MCQ – 477

Correct Answer » C Explanation

Detailed Explanation:

Clinical Reasoning for the Correct Answer:
– The cardinal ligament attaches the cervix and upper vagina to the lateral pelvic wall.
– It provides major apical support to the uterus, preventing descent into the vagina and thus prolapse.

Why Option A is Incorrect (Round ligament):
– The round ligament maintains the anteverted position of the uterus.
– It does not provide significant pelvic floor support or prevent prolapse.
– Classic pathology: round ligament pain in pregnancy due to stretching, not prolapse.

Why Option B is Incorrect (Broad ligament):
– The broad ligament is a double layer of peritoneum draping over the uterus and adnexa.
– Its main function is to act as a mesentery, not to provide substantial support.
– Prolapse still occurs in broad ligament defects; it does not anchor the uterus firmly.

Why Option D is Incorrect (Uterosacral ligament):
– The uterosacral ligament provides posterior support and helps maintain uterine position.
– While important for support, the cardinal ligament provides the principal lateral support against prolapse.
– Uterosacral ligament dysfunction may contribute to uterine descent but is not the main restraint.

Key Anatomical Structures
– Cardinal ligament: Anchors cervix to lateral pelvic wall; primary support, prevents prolapse.
– Uterosacral ligament: Attaches the cervix to the sacrum; provides posterior support.
– Round ligament: Maintains uterine anteversion; not a supportive structure.
– Broad ligament: Mesentery for uterus/adnexa; limited mechanical support.