子宫解剖及临床相关手术丨医学英语视听学习

Uterus

子宫

The uterus, also known as the womb, is located in the pelvic cavity of a female. You could try to look for it in males, but no luck there.

子宫（uterus/womb）位于女性盆腔内。你可以尝试在男性盆腔内查找，但是男性盆腔内没有子宫。

It is a thick-walled muscular structure that lies in the midline as we can see here in our image of the abdominopelvic cavity. The uterus is about eight centimeters in length and it's actually roughly the size and shape of an upside-down pear.

子宫是位于中线的厚壁肌肉结构，我们可以在我们的腹盆腔图像中看到。子宫长约 8 cm，大小和形状大致相当于倒置的梨。

If we change our perspective so we can see a sagittal section of the abdominopelvic cavity, we can understand the location of the uterus and its relationship to other structures a little better.

如果我们改变视图，看一下腹盆腔的矢状面，我们可以更好地了解子宫的位置，及其与其他结构的关系。

As we can see, the uterus sits between the bladder and the rectum and is connected to the vagina inferiorly. Okay, now that we're familiar with the location of the uterus, let's explore some of its anatomy.

如我们所见，子宫位于膀胱和直肠之间，下方与阴道相连。现在已经了解了子宫的位置，我们来探讨一下它的解剖学。

The uterus can be divided into four key parts – the fundus, the body, the isthmus, and the cervix. Let’s move on to look at these in more detail starting with the fundus.

子宫分为 4 个关键部分：子宫底、子宫体、子宫峡部和子宫颈。我们详细地看一下这些结构，首先是子宫底。

As you can see here, the fundus is at the top of the uterus and is situated above the entry points of the uterine tubes. Moving inferiorly, we have the body of the uterus, which is also known as the corpus.

如你们所见，子宫底在子宫顶部，输卵管入口上方。继续向下，我们看到子宫体（corpus）。

As we can see in our illustration, the cavity of the body is shaped like an inverted triangle due to its connection to the isthmus and both uterine tubes. Implantation of the blastocyst normally occurs here.

如我们的插图所示，由于与子宫峡部和两条输卵管相连，子宫体腔的形状呈现倒置的三角形。囊胚植入通常发生在这里。

Next, we have the isthmus. The isthmus is about one centimeter long and, as you can see, is the constricted part of the uterus between the body and the cervix.

接下来是子宫峡部。峡部长约 1 cm，如你所见，它是子宫体和子宫颈之间的狭窄部分。

Lastly, we have the cervix which connects the uterine cavity to the lumen of the vagina. The cervix is approximately two point five centimeters long and has two openings – the internal os which opens into the uterus and the external os which opens into the vagina.

最后是连接子宫腔和阴道腔的子宫颈。子宫颈长约 2.5 cm，有两个开口，内口通向子宫，外口通向阴道。

Now it's time to have a brief look at some associated structures of the uterus.

现在，我们简单看一下子宫的一些相关结构。

The first structure that we're going to talk about is the broad ligament of the uterus, which is a double layer of peritoneum. This ligament connects the uterus to the lateral walls of the pelvis and contains the uterine and ovarian arteries.

我们将讨论的第一个结构是子宫阔韧带，它是双层腹膜。子宫阔韧带连接子宫和盆腔侧壁，包含子宫和卵巢动脉。

Next, we have the uterine tube which is also known as the fallopian tube. We have two uterine tubes along which eggs travel from the ovaries to the uterus.

然后是子宫管，也称输卵管。我们有两条输卵管，卵子沿输卵管从卵巢进入子宫。

Okay, let's move on to look at the ovary, which produces and releases eggs. As you can see, you also have two ovaries. 

我们继续看一下卵巢，卵巢产生并释放卵子。如你所见，卵巢也有两个。

I mentioned earlier that the uterus is connected to the vagina inferiorly. The vagina serves as a conduit for menstrual blood from the uterus, accommodates the penis during intercourse and, during childbirth, the baby passes through the vagina to reach the external environment.

我之前提到过，子宫下方连接阴道。阴道是子宫经血通过的管道，在性交期间容纳阴茎，分娩期间，胎儿通过阴道，娩出到外部环境。

As you can see, this was a very brief overview of associated structures, but if you came for more, then visit our website for more in-depth tutorials on these topics.

如你所见，这大致就是子宫的相关结构，但是如果想了解更多内容，请访问我们的网站，获取更多深入详尽的相关教程。

Okay, so let's move on to the blood supply, innervation, and lymphatics of the uterus.

好了，我们继续看一下子宫的血供、神经支配和淋巴管。

The uterus is supplied by the uterine artery, which we can see here highlighted in green and the uterine branch of the ovarian artery. The venous drainage of the uterus is carried out by the uterine vein.

子宫由子宫动脉（见这里的绿色高亮部分），及卵巢动脉的子宫支供应。子宫静脉收集子宫的静脉血。

Okay, so let's move on now to talk about the innervation of the uterus.

现在，我们继续讨论子宫的神经支配。

The sympathetic supply is derived from the inferior hypogastric plexus, which we can see here highlighted in green, whereas the parasympathetic supply is derived from the pelvic splanchnic nerves.

子宫的交感神经来自腹下神经丛（见绿色高亮区域），而副交感神经则来自盆内脏神经。

Lastly, we have the lymphatic drainage of the uterus. Lymph from the body and cervix drains mostly to the internal and external iliac nodes, which we can see here highlighted in green. Lymph from the fundus drains to the para-aortic nodes.

最后是子宫的淋巴引流。来自子宫体和子宫颈的淋巴主要引流到髂内和髂外淋巴结（见绿色高亮部分）。来自子宫底的淋巴引流到主动脉旁淋巴结。

It’s time to move on to our next topic, which is the functions of the uterus.

现在来看下一个话题：子宫的功能。

Once a blastocyst has implanted in the body of the uterus, the uterus carries out various functions to aid the growth and development of the baby or the fetus.

囊胚植入子宫体内后，子宫将发挥各种功能，帮助孩子或胎儿生长和发育。

Firstly, it provides mechanical protection preventing any physical damage to the fetus. It also provides nutritional support which is essential for growth and removes waste keeping the fetal environment nice and clean.

首先，它提供机械保护，防止胎儿遭受任何身体伤害。它也提供营养支持，这是胎儿生长必不可少的；清除废物，保持胎儿的生存环境健康清洁。

I mentioned earlier that the uterus sits in the pelvic cavity; however, during pregnancy, the uterus expands up into the abdominal cavity as the baby grows.

我之前提到过子宫位于盆腔内，但是，怀孕期间，随着胎儿生长，子宫将向上延展到腹腔内。

When the baby is ready, the muscular wall of the uterus contracts to help push the baby out at the time of delivery. 

当胎儿准备好时，子宫壁肌肉收缩，推动胎儿在分娩时娩出体外。

If fertilization of the egg doesn't occur and there's no implantation of the blastocysts, the uterus will eventually shed its lining in a process known as menstruation.

如果卵子没有受精，囊胚没有着床，子宫内膜最后将通过称为月经的过程脱落。

Now that we’re clued up on the uterus and its functions, let's get clinical. In today's clinical notes, we're going to talk about a procedure known as the hysterectomy.

我们已经了解了子宫及其功能，现在看一下临床相关内容。在今天的临床记录中，我们将讨论子宫切除术。

A hysterectomy is the surgical removal of the uterus and there are several types. If the entire uterus is removed, it is a total hysterectomy.

子宫切除术是切除子宫的手术，分为许多类型。如果完全切除子宫，称为全子宫切除术。

If only the part of the uterus is removed, it is called a subtotal hysterectomy. Sometimes, the ovaries and the fallopian tubes are also removed, which is known as a total hysterectomy and bilateral salpingo-oophorectomy.

如果只切除部分子宫，称为子宫次全切除术。有时，也切除卵巢和输卵管，这称为全子宫切除术或双侧输卵管卵巢切除术。

This surgery is a very common procedure and has various indications including reproductive malignancy, uterine prolapse, endometriosis, and major postpartum hemorrhage.

这是一种非常常见的手术，适应症很多，包括生殖道恶性肿瘤、子宫脱垂、子宫内膜异位症和产后大出血。

As with any surgery, a hysterectomy comes with a risk of complications including hemorrhage, infection, pain, and general anesthetic complications. 

与其他所有手术一样，子宫切除术也有并发症的风险，包括出血、感染、疼痛和全麻并发症。

Depending on the type of procedure, you can take six to eight weeks to fully recover from a hysterectomy.

根据手术类型，患者接受子宫切除术后，可能需要 6~8 周才能完全恢复。