COURSE TITLE: APPLIED ANATOMY AND PHYSIOLOGY

COURSE CODE: BMP 210

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TOPIC: ANATOMY OF FEMALE GENITAL TRACT

OBJECTIVES: At the end of this lecture, a student should be able to describe the structures and

functions of external organs of female reproductive system.

INTRODUCTION

The reproductive system; This is the system that is concerned with the production of new, living,

independent human being. The production of the living beings is only made possible especially

as a result of the fertilization of female reproductive cell called ovum or egg by the male

reproductive cell called spermatozoa.

THE FEMALE REPRODUCTIVE SYSTEM

This is made up of External and Internal sex organs that function in reproduction of new

offspring.

FRS: This is the system that is concerned or that helps to form the reproductive cells called ova,

and nurture them, after fertilization by the spermatozoa until they are able to live independent

life.

CLASSIFICATION

The anatomy of female genital tract is divided into:

External genitalia (External organs)

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Internal genitalia (Internal organs)

Accessory reproductive organs

EXTERNAL GENITALIA (vulva; pudendum) The vulva includes the structures visible

externally from the symphysis pubis to the perineal body (Perineum). Bounded Anteriorly: by

mons pubis Laterally: by thighs and Posteriorly: by perineum

VULVA includes; Mons pubis, Labia majora, Labia minora, Clitoris, Hymen, Vestibule,

Urethral opening, Greater vestibular or Bartholin’s glands, Minor vestibular glands, Paraurethral

glands and Fourchette.

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MONS PUBIS: Triangular mound of subcutaneous adipose connective tissue that covers the

pubic bone. Growth of curly hair on the mons pubis after puberty forms the escutcheon. Hair is

distributed in a triangle, whose base covers the upper margin of symphysis pubis and tip ends at

the clitoris.

LABIA MAJORA (greater lips) They are 7 to 8cm in length, 2 to 3cm in depth, and 1 to 1.5cm

in thickness. They are two large, rounded, fleshy folds of fats that joins anteriorly to form the

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mons pubis, and Posteriorly, merge into the area overlying the perineal body to form the

posterior commissure. The outer surface of the labia majora is covered with hair, While the Inner

surface has abundant apocrine and eccrine sweat and sebaceous glands and is hairless. The labia

majora are covered by squamous epithelium. Beneath the skin, dense connective tissue and

adipose tissue are present which are supplied with a rich venous plexus. Nearly void of muscular

elements, Homologous with the scrotum in males.

It contains the termination of round ligament of uterus at its distal third and the obliterated

processus vaginalis (canal of nuck). The round ligament can give rise to leiomyomas in this

region. Obliterated processus vaginalis can be seen as dilated embryonic remanant in adults.

During pregnancy, this vasculature commonly develops varicosities, especially in parous

women, from increased venous pressure created by advancing uterine weight. May form

haematoma if ruptured during childbirth.

LABIA MINORA (lesser lips) Each labia minora is a thin fold of tissue, lying medial to each

labia majora. The length is about 2 to 10cm, and width 1 to 5cm. Extend superiorly, where each

divides into two lamellae. The lower pair fuses to form the frenulum of the clitoris, and the

upper pair merges to form the prepuce. Inferiorly, extend to approach the midline as low ridges

of tissue that fuse to form the fourchette (lacerated during childbirth).

Structurally, the labia minora are composed of connective tissue with many vessels, elastin

fibers, and some smooth muscle fibers. They are supplied with a variety of nerve endings. There

are many sebaceous glands, but lack hair follicles.

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The lateral portion of the inner surface is covered by stratified squamous epithelium to a

demarcating line— The Hart line. Medial to this line, each labium is covered by squamous

epithelium that is nonkeratinized.

Cutaneous structures lie on a connective tissue stratum, that is loosely organized and thus

permits mobility of skin during coitus. This loose attachment allows skin to be easily dissected

off the underlying fascia during skinning vulvectomy in that area, Homologous to the ventral

aspect of penis.

FOURCHETTE: This is a small fold of membrane connecting the labia minora in the posterior

part of the vulva.

CLITORIS: This is principal female erogenous organ that is located beneath the prepuce and

above the urethra. It projects downward between the branched extremities of the labia minora,

and the free end points downward and inward toward the vaginal opening. The clitoris rarely

exceeds 2cm in length and is composed of a glans, a corpus or body, and two crura.

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The glans is usually less than 0.5cm in diameter, is composed of spindle-shaped cells, and is

covered by stratified squamous epithelium that is richly innervated. The clitoral body contains

two corpora cavernosa. Extending from the clitoral body, each corpora cavernosa diverges

laterally to form the long, narrow crura. These lie along the inferior surface of the ischiopubic

rami and deep to the ischiocavernosus muscles. The clitoris is attached to the undersurface of

pubic symphysis by suspensory ligament.

BLOOD SUPPLY from branches of Internal Pudendal Artery, Clitoral body: Deep Artery of the

clitoris Glans & prepuce: Dorsal artery of clitoris

VESTIBULE: In adult women, it is an almond-shaped area that is enclosed by a Hart line

laterally, External surface of the hymen medially, Clitoral frenulum anteriorly and Fourchette

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posteriorly. i.e The vestibule is an oval shaped area formed between the labia minora, the clitoris

and the fuechette.

The vestibule usually is perforated by six openings: the urethra, the vagina, two Bartholin

gland ducts, and at times, two ducts of the largest paraurethral glands—the Skene glands. The

urethral orifice lies about 2.5cm posterior to the clitoris, while The vaginal orifice occupies the

posterior 2/3 of the vestibule. The posterior portion of the vestibule between the fourchette and

the vaginal opening is called the fossa navicularis. It is usually observed only in nulliparous

women.

URETHRAL OPENING: Situated in front of vaginal opening, 1-1.5 cm below the pubic arch.

The paraurethral glands open either on the posterior wall of the urethral orifice or directly into

the vestibule.
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VAGINAL OPENING & HYMEN: Lies at the posterior end of vestibule. The vaginal opening

is rimmed distally by the hymen or its remnants. It is composed mainly of elastic and

collagenous connective tissue, and both outer and inner surfaces are covered by stratified

squamous epithelium.

In pregnant women, the epithelium of the hymen is thick, and the tissue is rich in glycogen.

Changes produced in the hymen by childbirth are usually readily recognizable. Over time, the

hymen consists of several nodules of various sizes, also termed hymenal caruncles.

VESTIBULAR GLANDS OR BARTHOLIN’S GLANDS: Termed greater vestibular glands

or Volvoviginal glands, these are the major glands, measure about 0.5 to 1cm in diameter,

yellowish white in colour, and lie inferior to the vestibular bulbs and deep to the inferior end of

the bulbo cavernosus muscle on either side of the vaginal opening.

Their ducts are 1.5 to 2cm long and open distal to the hymenal ring at 5 and 7 o’clock on the

vestibule at the junction of the anterior two third and posterior one third. The duct is lined by

columnar epithelium and stratified squamous epithelium near its opening.

During sexual excitement it secretes abundant alkaline mucus which helps in lubrication.

Following trauma or infection, either duct may swell and obstruct to form a cyst or abscess.

MINOR VESTIBULAR GLANDS Shallow glands lined by simple mucin secreting epithelium

and open along the Hart line.

PARAURETHRAL GLANDS: Collective arborization of glands whose ducts open

predominantly along the entire inferior aspect of the urethra. The two largest are called Skene

glands, and their ducts typically lie distally near the urethral meatus. • Inflammation and duct

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obstruction of any of the paraurethral glands can lead to urethral diverticulum formation.

Homologous to prostate in males.

VESTIBULAR BULBS: These are almond-shaped aggregations of veins, 3 to 4 cm long, 1 to 2

cm wide, and 0.5 to 1 cm thick. Lie beneath the bulbocavernosus muscle on either side of the

vestibule in front of the bartholin’s glands. Homologous to the single bulb of the penis and

corpus spongiosum in the male. Likely to be injured during childbirth and may even rupture to

create vulvar hematoma.

BLOOD SUPPLY

Arterial blood supply: This is by the external and internal pudendal arteries.

Venous drainage: This is by the external and internal pudendal veins draining into the internal

iliac veins.

LYMPHATIC DRAINAGE

This is by the superficial inguinal lymph glands in the groin.

NERVE SUPPLY

This is by the pudendal nerve.

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