Anatomy of female reproductive organs, external genitalia of females

In this article, we will understand in detail about the reproductive organs of women.

Females Reproductive Organs:

The reproductive organs in females are those which are concerned with copulation, fertilization, growth and development of the fetus and its subsequent exit to the outer world. The female reproductive system is made up of the internal and external sex organs that function in the reproduction of new offspring. The female reproductive system includes the ovaries, fallopian tubes (salpinx), vagina, uterus, accessory glands, and external genital organs.

The organs are broadly divided into :

• External genitalia

• Internal genitalia

• Accessory reproductive organs

External Genitalia (Syn: Pudendum, Vulva)

The vulva is the global term that describes all of the structures that make the female external genitalia. The vulva includes all the visible external genital organs in the perineum. Vulva consists of the following: The mons pubis, labia majora, labia minora, clitoris, hymen, vestibule, urethra and Skene’s glands, Bartholin’s glands and vestibular bulbs. It is therefore bounded anteriorly by mons pubis, posteriorly by the rectum, laterally by the genitocrural fold. The vulvar area is covered by keratinised stratified squamous epithelium.

Females External Genitalia

Mons Veneris (Mons Pubis):The mons pubis is a pad of fatty tissue that covers the pubic bone. It’s sometimes referred to as the mons or the mons veneris. It is the pad of subcutaneous adipose connective tissue lying in front of the pubis and in the adult female is covered by hair. The hair pattern (escutcheon) of most women is triangular with the base directed upwards.

Labia Majora: The vulva is bounded on each side by the elevation of skin and subcutaneous tissue which form the labia majora. They are continuous where they join medially to form the posterior commissure in front of the anus. The skin on the outer convex surface is pigmented and covered with hair follicles. The thin skin on the inner surface has sebaceous glands but no hair follicle. The labia majora are covered with squamous epithelium and contain sweat glands. Beneath the skin, there is dense connective tissue and adipose tissue. The adipose tissue is richly supplied with venous plexus which may produce haematoma, if injured during childbirth. The labia majora are homologous to the scrotum in the male. The round ligament terminates at its upper border.

Labia Minora: They are two thin folds of skin, devoid of fat, on either side just within the labia majora. Except in the parous women, they are exposed only when the labia majora are separated. Anteriorly, they divide to enclose the clitoris and unite with each other in front and behind the clitoris to form the prepuce and frenulum respectively. The lower portion of the labia minora fuses across the midline to form a fold of skin known as fourchette. It is usually lacerated during child birth. Between the fourchette and the vaginal orifice is the fossa navicularis. The labia minora contains no hair follicles or sweat glands. The folds contain connective tissues, numerous sebaceous glands, erectile muscle fibers and numerous vessels and nerve endings. The labia minora are homologous to the penile urethra and part of the skin of the male.

Clitoris: The clitoris is located above the vaginal opening.Your clitoris is the pleasure center of your reproductive anatomy. It is the most sensitive feel-good zone of the body. It is a small cylindrical erectile body, measuring about 1.5-2 cm situated in the most anterior part of the vulva. It consists of a glans, a body and two crura. The clitoris consists of two cylindrical corpora cavernosa (erectile tissue). The glans is covered by squamous epithelium and is richly supplied with nerves. The vessels of the clitoris are connected with the vestibular bulb and are liable to be injured during childbirth. Clitoris is homologous to the male’s penis but it differs in being entirely separate from the urethra. It is attached to the under surface of the symphysis pubis by the suspensory ligament.

Vestibule: The area between the labia minora is the vulva vestibule. This is a smooth surface that begins superiorly just below the clitoris and ends inferiorly at the posterior commissure of the labia minora. There are four openings into the vestibule.

(A) Urethral Opening: The opening is situated in the midline just in front of the vaginal orifice about 1-1.5 cm below the pubic arch. The paraurethral ducts open either on the posterior wall of the urethral orifice or directly into the vestibule.

(B) Vaginal Orifice and Hymen: The vaginal orifice lies in the posterior end of the vestibule and is of varying size and shape. In virgins and nulliparae, the opening is closed by the labia minora, but in parous, it may be exposed. It is incompletely closed by a septum of mucous membrane, called hymen. The membrane varies in shape but is usually circular or crescentic in virgins. The hymen is usually ruptured at the consummation of marriage. During childbirth, the hymen is extremely lacerated and is later represented by cicatrised nodules of varying size, called the carunculae myrtiformes. On both sides it is lined by a stratified squamous epithelium.

(C) Opening of Bartholin’s Ducts: The Bartholin’s glands (or greater vestibular glands) are important organs of the female reproductive system. There are two Bartholin glands (greater vestibular gland), one on each side. They are situated in the superficial perineal pouch, close to the posterior end of the vestibular bulb. They are pea-sized and yellowish white in colour. During sexual excitement, it secretes abundant alkaline mucus which helps in lubrication. The glands are of compound racemose variety and are lined by cuboidal epithelium. Each gland has got a duct which measures about 2cm and opens into the vestibule outside the hymen at the junction of the anterior two third and posterior one third in the groove between the hymen and the labium minus. The duct is lined by columnar epithelium but near its opening by stratified squamous epithelium. Bartholin’s glands are homologous to the bulb of the penis in male.

(D) Skene’s glands: Skene’s glands are the largest paraurethral glands. Skene’s glands are homologous to the prostate in the male. The two Skene’s ducts may open in the vestibule on either side of the external urethral meatus.

Vestibular Bulb: These are bilateral elongated masses of erectile tissues situated beneath the mucous membrane of the vestibule. Each bulb lies on either side of the vaginal orifice in front of the Bartholin’s gland and is incorporated with the bulbo-cavernosus muscle. They are homologous to the bulb of the penis and corpus spongiosum in the male. They are likely to be injured during childbirth with brisk haemorrhage.

Blood Supply: Arteries (a) Branches of internal pudendal artery- the chief being labial, transverse perineal, artery to the vestibular bulb and deep and dorsal arteries to the clitoris. (b) Branches of femoral artery-superficial and deep external pudendal.

Veins: The veins form plexuses and drain into: (a) internal pudendal vein (b) vesical or plexus and (c) long saphenous vein. Varicosities during pregnancy are not uncommon and spontaneously causing visible bleeding or haematoma formation. vaginal venous may rupture spontaneously causing visible bleeding or haematoma formation.

(a) Antero-superior part is suppNERVE SUPPLY: The supply is through bilateral spinal somatic nerves lied by the cutaneous branches from the ilio-inguinal and genital branch of genito-femoral nerve (L₁ and L₂) and the posterior-inferior part by the pudendal branches from the posterior cutaneous nerve of thigh Between these two groups, the vulva is supplied by the labial and perineal branches of the pudendal nerve.

Lymphatic: Vulval lymphatics have bilateral drainage. Lymphatics drain into-(a) superficial inguinal nodes (b) intermediate groups of inguinal lymph nodes – gland of Cloquet and (c) external and internal iliac lymph nodes.

Development: External genitalia is developed in the region of the cranial aspect of ectodermal cloacal fossa; clitoris from the genital tubercle; labia minora from the genital folds; labia majora from the labioscrotal swelling and the vestibule from the urogenital sinus.

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By GS India Nursing Academy!!

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