Genital Examination Findings
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Reference Sheet 1
MALE SEXUAL SYSTEM 8 7 8 OJ 7 .£l"00\.....• ;:; ::>0\~ <Il '"~IQ)I"->. ~cru::>s ~ 6 5 bladder penis prostate gland 4 scrotum seminal vesicle testicle urethra vas deferens FEMALE SEXUAL SYSTEM 2 1 8 " \ 5 ... - ... j 4 labia \ ""\ bladderFallopian"k. "'"f"";".'''¥'&.tube\'WIT / I cervixt r r' \ \ clitorisurethrauterus 7 \ ~~ ;~f4f~ ~:iJ 3 ovaryvagina / ~ 2 / \ \\"- 9 6 adapted from F.L.A.S.H. Reproductive System Reference Sheet 3: GLOSSARY Anus – The opening in the buttocks from which bowel movements come when a person goes to the bathroom. It is part of the digestive system; it gets rid of body wastes. Buttocks – The medical word for a person’s “bottom” or “rear end.” Cervix – The opening of the uterus into the vagina. Circumcision – An operation to remove the foreskin from the penis. Cowper’s Glands – Glands on either side of the urethra that make a discharge which lines the urethra when a man gets an erection, making it less acid-like to protect the sperm. Clitoris – The part of the female genitals that’s full of nerves and becomes erect. It has a glans and a shaft like the penis, but only its glans is on the out side of the body, and it’s much smaller. Discharge – Liquid. Urine and semen are kinds of discharge, but the word is usually used to describe either the normal wetness of the vagina or the abnormal wetness that may come from an infection in the penis or vagina. Duct – Tube, the fallopian tubes may be called oviducts, because they are the path for an ovum. -
Chapter 28 *Lecture Powepoint
Chapter 28 *Lecture PowePoint The Female Reproductive System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • The female reproductive system is more complex than the male system because it serves more purposes – Produces and delivers gametes – Provides nutrition and safe harbor for fetal development – Gives birth – Nourishes infant • Female system is more cyclic, and the hormones are secreted in a more complex sequence than the relatively steady secretion in the male 28-2 Sexual Differentiation • The two sexes indistinguishable for first 8 to 10 weeks of development • Female reproductive tract develops from the paramesonephric ducts – Not because of the positive action of any hormone – Because of the absence of testosterone and müllerian-inhibiting factor (MIF) 28-3 Reproductive Anatomy • Expected Learning Outcomes – Describe the structure of the ovary – Trace the female reproductive tract and describe the gross anatomy and histology of each organ – Identify the ligaments that support the female reproductive organs – Describe the blood supply to the female reproductive tract – Identify the external genitalia of the female – Describe the structure of the nonlactating breast 28-4 Sexual Differentiation • Without testosterone: – Causes mesonephric ducts to degenerate – Genital tubercle becomes the glans clitoris – Urogenital folds become the labia minora – Labioscrotal folds -
Peripartum Pubic Symphysis Diastasis—Practical Guidelines
Journal of Clinical Medicine Review Peripartum Pubic Symphysis Diastasis—Practical Guidelines Artur Stolarczyk , Piotr St˛epi´nski* , Łukasz Sasinowski, Tomasz Czarnocki, Michał D˛ebi´nski and Bartosz Maci ˛ag Department of Orthopedics and Rehabilitation, Medical University of Warsaw, 02-091 Warsaw, Poland; [email protected] (A.S.); [email protected] (Ł.S.); [email protected] (T.C.); [email protected] (M.D.); [email protected] (B.M.) * Correspondence: [email protected] Abstract: Optimal development of a fetus is made possible due to a lot of adaptive changes in the woman’s body. Some of the most important modifications occur in the musculoskeletal system. At the time of childbirth, natural widening of the pubic symphysis and the sacroiliac joints occur. Those changes are often reversible after childbirth. Peripartum pubic symphysis separation is a relatively rare disease and there is no homogeneous approach to treatment. The paper presents the current standards of diagnosis and treatment of pubic diastasis based on orthopedic and gynecological indications. Keywords: pubic symphysis separation; pubic symphysis diastasis; pubic symphysis; pregnancy; PSD 1. Introduction The proper development of a fetus is made possible due to numerous adaptive Citation: Stolarczyk, A.; St˛epi´nski,P.; changes in women’s bodies, including such complicated systems as: endocrine, nervous Sasinowski, Ł.; Czarnocki, T.; and musculoskeletal. With regard to the latter, those changes can be observed particularly D˛ebi´nski,M.; Maci ˛ag,B. Peripartum Pubic Symphysis Diastasis—Practical in osteoarticular and musculo-ligamento-fascial structures. Almost all of those changes Guidelines. J. Clin. Med. -
Pelvic Anatomyanatomy
PelvicPelvic AnatomyAnatomy RobertRobert E.E. Gutman,Gutman, MDMD ObjectivesObjectives UnderstandUnderstand pelvicpelvic anatomyanatomy Organs and structures of the female pelvis Vascular Supply Neurologic supply Pelvic and retroperitoneal contents and spaces Bony structures Connective tissue (fascia, ligaments) Pelvic floor and abdominal musculature DescribeDescribe functionalfunctional anatomyanatomy andand relevantrelevant pathophysiologypathophysiology Pelvic support Urinary continence Fecal continence AbdominalAbdominal WallWall RectusRectus FasciaFascia LayersLayers WhatWhat areare thethe layerslayers ofof thethe rectusrectus fasciafascia AboveAbove thethe arcuatearcuate line?line? BelowBelow thethe arcuatearcuate line?line? MedianMedial umbilicalumbilical fold Lateralligaments umbilical & folds folds BonyBony AnatomyAnatomy andand LigamentsLigaments BonyBony PelvisPelvis TheThe bonybony pelvispelvis isis comprisedcomprised ofof 22 innominateinnominate bones,bones, thethe sacrum,sacrum, andand thethe coccyx.coccyx. WhatWhat 33 piecespieces fusefuse toto makemake thethe InnominateInnominate bone?bone? PubisPubis IschiumIschium IliumIlium ClinicalClinical PelvimetryPelvimetry WhichWhich measurementsmeasurements thatthat cancan bebe mademade onon exam?exam? InletInlet DiagonalDiagonal ConjugateConjugate MidplaneMidplane InterspinousInterspinous diameterdiameter OutletOutlet TransverseTransverse diameterdiameter ((intertuberousintertuberous)) andand APAP diameterdiameter ((symphysissymphysis toto coccyx)coccyx) -
The Cyclist's Vulva
The Cyclist’s Vulva Dr. Chimsom T. Oleka, MD FACOG Board Certified OBGYN Fellowship Trained Pediatric and Adolescent Gynecologist National Medical Network –USOPC Houston, TX DEPARTMENT NAME DISCLOSURES None [email protected] DEPARTMENT NAME PRONOUNS The use of “female” and “woman” in this talk, as well as in the highlighted studies refer to cis gender females with vulvas DEPARTMENT NAME GOALS To highlight an issue To discuss why this issue matters To inspire future research and exploration To normalize the conversation DEPARTMENT NAME The consensus is that when you first start cycling on your good‐as‐new, unbruised foof, it is going to hurt. After a “breaking‐in” period, the pain‐to‐numbness ratio becomes favourable. As long as you protect against infection, wear padded shorts with a generous layer of chamois cream, no underwear and make regular offerings to the ingrown hair goddess, things are manageable. This is wrong. Hannah Dines British T2 trike rider who competed at the 2016 Summer Paralympics DEPARTMENT NAME MY INTRODUCTION TO CYCLING Childhood Adolescence Adult Life DEPARTMENT NAME THE CYCLIST’S VULVA The Issue Vulva Anatomy Vulva Trauma Prevention DEPARTMENT NAME CYCLING HAS POSITIVE BENEFITS Popular Means of Exercise Has gained popularity among Ideal nonimpact women in the past aerobic exercise decade Increases Lowers all cause cardiorespiratory mortality risks fitness DEPARTMENT NAME Hermans TJN, Wijn RPWF, Winkens B, et al. Urogenital and Sexual complaints in female club cyclists‐a cross‐sectional study. J Sex Med 2016 CYCLING ALSO PREDISPOSES TO VULVAR TRAUMA • Significant decreases in pudendal nerve sensory function in women cyclists • Similar to men, women cyclists suffer from compression injuries that compromise normal function of the main neurovascular bundle of the vulva • Buller et al. -
Female Perineum Doctors Notes Notes/Extra Explanation Please View Our Editing File Before Studying This Lecture to Check for Any Changes
Color Code Important Female Perineum Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. Objectives At the end of the lecture, the student should be able to describe the: ✓ Boundaries of the perineum. ✓ Division of perineum into two triangles. ✓ Boundaries & Contents of anal & urogenital triangles. ✓ Lower part of Anal canal. ✓ Boundaries & contents of Ischiorectal fossa. ✓ Innervation, Blood supply and lymphatic drainage of perineum. Lecture Outline ‰ Introduction: • The trunk is divided into 4 main cavities: thoracic, abdominal, pelvic, and perineal. (see image 1) • The pelvis has an inlet and an outlet. (see image 2) The lowest part of the pelvic outlet is the perineum. • The perineum is separated from the pelvic cavity superiorly by the pelvic floor. • The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue. (see image 3) We will talk about them more in the next lecture. Image (1) Image (2) Image (3) Note: this image is seen from ABOVE Perineum (In this lecture the boundaries and relations are important) o Perineum is the region of the body below the pelvic diaphragm (The outlet of the pelvis) o It is a diamond shaped area between the thighs. Boundaries: (these are the external or surface boundaries) Anteriorly Laterally Posteriorly Medial surfaces of Intergluteal folds Mons pubis the thighs or cleft Contents: 1. Lower ends of urethra, vagina & anal canal 2. External genitalia 3. Perineal body & Anococcygeal body Extra (we will now talk about these in the next slides) Perineum Extra explanation: The perineal body is an irregular Perineal body fibromuscular mass. -
Applied Anatomy of the Hip RICARDO A
Applied Anatomy of the Hip RICARDO A. FERNANDEZ, MHS, PT, OCS, CSCS • Northwestern University The hip joint is more than just a ball-and- bones fuse in adults to form the easily recog- socket joint. It supports the weight of the nized “hip” bone. The pelvis, meaning bowl head, arms, and trunk, and it is the primary in Latin, is composed of three structures: the joint that distributes the forces between the innominates, the sacrum, and the coccyx pelvis and lower extremities.1 This joint is (Figure 1). formed from the articu- The ilium has a large flare, or iliac crest, Key PointsPoints lation of the proximal superiorly, with the easily palpable anterior femur with the innomi- superior iliac spine (ASIS) anterior with the The hip joint is structurally composed of nate at the acetabulum. anterior inferior iliac spine (AIIS) just inferior strong ligamentous and capsular compo- The joint is considered to it. Posteriorly, the crest of the ilium ends nents. important because it to form the posterior superior iliac spine can affect the spine and (PSIS). With respect to surface anatomy, Postural alignment of the bones and joints pelvis proximally and the PSIS is often marked as a dimple in the of the hip plays a role in determining the femur and patella skin. Clinicians attempting to identify pelvic functional gait patterns and forces associ- distally. The biomechan- or hip subluxations, leg-length discrepancies, ated with various supporting structures. ics of this joint are often or postural faults during examinations use There is a relationship between the hip misunderstood, and the these landmarks. -
Preparation for Your Sex Life
1 Preparation for Your Sex Life Will every woman bleed during her first sexual intercourse? • Absolutely not. Not every woman has obvious bleeding after her first sexual intercourse. • Bleeding is due to hymen breaking during penetration of the penis into the vagina. We usually refer it as "spotting". It is normal and generally resolves. • Some girls may not have hymen at birth, or the hymen may have been broken already when engaging in vigorous sports. Therefore, there may be no bleeding. Is it true that all women will experience intolerable pain during their first sexual intercourse? • It varies among individuals. Only a small proportion of women report intolerable pain during their first sexual intercourse. The remaining report mild pain, tolerable pain or painless feeling. • Applying lubricants to genitals may relieve the discomfort associated with sexual intercourse; however, if you experience intolerable pain or have heavy or persistent bleeding during or after sexual intercourse, please seek medical advice promptly. How to avoid having menses during honeymoon? • To prepare in advance, taking hormonal pills like oral contraceptive pills or progestogens under doctor's guidance can control menstrual cycle and thereby avoid having menses during honeymoon. Is it true that women will get Honeymoon Cystitis easily during honeymoon? • During sexual intercourse, bacteria around perineum and anus may move upward to the bladder causing cystitis. Symptoms include frequent urination, difficulty and pain when urinating. • There may be more frequent sexual activity during honeymoon period, and so is the chance of having cystitis. The condition is therefore known as "honeymoon cystitis". • Preventive measures include perineal hygiene, drinking plenty of water, empty your bladder after sexual intercourse and avoid the habit of withholding urine. -
Role of Greater Sciatic Notch in Sexing Human Hip Bones
International Journal of Recent Trends in Science And Technology, ISSN 2277-2812 E-ISSN 2249-8109, Volume 7, Issue 3, 2013 pp 119-123 Role of Greater Sciatic Notch in Sexing Human Hip Bones Rajashree Sheelawant Raut 1*, Prakash B. Hosmani 2, P. R. Kulkarni 3 1Assistant Professor, Department of Anatomy, B. J. Government Medical College, Pune, Maharashtra, INDIA. 2Associate Professor, Department of Anatomy, Dr. V. M. Government Medical College, Solapur, Maharashtra, INDIA. 3 Professor and Head, Department of Anatomy, Government Medical College, Latur, Maharashtra, INDIA. *Corresponding Address: [email protected] Research Article Abstract: Identification of the deceased person from bones is the in archaeological collections that they cannot be used for most critical problem faced by anatomist, forensic science experts sex determination. When pubic material is not preserved, & anthropologists. Skeletal remains have been used for sexing the sex determinations must be made using other less individual as bones of the body are last to perish after death. Hip bone, especially t he greater sciatic notch is valuable in deformed diagnostic features. The greater sciatic notch is especially bones because it is highly sexually dimorphic, is resistant to valuable in such situations because it is highly sexually damage, and thus can often be scored in poorly preserved dimorphic, is resistant to damage, and thus can often be skeletons. In present study one hundred and eighty three adult hip scored in poorly preserved skeletons[3]. Many attempts bones of known sex (125 male and 58 female) are studied for have been made to describe sex differences in the sciatic various parameters of greater sciatic notch. -
MR Imaging of Vaginal Morphology, Paravaginal Attachments and Ligaments
MR imaging of vaginal morph:ingynious 05/06/15 10:09 Pagina 53 Original article MR imaging of vaginal morphology, paravaginal attachments and ligaments. Normal features VITTORIO PILONI Iniziativa Medica, Diagnostic Imaging Centre, Monselice (Padova), Italy Abstract: Aim: To define the MR appearance of the intact vaginal and paravaginal anatomy. Method: the pelvic MR examinations achieved with external coil of 25 nulliparous women (group A), mean age 31.3 range 28-35 years without pelvic floor dysfunctions, were compared with those of 8 women who had cesarean delivery (group B), mean age 34.1 range 31-40 years, for evidence of (a) vaginal morphology, length and axis inclination; (b) perineal body’s position with respect to the hymen plane; and (c) visibility of paravaginal attachments and lig- aments. Results: in both groups, axial MR images showed that the upper vagina had an horizontal, linear shape in over 91%; the middle vagi- na an H-shape or W-shape in 74% and 26%, respectively; and the lower vagina a U-shape in 82% of cases. Vaginal length, axis inclination and distance of perineal body to the hymen were not significantly different between the two groups (mean ± SD 77.3 ± 3.2 mm vs 74.3 ± 5.2 mm; 70.1 ± 4.8 degrees vs 74.04 ± 1.6 degrees; and +3.2 ± 2.4 mm vs + 2.4 ± 1.8 mm, in group A and B, respectively, P > 0.05). Overall, the lower third vaginal morphology was the less easily identifiable structure (visibility score, 2); the uterosacral ligaments and the parau- rethral ligaments were the most frequently depicted attachments (visibility score, 3 and 4, respectively); the distance of the perineal body to the hymen was the most consistent reference landmark (mean +3 mm, range -2 to + 5 mm, visibility score 4). -
Understanding Cancer of the Vulva
Understanding Cancer of the Vulva An information sheet for women with cancer, their families and friends. This information has been prepared to help you If something goes wrong with the genes that understand more about cancer of the vulva control a cell, that cell may start behaving (vulvar cancer). It is an introduction to the strangely. Instead of growing normally, it may diagnosis, treatment and effects of this cancer. grow and divide in an uncontrolled way, forming a mass of cells. The mass of cells looks We cannot advise you about the best treatment and feels like a lump, and is called a tumour. for you. You need to discuss this with your doctors. However, we hope this information A tumour can be benign (not cancer) or it can will answer some of your questions and help be malignant (cancer). The difference is that you think about the questions you want to ask benign tumours do not spread to other parts of your doctors. the body, while malignant tumours can. For more detailed information on cancer of the A malignant tumour is made up of cancer cells. vulva, you may wish to contact the Cancer When it first develops, the tumour stays in one Council Helpline on 13 11 20 or refer to the place. This is called the primary tumour. list of recommended websites under the heading Information on the Internet on the If the cancer cells that make up the primary back page of this booklet. tumour are not treated, they may start to spread to other areas of the body and form new tumours. -
Evaluation of Abnormal Uterine Bleeding
Evaluation of Abnormal Uterine Bleeding Christine M. Corbin, MD Northwest Gynecology Associates, LLC April 26, 2011 Outline l Review of normal menstrual cycle physiology l Review of normal uterine anatomy l Pathophysiology l Evaluation/Work-up l Treatment Options - Tried and true-not so new - Technology era options Menstrual cycle l Menstruation l Proliferative phase -- Follicular phase l Ovulation l Secretory phase -- Luteal phase l Menstruation....again! Menstruation l Eumenorrhea- normal, predictable menstruation - Typically 2-7 days in length - Approximately 35 ml (range 10-80 ml WNL - Gradually increasing estrogen in early follicular phase slows flow - Remember...first day of bleeding = first day of “cycle” Proliferative Phase/Follicular Phase l Gradual increase of estrogen from developing follicle l Uterine lining “proliferates” in response l Increasing levels of FSH from anterior pituitary l Follicles stimulated and compete for dominance l “Dominant follicle” reaches maturity l Estradiol increased due to follicle formation l Estradiol initially suppresses production of LH Proliferative Phase/Follicular Phase l Length of follicular phase varies from woman to woman l Often shorter in perimenopausal women which leads to shorter intervals between periods l Increasing estrogen causes alteration in cervical mucus l Mature follicle is approximately 2 cm on ultrasound measurement just prior to ovulation Ovulation l Increasing estradiol surpasses threshold and stimulates release of LH from anterior pituitary l Two different receptors for