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Female urogenital triangle
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Includes female external genitalia, perineal muscles and anal canal

Female external genitalia
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Mons pubis, labia majora, labia minora, clitoris, bulbs of vestibule and greater
and lesser vestibule glands
All the above comprise the pudendum (vulva)
Functions of the pudendum
o Sensory and erectile for arousal and intercourse
o Direct urine flow
o Barrier to entry of foreign material to urogenital tract

Mons pubis
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Rounded fatty eminence anterior to pubic symphysis, pubic tubercles and
superior pubic rami
Amount of fatty subcutaneous tissue increases at puberty and decreases
after menopause
Covered with hair after puberty

Labia majora
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Prominent folds of skin
Protect clitoris and urethral and vaginal orifices
Loose subcutaneous tissue containing smooth muscle
Lie on the sides of the pudendal cleft (where thighs are adducted)
External aspects are pigmented skin with sebaceous glands
Covered with pubic hair externally, internal aspects are smooth and hairless
Thicken anteriorly to form the anterior commissure, and form a posterior
commissure, overlying the perineal body
o Posterior commissure usually disappears after first vaginal birth

Labia minora
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Rounded folds of fat free, hairless skin
Surround and close over the vestibule of the vagina
Core of spongy connective tissue, containing erectile tissue and blood vessels
Form two laminae anteriorly
Medial laminae unite to form the frenulum of the clitoris
o Overlap the glans clitoris, forming the prepuce of the clitoris
In young women (virgins) the labia minora connected by the frenulum of the
labia minora (transverse fold)
Contains sebaceous glands and nerve endings

Taken from Moore et al, Clinically Oriented Anatomy, Seventh Edition
...


Vestibule of the vagina
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Space surrounded by the labia minora where orifices of the urethra and
vagina and ducts of the greater and lesser vestibular glands open
External urethral orifice is posteroinferior to the glans clitoris, anterior to the
vaginal orifice
Para-urethral glands located either side of the external urethral orifice
Openings of ducts of greater vestibule glands located on the medial labia
minora
Size and appearance of vaginal office depends on presence or absence of
the hymen (thin fold of mucous membrane)
o Remnants are left after rupture (hymenal caruncles) demarking the
vagina from the vestibule

Bulbs of vestibule
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Paired masses of erectile tissue, lying along the side of the vaginal orifice
Superior/deep to labia minora, inferior to perineal membrane
Covered by bulbospongeous muscles

Vestibular glands
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

Greater (Bartholin)
o Located in superficial perineal pouch, lie on either side of the vestibule
of the vagina
o Partly overlapped by bulbs of the vestibule
o Ducts open into the vestibule; secrete mucus during sexual arousal
Lesser
o Smaller glands on either side of the vestibule
o Open into vestibule to secrete mucous, moistening labia and vestibule

Arterial supply and venous drainage of the vulva
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External and internal pudendal arteries
Labial veins are tributaries of the internal pudendal veins and accompanying
veins
Venous engorgement during arousal causes increase in size and consistency
of the clitoris and bulbs of the vestibule

Innervation of the vulva
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Anterior aspects (mons pubis, anterior labia) via anterior labial nerves, derived
from the ilio-inguinal nerve and genital branch of genitofemoral nerve
Posterior aspect via perineal branch of posterior cutaneous nerve of the thigh
(lateral aspects) and branches of pudendal nerve (centrally; main nerve)
Bulb of vestibule and clitoris receives PNS from cavernous nerves of the
uterovaginal nerve plexus
o Stimulation results in increased secretion, erection of the clitoris,
engorgement of erectile tissue in the bulbs of the vestibule

Taken from Moore et al, Clinically Oriented Anatomy, Seventh Edition
...


Perineal muscles of the female


Superficial perineal muscles include the superficial transverse perineal,
ischiocavernous, and bulbiospongious muscles

Clinical note
Pudendal nerve block
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Pudendal nerve anaesthesia can be used to relieve perineal pain
during childbirth
Injects local anaesthetic into tissue surrounding the pudendal nerve,
where it crosses the sacrospinous ligament
Needle via vagina or through overlying skin
Physicians finger MUST be placed between the needle tip and baby’s
head

Ilio-inguinal nerve block


Used to abolish sensation from anterior peritoneum

Taken from Moore et al, Clinically Oriented Anatomy, Seventh Edition
...
Moore et al
...
Seventh Edition

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