Gross Anatomy - Ligaments or Folds and Pouches of the Pelvis

• Consists of two layers of peritoneum , extends from the lateral margin of the uterus to the lateral pelvic wall, and serves to hold the uterus in position.
• Contains the uterine tube, uterine vessels, round ligament of the uterus, ovarian ligament, ureter (lower part), uterovaginal nerve plexus, and lymphatic vessels.
• Does not contain the ovary but gives attachment to the ovary through the mesovarium.
• Has a posterior layer that curves from the isthmus of the uterus (the rectouterine fold ) to the posterior wall of the pelvis alongside the rectum.

1. Mesovarium

• Is a fold of peritoneum that connects the anterior surface of the ovary with the posterior layer of the broad ligament.

2. Mesosalpinx

• Is a fold of the broad ligament that suspends the uterine tube.

3. Mesometrium

• Is a major part of the broad ligament below the mesosalpinx and mesovarium.

• Is attached to the uterus in front of and below the attachment of the uterine tube and represents the remains of the lower part of the gubernaculum.
• Runs within the layers of the broad ligament, contains smooth muscle fibers, and holds the fundus of the uterus forward, keeping the uterus anteverted and anteflexed.
• Enters the inguinal canal at the deep inguinal ring, emerges from the superficial inguinal ring, and becomes lost in the subcutaneous tissue of the labium majus.

• Is a fibromuscular cord that extends from the ovary to the uterus below the uterine tube, running within the layers of the broad ligament.

• Is a band of peritoneum that extends upward from the ovary to the pelvic wall and transmits the ovarian vessels, nerves, and lymphatics.

• Are fibromuscular condensations of pelvic fascia from the cervix and the vagina to the pelvic walls, extend laterally below the base of the broad ligament, and support the uterus.

• Are firm bands of connective tissue that extend from the posterior surface of the pubis to the cervix of the uterus.

• Are condensations of the pelvic fascia that extend from the neck of the bladder (or the prostate gland in the male) to the pelvic bone.

• Are firm fibromuscular bands of pelvic fascia that extend from the lower end of the sacrum to the cervix and the upper end of the vagina.

• Arches across the inferior aspect of the pubic symphysis and attaches to the medial borders of the inferior pubic rami.

• Hold the cervix back and upward and sometimes elevate a shelf-like fold of peritoneum (rectouterine fold) , which passes from the isthmus of the uterus to the posterior wall of the pelvis lateral to the rectum. It corresponds to the sacrogenital (rectoprostatic) fold in the male.

• Is a sac or recess formed by a fold of the peritoneum dipping down between the rectum and the uterus.
• Lies behind the posterior fornix of the vagina and contains peritoneal fluid and some of the small intestine.

• Is a peritoneal recess between the bladder and the rectum in males, and the vesicouterine pouch is a peritoneal sac between the bladder and the uterus in females.