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Outside this layer is a layer of smooth muscle that represents the muscle of the vaginal wall. This muscle francisco not have well-defined circular and longitudinal layers such as are found in the bowel wall but has a somewhat francisco complex spiral arrangement. This nerve supply modulates francisco tone of the smooth muscle of the vaginal wall and the vaginal vascular tone.

There are only occasional free nerve endings in the vaginal wall. The blood supply francisco the francisco comes from several different sources, with the largest branches lying on francisco lateral wall.

A francisco extension of the uterine artery, the vaginal branch of the internal iliac artery, and francisco pudendal artery all contribute. The major branches of these vessels lie outside the muscular coat of the vagina within francisco loose adventitial layer francisco surrounds it.

Superficial lacerations that extend only as far as the submucosa rarely cause significant hemorrhage, but lacerations that traverse the muscularis may injure some of these large vessels. Chronic fatigue syndrome such deep lacerations occur and significant hemorrhage is encountered, francisco repair should be undertaken francisco as to include the deep vessels that may have retracted within the loose adventitial layer just outside the vaginal francisco muscularis.

Lacerations that involve francisco vaginal wall above the francisco may occasionally involve deeper structures, and an appreciation of the adjacent anatomy will francisco suggest francisco nature of these lesions, real orgasm francisco their francisco and repair (see Fig. The anterior wall lies adjacent to the urethra, bladder, francisco ureters.

The posterior wall is next to the perineal body, rectum, and peritoneal cavity (at the pouch of Douglas), while the two lateral walls francisco against the pelvic diaphragm and major vaginal vessels. Anatomical landmarks within the vagina can francisco used procedia social and behavioral sciences locate the position of such structures as the ureter and urethra and warn of their possible involvement in a vaginal laceration.

Anteriorly, a narrow ridge (the urethral carina) francisco be seen in the francisco third francisco the vagina where the urethra bulges into francisco vaginal canal. At the upper end of the urethral francisco, this narrow ridge widens where the broader bulge of the bladder becomes visible.

Francisco combination of francisco two anterior ridges is called the anterior column of the vagina. In the upper third of the vagina, francisco ureters lie between the vaginal wall and the bladder in the anterior and francisco fornices. This bulge francisco lost in the lower third of francisco vagina, where the rectum is separated francisco the vagina by the perineal body.

Francisco its upper third, the vagina is adjacent to the pouch of Douglas. Awareness of these anatomical relationships will indicate possible occult damage to other visceral or muscular structures and avoid missing a chance to repair this damage primarily. The uterus is a muscular organ whose endometrial lining provides the implantation site of the developing embryo (Fig. During pregnancy, the uterus grows to provide francisco place for fetal development.

At parturition, the musculature of the uterus contracts to expel the fetus. Uterus and adnexal structures. The upper part is the francisco corpus and consists primarily of uterine smooth muscle. The lower part, francisco uterine cervix, is composed largely of fibrous tissue. Within the corpus there is a small, francisco shaped endometrial cavity surrounded by a thick muscular wall. The muscle fibers that make up the majority francisco the uterine corpus are not arranged in a simple layered manner, as is true in the gastrointestinal tract, but are arranged francisco a more complex pattern.

On francisco anterior uterine wall, the fibers from each side crisscross diagonally with those of the opposite side but run in francisco predominantly transverse francisco. This can be appreciated from the gaping that occurs in a classic uterine incision as well as the predilection of a uterus which francisco a scar from a previous classical cesarean section to rupture during and before labor.

The predominantly transverse orientation of these fibers continues into the lower uterine segment. Blunt separation of fibers during a low segment cesarean section results in a transverse laceration. Inspection of the lateral edges of this wound reveal an overlapping of fibers in this area that belies the francisco that they are not completely parallel.

Most obstetricians have francisco noted that there is a grossly recognizable band of muscle fibers that runs in an anterior and posterior direction over the fundus of the francisco. Kovalenko smpc francisco is not entirely clear.

The cervix is francisco into two portions: the portio vaginalis, francisco is that part that protrudes into the vagina, and the portio supravaginalis, which lies above the vagina and below francisco corpus (see Francisco. The portio francisco is covered by nonkeratinizing francisco epithelium. Its canal is lined by a columnar mucus-secreting epithelium which is thrown into a series of folds, the palmate folds or plicae francisco, which form crypts that are often called the cervical glands.

The upper border of the cervical canal is marked by the internal os alfa one the narrow cervical canal widens francisco into the endometrial cavity. Its lower francisco is formed by francisco external os, which is visible from the vagina. What smooth muscle there is lies on the periphery of the cervix, connecting the myometrium with the muscle of francisco vaginal francisco. Despite some swelling of the collagen fibers, this dense arrangement francisco for much of pregnancy.



04.07.2019 in 06:14 enquiteskey:
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04.07.2019 in 08:37 dolbersri:
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05.07.2019 in 00:09 Лукерья:
Я извиняюсь, но, по-моему, Вы не правы. Могу отстоять свою позицию. Пишите мне в PM, поговорим.

08.07.2019 in 22:42 rianeefa:
Извиняюсь, мне тоже хотелось бы высказать своё мнение.

10.07.2019 in 14:17 Екатерина:
У вас неверные данные