5.20 Female Urogenital Region

 

Plates 350-2

Essential difference from male is failure of midline fusion of the genital folds

-           scrotum = labia majora; CS ¨ labia minora

Vulva

Formed by mons pubis, labia majora & minora, clitoris, vestibule of vagina, bulb of vestibule, greater vestibular glands.

Mons pubis

Mound of skin & fat anterior to pubic bones.

Labia majora

Inferior extension of mons; fatty folds forming boundary of pudendal cleft. 

-           round ligaments end in front of each labium

-           joined at front at anterior commissure and back by posterior commissure (over perineal body)

Labia minora

Fatless cutaneous folds = boundaries of vestibule.

Anterior aspects form prepuce and frenulum of clitoris. 

Clitoris

Homologue of penis; consists of CC only without CS (CS ¨ labia minor); Free extremity = glans; overlapped by prepuce.

Perineal membrane

Pierced transversely by vagina; wider and weaker than male (see pl 352)

-           attachment for crura of clitoris and ischiocavernosus muscles.

-           Bulb of vestibule is erectile tissue to each side of vaginal orifice, each covered by bulbocavernosus muscle; fibres extend from perineal body around vagina and urethra to clitoris ¨ perineal sphincter

Greater vestibular glands (of Bartholin)

1cm masses behind bulbs of vestibule; open into vaginal orifice by single duct.

Homologous with male bulbourethral glands (of Cowper).

Make negligible contribution to vaginal lubrication; majority of that is transuded fluid through vaginal wall (mucosa doesnŐt contain mucous glands). 

Lesser vestibular glands

Very small mucous glands with minute openings b/n urethral and vaginal openings.

Hymen

Mucosal fold of variable extent at vaginal opening: if completely closing opening, must be incised to allow menses through.

Deep perineal space (352 lower)

Traversed by urethra and vagina;

Contains: sphincter urethrae, deep transverse perineal muscles, pudendal nerve and internal pudendal vessels (have corresponding course to male)

-           pudendal nerve can be blocked by needle through vaginal wall aimed at ischial spine and sacrospinous ligament (palpable per vagina)

Perineal body

More mobile than male counterpart since perineal membrane is incomplete. 

And just as well.