THE OVARIES.
The ovaries are the essential organs of woman's genital apparatus. Thus their analogy with the testicles caused the ancients to name them the Testes muliebris.
Position—Direction—Volume—Shape—Attachments.
They are situated in the posterior layer of the broad ligaments, at the side of the uterus, behind the tubes and the round ligament, and in front of the rectum. They are ordinarily separated from the rectum by loops of intestine.
They are attached to the uterus by a round and resisting ligament, the ligament of the ovary, and to the lateral walls of the pelvis by the broad ligaments. Thus, placed within a fold of peritoneum, they are, at the same time, fixed and movable. This mobility allows them to follow the displacement of the neighboring organs. (See Fig. 33.) Their position in the posterior fold gives them movements of displace ment from above downward, and from below upward, from without in ward, and from within outward.
The displacements due to the laxity of the broad ligaments are especi ally caused by the fact that the bladder, in distending, pushes the womb and the broad ligaments backward and downward. The ovaries then rest against the sides of the middle portion of the intestine, above the utero-sacral ligaments.
These displacements, due to increase of the uterus, cause the ovaries to occupy successively the pelvic cavity, the hypogastrium, the umbilical region, and finally the iliac regions. After delivery the ovaries lie in the iliac fosse.
The pathological displacements are extremely varied.
The direction of the ovaries is transverse.
Their volume varies with age, and with the state of evolution of the ovules. They have, in general, the following dimensions: Transverse diameter . . 1.2 inches, length.
Vertical diameter .7 of an inch, height.
Antero-posterior diameter • . .6 inch, thickness. Their weight is, on an average, from 90 to 120 grains.
Shape.—They are shaped like an ovoid, long in the transverse direc tion, and slightly flattened from before backwards. They have two sur faces, two edges, and two ends.
The surfaces are smooth, uniform, and whitish, until puberty, becom ing, however, more and more irregular as the cicatrices, due to ovulation, increase. They then become yellowish-brown, and have a rough and
wrinkled aspect.
The antero-posterior surface faces upward and forward, the postero-m ferior downward and backward.
The edges are turned transversely from within outward.
The superior and posterior edge is convex. The inferior and anterior is rectilinear, and is attached to a fold of peritoneum which forms the posterior layer. This is the hilum of the ovary.
The arteries enter and the veins and lymphatics leave the ovary by this edge. At the external extremity of this edge are attached the liga ment of the tube, and the ligamentum teres, or lumbar ligament; to the internal extremity is attached the ligament of the ovary.
The ligaments of the ovary are three in number: 1st, The ligament of the ovary. This is a cord about .1 inch long, and .15 of an inch in diameter. It is composed of muscular fibres which blend, within, with those of the posterior face of the uterus, and, without, with the internal extremity of the inferior edge of the ovary.
2d, The ligament of the tube. It is formed by that fringe of the pavil ion of the tube, which extends to the external extremity of the adherent edge of the ovary. This fringe contains muscular fibres, some of which, at the level of the hilum, blend with those of the ligament of the ovary; the greater part, however, pierce the thickness of the organ.
3d, The posterior round ligament. This was first mentioned by Rouget, and is composed of fibres, which, above, spring from the sub-peritoneal fascia, and follow the course of the vessels of the ovary, which are in great measure surrounded and covered by them. When they reach the broad ligaments, they spread over the posterior lamina, then pass along the posterior surface of the body of the uterus, to the pavilion of the tube, and to the hilum of the ovary, to be prolonged partly within the gland, and partly within the ala of the tube.