Vaginal anatomy and functions

1. THE VAGINA
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Stree Roga Anatomy (2)
DR. RAM VEER SHARMA
M.D. Ayu.(PT&SR)
PROF.& H.O.D.
Prasuti Tantra & Stree Roga Dep't.
M.M.M .Govt. Ayu. College UDAIPUR
Mob. 9414757932
Email. ramveersharma1960@gmail.com
Dr. Ram Veer Sharma

2. The Vagina
 The vagina is an - Fibro muscular, membranous, canal
sheath.
 Extending from the vaginal cervix above to the vulva below.
Stree Roga Anatomy (2)
Site:- It is lies between -
 In the Front Bladder and urethra &
 In the Behind Rectum and anal canal.
 It forms the lowest segment of the internal genital tract.
Dr. Ram Veer Sharma

3. The Vagina
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

4.  Relations
Anterior -
 Upper 1/3 – related to base of bladder
 Lower 2/3– are with urethra
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Posterior -
Upper 1/3 related with the pauch of Dauglas
Middle 1/3 related with anterior rectal wall
Lower 1/3 is separated from the anal canal by perineal body.
Dr. Ram Veer Sharma

5. Lateral wall -
 Upper 1/3 Is related with , the pelvic cellular tissues at base
of broad ligament in which , the Ureter and uterine arteries lies.
 Middle 1/3 Is related with lavator ani muscle.
 Lower 1/3 Is related with the bulbo - cavernosus muscles,
Stree Roga Anatomy (2)
 Lower 1/3 Is related with the bulbo - cavernosus muscles,
• Vestibular bulb
• And Bartholin’s glands.
Dr. Ram Veer Sharma

6. Stree Roga Anatomy (2)
Female Genital Organs
Dr. Ram Veer Sharma

7. Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

8. Structure:- It consist of Four layers (Coat) .
i) Fibrous layer -
 It is the outer most, derived from endopelvic fascia which is
rich in venous plexus, lymphatic's , and nerves.
ii) Muscular layer- Consist of 2 layer.
Stree Roga Anatomy (2)
ii) Muscular layer- Consist of 2 layer.
a. Outer - Longitudinal arrangement of fibers, and
b. Inner - Circular arrangement of fibers.
iii) Sub mucous layer:-
• Containing loose areolar ,elastic tissue, and plexus of vessels.
Dr. Ram Veer Sharma

9. iv) Mucous Layer:- It is
 Stratified squamous , Non-keratinized epithelium, with out
glands.
Depth - The mucosa is some 10 - 30 cell deep, and becomes with
identical epithelium covering the vaginal portion of cervix.
Stree Roga Anatomy (2)
• The layer undergoes changes depending on ovarian hormone.
Dr. Ram Veer Sharma

10. • Mucous layer consist of three layers,
(a) Deep basal layer- resting on basement membrane.
• Cells shape - are round or oval ,
• Nuclei - Large basicular
• Cytoplasm - Thick cytoplasm.
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

11. (b) Deepest Layer - Is single layer , lying on the basement
membrane - is the germinal cell layer which does not
exfoliated.
 Three to four layer cells superficial to this layer are called
parabasal cells.
Stree Roga Anatomy (2)
 Cells of the basal layer proliferate to give rise to more
superficial, mature cells which show degeneration in the
superficial layer.
Dr. Ram Veer Sharma

12. .
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

13. c)Intermediate layer -
 Cell are longer,
 Cytoplasm - Plate like cytoplasm.
 Nuclei - Round and oval vascular nuclei.
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

14. d) Superficial layer:- Has two types of cells.
i. Pre cornified cells:- Cells are - larger than middle layer,
Nuclei - Small, and vascular
Cytoplasm - Plenty, basophilic.
ii. Cornified cells:- Cells are - Large and flat cells,
Stree Roga Anatomy (2)
• Nuclei - Small, cork pylinatic uniform size.
Cytoplasm - Abundant, acidophilic
 Cells are degenerate but represent the maximum Oestrogenic
activities. The full development of epithelium occurs as a result
of unopposed oestrogenic activities.
Dr. Ram Veer Sharma

15. Stree Roga Anatomy (2)
Cell shape of Epithelium
Dr. Ram Veer Sharma

16. Stree Roga Anatomy (2)
Position:-
 The canal is directed upwards and backwards,
 Forming an angle of 45º with the
 Horizontal in erect posture.
Dr. Ram Veer Sharma
The long axis off the vagina almost lies parallel to the
plane of the pelvic and at slight angle to that of the
uterus.

17. Measurements:-
 The diameters of the canal is about 2.5", being widest in upper
part and narrowest at its introitus.
 It has got enough power of distensability.
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

18. Walls :- 4.
a. Anterior - 7cm.
b. Posterior -10 cm. Opposed each other-
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• Gives a H shape in longitudinal section..
• Lateral walls are comparatively stiffer, specially at its middle ,
as such it look H shape in transverse section.
Dr. Ram Veer Sharma

19. Fornices:- 4
1- Anterior most shallow
1- Posterior is deeper
2 - Lateral
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 The cleft forms at the top of vagina due to the projection of the
uterine cervix through the vaginal wall.
Dr. Ram Veer Sharma

20. Secretions -
 During reproductive life secretion occurs - From vaginal
epithelial lining - mixed with cervical, uterine, and tubal
secretion.
 Appearance - Watery, Transudent & Semi Fluid.
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 Colour - Whitish or Yellowish.
 Reaction - Acidic– Ph. 4-4.5
Dr. Ram Veer Sharma

21. Secretions -
 Amount:- The amount should not be as much as to bath the
vulva, causing irritation.
 Microscopically:- Grams +Ve, anaerobic, rod like Doderlin”s
Stree Roga Anatomy (2)
bacillus, and epithelial cells are present.
Dr. Ram Veer Sharma

22. Secretion characters & Diagnosis
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Dr. Ram Veer Sharma

23. Blood Supply
a) Artery:- Uterine artery,
 Upper 1/3 - Cervico vaginal artery.
 Middle 1/3 - Vaginal branch of internal iliac artery.
 Lower 1/3 - Internal pundendal artery Middle rectal artery.
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

24. Stree Roga Anatomy (2)
Female Genital Organs Blood Supply
Dr. Ram Veer Sharma

25. Blood Supply
b) Veins:- From two plexus, One at the sub mucus layer
2nd other at the outer fascial area (coat)
• Both plexus are drained by the vaginal vein
• In to internal iliac vein.
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

26. C) Lymphatic's:-
 These are mucosal & muscular lymphatic plexus. from –
 Lower 1/3 they drain together with those of external genitalia
in to superficial and deep inguinal nodes.
 Middle 1/3 drain in to Internal iliac nodes.
Stree Roga Anatomy (2)
 Upper 1/3 Pass in to External iliac nodes.
Dr. Ram Veer Sharma

27. Lymphatic's Drainage
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Dr. Ram Veer Sharma

28. C) Nerves :- Autonomous nerves, on each side.
From the pelvic plexus
Lowest part - Perineal branch of Pundendal nerve.
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma

29. D)Nerves :- Autonomous nerves,
on each side.
from the pelvic plexus
Lowest part -Perineal branch of
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pundendal nerve.
Dr. Ram Veer Sharma

30. C) Nerves Supply:- Autonomous nerves, on each side.
From the pelvic plexus
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Lowest part - Perineal branch of Pundendal nerve.
Dr. Ram Veer Sharma

31. C) Nerves Supply -
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Dr. Ram Veer Sharma

32. Physiological Changes In Mucous Layer During Various
Phases
 Maturation index :- Para basal cells, Intermediate cells &
Superficial cells.
A)At birth:- Cells are arranged in many layer (Maternal
Stree Roga Anatomy (2)
Ostrogene),
 Glycogen appeared in superficial and intermediate cells.
M.I. = 0 / 95 / 5.
Dr. Ram Veer Sharma

33. B) After 10 days of birth :- Maternal hormone disappear -
 Epithelium - Atrophies up to basal layer, with no glycogen.
 Ph.= 7 Natural or alkaline.
C) During Menstrual life -
 Puberty to Menopause due to estrogenic activities,
Stree Roga Anatomy (2)
Puberty to Menopause due to estrogenic activities,
 Vaginal epithelium arranged in Many layered,
 Glycogen and Doderlin”s bacilli reappeared.
 Ph. = 4 - 4.5 (Acid reaction).
Dr. Ram Veer Sharma

34. a) Follicular phase- Epithelium - Gradually becomes-
Fully thickened and,
Proliferated and,
Cornification of superficial cells,
Vaginal smear - appear clean.
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M.I.= 0 / 40 / 60.
Dr. Ram Veer Sharma

35. b) Premenstrual - Secretary phase- effects of
 Progesterone + Some antagonizing estrogen-
 Epithelium - Hypertrophied,
 Maturation of intermediate zone
 But thinner superficial layers.
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 Vaginal smear- Appears dirty due to presence of
Leucocytes, Mucous, and Bacteria.
 The intermediate cells with folded and curled margin, in
cluster out number of superior cells.
 M.I.=0/70/30. Many cells are fragmented.
Dr. Ram Veer Sharma

36. c) During Pregnancy :- With effect of Oestrogene + Progesterone
 Mucosa undergoes further thickening that in menstrual cycle.
 Maturation processing only through - intermediate layer, are of
 Navicularis shape (Pregnancy cells).
• M.I.= 0 / 95 / 5.
Stree Roga Anatomy (2)
d) Menopause :-
• Withdraw of Oestrogene & Progesterone - Mucosa atrophy.
• The former mucosa is thick, showing complete lack of estrogen
effects, while in later - it is thin due to no evidence of any
vaginal epithelium maturation.
Dr. Ram Veer Sharma

37. Papanicolaou Stain Grade (PAP Smear)
Cytological grade of Vaginal cleaninliness
1st. Grade - Ph. = 4 to 4.5,
 Doderlin"s bacilli alone, yeast, and fungi can be found.
2nd. Grade - Ph. = 4.6 to5.2,
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 Mixed flora (Doderllin’s bacilli + and other bacteria's)
3rd. Grade - Ph. =5.3 to 6.8,
 No Doderllin’s bacilli ,Only other pathlogical bacteria.
Dr. Ram Veer Sharma

38. Functions -
1. Co - opulatory organ.
2. Sexual stimulation, Lubrication and orgasmic response during
coitus.
3. Receptive for semen pod mixed with cervical mucous to
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supply sperm to cervical mucous.
4. Preventing from infections by acidic Ph.
5. Biochemical activities - of vaginal epithelium is maintained
by various enzymes- they later my helps in lubrication of
semen & capacitation of sperm.
Dr. Ram Veer Sharma

39. 6. Absorption function:- Seminal prostaglandins absorbed
by vaginal wall Results with in minutes,
 Contraction of Myometrium and fallopian tubes occurs.
7. Immunological function:- the sperm antibody and anti
microbial immunoglobulin's are present in vagina.
Stree Roga Anatomy (2)
microbial immunoglobulin's are present in vagina.
8. Excretory duct for menstrual discharge.
9. Birth canal.
Dr. Ram Veer Sharma

40. .
Stree Roga Anatomy (2)
Dr. Ram Veer Sharma