THE FEMALE EXTERNAL GENITALS. 



4 6 3 



catheter it can be recognized by the sense of touch and so localized. The openings of 

 the para-urethral ducts are just below and to the outside of the meatus. The vulvo- 

 vaginal glands (of Bartholin) empty on the inner side of the labia minora in the 

 sulcus between them and the hymen. The openings of the ducts are just visible to 

 the naked eye. The openings are about opposite the middle of the vaginal orifice 



Hymen 

 Fossa navicularis 



Clitoris 



-Labium majus 

 Para-urethral duct 

 Labium minus 

 Vulvovaginal gland 



Fourchctte 

 Posterior commissure 



FIG. 465. External female genitals (vulva). 



and the ducts pass down and out to the glands, which are of the size of a bean and lie 

 on each side of the lower end of the vagina. 



The hymen partly occludes the lower end of the vagina across its posterior 

 portion. The caruncultz hymenales are the remains of the ruptured hymen. *Y}\e fossa 

 navicularis is the space between 

 the hymen and the fourchette. 



Clinical Considerations. 

 The external genitals are well 

 supplied with veins, and in preg- 

 nancy or pelvic growths they may 

 become enlarged and varicose, 

 especially over the labia majora. 

 The fourchette and perineum fre- 

 quently become ruptured in deliv- 

 ery, the tear, if complete, going 

 into the rectum. The meatus is 

 sometimes the seat of a papillo-an- 

 giomatous growth called urethral 

 caruncle. It is treated by removal. 

 The vulvovaginal glands are the 

 seat of cysts and abscesses. They 

 appear as swellings alongside the 

 posterior portion of the vaginal 

 opening. The former are to be carefully and completely excised and the latter opened 

 and packed. The vulvar slit is anteroposterior, the vagina forms a transverse slit 

 and the hymen is placed at the point of transition. In making a vaginal examination 

 (dorsal decubitus) the index finger is to be held vertically until the vestibule is 

 entered. It then is passed horizontally into the vagina and turned palmar surface 



: Cystocele 



Rectocele 



FIG. 466. Hernia of the bladder (cystocele) and of the rectum 

 (rectocele). 



