Suspensory ligament

Accommodation (fig. 9). The lens of the eye is suspended by the zonula (suspensory ligament) consisting of delicate transparent fibres attached on the one hand to the ciliary body and on the other to the elastic capsule covering the lens. At rest, this zonula is under tension and in consequence the lens assumes a flattened form. When the ciliary muscle contracts it pulls the... 

When solutions of directly acting choUnomimetics are applied to the eye (i.e., conjunctival sac), they cause contraction of the smooth muscle in two important structures, the iris sphincter and the ciliary muscles (Fig. 12.3). Contraction of the iris sphincter decreases the diameter of the pupil (miosis). Contraction of the circular fibers of the ciliary muscle, which encircles the lens, reduces the tension on the suspensory ligaments that normally stretch and flatten the lens, allowing the highly elastic lens to spontaneously round up and focus for near vision (accommodation to near vision). 

Each ovary is suspended in the peritoneal cavity by three supporting structures the mesovarium which anchors the ovary to the posterior aspect of the broad ligament the ovarian ligament which attaches the ovary to the uterine cornu and the suspensory ligament or infundibulopelvic which anchors the ovary to the pelvic side wall [6]. 

The ovarian ligament and suspensory ligament are not tight supporting structures but more comparable to a mesentery [4]. The ovarian blood vessels and lymphatics course within the peritoneal folds of the mesovarium and enter and exit the ovary through the ovarian hilum. Anastomosing branches of the ovarian and uterine vessels in close relationship with lymphatics are located within the mesovarium [6]. 

The suspensory ligament of the ovary is located at the superior lateral aspect of the broad ligament [6]. It extends from the ovary anterolaterally over the external and common iliac vessels and blends with coimective tissue over the psoas muscle [15]. Ovarian blood vessels and lymphatics traverse the suspensory ligament to reach the ovarian hilum along the mesovarium. 

The ovarian artery originates from the lumbar aorta near the renal hilum. It is accompanied along its retroperitoneal course by the ovarian vein and the ureter on the anterior surface of the psoas muscle. It then crosses the ureter and common iliac vessels near the pelvic brim to enter the suspensory ligament of the ovary. The ovarian artery courses inferiorly and medially between the two layers of the broad ligament near the mesovarian border [4]. It forms multiple branches that reach the ovarian hilum via the mesovarium. It has a tortuous course that is most pronounced near the ovary. 

Rupture of the suspensory ligament does not cause loss of penile rigidity, and the erectile function is unchanged. However, the patients can complain of an abnormal angle during erection. In this case a simple suture of the ligament through a suprapubic access can be easily performed. 

This lesion can occur when the erect penis is forcibly displaced towards the feet (Pryor and Hill 1979). Diagnosis of rupture of the suspensory ligament is made by history and by palpation of a gap between the base of the shaft of the penis and the symphysis pubis. An abnormal angle is noted during erection. Ultrasonography is able to document the gap between the pubis and the penile shaft and associated hematomas of the soft tissues (Fig. 12.5), but usually does not provide additional useful information (Bertolotto and Pozzi Mucelli 2004). 

Fig. 12.5. Rupture of the suspensory ligament. The patient experienced pain after his partner s fall during standing intercourse. Longitudinal scan showing a small hematoma ) in the gap between the corpora cavernosa (CC) and puhis (P)...

Pryor JP, Hill JT (1979) Abnormalities of the suspensory ligament of the penis as a cause for erectile dysfunction. Br J Urol 51 402-403... 

Posterior Spur Gray Substance White Substance Suspensory Ligaments Spinal Ganglion... 

Rather than exist in a segregated fashion, the various fasciae show continuous communication. Suspensory ligaments of the heart and other organs represent continuities. The recently discovered connection between the dura and the rectus capitis posterior minor is an example of the continuity and interrelatedness of bodily structures. The inguinal ligament is a reflection of the in-rolled lower edge of the external oblique muscle aponeurosis. 

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