The uterus is part of the female reproductive system that exists within the pelvis.

The word "uterus" comes from the Latin word for "womb." During pregnancy, the fetus or, in the case of twins or multiples, fetuses develops within the uterus. As the fetus develops, the uterus expands to give necessary room. Humans are not the only creatures that reproduce via a uterus. In fact, the uterus is the major female reproductive organ in most mammals. On one end of the uterus is the cervix, which opens into the vagina. On the other end, the uterus is connected to the fallopian tubes. There are two fallopian tubes, each of which is connected to one of the two ovaries. During ovulation, which happens once a month in female humans, ovum travel from the ovaries down the fallopian tubes and into the uterus.Ovum are commonly called "eggs" in casual speech. During ovulation, if a sperm reaches the ovum in the uterus, a pregnancy can result. If a woman does not get pregnant during her time of ovulation, then she will menstruate. Menstruation is the shedding of lining of the uteran walls. During the month, the uteran walls thicken in order to prepare for a possible pregnancy. In the event that an ovum is fertilized with sperm, then the resulting embryo will become embedded in one of these thickened uteran walls. In the months that a pregnancy does not occur and an embryo does not become embedded in one of the walls, the lining will come loose and express itself through the vagina. In most cases, the uterus is tucked up above the bladder, which is the reason why many pregnant women find that they have to urinate far more frequently than when they are not expecting. This

is because the developing fetus is literally sitting on top of the pregnant mother's bladder. There are some medical conditions in which the uteran placement or angle is abnormal. Sometimes the shape of the organ is unusual. These conditions can lead to difficult sexual function and complications with pregnancies. After puberty, the entire female reproductive system should be checked for general health by a gynecologist. A gynecologist is a doctor who specializes in the female reproductive system. Although certain reproductive issues may need to be addressed before puberty, some issues do not become apparent until after puberty or when the woman becomes sexually active.

Parts of uterus The uterus is divisible into 2 main parts. 1) The body 2) The cervix

1. BODY Forms the upper two-thirds. It has 2 parts. Fundus The rounded part of the body that lies superior to the orifices of the uterine tubes. Isthmus The relatively constricted region of the body (one cm. long) just above the cervix. The body of the uterus lies between the layers of the broad ligament and is freely movable. It has 2 surfaces. Vesical (related to the bladder) and intestinal. The uterine horns are superolateral regions where the uterine tubes enter. During childhood and post menopause, the body and cervix are approximately of equal length with cervix being of greater diameter (thickness). The slit like uterine cavity is approximately 6 cm in length from the external OS of the uterus to the wall of the fundus.

2. CERVIX OF THE UTERUS Approximately 2.5 cm. long in an adult non pregnant woman.

It is divided into Supravaginal and Vaginal parts. The Supravaginal part is separated from the bladder anteriorly by loose connective tissue and from the rectum posteriorly by the rectouterine pouch. The rounded vaginal part of the cervix extends into the vagina and communicates with it through the external os. The fusiform cervical canal extends from the isthmus of the uterine body to the external as of the uterus. The cervical canal is broadest at its middle part and communicates with the uterine cavity through the internal os and with the vagina through the external os.

Layers of uterus The wall of the body of the uterus consist of 3 layers. 1) The myometrium The middle muscular coat. It becomes greatly distended during pregnancy. The main branches of blood vessels and nerves of the uterus are located in the myometrium. 2) The endometrium The inner mucous coat. It is firmly adherent to the underlying myometrium. The amount of muscular tissue in the cervix markedly less than in the body of the uterus. The cervix mostly fibrous and is composed mainly of collagen with a small amount of smooth muscles and elastic. Uterine tubes the uterine tubes extend laterally from the uterine horns and opens into the peritoneal cavity near the ovaries. The uterine tubes (10cm. long) lie in the mesosalpinx formed by the free edges of the broad ligaments. The uterine tubes are divisible into 4 parts from lateral to medial. 1) The infundibulum is the funnel shaped distal end that opens into the peritoneal cavity through the abdominal ostium the finger like processes of the fimbriated and of the infundibulum- the fimbriae spread over the medical surface of the ovary. One large ovarian fimbria is attached to the superior pole of the ovary. 2) The ampulla The ampulla the widest and longest part, begin at the medial end of the infundibulum oocytes expected from the ovaries usually are fertilized in the ampulla. 3) The isthmus, the thick walled part, enters the uterine born.

4) The uterine part is the short intramural segment that passes through the wall of the uterus. Arterial supply The tubal branches arise as anastomosing terminal branches of the uterine and ovarian arteries. Venous and Lymphatic drainage The tubal veins drains into the ovarian veins and uterine venous plexus. The lymphatic vessels drain to the lumbar lymph nodes. Innervation of the uterine tubes The nerve supply derived partly from the ovarian plexus and partly from uterine plexus.

Functions of uterus The main function of the uterus is to nourish and provide a safe place for a fetus before it is born. The uterus is located in the pelvic cavity in females between the rectum and the bladder, and it is composed of two parts: the cervix and the corpus. Nearby organs are supported by the uterus because of its placement in the female body. The uterus is the place where a sperm is implanted into an egg, which is then implanted into the uterine wall. Another function of the uterus is to direct blood flow to the sexual organs during arousal and intercourse.

The cervix is the lower part of the uterus and is made out of muscle tissue. Functions of the cervix include providing support for the body of the uterus, known as the corpus or fundus, and allowing the flow of menstruation to occur. Additionally, sperm enters the uterus through the cervix, because the cervix opens into the vaginal canal. In the corpus of the uterus, the fetus is housed, and the fallopian tubes are connected. Organs such as the bladder and bowels rely on the placement of the uterus for keeping their structures in place within the body.

Approximately one time per month, the female ovaries release ova, or eggs, which are carried from the fallopian tubes into the uterus. If sperm is present in the cervix, an egg might be fertilized, after which it implants itself into the uterine wall and becomes an embryo. The embryo creates a protective sac around it which is known as a placenta, and the egg develops into a fetus. The placenta is connected to the uterine wall, so the fetus is able to get nutrients and nourishment from the mother. One function of the uterus is to allow the fetus to grow within it for approximately nine months until the birth occurs. Another function of the uterus is to direct blood flow into the genitals during times of sexual arousal. It does this naturally, because it is a hormone-driven female organ. When ovulation occurs, the uterus directs blood flow more often to the genitals and sexual organs, which increases the chance of fertilization. During arousal, blood flow is directed into the ovaries,

vagina, labia and clitoris. This particular function of the uterus can also help uterine orgasm occur in some women.
y y y y y y y serves to receive the sperm in mares transports sperm from site of deposition to uterine tubes for fertilization provides suitable environment for implantation of the embryo nourishment of the embryo & fetus during pregnancy provides mechanical protection of the fetus expels the mature fetus at the end of pregnancy

DISORDERS OF THE BODY OF THE UTERUS a) Acute endometritis Caused by non-specific infection following parturition or abortion. A variety of microbes may be involved as Staphylococci, Streptococci, Escherichia coli, pseudomonas. The infection may spread to Myometrium, perimetrium&Surrounding pelvic tissues which leads to thrombosis of illiac veins Uterine tubes causing salpingitis, fibrosis, obstruction and inferlity. It may cause peritonitis and adhesions.

b) Chronic endometritis This may follow as an acute attack or be due to spread of PID. It may follow abortion or partorition and may be associated with chronic salpingitis, endometrial carcinoma or the use of intrauterine contraceptive devices. c) Endometriosis This is the growth of endometrial tissue outside the uterus most commonly in the ovaries, uterine tubes and other pelvic structures. The ectopic tissue reacts to sex hormones causing menstrual bleeding in the ovaries causing chocolate cysts . There is intermittent pain due to swelling and recurrent hemorrhage causes fibrous tissue formation. It may cause pelvic inflammation, infertility, pelvic adhesions. d) Adenomyosis Presence of endometrium within the myometrium. The ectopic tissue may cause general or localised uterine enlargement. The liaisons may cause dysmenorrhoea and irregular excessive bleeding.

e) Endometrial hyperplasia The hyperplasia may affect endometrial glands, causing cyst formation or focal hyperplasia of atypical cells. The focal type frequently undergo malignant change. Both types are associated with a sustained high blood oestrogen level. f) Leiomyoma (fibroid, myoma) These are very common often multiple benign tumours of myometrium. Large tumours may undergo degenerative changes if they outgrow their blood supply, leading to necrosis, fibrosis, and calcification. They are hormone dependent. They tend to regress after the menopause. Large tumours may cause pelvic discomfort, frequency of micturition, menorrhagia, irregular bleeding dysmenorrhoea and reduced fertility. g) Endometrial carcinoma This occurs in nulliparous women between 50 and 60 years of age. The incidence is increased when an oestrogen secreting tumour is present and in women who are obese, hypertensive diabetic because they tend to have a high level of blood oestrogen. Lymphatic spread is delayed until there is extensive local spread. Distant metastases develop later, usually in liver, lungs and bones.

4) DISORDERS OF THE UTERINE TUBES a) Acute salpingitis Infection usually spreads form the uterus and exeasionally from peritoneal lavity. It causes unevenful recovery chronic inflammation, leading to fibrous tubal obstruction and infertility. pus formation (pyosalpinx) and further spread to ovaries and peritoneal cavity leading to fibrous tubal obstruction, infertility and pelvic adhesions. b) Ectopic pregnancy This is the implantation of a fertilised ovum outside the uterus, most commonly in a uterine tube. As the fetus grows the tube ruptures and its contents enter the peritoneal cavity, causing acute inflammation (peritonistis) and possibly severe intraperitonealhaemarrhage.

4 ABNORMAL POSITION OF UTERUS a) Prolapse

Prolapse is a common complaints and severe degrees are most often seen in women of menopausal age who have borne children. In prolapse straining causes protrusion of the vaginal wall, while in severe cases the cervix may be pushed down to the level of the vulva. In extreme cases the whole uterus and both vaginal walls may be extruded. This produces micturition symptoms, low mild sacral backache, and sense of weakness and insecurity in the region of perineum. Most common cause is atomicity and asthenia that follow menopause. It may also occur after difficult labour. b) Retroversion Retroversion means the position where the uterus is not anteverted. There can be mobile and fixed retroversion. Fixed retroversion means that the uterus is bound by adhesions or tumours. Retroversion may cause dysmenorrhoea, menorrhagia, pressure, backache, dyspareunia, inferlity or abortion. c) Inversion of the uterus In inversion uterus becomes turned inside out. At first fundus is pushed down into cavity of the uterus leaving a cupshaped depression on the peritoneal surface.