Anatomy, Abdomen and Pelvis: Cardinal Ligaments (Mackenrodts, Transverse Cervical, or Lateral Cervical Ligaments)

Excerpt

The muscles of the pelvic floor and the connective tissue of pelvis, including pelvic fascia, provide stability to the pelvic floor and are essential for the support of pelvic viscera. The visceral layer of pelvic fascia and parametrium becomes condensed around the uterus to form primary support of uterus in the form of true ligaments. These are pubocervical ligament anteriorly, cardinal ligament laterally, uterosacral ligament posteriorly, and round ligament. Cardinal ligament and the uterosacral ligaments provide apical support for the uterus and upper vagina. The cardinal ligament is a paired thickening of the parametrium and pelvic fascia at the base of the broad ligament, which extends between the cervix and vaginal fornix medially to the sidewall of pelvis laterally. It is composed of loose areolar connective tissue surrounded by blood vessels, nerves, and lymphatics. As per Terminologia Anatomica, the cardinal ligament has the name parametrium or paracervix; however, Mackenrodt ligament, transverse cervical ligament, lateral cervical ligament, paracervical ligament, retinaculum uteri sustentaculum of Bonny or the web are the other terms also used for it.

Peritoneal folds related to the uterus form less important secondary support of uterus in the form of peritoneal ligaments. These are uterovesical fold (anterior ligament) anteriorly, rectouterine fold (posterior ligament) posteriorly, and broad ligament laterally.