Chapter 14: female genitalia Flashcards
Mons pubis
hair covered fat pad overlying symphysis pubis
labia majora
rounded folds of adipose tissue. Prominent folds of skin overlaying the deposits of subcutaneous fat, and characterized by the presence of pigmented and hair bearing skin just adjacent to the thighs. The labia majora originates from the mons pubis anteriorly and merges with the perineal body posteriorly
labia minora
thinner pinkish red folds that extend anteriorly -forms prepuce/clittoral hood-clitoris. Thin folds of hairless skin located between the labia majora on either side of the vaginal and urethral openings. The skin of the labia minora is smooth and pigmented and is composed mainly of elastic fibers and blood vessels and possess a rich innervation. Anteriorly the skin folds split to enclose the clitoris, forming an anterior prepuce and a posterior frenulum, and the posterior ends are united in a sharp fold known as the fourchette.
urethral meatus
opening to meatus-below/posterior to clitoris
Skene’s gland
situated to each side of meatus: aka lesser vestibular/paraurethral glands
postulated that they help with lubrication
@ 1 and 3 oclock positions
Bartholin’s glands
5 and 7 o’clock positions-posterior
secrete mucus to lubricate.The greater vestibular glands situated deeply within the posterior parts of the labia majora. Each gland lies just inferior and lateral to the bulbocavernosus muscle. The main duct of each Bartholin’s gland opens at the lateral margin of the vagina in the lower half of the vestibule. The glands produce a clear secretion which is most noticeable during sexual arousal. The glands may be the site of infection and cysts formation at any age.
introitus
vaginal opening
perineum
tissue between the introitus and anus
forchette
Anteriorly the skin folds split to enclose the clitoris, forming an anterior prepuce and a posterior frenulum, and the posterior ends are united in a sharp fold known as the fourchette.
clitoris
The erectile tissue that is the equivalent of the male penis. It is situated at the apex of the vestibule anteriorly. The glands of the clitoris is partly hidden by the prepuce.
hymen
A thin and incomplete membrane of connective tissue at the junction of the vestibule and the vagina. Regular use of tampons or regular sexual intercourse will reduce the hymen to a series of irregular deviations around the vaginal opening termed carunculae myrtiformes.
vestibule
The area between the labia minora and the vagina. It extends from the clitoris to the posterior fourchette. Localised within the vestibule are the openings of the vagina, the urethra, the ducts of the Brtholin’s glands and the minor vestibular glands. The part of the vestibule between the vaginal orifice and the frenulum of the labia minora forms a shallow depression termed the vestibular fossa.
vagina
It is a fibromascular tube which gives access to the cervical canal and uterus. During sexual intercourse it envelopes the penis and during delivery the vagina is the birth canal for the infant. During these functions the vaginal walls can constrict and dilate due to the presence of smooth muscles and fibroelastic tissue. The adult vagina extends some 7-10 cm upwards and leaning towards the back. The vaginal orifice is protected by a thin mucosal fold called the hymen, which is perforated at its center. Vulva – the external portion of the female reproductive organs. It surrounds the vaginal orifice (opening) and consists of the vestibule, the hymen, the urethral opening and Skene’s gland ducts, the openings of the greater vestibular glands (Bartholin’s ducts), two sets of lips or labia – labia minora and majora, and the clitoris, the mons pubis and the perineum.
isthmus of uterus
The uterine isthmus is the inferior-posterior part of uterus, on its cervical end — here the uterine muscle (myometrium) is narrower and thinner. It connects superiorly-anteriorly to the complementary parts of the uterus: the body and the fundus.
fallopian tube
connect ovaries to uterus
external os of cervix
round, oval, or slitlike depression-opening into the endocervical canal
columnar epithelium
covers ectocervix-plushy, red surrounding the os, resembles the lining of the endocervical canal
squamous epithelium
shiny pink-continuous with vaginal lining
squamocolumnar junction
forms boundary between the columnar epithelium and squamous epithelium
transformation zone
during puberty the broad band of columnar epithelium encircling the os is gradually replaced by squamous epithelium
first pap
age 21
specula types and sizes
pedersen: Pederson Speculum
The Pederson speculum is a vaginal speculum used during pelvic examinations. This flat, narrow speculum is designed for use in women who have narrow vaginal canals. Narrow vaginal canals can be caused by traumatic injuries and scar tissue. They are also found in elderly women and women who have never had sexual intercourse. Using this narrow speculum can eliminate some of the discomfort of a pelvic exam and make it easier to visualize internal structures to ensure they are normal in size and shape. The Pederson speculum is available in metal and plastic.
Graves Speculum
The Graves speculum is a vaginal speculum that is available in sizes small, medium and large. The bills of the Graves speculum are wider than the bills of the Pederson speculum. The sides of this speculum are also curved. According to the University of Washington, this type of speculum is best used in women who have had sexual intercourse. This is because the vaginal canal may be wider in sexually active women, making the wider bills of the Graves speculum necessary to visualize the cervix and other internal structures of the pelvis. The Graves speculum also is available in plastic and metal varieties.
obtaining pap
- cervical scrape: place the longer end of the scraper in the cervical os. press, turn, and scrape in a full circle, making sure to include the transformational zone and the squamocolumnar junction. Smear the specimen on a glass slide. set the slide in a safe spot. doing the scrape first reduces obscuring cells with blood which usually occurs after use of endocervical brush
- endocervical brush: take the endocervical brush and place it in the os. roll it between your thumb and index finger clockwise and counterclockwise. remove the brush and pick up the slide you have set aside. smear the slide with the brish
milking urethra
suspected urethritis or inflammation of paraurethral glands-insert finger into vagina and milk the urethra from inside out noting discharge
cystocele
bulge of the upper two thirds of the anterior vaginal wall, together with the bladder above it.
bartholin’s gland infection
causes: trauma, gonococci anaerobes, chlamydia. tense, hot, tender abscess
rectocele
herniation of the rectum in to the posterior wall of the vagina, r/f weakness or defect in the endopelvic fascia
nabothian cysts
with increasing estrogen stimulation during adolescence, all or part of this columnar epithelium is transformed into squamous epithelium by a process called metaplasia. this change may block the secretions of columnar epithelium and cause retention cysts-nabothian cysts-translucent nodules on the cervical surface and have no pathologic significance
cervical polyp
usually arises from the endocervical canal. becoming visible when it protrudes through the cervical os. it is bright red, soft, and rather fragile. when only the tip is seen, it cannot be differentiated from a polyp originating in the endometrium
