and Marcille).

A branch of the deep epigastric artery accompanies the round ligament inward and anastomoses with the uterine and ovarian arteries. It may be enlarged in disease of the ovaries and tubes.

Lymphatics (According To Poirier And Cuneo)

The cervix has three sets of lymphatics. The first passes outward and upward along the side of the pelvis anterior to the ureter to empty into the nodes along the external iliac artery. The second set passes backward behind the ureter to empty into a node on the anterior division of the internal iliac artery. The third set passes from the posterior surface of the cervix almost directly backward in the uterosacral ligaments to empty, some into the lateral sacral nodes high up in the hollow of the sacrum and some into the nodes of the promontory (Fig. 461).

The lymphatics of the body of the uterus communicate with those of the cervix below and at the cornu pass out as four or five trunks along the broad ligament between the ovary and Fallopian tube, being joined by branches from the ovary. They pass through the infundibulopelvic (suspensory) ligament and follow the ovarian vessels to empty into the aortic nodes below the kidney. The ovarian lymphatics form four to six trunks which ascend with the ovarian vessels to end in the lower aortic nodes. Opposite the fifth lumbar vertebra they communicate with the trunks from the body of the uterus.