Female genital organs is a whole systems of reproductive and pelvic organs in females. Gyanaecology & obstetrics is very broad field and female genital organs is one of important topic of it. Both the gender is differentiated from each other through their genitals. It is very much important topic without which one cannot understand the female complaints. We will discuss in detail about every small important things. So please understand it properly.
External genital organs
External genitalia is also known as vulva or pudendum. It consists of several parts and structures, each with its own functions. Below mentioned structures are the part of female external genitalia.
• Mons pubis
• labia majora
• labia minora
• clitoris
• vestibule
• bartholin's gland
• perineum
Now we will discuss all of these separately.
Mons pubis
The mons pubis, also known as the mons veneris or simply mons, is a pad of subcutaneous fatty tissue located above the pubic bone in the pubic region of the body. It is a visible, rounded area that can vary in size and shape among individuals.
The mons pubis is part of the external female genitalia and is situated in the front of the pelvic area, just above the vulva. It is covered with pubic hair after puberty. The mons pubis serves several purposes :-
• Protection :- The layer of fatty tissue in the mons pubis acts as a cushion, providing protection to the underlying pubic bone and the delicate structures in the pelvic region.
• Aesthetic Appeal :- The size, shape, and prominence of the mons pubis can vary among individuals. It contributes to the overall appearance of the external genitalia and differs in appearance due to factors such as genetics, body weight, and hormonal changes.
• Sexual Stimulation :- The mons pubis contains numerous nerve endings, which can contribute to sexual arousal and pleasure when stimulated during sexual activities.
It is worth noting that the mons pubis can undergo changes throughout a person's life, such as variations in size due to weight fluctuations or hormonal shifts during puberty, pregnancy, or menopause. Like any part of the body, the mons pubis can vary in appearance and is unique to each individual.
Labia majora
The labia majora, also known as the outer lips, are part of the female external genitalia. They are two prominent folds of skin and fatty tissue that extend from the mons pubis (the area above the pubic bone) to the perineum (the area between the vaginal opening and the anus). The labia majora are typically thicker and more padded compared to the labia minora, which are the inner lips.
The labia majora serve multiple purposes. They act as a protective barrier for the more sensitive and delicate structures of the vulva, including the labia minora, clitoris, vaginal opening, and urethra. The labia majora help to prevent friction, provide cushioning, and reduce potential injuries or infections. They also contain sebaceous glands, sweat glands, and hair follicles, which contribute to the natural lubrication and overall health of the vaginal area. Labia majora is a homologous structure to scrotum of men.
Labia minora
They are located on either side of the vaginal opening, extending downward from the clitoral hood to the perineum. The labia minora are thin, elongated folds of skin and mucous membrane. Which are situated between the labia majora (outer lips) and enclose the vestibule, which houses the urethral opening, vaginal opening, and clitoris. They contain sebaceous glands, which produce lubrication and help maintain moisture in the area. The labia minora receive blood supply from various sources, including the labial branches of the pudendal artery, the posterior labial artery, and the dorsal clitoral artery. The labia minora are innervated by several nerve branches, including the pudendal nerve and branches from the ilioinguinal nerve and the perineal nerve. These nerves provide sensory innervation to the region. The labia minora play a protective role by covering and surrounding the sensitive structures of the vulva, such as the clitoris and vaginal opening. They help keep these areas moist and provide lubrication during sexual arousal. Labia minora is homologous to ventral aspect of penis.
Clitoris
The clitoris is a highly sensitive and erectile organ located at the anterior end of the vulva, above the urethral opening and vaginal opening. It is considered the primary sexual organ in females and plays a crucial role in sexual arousal and pleasure. The clitoris is composed of both external and internal structures. The external portion, known as the glans clitoris, is a small, rounded structure situated at the top of the vulva. It is covered by a fold of skin called the clitoral hood. The glans clitoris contains numerous nerve endings, making it highly sensitive to stimulation. The clitoris extends internally, with two shafts or corpora cavernosa that run along the sides of the vestibule. These shafts are composed of erectile tissue, similar to the erectile tissue found in the penis. When stimulated, the clitoral erectile tissue engorges with blood, leading to increased sensitivity and arousal. The size of the clitoris can vary among individuals. While the glans clitoris is typically small, the size and length of the shafts can vary considerably. Some individuals may have a more prominent clitoral hood, while others may have a smaller or less visible hood. The clitoris is densely innervated, containing thousands of nerve endings, including the highly sensitive nerve endings of the glans clitoris. This dense nerve supply makes the clitoris a significant source of sexual pleasure and sensitivity. The primary function of the clitoris is to provide sexual pleasure and contribute to sexual arousal. When stimulated, whether through direct contact, pressure, or arousal, the clitoris can engorge with blood and become erect, leading to increased sensitivity and pleasurable sensations. Stimulation of the clitoris can lead to sexual arousal and orgasm in many individuals. The clitoris is often considered the main source of female orgasm, as it contains a high concentration of nerve endings and is highly responsive to sexual stimulation.
Vestibule
The vestibule is a term used to describe the triangular area within the vulva that surrounds the vaginal and urethral openings. It is an important anatomical region involved in sexual function and urination.
Boundaries :- It is bounded anteriorly by clitoris and posteriorly by the fourchette and on the either side of the labium minus.
Vestibule contains the opening of
1) urethral opening
2) vaginal opening
3) bartholin's gland opening
4) skene's gland opening
The vestibule contains the external urethral meatus, which is the external opening of the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. The urethral opening is usually located just below the clitoris and above the vaginal opening.
The vestibule also houses the vaginal opening, which is the entrance to the vagina. The vagina is a muscular canal that connects the external genitalia to the cervix and uterus. The vaginal opening is located posterior to the urethral opening.
Skene's glands are located near the urethral opening within the vestibule. They produce a small amount of fluid that is sometimes released during sexual stimulation.
Bartholin's gland
The Bartholin's glands, also known as the greater vestibular glands, are a pair of small, pea-sized glands located on either side of the vaginal opening within the vestibule of the vulva. They play a role in lubricating the vagina and are part of the female reproductive system. Each Bartholin's gland is located on either side of the vaginal opening, within the vestibule. They are situated deep within the labia minora, near the posterior fourchette. Each Bartholin's gland has a single duct that opens onto the surface of the vestibule. These ducts, known as Bartholin's ducts, are lined with epithelial cells and carry the secretions of the gland to the vestibule. The Bartholin's glands produce a mucus-like fluid that helps lubricate the vestibule and vaginal opening during sexual arousal. This secretion provides moisture and reduces friction during sexual activity. The secretions of the Bartholin's glands contribute to the natural lubrication of the vagina, facilitating comfortable sexual intercourse. Insufficient secretion or blockage of the ducts can lead to discomfort or pain during intercourse.
Perineum
The perineum is the region of the body located between the genitals and the anus. It is a diamond-shaped area that includes both external and internal structures. The perineum is bounded by the pubic symphysis (at the front), the coccyx (at the back), and the ischial tuberosities (on either side).
In females, the perineum includes the vaginal opening, the labia majora (outer lips of the vulva), the labia minora (inner lips of the vulva), and the clitoral hood. In males, it includes the base of the penis, the scrotum, and the anus. The perineum contains several muscles that provide support to the pelvic organs and contribute to functions such as urination, defecation, and sexual activity. These muscles include the bulbospongiosus, ischiocavernosus, and external anal sphincter muscles.
The perineal body is a fibromuscular structure located at the center of the perineum. It acts as a central point of attachment for various muscles and ligaments, providing stability to the pelvic floor. The perineum is part of the pelvic floor, which is a group of muscles and connective tissues that support the pelvic organs, including the bladder, uterus (in females), and rectum.
The perineum is of particular importance during childbirth. It undergoes stretching and may tear during delivery to accommodate the passage of the baby's head. Episiotomy, a surgical incision made to widen the vaginal opening, may be performed in some cases to facilitate delivery.
Internal genital organs
Female internal genital organs is a structure responsible for production of eggs, fertilisation, implantation of fertilised egg and the development and nourishment of fetus during pregnancy. Below mentioned structures are part of internal genitalia of female.
1) vagina
2) uterus
3) fallopian tubes
4) ovaries
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Vagina
The vagina is a muscular canal that extends from the cervix to the external genitalia (vulva) in females. It serves as a passageway for menstrual blood, receives the penis during sexual intercourse, and acts as the birth canal during childbirth.
The vagina is located in the pelvic cavity, between the bladder (anteriorly) and the rectum (posteriorly). It extends upwards from the external opening, known as the vaginal opening, to the cervix. The vaginal canal is a flexible, muscular tube that is lined with mucous membranes. It has a distensible quality, allowing it to accommodate various sizes, such as during sexual intercourse and childbirth.
The length of the vagina can vary among individuals, but on average, it is approximately 7 to 10 centimeters (2.5 to 4 inches) long. Its shape is typically described as tubular, but it may have some natural curvature.
Layers of the walls of the vagina :- The vaginal walls consist of three layers. The innermost layer is the mucosa, which is made up of specialized cells and mucus-secreting glands. The middle layer is composed of smooth muscle tissue, allowing the vagina to expand and contract. The outermost layer is a connective tissue layer that provides support and protection.
Vaginal epithelium :-
Vaginal epithelium is the inner lining of the vagina. In the start of life it is made up of simple squamous epithelium. Which in the puberty convert in to the stratified squamous epithelium. The vaginal epithelium does not contain glands. Instead, it relies on secretions from nearby structures, such as the cervix and Bartholin's glands, to provide lubrication and maintain a healthy environment.
The vaginal epithelium contains glycogen, which is stored in the superficial layers of cells. Glycogen acts as a nutrient source for doderlein's bacillus, the beneficial bacteria that help maintain a healthy vaginal pH. Doderlein's bacillus metabolize glycogen, producing lactic acid, which contributes to the acidic environment of the vagina.
The number of epithelial cells in the vaginal smear can vary depending on factors such as menstrual cycle, hormonal changes, sexual activity, and vaginal infections. For example, during the reproductive years, estrogen promotes the growth and maturation of vaginal epithelial cells, resulting in a higher cellularity.
Doderlein's bacillus are normal residents of the vaginal ecosystem. They adhere to the vaginal epithelial cells and contribute to vaginal health by producing lactic acid, maintaining the acidic pH, and inhibiting the growth of harmful bacteria.
Vaginal secretions :-
The vagina has a natural mechanism of self-cleansing and lubrication through the secretion of various fluids. These secretions are produced by different structures within and around the vaginal canal.
The cervix produces mucus that can be released into the vagina. The amount, consistency, and composition of cervical mucus change throughout the menstrual cycle under the influence of hormones. During ovulation, the mucus becomes thinner, clearer, and more stretchy, resembling raw egg whites. This type of mucus facilitates sperm transport and provides an optimal environment for fertilization.
The vaginal walls contain specialized cells that secrete a fluid to keep the vagina moist and lubricated. This fluid is typically clear or whitish in color and serves to reduce friction during sexual intercourse. The amount and consistency of vaginal fluid can vary depending on factors such as hormonal fluctuations, sexual arousal, and hydration levels.
Bartholin's glands are located on either side of the vaginal opening. These small glands produce a lubricating fluid that is released during sexual arousal. The fluid helps to reduce discomfort or pain during sexual intercourse by providing additional lubrication.
Uterus
The uterus, also known as the womb, is a hollow, muscular organ located in the pelvis of the female reproductive system. It plays a central role in supporting pregnancy and menstruation.
Position of the uterus :- The position of the uterus can vary among individuals and can also change depending on factors such as age, pregnancy, and the fullness of the bladder. The most common position of the uterus is described as anteverted and anteflexed, but other positions are possible. Here are the three main positions of the uterus :-
Anteverted :- In an anteverted uterus, the body of the uterus tilts forward towards the bladder. This is the most common position, and it allows the uterus to rest on top of the bladder.
Anteflexed :- In an anteflexed uterus, the body of the uterus is bent forward at the junction between the cervix and the body. This means that the entire uterus is bent forward, with the cervix pointing slightly upward.
Retroverted :- In a retroverted uterus, the body of the uterus tilts backward towards the rectum. This position is less common but is still considered normal in many cases. Some women may have a retroverted uterus naturally, while others may develop it due to conditions such as endometriosis or pelvic scarring.
Measurement of uterus :- Normally, uterus measures about 7-8 cm long, 5 cm wide at fundus with 1.25 cm thickness of its wall. And the weight of the uterus is varies from 50-80 g.
Parts of the uterus :- Uterus is divided mainly in three parts. But sometimes isthmus is also labelled as different part.
1) Fundus
2) Body
3) Isthmus
4) Cervix
Now we will discuss all the parts in detail.
Fundus of the uterus :- The fundus of the uterus is the rounded, uppermost portion of the uterus. It is located above the entrance of the fallopian tubes and is opposite to the cervix, which is the lower part of the uterus.
Location :- The fundus is the most superior part of the uterus. It is typically located at the level of or slightly above the pelvic brim, which is the upper margin of the bony pelvis.
The fundus has a convex, dome-like shape. Its size can vary depending on factors such as age, hormonal status, and pregnancy. During pregnancy, the fundus expands as the uterus grows to accommodate the developing fetus. The fundus of the uterus can be palpated (felt) during a pelvic examination. It is usually assessed by gently pressing on the lower abdomen with the fingertips to feel for the topmost part of the uterus.
In pregnant women, the fundus is an important indicator of gestational age. Its height in centimeters from the pubic symphysis (the bony prominence at the front of the pelvis) provides an estimate of the stage of pregnancy. This measurement is known as the fundal height and is frequently used during prenatal care to monitor fetal growth and development.
Body of the uterus
The body of the uterus, also known as the corpus, is the main part of the uterus located between the fundus (upper portion) and the cervix (lower portion). It is the largest and most significant part of the uterus. The body of the uterus has an inverted pear shape, with the wider upper part (fundus) tapering down towards the narrower lower part (cervix).
Structure of the body :- The uterine body is composed of three layers that make up the uterine wall :-
1) Endometrium :- The innermost layer of the uterine wall is the endometrium. It is a highly vascularized lining that undergoes cyclic changes in response to hormonal fluctuations. The endometrium thickens during the menstrual cycle to prepare for potential embryo implantation.
2) Myometrium :- The middle layer of the uterine wall is the myometrium, consisting of thick, smooth muscle tissue. It is responsible for the powerful contractions during labor and delivery. The myometrium contracts during menstruation to shed the uterine lining.
3) Perimetrium :- The outermost layer of the uterine wall is the perimetrium. It is a thin serous membrane that covers the uterus and provides protection.
During pregnancy, if fertilization occurs, the fertilized egg implants and grows within the uterine body. The endometrium thickens further to support the developing embryo and provide nourishment. The body of the uterus is involved in the menstrual cycle. If pregnancy does not occur, the endometrium in the uterine body sheds, resulting in menstrual bleeding. The uterine body plays a supportive role during pregnancy. It expands and accommodates the growing fetus as it develops. The muscle fibers in the myometrium help facilitate contractions during labor and childbirth.
Isthmus of uterus :- The isthmus of the uterus, also known as the uterine isthmus or cervical isthmus, is a narrow, constricted portion of the uterus located between the uterine body (corpus) and the cervix. It is the lower part of the uterus that connects to the upper part of the cervix. Anatomically, the isthmus is a thick-walled region that has a smaller diameter compared to the rest of the uterus. It serves as a transitional zone between the body of the uterus and the cervix, which is the lower part of the uterus that opens into the vagina.
During pregnancy, the isthmus plays an important role in maintaining the integrity of the gestational sac within the uterus. It undergoes changes to prevent premature dilation or opening of the cervix and helps to keep the developing fetus protected. In terms of reproductive health, the isthmus is involved in the process of menstruation and is an important site for sperm transport into the uterus. It also plays a role in regulating the flow of menstrual blood from the uterus to the cervix and vagina during menstruation.
Cervix
Cervix is cylindrical or conical shaped organ located near the lower end of the uterus, connect the uterus to the vagina. One of its main functions is to allow the passage of menstrual blood from the uterus to the vagina during menstruation. It also serves as a pathway for sperm to enter the uterus during sexual intercourse and facilitates the movement of sperm towards the fallopian tubes, where fertilization of an egg may occur.
During pregnancy, the cervix undergoes changes to support the developing fetus. It forms a mucus plug to seal off the uterus, providing protection against infection. As labor approaches, the cervix softens, thins out (effaces), and dilates to allow the baby to pass through during childbirth.
Epithelium of cervix :- The epithelium of the cervix consists of two main types :- the endocervical epithelium and the ectocervical epithelium, also known as the squamous epithelium.
1) Endocervical epithelium :- This type of epithelium lines the endocervical canal, which is the passage that connects the uterus to the vagina. The endocervical epithelium is composed of columnar cells, which are tall and cylindrical in shape. These cells produce mucus that helps lubricate the cervix and protect it from infections.
2) Ectocervical epithelium :- The ectocervical epithelium covers the outer surface of the cervix that is exposed to the vaginal environment. It is a stratified squamous epithelium, which means it consists of multiple layers of flat, scale-like cells. The outermost layer of cells, known as the squamous cells, are continuously shed and replaced. The ectocervical epithelium is more resistant to wear and tear compared to the endocervical epithelium.
The transition between the endocervical epithelium and the ectocervical epithelium occurs at a region called the transformation zone. This zone is of particular interest in cervical health because it is the area where most cervical abnormalities, including precancerous and cancerous lesions, are likely to develop. Regular cervical screenings, such as Pap smears, are performed to detect any abnormal changes in the cervical epithelium, especially in the transformation zone, for early detection and treatment of cervical conditions.
Vaginal fornices :- The vaginal fornices are recessed areas or spaces in the vaginal wall. They are located where the upper end of the vagina meets the cervix. The fornices form a ring-like structure around the cervix and are named based on their anatomical positions :- anterior (front), posterior (back), and lateral (sides).
1) Anterior fornix :- The anterior fornix is situated at the front of the vagina, between the cervix and the bladder. It is the shallowest fornix and can be easily accessed during gynecological examinations.
2) Posterior fornix :- The posterior fornix is located at the back of the vagina, between the cervix and the rectum. It is the deepest fornix and can be reached during certain medical procedures, such as a rectovaginal examination.
3) Lateral fornices :- The lateral fornices are on either side of the cervix, between the cervix and the pelvic sidewalls. They are less commonly mentioned compared to the anterior and posterior fornices.
The vaginal fornices are important in terms of sexual activity and reproduction. During sexual intercourse, the penis can reach and stimulate the fornices, providing pleasurable sensations for some individuals. The fornices also play a role in fertility as they serve as potential reservoirs for semen during ejaculation, allowing sperm to come into close proximity with the cervix.
Fallopian tubes
The fallopian tubes, also known as uterine tubes or oviducts, are a pair of thin, flexible tubes that extend from the upper corners of the uterus towards the ovaries in the female reproductive system. They play a vital role in the process of fertilization and transportation of the egg (ovum) from the ovary to the uterus.
Each fallopian tube is approximately 10-13 centimeters (4-5 inches) in length and consists of several segments :-
1) Infundibulum :- The infundibulum is the funnel-shaped, distal end of the fallopian tube located near the ovary. It has finger-like projections called fimbriae that sweep over the ovary to capture the released egg during ovulation.
2) Ampulla :- The ampulla is the wider middle segment of the fallopian tube. It is the most common site for fertilization to occur. The ampulla is lined with ciliated epithelial cells and smooth muscle, which aid in the movement of the egg and sperm.
3) Isthmus :- The isthmus is the narrower, muscular segment that connects the ampulla to the uterine cavity. It is responsible for transporting the fertilized egg (zygote) towards the uterus.
4) Intramural or interstitial :- The interstitial part of the fallopian tube is the proximal portion that enters the uterus. It opens into the uterine cavity through an opening called the uterotubal junction.
The fallopian tubes have several essential functions :-
1) Ovum capture :- During ovulation, the fimbriae of the infundibulum sweep over the ovary to capture the released egg. The fimbriae create a gentle current that guides the egg into the fallopian tube.
2) Fertilization :- If sperm is present in the fallopian tube at the time of ovulation, fertilization may occur in the ampulla. Sperm can travel from the vagina, through the cervix, into the uterus, and finally reach the fallopian tubes, where they can meet the egg.
3) Transportation :- The fallopian tubes provide a pathway for the egg to travel from the ovary to the uterus. The cilia lining the tube and the muscular contractions of the tube help move the egg and any potential embryos towards the uterus.
4) Early development :- The fallopian tubes provide a suitable environment for the early development of the fertilized egg. The zygote undergoes several cell divisions as it moves through the fallopian tube towards the uterus, forming a ball of cells called a blastocyst.
Ovaries
The ovaries are important organs in the female reproductive system. They are paired structures located in the lower abdomen on either side of the uterus. The ovaries are responsible for the production and release of eggs (ova) as well as the production of hormones, primarily estrogen and progesterone.
Each ovary is an almond-shaped organ measuring about 3-5 centimeters in length and approximately 1.5-3 centimeters in width. They are connected to the uterus by ligaments and are suspended in the pelvic cavity. The outer surface of the ovaries is covered by a layer of epithelial cells called the germinal epithelium.
Inside the ovaries, there are two main regions :- the outer cortex and the inner medulla.
1) Cortex :- The cortex forms the outer layer of the ovary and contains the ovarian follicles. Ovarian follicles are tiny sac-like structures that each contain an immature egg, also known as an oocyte. These follicles are at various stages of development, with some in primordial form and others progressing through the stages of development.
2) Medulla :- The medulla is the inner part of the ovary. It contains blood vessels, lymphatics, and connective tissue that support the ovarian function.
The ovaries play crucial roles in both reproduction and hormone production. Here are the key functions of the ovaries :-
1) Oogenesis :- Oogenesis refers to the process of egg cell development within the ovaries. It begins before birth when the primordial follicles form in the ovaries. Each primordial follicle contains an immature egg called an oocyte. During a woman's reproductive years, a certain number of follicles are recruited each month to begin maturation. Only one follicle typically reaches full maturity and is released during ovulation.
2) Ovulation :- Ovulation is the process by which a mature egg is released from the ovary. It occurs approximately once every menstrual cycle, usually around the middle of the cycle. The ovary releases the mature egg into the fallopian tube, where it can potentially be fertilized by sperm.
3) Hormone Production :- The ovaries produce two main hormones :- estrogen and progesterone. These hormones are responsible for regulating the menstrual cycle and maintaining the female reproductive system. Estrogen promotes the development of secondary sexual characteristics, such as breast development and the widening of the hips. Progesterone helps prepare the uterus for potential pregnancy by thickening the uterine lining.
4) Menopause :- As a woman ages, the function of the ovaries declines, leading to a gradual decrease in hormone production and the cessation of menstrual cycles. This stage is known as menopause and typically occurs between the ages of 45 and 55.
The ovaries are essential female reproductive organs responsible for producing eggs, releasing mature eggs during ovulation, and producing hormones that regulate the menstrual cycle and maintain reproductive health.
So this is all about the female external genitalia. I have not covered the blood supply, nerve supply and lymphatics in this blog. If you want to study that you can refer any of anatomy or obgy books. And if you want separate blog about that you can comment me. If you find any query so please write me in a feedback section. Thank you.
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