Uterus

nerves, plexus, branches and hypogastric

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Lymphatics.— These vessels are far more easily examined in the gravid than in the un impregnated uterus. They are very numerous, and are divided by Cruveilhier into two orders; the superficial, which lie immediately beneath the peritoneum ; and the deep-seated, which ramify in several places in the sub stance of the uterine walls. The lymphatics of the cervix terminate in the pelvic and sacral glands. Those of the body of the uterus, after traversing the broad ligaments and uniting with the lymphatics proceeding from the Fallopian tubes, ovaries, and round liga ments, empty themselves the glands situated in front of the aorta and vena cava.

.Yerves. — The nerves which supply the uterus are derived partly from the spinal, but principally from the sympathetic system. Ac cording to the dissections of Dr. Snow Beck*, the nerves which compose the hypogastric plexus, consisting of gelatinous and tubular fibres derived from the lower part of the superior aortic plexus*, on approaching the neck of the uterus begin to separate, and on a level with the os uteri are joined by branches mhich accompany the superior hmmorrhoidal artery-. The anterior portion of the hypo gastric plexus, after receiving branches which accompany the iliac arteries, passes inwards by the broad ligament, and supplies the lower half of the uterus. These nerves, which are

continuations of the hypogastric plexus, as they approach the body of the uterus se parate, and each pursues a different distribu tion. They lose the plexiform character and form a number of distinct fine cords.

These nerves, like all the nerves supplied to the uterus, are chiefly composed of gelatinous fibres, although soine tubular fibres accom pany them ; but they are few in number, and appear to be far from forming the essential element of the uterine nerves.

The middle portion of the uterus is sup plied by a distinct branch from the inferior aortic plexus ; which, without communicating with the hypogastric branches, passes to the upper part of the uterine body and then divides, to supply the part between the previously described branches and the Fallopian tube, sending also a branch to the ovary.

The fundus is supplied sonietinies by a branch Which proceeds from the renal plexus in company with the spermatic artery, and is distributed also to the ovary.

Another set, distinct from these nerves, comes also from the same continuation of the hypogastric plexus, but forms a plexiforni ar rangement around the vessels ; and among these are found here and there minute ganglia. These nerves are very minute.*

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