The uterus




Hover to show names
  • Expanded superior 2/3rd
  • Fundus- rounded superior part
  • Cornu- part of the body where the uterine tubes insert


  • A narrow cone
  • Transition between the body and the cervix
  • Most obvious in  nulliparous women


  • Cylindrical inferior 1/3rd of the uterus
  • Supravaginal part
  • Infra vaginal part
  • Internal/ external os


Anteflexed: Uterus is bent anteriorly over the bladder between the cervix and  the body

Anteverted: The entire uterus is bend anteriorly with respect to the vagina

Sometime especially in older women, the uterus may be bent posterioly (retroversion)

Note: When the urinary bladder fills, the uterus is straightened into line with the vagina.

Peritoneal relations


  • Peritonioum covers , posterior, superior and anterior surfaces of the uterus, except vaginal part of cervix

  • Peritoneum is reflected anteriorly onto the bladder and posteriorly onto the rectum

  • A double layered peritoneal sheet - the broadligament- extend from the sides of the uterus to the lateral walls, and the floor of the pelvis.



  • Separated from urinary bladder by the vesico uterine pouch
  • This pouch is normally empty when the uterus is in the normal position. 
  • When the uterus is retroverted the pouch contains a loop of intestine.


  • A layer of peritoneum  and the peritoneal cavity separate the posterior part from sigmoid colon.
  • The recto uterine pouch separates the uterus from the rectum.


  • The coils of small intestine


  • The broad ligaments and their contents

Uterine support  

  • The principal supports of the uterus are the pelvic floor  and the pelvic viscera surrounding the uterus and its continuity with the vagina

  • The broad ligaments hold the uterus in its relatively normal position.

  • The body of the uterus is freely mobile. The cervix is not very mobile because it is held in position by several ligaments (Thickenings of the endopelvic fascia).

    (+) Transverse cervical (Cardinal) ligaments
    (+) Utero sacral ligaments (recto uterine),
    (+) Pubocervical

Blood supply


  • Uterine arteries from the internal iliac
  • Ovarian arteries from the aorta
  • These two anastomose
  • The uterine veins form a uterine venous plexus on each side of the cervix. Their tributaries drain into the internal iliac veins.
  • This plexus is connected with the superior rectal veins forming a porto systemic anastomsis




  • Aortic (lumbar) nodes.
  • Superficial inguinal nodes.
  • Body- para uterine lymph nodes thence to the external iliac nodes
  • cervix – internal iliac and sacral lymph nodes.



  • Autonomic from the inferior hypogastric plexus largely from the uterovaginal plexus in the broad ligament.
  • Most of the efferent fibres ascend through the hypogastric plexus and the spinal cord via T10- L1 spinal nerves

Summary of pelvic viscera