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ply of the bulb is derived, on each side, from the arteria bulbi vestibuli, ternal pudendal.
GLANDULA VESTIBULARES MAJORES. vestibular glands (O.T. glands of Bartholin) are placed one on ower part of the vagina, and represent the bulbo-urethral glands in
TRIANGULAR (FASCIA INFERIOR OF
LIGT UROGENITAL DIAPHRAGM)
Larger vestibular glands
Central point of perineum -DISSECTION OF FEMALE PERINEUM TO SHOW THE CLITORIS, THE BULB OF THE VESTIBULE,
AND THE LARGER VESTIBULAR GLANDS (D. J. Cunningham).
They are often overlapped by the posterior ends of the bulbus vestibuli, covered by the bulbo-cavernosus muscle. Each is about the size and f a small bean, and possesses a long slender duct which opens into the dendi in the angle between the attached border of the labium minus and the - opening
DEVELOPMENT OF THE URO-GENITAL ORGANS.
THE URO-GENITAL PASSAGES.
General Account. --- In tracing the developmental history of the uro-genital ages we may for convenience begin with an embryo of fifteen days old. About this e a duct, which runs in a longitudinal direction, and occupies a position on the lateral of the protovertebral somites, begins to develop on each side of the body. With the eption of the anterior portion of the cloaca and the proximal part of the allantois, this ict, which has received the name of primary excretory or Wolffian duct, is the earliest rmed structure from which, or in connexion with which, the parts of the adult Tino-genital system arise.
The Wolffian duct serves as the canal, or duct, for the primitive secretory organshe pronephros and the mesonephros of the embryo. With the atrophy of these the duct suffers modification, yet both sexes in the adult possess structures which have their embryonic origin from the Wolffian duct. In the male the duct of the epididymis, the ductus deferens, and the ejaculatory duct, are to be looked upon as directly developed from the Wolffian duct of the embryo; while in the female the longitudinal duct of the ep-oöphoron and the appendices vesiculosi are rudimentary structures having a like origin. Further, the ureter and its pelvis arise in both sexes as an outgrowth from the Wolffian duct (Fig. 1037). In the male the vesicula seminalis is developed as a diverticulum of the Wolffian duct.
The primitive secretory organs, the pronephros and the mesonephros, develop in connexion with the anterior part of the Wolffian duct (p. 48), and, during the early life of the embryo, the latter of these is a most important structure. Even in the embryo
er. Near its termination the vagina pierces the fascia inferior of the uroiaphragm, and is related on each side to the bulbus vestibuli, the larger · glands, and the bulbo-cavernosus (sphincter vagine) muscle. ture of the Vagina.—The vaginal wall has a distinct tunica muscularis, of unstriped muscle fibres, most of which are longitudinally disposed. Towards
Spina iliaca superior posterior
Apex of os sacrum
Incisura ischiadica major
External sphincter ani
attached to them, have been removed. The levatores ani have been separated along the median raphe,
the lower end of the passage circularly disposed bundles of striped muscle fibres, some of which are continuous with those forming a part of the urethral wall, are found in the muscular coat. The thick tunica mucosa, which has a stratified scaly epithelium, is
corrugated, and presents a number of transverse ridges or elevations called rugæ vaginales. by In addition to these transverse rugæ, a slightly marked longitudinal ridge, or column, is
to be seen on the anterior and on the posterior wall of the vagina. These receive the name columnæ rugarum, and, like the transverse rugæ, are best seen in young subjects and in the lower part of the vagina. The urethral canal lies in close relationship to the anterior column of the vagina in its lower part, and hence this portion of the anterior column is sometimes called the carina urethralis.
Within the tunica mucosa are to be found small collections, or nodules, of lymaps tissue.
The vaginal wall is surrounded by a layer of loose vascular connective tissue containing numerous large communicating veins.
Vessels and Nerves of the Vagina. — The blood-supply of the vagina is for the most far derived from the vaginal artery, the vaginal branch of the uterine artery, the vaginal branco of the middle hæmorrhoidal artery, and from the branches of the internal pudendal. The veins form a plexus surro
rrounding the vaginal wall, and drain their blood into the tributaries of it hypogastric.
The lymph-vessels from the upper part of the vagina join the hypogastric group of glands while those from the lower part end in the superficial inguinal glands.
The nerves of the vagina are derived from the plexus uterovaginalis and from the plexus vesicalis. Other fibres are derived directly from the third and fourth sacral nerves.
THE FEMALE EXTERNAL GENITAL ORGANS.
(PUDENDUM MULIEBRE.) The term pudendum muliebre, or vulva, is applied collectively to the female external genital organs, i.e. to the labia majora and the structures which lie between them.
Labia Majora.-The labia majora represent the scrotum in the male, and form the largest part of the female external genital organs. They form the boundaries. on each side, of the rima pudendi or uro-genital cleft, into which the urethra and vagina open. Each labium is a prominent rounded fold of skin, narrow behind where it approaches the anus, but increasing in size as it passes forwards aud upwards to end in a median elevation, the commissura labiorum anterior, or the mons pubis or Veneris. The mons Veneris lies over the symphysis pubis, and, like the labia majora, it is composed chiefly of fatty and areolar tissue, and is covered with hair. The lateral convex surface of each labium majus is covered by skin containing numerous sebaceous glands and resembling that of the scrotum in the male. but the medial, flatter surface is smooth, and presents a more delicate integumentary covering. In some cases the posterior narrow ends of the labia majora are connected across the middle line, in front of the anus, by a slight transverse foldthe commissura labiorum posterior or posterior commissure.
Usually, especially in young adult subjects, the labia majora are the only visible parts of the external genital organs, since they are in contact with one another, and completely enclose the structures within the rima pudendi.
The round ligament of the uterus ends in the fatty tissue of the labium majus The superficial subcutaneous tissue resembles that of the scrotum, but contains no muscular fibres.
The nerve-supply corresponds with that of the scrotum, the anterior part of each labium being supplied by the branches of the ilio-inguinal nerve, and the posterior part by branches from the internal pudendal and by the perineal branch from the posterior cutaneous nerve of the thigh The blood-vessels of the labia majora are derived from the external pudendal arteries and fror the perineal branches of the internal pudendal vessels.
Labia Minora.– The labia minora pudendi (O.T. nymphæ) are a pair of much smaller and narrower longitudinal folds, usually completely enclosed within the cleft between the labia majora. Diminishing in size, and becoming less marked in their posterior parts, the labia minora end by gradually joining the medial surfaces of the labia majora. In the young subject, 'a slightly raised transverse fold is usually seen connecting the posterior ends of the labia minora; to this fold the term frenulum labiorum pudendi (O.T. fourchette) is applied. Traced forwards, each labium minus divides into two portions, a lateral and a wedial The lateral portions of the two labia unite over the glans clitoridis, and form for it a fold or coveriny called the præputium clitoridis. The medial portions, uniting at an acute angle, join the glans and form the frenulum clitoridis. The skin of the labia minora resembles the integument on the medial or deep surface of the labia majora, being smooth, moist, and pink in colour. The medial surfaces of the labia minora are in contact with one another; their lateral surfaces are applied against the medial aspects of the labia majora.
the urethra and vagina are placed in the median plane, in the e labia minora, which must be separated to bring them into
ginæ.-The vestibule is the name applied to the cleft that lies minora and behind the glans clitoridis. In its floor are the thra, the vagina, and the minute ducts of the larger vestibular
Fig. 1035.-FEMALE EXTERNAL GENITAL ORGANS. The frenulum labioruin is seen stretching across behind the fossa navicularis and in m front of the posterior commissure. The ducts of the larger vestibular glands open al
in the intervals between the vaginal orifice and the medial edges of the labia
the orifice of the urethra. The appearance of the opening condition of the hymen-a membrane which in the young subject aperture. When the hymen is intact the opening is small, and en the membrane is put on the stretch. When the hymen has the opening is much larger, and round its margins are often seen scarunculæ hymenales—which are to be looked upon as persistent e hymen. is a thin membranous fold, partially closing the lower end of the nally perforated somewhat in front of its middle point. The posiening gives the fold, when stretched, a crescentic appearance. The hymen is sometimes cleanly cut, sometimes fringed. The membrane ed tightly across the lower end of the vagina, but is so ample 8 downwards into the rima pudendi, and the parts of its upper
contact with one another on each side of the opening. The is a median slit whose margins are normally in contact. The upper