Describe the round ligaments of the uterus 3. They are two muscular cords, four or five inches long, commencing at the superior angles of the uterus to pass forward and outward through the internal abdominal ring into the inguinal canal, to become lost in the labia majora and in the fatty tissue of the mons Veneris; they consist of dense fibrous tissue and unstriped muscle, enclosed, in the fetal state, by a process of the peritoneum extending a short distance into the inguinal canal, the so-called canal of Nuck, usually obliterated in the adult, but sometimes pervious throughout life; this corresponds to the processus vaginalis of the male. Describe the structure of the uterus. The womb has three coats, viz. A serous, derived from the peritoneum, covering the fundus of the organ, its posterior surface, and posterior part of the cervix; also the whole of the anterior surface of the body to a point opposite the internal os. A muscular, forming the bulk of the uterus, composed of bundles of unstriped muscular tissue interspersed with areolar tissue, blood-vessels, lymphatics, and nerves. The fibers are disposed in three layers, viz. external, in front of and behind the fundus; middle layers, passing longitudinally, obliquely, and transversely; and internal, arranged in two hollow cones whose apices surround the orifices of the Fallopian tubes, whose bases fuse in the middle of the uterine body; at the internal os these fibers are circular and sphincteric. A mucous, thin, smooth, and closely adherent to the subjacent parts, covered with columnar ciliated epithelium, and containing numerous tubular follicles, most numerous in the cervix; when their ducts become obliterated their secretion is retained, forming small vesicular elevations within the os and cervix, called ovula Nabothi. The epithelium loses its cilia at the lower third of the cervix. Name the uterine vessels and nerves. The arteries are the uterine, from the internal iliac, and ovarian, from the aorta, which pursue a very tortuous course and freely anastomose. The veins accompany the arteries and terminate in uterine plexuses; during pregnancy they are called uterine sinuses, consisting of the lining membrane of the vein adhering to the walls of canals channelled through the uterine substance; the Lymphatics terminate in the pelvic and lumbar glands; the Nerves are branches of the inferior hypogastric and spermatic plexuses, and of the third and fourth sacral nerves. What are the Fallopian tubes? They are the oviducts, two tubes four to five inches long, extending between the layers of the broad ligament on each side from the superior angle of the uterus, passing out for one inch to the side of the pelvis, then upward, backward, and downward to the inner surface of the ovary. Each has an isthmus, ampulla, neck, and fimbriated extremity; the isthmus is the inner constricted third of the tube, opening into the uterine cavity by a bristle-sized orifice; the ampulla is larger, tortuous, curves over the ovary, and includes one-half of the total length, passing from the isthmus to the neck. The ovarian end expands like a trumpet into the infundibulum, with its ostium abdomi nale 10 surrounded by fringe-like fimbria, hence the term fimbriated extremity 10; one band is attached to the ovary, ovarian fimbria, and has a longitudinal groove. Their walls are formed of a serous or peritoneal coat, a muscular, formed of longitudinal and circular fibers, and a mucous coat covered with ciliated columnar epithelium, continuous on one side with the uterine mucous membrane, on the other with the peritoneum. Describe the ovaries"1. They are two flattened, ovoid bodies suspended by their anterior margins from the back of the broad ligaments', in loops of the Fallopian tubes; they have mesial and lateral surfaces, posterior and anterior borders, upper and lower extremities (His); they are attached by their lower extremities to the uterus, by the ovarian ligaments and by their upper ends to one of the fimbriæ of the Fallopian tube; their dimensions are: length, one and a half inches; width, three-fourths of an inch; thickness, one-half inch. Describe the structure of the ovaries. They consist of numerous Graafian follicles embedded in a fibrous stroma, covered externally by modified peritoneum, hav ing columnar instead of squamous cells of a dull white appear ance. The stroma consists of numerous spindle-cells with connective tissue and abundant blood-vessels; a condensed peripheral layer under the epithelium was formerly described as the tunica albuginea. The stroma has elastic and muscular tissue. What are the Graafian follicles? Ovisacs, minute vesicles, 70,000 at birth, diameter from 10 inch (0.25 mm.) to the size of a currant when ready to rupture; microscopically they are seen to consist of an external fibro-vascular coat connected with the stroma by a vascular network, and an internal coat, or ovicapsule, lined with a layer of nucleated cells, the membrana granulosa, which are heaped up around the ovum at that part of the Graafian follicle nearest the ovarian surface, forming the discus proligerus; the follicle contains also a transparent, albuminous fluid, liquor folliculi, supporting the ovum. Describe the human ovum. It is a spherical mass of protoplasm, inch (0.2 mm.) in diameter, just visible to the naked eye, and consists of the Vitelline membrane, zona pellucida, or, best, zona radiata, as it possesses striæ thought to be pores; it surrounds the Vitellus, or yolk, a fluid containing granules, protoplasm, deutoplasm, and a nucleus inch (0.05 mm.) in diameter; the nucleus is the Germinal vesicle, containing a smaller body, or nucleolus, the Germinal spot, 36 inch in diameter. What is a corpus luteum? An irregular yellow spot in the ovary at the site of a ruptured Graafian follicle, which differs in appearance according as it is a true or false corpus luteum. Describe the differences between these two kinds. The true corpus luteum is that of pregnancy; it is single and increases up to a certain point, at the fifth month occupying sometimes the greater part of the ovary, and usually does not entirely disappear until one or two months after delivery. The false corpus luteum is that following ordinary menstruation; it is much smaller and disappears in about two months. Name the ovarian arteries, veins, and nerves. The arteries are the ovarian, from the aorta, anastomosing with the uterine artery; these vessels also supply the Fallopian tubes; the Veins follow the arteries and form a plexus near the ovary, called the pampiniform plexus. The nerves are derived from the inferior hypogastric or pelvic plexus, and from the ovarian plexus; the Fallopian tubes receive branches from the uterine nerves. What is the parovarium? It is also called the organ of Rosenmüller; it is the remains of a fetal structure, and in the adult consists of a few closed convoluted tubes lined with epithelium, one commonly ending in a bulbous hydatid-like swelling; at its tubal end the parovarium is connected with the remains of the Wolffian duct-the duct of Gärtner. THE MAMMARY GLANDS. Describe the mammæ. They exist in both sexes, being in the male only rudimentary, but in the female are two large hemispherical eminences situated toward the lateral aspect of the pectoral region, reaching from the midaxillary line to the sternum, and from the second to the sixth or seventh ribs; just below the center at the fourth rib projects a conical prominence, the nipple, surrounded by a light-colored areola, in which are numerous prominent sebaceous glands, which enlarge during pregnancy; the color of both nipple and areola darkens during pregnancy, and the latter also extends its area. Describe the structure of the mammary glands. They are composed of gland-tissue, of fibrous tissue connecting the lobes, and fatty tissue in intervals between the lobes; the lobes consist of lobules formed of a number of rounded vesicles grouped about a small lactiferous tube into which their ducts open, and by their union finally form fifteen or twenty excretory ducts, or tubuli lactiferi, which converge toward the areola, dilating beneath it into the ampulla at the base of the nipple, where they contract into straight tubes perforating the summit of the nipple; the lobules are surrounded by a dense capillary network during lactation, as is also the nipple, which becomes erected when irritated, partly from fulness of blood, partly from contraction of its muscular tissue. Name the vessels and nerves of the mammæ. The arteries are derived from the thoracic branches of the axillary, intercostal, and internal mammary arteries; the Veins form an anastomotic circle around the base of the nipple, called the circulus venosus, from which large vessels radiate to terminate in the axillary and internal mammary veins; the Lymphatics chiefly run along the lower border of the pectoralis major to the axillary glands, a few pass through the intercostal spaces to the anterior mediastinal glands; the Nerves come from the anterior and lateral thoracic cutaneous. Enumerate the accessory structures contained in the skin. Hair-follicles, skin. Nails, hairs, sebaceous glands, sudoriferous or sweat-glands. Where do sweat- and sebaceous glands with the hair-follicles lie? Chiefly in the subcutaneous fatty tissue, but sometimes in the deepest layers of the corium. |