The simple idea (no memorising)
The womb sits between the bladder in front and the rectum behind. In most women it tilts forward in two ways:
- anteversion — the whole womb leans forward relative to the vagina;
- anteflexion — the body of the womb bends forward over the cervix.
(Memory tip: Version = the cervix‑to‑Vagina angle; Flexion = the body‑to‑cervix bend.)
From top to bottom the womb has: fundus → body → isthmus → cervix. Its wall has three layers: endometrium (lining) → myometrium (muscle — where fibroids grow) → perimetrium (outer coat).
The most important surgical landmark
The uterine artery supplies the womb, and the ureter (the tube carrying urine from kidney to bladder) passes right underneath it.
This is why surgeons are so careful when tying off the uterine vessels — the ureter is hiding just below.
The supports (this sets up prolapse)
The womb doesn't dangle from one string. It's held by a team:
- Cardinal ligaments — main sideways support of the cervix;
- Uterosacral ligaments — main top/back ("apical") support;
- the pelvic floor muscles (levator ani) — the dynamic hammock underneath.
The round ligament helps aim the womb forward but is not a main anti‑prolapse support — a favourite exam point.
One drainage pearl
Lymph from the ovary drains all the way up to para‑aortic nodes (high in the abdomen), because the ovary began life up there and descended. This matters for cancer spread in Part 8.
Why it matters
This map is the stage on which prolapse, surgery and cancer spread all play out. The "water under the bridge" image alone can prevent a serious surgical injury.
Quick check ✅
- What's the difference between anteversion and anteflexion?
- What does "water under the bridge" mean, and why does it matter?
Remember this 🌟
Where we're going next → Remember the two ducts that built the womb? Concept 24 shows what happens when their building goes slightly wrong.