Page 160 - Clinical Anatomy

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The female genital organs 145

tion into the peritoneum from the exterior and is a potential pathway for
infection (for example, in gonorrhoea).
2◊◊The fertilized ovum may implant ectopically, i.e. in a site other than
the endometrium of the corpus uteri. When this occurs in the Fallopian
tube it is called, according to the exact site, fimbrial, ampullary, isthmic or
interstitial, of which the ampullary is the commonest and interstitial the
rarest.
As the ectopic embryo enlarges, it may abort into the peritoneal cavity
(where rarely it continues to grow as a secondary abdominal pregnancy), or
else ruptures the tube. This second fate is particularly likely to occur in the
narrow and relatively non-distensible isthmus; rupture is usually into the
peritoneal cavity but may rarely occur into the broad ligament.

The ovary (Fig. 106)

The ovary is an almond-shaped organ, 1.5in (4cm) long, attached to the
back of the broad ligament by the mesovarium. The ovary has two other
attachments, the infundibulopelvic ligament, (sometimes called the suspen-
sory ligament of the ovary), along which pass the ovarian vessels and lym-
phatics from the side wall of the pelvis, and the ovarian ligament, which
passes to the cornu of the uterus.

Relations

The ovary is usually described as lying on the side wall of the pelvis oppo-
site the ovarian fossa, which is a depression bounded by the external iliac
vessels in front and the ureter and internal iliac vessels behind and which
contains the obturator nerve. However, the ovary is extremely variable in
its position and is frequently found prolapsed into the pouch of Douglas in
perfectly normal women.
The ovary, like the testis, develops from the genital ridge and then
descends into the pelvis. In the same way as the testis, it therefore drags its
blood supply and lymphatic drainage downwards with it from the poste-
rior abdominal wall.

Blood supply, lymph drainage and nerve supply
Blood supply is from the ovarian artery which arises from the aorta at the
level of the renal arteries. The ovarian vein drains, on the right side, to the
inferior vena cava, on the left, to the left renal vein, exactly comparable to
the venous drainage of the testis.
Lymphatics pass to the aortic nodes at the level of the renal vessels, fol-
lowing the general rule that lymphatic drainage accompanies the venous
drainage of an organ.
Nerve supply is from the aortic plexus (T10).
All these structures pass to the ovary in the infundibulopelvic ligament.