Podcast
Questions and Answers
What is a typical local sign indicating virginity during examination?
What is a typical local sign indicating virginity during examination?
In a medicolegal examination, which aspect should be assessed if the hymen is found to be lacerated?
In a medicolegal examination, which aspect should be assessed if the hymen is found to be lacerated?
What is the primary concern when examining a hymen for potential recent ruptures?
What is the primary concern when examining a hymen for potential recent ruptures?
Which type of hymen may simulate a ruptured hymen due to its structure?
Which type of hymen may simulate a ruptured hymen due to its structure?
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In which position should the clinical examination of the hymen typically be performed?
In which position should the clinical examination of the hymen typically be performed?
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What is a characteristic of an imperforate hymen?
What is a characteristic of an imperforate hymen?
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Why is good illumination necessary during a hymen examination?
Why is good illumination necessary during a hymen examination?
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Which of the following characteristics describes the annular hymen?
Which of the following characteristics describes the annular hymen?
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Study Notes
Medicolegal Hymen Examination
- Reasons for examination: Female examined for virginity in cases of alleged rape, suspected impotence of husband, or contested marriage validity.
Diagnosis of Virginity
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General signs: Firm, hemispherical breasts with small, rosy areolae.
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Local signs:
- Firm, rounded labia majora completely closing vaginal orifice, remaining closed in lithotomy (lying with legs up).
- Narrow vagina with mucosal rugae (folds).
- Intact posterior commissure and fourchette (fold connecting posterior labia minora).
- Hymen (thin, membranous diaphragm) partially closing vaginal introitus.
Clinical Hymen Examination
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Illumination: Performed in daylight or good lighting.
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Position: Lithotomy position (lying with legs up).
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Procedure: Gentle traction on labia to stretch hymen; if intact, type is defined. If lacerated, evaluate:
- Number of tears (single or multiple).
- Position of tears.
- Age of tears (recent or old).
- Type of rupture (tears, lacerations, remnants).
- Cause of rupture.
Hymen Varieties (and medicolegal implications)
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Semilunar (Crescentic): Most common type; rupture on both sides.
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Annular: Common type; rupture posteriorly (at 6 o'clock position). Can be flexible/elastic (intercourse possible with no rupture). Elastic hymen ruptures only with first vaginal delivery.
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Dentate: Orifice with indentations/folds; may mimic ruptured hymen.
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Fimbriate: Orifice with fimbriae (fringes); may mimic ruptured hymen.
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Cribriform: Multiple small openings (sieve-like); may be a valid intact structure.
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Septate: Opening has septum (dividing into compartments), typically ruptures on first intercourse.
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Imperforate: No opening; closes completely; causes retention of menstrual blood (hematocolpus, hematometrium); may simulate pregnancy, needs surgical correction.
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Description
This quiz covers the key aspects of medico-legal hymen examination, focusing on the reasons for examination, clinical signs of virginity, and the procedure involved in a hymen examination. It is essential for understanding the implications in cases of alleged rape, impotence, and contested marriages.
