Female Genitalia

• External genitalia


  Vulva / Pudendum (extends from mons pubis to anal opening)
• Mons pubis


  • Fat pad located over the symphysis pubis
  • Covered with pubic hair in a triangular pattern
• Function of pubic hair

  Absorb force and to protect the symphysis pubis during coitus
• Labia majora


  • Folds of skin that extend posteriorly & inferiorly from the mons pubis to the perineum
  • Composed of adipose tissue, sebaceous glands, sweat glands
• Labia minora


  • Thinner skin folds inside the labia majora
  • Anteriorly: prepuce or hood around the clitoris
  • Posteriorly: frenulum
  • Hairless, darker pink, numerous sebaceous glands that PROMOTE lubrication and maintain a moist environment
• Clitoris


  • Located at the anterior end of the labia minora
  • Small, cylindrical mass of erectile tissue and nerves
  • 3 parts: glans, corpus, crura
  • Similar to male penis & contains many blood vessels
• Vestibule

  Boat shaped area or fossa formed by the skin folds of the labia minora & labia majora
• Urethral meatus

  • Located between vaginal orifice and clitoris
  • Openings of skene glands located on either side, usually not visible
  • Skene glands secrete mucus that lubricates & maintains moist environment, often referred to as the lesser vestibular glands
• Vaginal orifice

  • External opening of the vagina, has either a slit like or irregular circular structure, depending on the configuration of a hymen
• Hymen

  • Fold of membranous tissue that covers part of the vagina
• Bartholin glands

  • Located between vaginal orifice & labia minora
  • Secrete mucus, which lubricates area during coitus
• Greater vestibular gands


  Bartholin gland
• Visible, rounded portion of the clitoris

  Glans
• The body of the clitoris


  Corpus
• 2 bands of fibrous tissue that attach clitoris to the pelvic bone

  Crura
• • Cervix is pointed posteriorly
  • Body of the uterus is at the level of the pubis over the bladder

  Anteverted Position
• Uterine body is ANTERIORLY FLEXED in relation to the cervix


  Anteflexed
• Cervix and the body of the uterus is tilting backward 


  Retroverted
• Uterine wall may be felt through posterior fornix or rectal wall


  Prominently retroverted
• Uterine wall may not be palpable through the abdominal wall or rectal wall


  Moderate retroversion
• • Uterine body being flexed posteriorly in relation to the cervix
  • Position of the cervix remains normal
  • BODY OF THE UTERUS may be felt through posterior fornix or rectal wall


  Retroflexed
• • Cervix is pointed SLIGHTLY ANTERIORLY (CA)
  • Body of uterus is POSITIONED MORE POSTERIORLY (BUP)
  • Body of uterus is midway between bladder and rectum

  MIDPOSITION
• Internal female genitalia consists of:

  Vagina, Cervix, Uterus, Ovaries, Fallopian Tube
• Graves Speculum


  Speculum most appropriate for adult women and available in various lengths and widths
• Speculum appropriate for virgins amd some postmenopausal women who have a narrow vaginal orifice

  Pederson speculum
• In pregnant clients, the cervix appears blue

  Chadwick's sign
• 4 layers of the vaginal wall

  • Outer layer
  • Submucosal layer
  • Smooth muscle
  • Connective tissue and vascular network
• Vagina

  • Muscular, tubular organ, extends slightly back toward the rectum from the vaginal orifice to the cervix
  • Lies between the rectum posteriorly and urethra and bladder anteriorly
• Functions of vagina

  • Passage of menstrual flow
  • Receives penis during sexual intercourse
  • Serves as lower portion of the birth canal during delivery
• • Allow vagina to expand during intercourse
  • Facilitate vaginal delivery of a fetus


  Transverse folds / Rugae
• Contains blood vessels, nerves, and lymphatic channels

  Submucosal layer
• Junction of isthmus and cervix

  Internal os
• Junction of cervix and vagina

  External os / ectocervix
• • "Neck of the uterus"
  • Gives rise to areas known as anterior and posterior fornices
  • Separates the upper end of the vagina from the isthmus of the uterus

  Cervix
• The acidic environment of the vagina is maintained because the vaginal flora is composed of

  Döderlein Bacili
• The end of the fallopian tube near ovary that has fingerlike extensions

  Fimbriae
• 3 layers of the uterine wall

  • Endometrium - inner mucosal layer
  • Myometrium - functions to expel products of conception
  • Perimetrium - outer uterine layer that covers the uterus and separates it from the abdominal cavity; Forms anterior and postetior pouches around uterus
• Postetior pouch is called

  Rectouterine pouch / cul-de-sac of douglas
• • Situated in the lateral aspect of the pelvic cavity
  • 3 cm long, 2 cm wide, 1 cm deep
  • Release ova
  • Produce estrogen, progesterone, testosterone

  Ovaries
• Point where the 2 types of epithelium in the ectocervix meet

  Squamocolumnar junction