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By Tim Chard MD, FRCOG, Richard Lilford MRCOG, MRCP (auth.)

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A network of veins around the cervix communicates with a similar network around the bladder neck. The main lymphatic drainage of the uterus is into the external and internal iliac group of lymph nodes, although some lymphatics from the upper part of the uterus pass directly to the lateral aortic nodes, following the ovarian blood supply. A few small branches run with the round ligament into the superficial inguinal nodes. 44 Basic Sciences for Obstetrics and Gynaecology Endometrium The endometrium undergoes various changes in early pregnancy, characterised principally by proliferation of stromal cells.

The parasympathetic nerves (5-2 to 5-4, nervi erigentes) convey motor fibres to the detrusor. The sympathetic nerves (T-11, T-12, L-l, L-2) may have the opposite effect, but their main function is vasomotor control. Afferent sensory fibres run with both the sympathetic and the parasympathetic nerves, pain fibres being predominantly in the latter. Urethra The female urethra is 4 cm long and is embedded in the anterior wall of the vagina (Fig. 5). The smooth muscle layer is continuous with that of the bladder and there is no separate internal sphincter at the junction with the bladder.

5 cm long and consists of a main part (the body or corpus), a constricted part which also includes the internal os (the isthmus), and a narrow terminal part (the cervix); the portion lying above the openings of the fallopian tubes is known as the fundus. The cervix penetrates the anterior wall but is divided into supravaginal and intravaginal portions. --I tendon & arc;uate line Fat Urogenital diaphragm §;;;:;~~~;:=;~~t-Jr- Deep transverse perineal muscle Perineal artery Superficial perineal pouch Vestibular bulb Vagina (showing mucosal ridges) Fig.

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