Anatomy And Physiology

The word vagina means sheath and it is a fibromuscular tube between 6 and 10 cm long in a adult female extending from the cervix (outer end) of the uterus (Figure 12.1). The vagina lies obliquely upward and backward behind the bladder and urethra and in front of the rectum and anal canal. The axis of the vagina forms an angle of over 90° with that of the uterus, but this can vary considerably depending on the fullness of the bladder and rectum, and during pregnancy. The cervix of the uterus extends for a short distance into the vagina. It is normally pressed against its posterior wall creating recesses in the vagina at the back, on each side, and at the front of the cervix. These are known as the anterior and posterior fornices located to the front and back of the cervix. The posterior fornix is the largest of the fornices and the lateral fornices found to the sides. The upper part of the posterior wall of the vagina is covered by peritoneum which is folded back onto the rectum to form the rectouterine pouch. The lower part of the posterior vaginal wall is separated from the anal canal by tissue known as the perineal body.

In female mammals the function of the vagina is to receive the male reproductive cells, or sperm, and is part of the birth canal. In humans, it also functions as an excretory canal for the products of menstruation.

The uterus or womb is a hollow, inverted pear-shaped fibro-muscular organ. Its shape and weight varies enormously depending on menstrual cycle and previous pregnancies. In a young female, with no previous pregnancies, the uterus is approximately 8 cm long, 5 cm wide and 2.5 cm thick and weighs approximately 30-40 g but it enlarges to four to five times this size in pregnancy.

The narrower, lower end is called the cervix; this projects into the vagina. The cervix is made of fibrous connective tissue and is of a firmer consistency than the body of the uterus. The two uterine tubes enter the uterus at opposite sides, near its top. The part of the uterus above the entrances of the tubes is called the fundus; that below is termed the body.

Between birth and puberty, the uterus gradually descends into the true pelvis from the abdomen. After puberty, the uterus is located behind the symphysis pubis and bladder and in front of the rectum. The uterus is supported and held in position by the other pelvic


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