FEMALE GENITALIA

• fibromuscular tube extending from vestibule pf vulva, between labia minora, to uterine cervix

  vagina
• located posterior (dorsal) to urinary bladder and anterior (ventral to rectum


  vagina
• vagina is separated from bladder by fibroadipose tissue; urethra enters vagina wall distally
• basal cell layer comprised of single columnar epithelial layer with high nuclear: cytoplasmic ratio


  stratified nonkeratinizing squamous epithelium
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  parabasal layer comporomised of 2 cell layers
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  intermediate cell layer is most prominent with more abundant cytoplasm that is sometimes glycogenated
• superficial cell layer appears flattened with cells showing pyknotic nuclei and dense eosinophilic cytoplasm with occasional keratohyalin granules
• outer longitudinal layer of smooth muscle is continuous with uterus
• fewer smooth muscle fibers anteriorly due to urethra
• inner dense connective tissue layer adjacent to muscularis

  adventitia
• epithilia proliferation and maturation varies with menstrual cycle
• predominance of thick glycogenated squamous epithelium pior to ovulation
• gradual decrease in cell layers after ovulation until start of next cycle
• fewer cell layers and loss of cytoplasm imparts basophilic appearance

  atrophic epithelial changes
• collection of round elongated glands with central eosinophilic secretion


  wolffian duct remnants
• wolffian (mesonephric) duct remnants


  most commonly in lateral walls
• glandular epithelium located at stromal-epithelial interface, due to persistence of membryonic mullerian glandar tissue

  adenosis
• epithelium may be mucinous, tuboendometrioid, or embryonal type


  adenosis
• after menopause, vagina epithelium atrophies due to low estrogenic state
• new borns, vaginal epithelium is often fully mature due to maternal estrogen
• parakeratosis of epithelium may be seen with uterine prolapse
• promince over pubic symphysis that is composed of adipose tissue, anteriormost region of vulva

  mons pubis
• border of distal-most extent of vagina and posterior aspect of vulvar vestibule

  hymen
• located lateral (parallel) to labia minora

  labia majora
• present lateral to vulvar vestibule and medial to labia majora

  labia minora
• located anterior to frenulum at junction of labia minora

  clitoris
• extends from exterior surface of hymen to clitoris anteriorly, fourchette posteriorly, labia minora anterolaterally, and heart line posterolaterally


  vulvar vestibule
• includes vaginal opening and utheral orifice

  vulvar vestibule
• vulvar vestibule includes openings for paired skene ducts, vestibular glands, and bartholin glands
• inferior junction between vulvar vestibule and perineal skin

  hart line
• stromal cell can be spindled, fusiform, stellate and may have nuclear multilobation


  stroma
• labia majora contains eccrine glans, sabaceous glans, hair follicles, similar to those found in skin at other locations


  adnexal structure