Thursday, October 27, 2016



Fig.1. The ducts, commencing from the lateral aspect of the pelvis, curving forwards and medially, to the junction, with the gubernaculum of the ovary, this meeting point splits the gubernaculum, into a proximal part called ovarian ligament, usually short and a distal part called round ligament, longer, which terminates in the deep inguinal ring as a ligament. The right ovary is partially seen below in the midline and the ovarian ligament is seen fusing with the uterine nodule and continuing upwards, as round ligament to enter the right inguinal canal. To the right of ovarian ligament, close to the nodule, a rudimentary tube bit can be seen. (the four of them, forming a + sign).


Fig.2. The same case, as Fig.1. (above), showed on the left side, the ovary entering the left inguinal canal. No nodule and tube seen, but the ovary shows below some tissue suggestive of fimbria ovarica.
Fig. 3. & 4.
The round ligament is seen on the upper margin of the small uterus on the left side proceeding to the left, taking a ‘U’ turn and ending in a sac over the left inguinal region overlying the ring.
Below the uterus one can see the left tubal end showing a fimbrial cyst and an ovary with attachment of fimbria ovarica. Towards the right the junction of the bilateral nodules are seen, with the left one dipping into the POD while the other on does not dip and shows a small nodule. There is a bigger nodule on the right side. (two nodules on one side) seen in the next picture.

Fig.3.

Fig.4.
and the ducts become tubes.
The right duct after meeting the gubernaculum of the ovary is becoming a tube.


Fig.5. The right round ligament is seen entering a sac and the right ovary is partially seen below the tube.


Fig.6. The right round ligament is seen entering the inguinal canal along with other tissues.


Fig.7. The major portion of the left ovary is within the inguinal canal.

(1). Mullerian tissues. – may be
(a) formative Fig.8. & 9. (embryonic structural precursor) or
(b) definitive (mature – filled with tissue).
(a). mullerian tract framework.


 Fig.8. The outline of the mullerian tract is seen without any fibromuscular tissue. On the right, the tube is beginning to form.


Fig.9. Same as above except on the left, the tube is beginning to form.
(b) definitive. (mature filled with tissue)


Fig. 10. The picture shows (a more developed generative tract) the two ovaries with their ligaments attached to the bilateral uterine nodules and continuing as round ligaments to the inguinal canals, the transverse bands stretching across the pelvic cavity, to fuse in the midline (no hump or expansion suggestive of uterine formation) and then dip and merge with the apex of the uterosacrals, (seen as a rainbow like arch below) with no fluid in the POD.
[This meeting point is seen in the adult as three discrete points (Fig11), (Fig.12) & (Fig.13). – the ovarian ligament ends at a point posterior and inferior to the tubal take-off and the round ligament take-off is seen below the tubal take-off at a short distance. In other words, this single meeting point has become a tripod within the corpus. At this stage, we find that the round ligament is anterior, then the nodule and tubal take-off and finally the ovarian ligament (so, if we find the ovary entering or on the verge of entering the inguinal canal, it stands to reason the structures anterior to the ovary would have entered the inguinal canal).Rarely, during development, this meeting point, which has been pulled towards the midline and into the corpus might result in unusual length of tube (seen in HSG)].


Fig.11.The three points, mentioned above, can be made out easily on the left side. The left nodule shows the ovarian ligamental attachment to the nodule and continuing, as the round ligament on the opposite side and the tubal take off on the left side of the nodule.


Fig.12.The three points, mentioned above, can be made out easily. The ovarian ligament’s meeting with uterine nodule can be made at the lower midpoint of the nodule whereas the thickened round ligament on the left and, below and behind, is the tubal take-off from the uterine nodule.




 Fig.13. In this figure, the ovarian ligament is longer, than the round ligament, which is thicker.


Fig.14.The merged transverse bands are dipping as a broad band to merge with the utero-sacral arch.


 Fig.15. The bilateral transverse bands fuse in the midline but do not show any dipping towards the utero-sacral ligament below. Parts of both ovaries are seen.


Fig.16. The transverse bands are tapering towards the midline but are not dipping to the widened utero-sacrals.



Fig. 17. The picture shows a developing uterus in the midline and a separate nodule on the left side with its tube and ovary.

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