Basic Anatomy
Greater Vestibular Glands
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The greater vestibular glands are a pair of small mucus-
ous nerves of the thigh.
branches of the perineal nerves and the posterior cutane
nerves. The posterior parts of the vulva are supplied by the
guinal nerves and the genital branch of the genitofemoral
The anterior parts of the vulva are supplied by the ilioin
Nerve Supply
Medial group of superficial inguinal nodes.
Lymph Drainage
superficial inguinal nodes.
The skin of the vulva is drained into the medial group of
each side.
Branches of the external and internal pudendal arteries on
lar bulb, and the greater vestibular glands.
minora, the clitoris, the vestibule of the vagina, the vestibu
nal genitalia and includes the mons pubis, labia majora and
is the collective name for the female exter
vulva
The term
Vulva
tric plexuses.
The vagina is supplied by nerves from the inferior hypogas
Nerve Supply
Superficial inguinal nodes
Lower third:
Internal iliac nodes
Middle third:
Internal and external iliac nodes
Upper third:
Lymph Drainage
Vaginal veins drain into the internal iliac veins.
Veins
the vaginal branch of the uterine artery supply the vagina.
The vaginal artery, a branch of the internal iliac artery, and
Arteries
Perineal body
Lower third:
Urogenital diaphragm
Middle third:
vical, pubocervical, and sacrocervical ligaments
Levatores ani muscles and transverse cer
Upper third:
Supports of the Vagina
anteriorly and the anal canal posteriorly (see Fig. 8.18).
the lower half lies within the perineum between the urethra
between the bladder anteriorly and the rectum posteriorly;
of the vagina lies above the pelvic floor within the pelvis
which is perforated at its center. The upper half
hymen,
nal orifice in a virgin possesses a thin mucosal fold, called
The cervix of the uterus pierces its anterior wall. The vagi
the uterus (see Fig. 8.4). It measures about 3 in. (8 cm) long.
tube extends upward and backward between the vulva and
the uterus and forms part of the birth canal. This muscular
serves as the excretory duct for the menstrual flow from
The vagina not only is the female genital canal but also
Location and Description
Vagina
glands secrete a lubricating mucus during sexual intercourse.
the posterior part of the labium minus (see Fig. 8.19). These
duct, which opens into the groove between the hymen and
and 8.18). Each drains its secretion into the vestibule by a small
the bulb of the vestibule and the labia majora (see Figs. 8.15
secreting glands that lie under cover of the posterior parts of
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the
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Blood Supply
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Blood Supply
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Vulval Infection
In the region of the vulva, the presence of numerous glands and
ducts opening onto the surface makes this area prone to infec-
tion. The sebaceous glands of the labia majora, the ducts of the
greater vestibular glands, the vagina (with its indirect communi-
cation with the peritoneal cavity), the urethra, and the paraure-
thral glands can all become infected. The vagina itself has no
glands and is lined with stratified squamous epithelium. Provided
that the pH of its interior is kept low, it is capable of resisting
infection to a remarkable degree.
The Vulva and Pregnancy
An important sign in the diagnosis of pregnancy is the appear-
ance of a bluish discoloration of the vulva and vagina as a result
of venous congestion. It appears at the 8th to 12th week and
increases as the pregnancy progresses.
Urethral Infection
The short length of the female urethra predisposes to ascending
infection; consequently, cystitis is more common in females than
in males.
Urethral Injuries
Because of the short length of the urethra, injuries are rare. In
fractures of the pelvis, the urethra may be damaged by shearing
forces as it emerges from the fixed urogenital diaphragm.
Catheterization
Because the female urethra is shorter, wider, and more dilat-
able, catheterization is much easier than in males. Moreover, the
urethra is straight, and only minor resistance is felt as the cath-
eter passes through the urethral sphincter.
C L I N I C A L N O T E S
(continued)