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ligament

(l g -m nt) A sheet or band of tough fibrous tissue that connects two bones or holds an organ of the body in place.
Other Terms: Hunter's ligament, Ligamentum teres uteri, Ligament rond de l'utrus Description
The round ligaments are composed of muscular and connective tissue. They extend from the sides of the uterus to which they are attached immediately below and in front of the uterine tubes, and curve upward and lateralward beneath the anterior layers of the broad ligaments to reach the brim of the pelvis. Each ligament then crosses the external iliac vessels and turns forward to the lateral side of the deep (inferior) epigastric artery, where it passes through the internal abdominal ring to enter the inguinal canal. The round ligament while in the inguinal canal receives additional muscle fibers that correspond to the cremaster muscle of the male.

Latin
Ligamentum teres uteri

round ligament of the uterus - ligament attached to the uterus on either side in front of and below the opening of the Fallopian tube and passing through the inguinal canal to the labia majora
The round ligament of the uterus originates at the uterine horns, in the parametrium. The round [2] ligament leaves the pelvis via the deep inguinal ring , passes through the inguinal canal and continues [3] on to the labia majora where its fibers spread and mix with the tissue of the mons pubis.
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[edit]Function The function of the round ligament is maintenance of the anteversion of the uterus (a position where the fundus of the uterus leans ventrally) during pregnancy. Normally, the cardinal ligament is what supports the uterine angle (angle of anteversion). When the uterus grows during pregnancy, the round [4] ligaments can stretch causing pain. [edit]Embryology The round ligament develops from the gubernaculum which attaches the gonad to the labioscrotal [1] swellings in the embryo. [edit]Blood

Supply

The round ligament is supplied by the artery of the round ligament, otherwise known as "Sampson's artery." Ligaments.The ligaments of the uterus are eight in number: one anterior; one posterior; two lateral or broad; twouterosacral; and two round ligaments. The anterior ligament consists of the vesicouterine fold of peritoneum, which is reflected on to the bladder from the front of the uterus, at the junction of the cervix and body. The posterior ligament consists of the rectovaginal fold of peritoneum, which is reflected from the back of the posterior fornix of the vagina on to the front of the rectum. It forms the bottom of a deep pouch called the rectouterine excavation, which is bounded in front by the posterior wall of the uterus, the supravaginal cervix, and the posterior fornix of the vagina; behind, by the rectum; and laterally by two crescentic folds of peritoneum which pass backward from the cervix uteri on either side of the rectum to the posterior wall of the pelvis. These folds are named the sacrogenital or rectouterine folds. They contain a considerable amount of fibrous tissue and
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non-striped muscular fibers which are attached to the front of the sacrum and constitute theuterosacral ligaments. The two lateral or broad ligaments (ligamentum latum uteri) pass from the sides of the uterus to the lateral walls of the pelvis. Together with the uterus they form a septum across the female pelvis, dividing that cavity into two portions. In the anterior part is contained the bladder; in the posterior part the rectum, and in certain conditions some coils of the small intestine and a part of the sigmoid colon. Between the two layers of each broad ligament are contained: (1) the uterine tube superiorly; (2) the round ligament of the uterus; (3) the ovary and its ligament; (4) the epophoron and parophoron; (5) connective tissue; (6) unstriped muscular fibers; and (7) bloodvessels and nerves. The portion of the broad ligament which stretches from the uterine tube to the level of the ovary is known by the name of the mesosalpinx. Between the fimbriated extremity of the tube and the lower attachment of the broad ligament is a concave rounded margin, called the infundibulopelvic ligament. The round ligaments (ligamentum teres uteri) are two flattened bands between 10 and 12 cm. in length, situated between the layers of the broad ligament in front of and below the uterine tubes. Commencing on either side at the lateral angle of the uterus, this ligament is directed forward, upward, and lateralward over the external iliac vessels. It then passes through the abdominal inguinal ring and along the inguinal canal to the labium majus, in which it becomes lost. The round ligaments consists principally of muscular tissue, prolonged from the uterus; also of some fibrous and areolar tissue, besides bloodvessels, lymphatics; and nerves, enclosed in a duplicature of peritoneum, which, in the fetus, is prolonged in the form of a tubular process for a short distance into the inguinal canal. This process is called the canal of Nuck. It is generally obliterated in the adult, but sometimes remains pervious even in advanced life. It is analogous to the saccus vaginalis, which precedes the descent of the testis. In addition to the ligaments just described, there is a band named the ligamentum transversalis colli (Mackenrodt) on either side of the cervix uteri. It is attached to the side of the cervix uteri and to the vault and lateral fornix of the vagina, and is continuous externally with the fibrous tissue which surrounds the pelvic bloodvessels. The form, size, and situation of the uterus vary at different periods of life and under different circumstances.

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What is round ligament pain?


The round ligaments surround your uterus in your pelvis. As your uterus grows during pregnancy, the ligaments stretch and thicken to accommodate and support it. These changes may occasionally cause pain on one or both sides of your abdomen, typically first noticed during the second trimester.

VIDEO Inside pregnancy: Weeks 28 to 37

A 3D animated look at a baby in the third trimester of pregnancy.

You may feel round ligament pain as a short jabbing sensation or a sharp, stabbing pain if you suddenly change position, such as when you're getting out of bed or out of a chair or when you cough, roll over in bed, or get out of the bathtub. You might also feel it as a dull ache after a particularly active day when you've been walking a lot or doing some other physical activity. You may feel the pain starting from deep inside your groin, moving upward and outward on either side to the top of your hips. The pain is internal, but if you were to trace it on your skin, it would follow the bikini line on a very high-cut bathing suit.

What can I do to relieve the discomfort?


If you've been reassured by your practitioner that what you're feeling is round ligament pain, sit down and try to relax when the pain strikes. Resting comfortably should help ease your symptoms. You can also try flexing your knees toward your abdomen to get some relief or try lying on your side with a pillow under your belly for support and another one between your legs. A warm bath may help, too. If you find that you're more prone to round ligament pain when you're particularly active, cut back to see if that helps. Then, when you feel fine, you can gradually increase your activity until you find the level of exertion that's comfortable for you.

Artery An artery with its origin in the inferior epigastric artery and withdistribution to the r ound ligament.

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