Cardinal ligament explained

Cardinal ligament
Latin:	ligamentum cardinale, ligamentum transversum cervicis, ligamentum transversalis colli

The cardinal ligament (also transverse cervical ligament, lateral cervical ligament, or Mackenrodt's ligament^{[1] [2]} ) is a major ligament of the uterus formed as a thickening of connective tissue of the base of the broad ligament of the uterus. It extends laterally (on either side) from the cervix and vaginal fornix to attach onto the lateral wall of the pelvis. The female ureter, uterine artery, and inferior hypogastric (nervous) plexus course within the cardinal ligament. The cardinal ligament supports the uterus.

Structure

The cardinal ligament is a paired structure on the lateral side of the uterus. It originates from the lateral part of the cervix.^[3]

Attachments

It attaches the cervix to the lateral pelvic wall by its attachment to the obturator fascia of the obturator internus muscle.^[4] It attaches to the uterosacral ligament.

Relations

It is continuous externally with the fibrous tissue surrounding the pelvic blood vessels.

Function

The cardinal ligament supports the uterus, providing lateral stability to the cervix.

Clinical significance

The cardinal ligament may be affected in hysterectomy.^{[5] [6]} Due to its proximity to the ureters, it can get damaged during ligation of the ligament. It is routinely cut during some uterine operations, although this can have side effects.

See also

• Pelvic splanchnic nerves

Notes and References

1. Book: Netter, Frank H. . Atlas of Human Anatomy, Professional Edition . Saunders . Philadelphia . 2003 . 1-4160-3699-7 . 370.
2. Book: Sinnatamby, Chummy . Last's Anatomy . 2011 . 978-0-7295-3752-0 . 12th . 304.
3. Ito. E.. Saito. T.. December 2004. Nerve-preserving techniques for radical hysterectomy. European Journal of Surgical Oncology (EJSO). 30. 10. 1137–1140. 10.1016/j.ejso.2004.06.004. 15522564. 0748-7983.
4. Book: ((Kyung Won, PhD. Chung)) . Gross Anatomy (Board Review) . Lippincott Williams & Wilkins . Hagerstown, MD . 2005 . 0-7817-5309-0 . 274.
5. Kato T, Murakami G, Yabuki Y . Does the cardinal ligament of the uterus contain a nerve that should be preserved in radical hysterectomy? . Anat Sci Int . 77 . 3 . 161–8 . 2002 . 12422408 . 10.1046/j.0022-7722.2002.00023.x. 43367709 .
6. Kato T, Murakami G, Yabuki Y . A new perspective on nerve-sparing radical hysterectomy: nerve topography and over-preservation of the cardinal ligament. . Jpn J Clin Oncol . 33 . 11 . 589–91 . 2003 . 14711985 . 10.1093/jjco/hyg107. free .