VESSELS AND NERVES OF THE UTERUS (FIGS. 41 AND 42).
I. Arteries.
The uterus is supplied by six arteries: The uterine arteries, branches of the hypogastric; The utero-ovarian arteries, which come directly from the aorta; The two arteries which are in the round ligament, and which arise from the epigastric arteries.
Three of these arteries enter at the right border, three at the left. The arteries on each side intercommunicate to a large extent. Whether superficial or deep they are all flexuous, and are go, not only during the state of vacuity, but also during pregnancy.
II. Veins.
They are very much expanded, and follow the course of the arteries, adhering by a thick cellular tissue to the muscular layer of the organ. During pregnancy they reach an enormous size, and are called sinuses.
Some follow the utero-ovarian arteries, and form the veins of the same name; their right terminal branches empty into the inferior vena cava, their left into the left renal vein.
Others, the uterine veins, belong, like the arteries, to the inferior part of the body of the uterus, and to the cervix; their terminal branches empty into the hypogastric plexus.
Finally, those which are deep in the round ligament, empty into the epigastric veins, or the external iliac veins.
III. Lymphatics.
The study of these vessels was undertaken in 1873 by Leopold, who divides them into three layers.
1st. A sub-serous layer; 2d. A layer belonging to the muscular coat; 3d. A mucous layer.
Directly below the serous, the sub-serous lymphatics form a thick net work, composed of short and ampulliform vessels which make a kind of plexus that surrounds the uterus. At the insertion of the tubes this net work passes above these organs, binding them to their abdominal end, and to the uterine insertion of the broad ligaments.
In places, these lymphatics abruptly turn into the muscular tissue to unite with the lymphatics of this tissue.
These last lymphatics of the muscular tissue consist of three kinds of vessels.
1st. A system of lymphatic tubes which lead directly to the sub-serous lymphatics and are situated between the large muscular fascia.
2d. Of fine lymphatic lacunas, placed between the muscular fibrils, which all open into larger ducts.
3d. These represent large anastomoses, which form a net-work placed between the layers of the muscular tissue, and spread into the broad liga ments.
The lymphatics of the mucosa are not true vessels; they are formed of an enormous system of vacuoles, and lymphatic cavities, communicating with each other; in other words the mucous membrane is an enormous lymph gland. These lymphatic vacuoles communicate with the lym phatics of the muscular tissue by means of a number of trunks which, coming from the muscular coat, open into the bottom of the lymphatic vacuoles of the mucosa. Lucas Championiere discovered a ganglion above the vaginal cul-de-sac at the union of the cervix and the body. Accord ing to him it plays an important part in the development of puerperal diseases.
IV. The Nerves of the Uterus.
The nerves of the uterus arise from the ovarian, and from the hypogas tric plexus. At first they follow the arteries, then penetrate the muscu lar coat, for which they seem to be specially designed. Frankenhauser (1867) demonstrated that, in the state of vacuity, the nerves in the broad ligament are divided into two kinds, one of which has the form of com plete tubes, the other that of a thread reduced to an axis cylinder. Ac cording to Frankenhauser, the terminal filaments can not only pass into the nucleus, but even into the nucleolus of the fibrous cells.
Their presence has been contested by Jobert (de Lamballe), but the researches of Robert Lee, of Richet, of Boullard, of Sappey, and of Frankenhauser are opposed to this assertion of Jobert.