Obstetrics & Gynecology
External Genitalia
The vulva consists of the mons veneris (mons pubis), the clitoris, the labia majora and labia minora, Vestibule which has four parts : The urethral opening, the vaginal opening, hymen and Opening of the Bartholin’s ducts.
Mons Pubis
This is a pad of fibro–fatty tissue in the pubic area. It is covered with pubic hair. The skin of this part is coarse. It contains sweat glands, sebaceous gland and hair follicle.
Labia Majora
These are two folds of skin and fat below the mons pubis. Labia majora are more prominent after childbirth and are closed in women who have not given birth. The surface is pigmented and hairy. The inner part contains sebaceous (sweat) glands and is hairless. They become atrophic in menopausal age and is very thin during puberty.
Labia Minora
These are two folds of skin which lie inside each labia majora. It contains sweat and sebaceous glands. They are more prominent before puberty. It has no hair.
Clitoris
This is a small, sensitive area in the females just as in males there is penis. It has a rich nerve supply. It plays an important part in female arousal during sex.
Vestibule
This is a triangular area which extends from the labia minora and the Hymen.
Hymen
The hymen closes the vaginal opening partially. It has a small outlet for the passage of blood. In some cases, the outlet through which blood can pass at puberty is not there. This leads to the accumulation of blood in the vagina. This condition is a type of amenorrhea (absence of periods) and it requires medical attention. The hymen is usually ruptured during sex. However, gymnastic exercise and horse riding may also rupture the hymen. After childbirth, it more or less disappears. A woman who has never had sex has an unruptured hymen and this state is commonly referred to as virginity.
Bartholin’s Glands
These are two glands which are 1–1.5 cm in size and are yellowish white in color. They lie deep inside the vestibular bulb. The glands produce special watery secretions during coitus.
Internal Genitalia
The Internal Reproductive Organs
Vagina
It lies between the urinary bladder and the rectum. This is the three–inch long passage that leads from the uterus to the exterior. It does not contain hair follicles, sweat and sebaceous glands. The vaginal secretions are very small in amount but it may be excess during sexual activity, in menstruation and during pregnancy. The mucus is secreted by Bartholin’s glands which lubricates the vagina. There occur changes in the mucous membrane of the vagina during menstrual cycle which is mainly due to estrogenic hormones. The vagina has Doderlein’s bacilli during child–bearing age. This organism acts on the glycogen to produce lactic acid and hence due to this acidity in the secretions in vagina it acts as a defensive barrier for vaginal infections. The opening to the vagina is partially covered by the hymen.
Uterus
The uterus is a hollow, muscular organ that lies in the pelvis between the rectum and the urinary bladder. The cervix is the lowermost part of the uterus. A pair of Fallopian tubes extend from each of its sides. It is the main organ of the reproductive system in which a fertilized ovum gets implanted and develops into a fetus through the period of pregnancy. The mucous membrane of the body of the uterus is called the endometrium. It provides a position for implantation of the fetus. The lining of the uterus is shed every month as a menstrual period, if conception does not occur.
Cervix
The lower third of the uterus is called the cervix. It is approximately 2.5 cm in length. It projects into the vault of the vagina. Nearly half of the cervix lies in the vagina. It is called the portiovaginalis. It provides an alkaline secretion, which helps the penetration of sperm for the purpose of fertilization. It acts as a sphincter for the uterus and plays a very important part during pregnancy and child birth. Cancer of the cervix and chronic cervicitis are diseases of the cervix.
Fallopian Tubes
These are two delicate tubes that join to the uterus at its sides on one end. They extend up to the ovaries at the other end. The tubes measure approximately 10 cm in length. They carry the ova from ovaries to the uterus. Fertilization of the ovum actually occurs in the tubes. Hence obstruction of the tubes may prevent conception and lead to infertility. If fertilization occurs, the fertilized ovum gets implanted in the uterus on the fifth or sixth day after fertilization. A tubal (ectopic) pregnancy results if the zygote gets implanted in the tubes instead of passing to the uterus. The infection of the fallopian tubes is known as Salpingitis.
Ovaries
The two almond–shaped ovaries are attached to the ends of the fallopian tubes on either sides of the uterus. They are approximately 4 cm in length, 2.5 cm in breath and 1.5 cm in thickness. They contain thousands of ova or eggs in various stages of development. These ova are present in the ovaries before puberty. After puberty, they become what are known as graafian follicles, under hormonal stimulation. The ovaries also produce the sex hormones estrogen and progesterone.
Ovulation
Each month one or more eggs get released from the ovary, this is known as ovulation and it is the part of the woman’s menstrual cycle. Ovulation does not take place when the women is pregnant.
Corpus Luteum
The corpus luteum is a part of the ovary. After ovulation, the graafian follicle ruptures to develop corpus luteum.
Obstetrics & Gynecology
Health Professional's Negligence
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