Human Anatomy: External & Internal Genital Organs

Study Notes

The vulva is the collective term for the external female genital organs.
The mons pubis is a fatty mound covering the pubic bone, becoming hairy during puberty and containing oil-secreting glands.
The labia majora are fleshy folds enclosing and protecting the vulva, becoming hairy during puberty.
The labia minora lie inside the labia majora and surround the vaginal and urethral openings.
The Bartholin glands secrete lubricating fluids.
The clitoris is a sensitive structure involved in sexual pleasure.

The uterus is a pear-shaped organ responsible for housing a developing fetus.
The corpus (body) of the uterus weighs approximately 70 grams and is twice as long as the cervix during reproductive years.
The corpus comprises the endometrium (functional and basalis layers), myometrium, and serosa.
The cervix is the lower portion of the uterus.
The fallopian tubes are 8 to 14 cm long, connecting the ovaries to the uterus.
Anatomically, fallopian tubes consist of the interstitial portion, isthmus, ampulla, and infundibulum.
The ovaries are approximately 2.5-5 cm long, situated in the upper pelvic cavity resting on the lateral wall.
The ovary contains the cortex and medulla, with the cortex holding oocytes and developing follicles.

The bony pelvis is composed of the sacrum, coccyx, and two innominate bones.
Each innominate bone is formed by the fusion of the ilium, ischium, and pubis.
The innominate bones join the sacrum at the sacroiliac synchondroses and each other at the symphysis pubis.

The pelvis is conceptually divided into the false pelvis (above the linea terminalis) and the true pelvis (below the linea terminalis).
The pelvic inlet is the superior opening of the true pelvis.
The pelvic outlet is the inferior opening of the true pelvis.
The midpelvis (plane of least pelvic dimensions) represents the narrowest part of the true pelvis.
Important pelvic diameters include:
- Anteroposterior: True conjugate, obstetrical conjugate, diagonal conjugate.
- Transverse: Greatest distance between the linea terminalis on either side.
- Two oblique diameters: Extending from one sacroiliac synchondrosis to the contralateral iliopubic eminence.

The symphysis pubis joins the pelvic bones anteriorly and is made of fibrocartilage and supporting ligaments.
The sacroiliac joints connect the pelvic bones posteriorly.
During pregnancy, pelvic joints relax significantly, increasing pelvic outlet diameter by 1.5 to 2 cm.

The McRoberts maneuver utilizes sacroiliac joint mobility to release an obstructed shoulder during a shoulder dystocia delivery.

The Caldwell–Moloy classification identifies four types of female pelvis:
- Gynecoid: True female pelvis, found in approximately 50% of women.
- Android: Funnel-shaped, found in approximately 20% of women.
- Anthropoid: Elongated and narrow, found in approximately 20% of women.
- Platypelloid: Flat and wide, found in approximately 5% of women.

Evidence-based medicine aims to improve care by identifying and promoting effective practices while eliminating ineffective or harmful ones.
Evidence-based medicine promotes critical thinking and demands scientific proof for the effectiveness of interventions, diagnostic tests, and prognostic markers.

Meta-analysis combines results from multiple scientific studies to provide a comprehensive overview.
Advantages of meta-analyses include:
- Systematic and explicit evidence synthesis.
- Quantitative overall estimate and confidence intervals derived from individual studies.
- Early evidence of treatment effectiveness, reducing the need for further studies.
- Examination of specific subgroups.

Obstetrics is often associated with a high risk of litigation.
Common causes of obstetric litigation include:
- Missing structural abnormalities during obstetric ultrasound and failure to inform patients.
- Intrapartum fetal distress.
- Shoulder dystocia.
- Complications of vaginal birth after Caesarean section.