Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her BabyVan Blarcom, Carolyn Conant
Science
Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her Baby
Van Blarcom, Carolyn Conant
Infants -- Care; Maternity nursing; Pregnancy
=The labia minora= are two small cutaneous folds lying between the labia
majora on each side of the vagina. Like the larger folds, they taper
toward the back and practically disappear in the vaginal wall. Their
attenuated posterior ends are joined together behind the vagina by means
of a thin, flat fold called the _fourchette_. The labia minora divide
for a short distance before joining at an angle in front, thus forming a
double ridge anteriorly. In the depression between these ridges is the
_clitoris_, a small, sensitive projection composed of erectile tissue,
nerves and blood vessels and covered with mucous membrane. The meatus
urinarius is just below the clitoris and between two small folds of the
mucous membrane.
=The vestibule= is the triangular space between the labia minora, and
into it open the meatus urinarius, the vagina and the more important
vulvo-vaginal glands.
=The vaginal opening= is below the vestibule and above the perineum. It
is partially closed by the hymen, a fold of mucous membrane disposed
irregularly around the outlet, somewhat after the fashion of a circular
curtain. The hymen is ragged or more or less scalloped in outline, and
varies greatly in size in different women, in some instances extending
so far over the opening as nearly or quite to close it.
=The fossa navicularis= is a depressed space between the hymen and
fourchette, so named because of its boat-like shape.
=The Bartholin glands=, probably the largest and most important of the
vulvo-vaginal glands, are situated one on each side of the vagina and
open into the groove between the hymen and labia minora. Reference is
made to these glands because of the danger of their becoming infected. A
gonorrheal infection of these glands is particularly troublesome.
=The perineum= is a pyramidal structure of connective tissue and muscle
which occupies the space between the rectum and vagina, and by forming
the floor of the pelvis serves as a support for the pelvic organs. The
lower and outer surface of this mass, representing the base of the
pyramid, lies between the vaginal opening and the anus and is covered
with skin. As the anterior part of the perineum is incorporated in the
posterior wall of the vagina, the entire structure becomes stretched and
flattened when the vagina is dilated during labor by the passage of the
child’s head.
Unless very carefully guarded at the time of delivery, and often even
then, the perineum gives way under the great tension undergone at that
time, and a tear is the result. The injury may be only a slight nick in
the mucous membrane or it may extend to, or into the _levator ani_, the
most important muscle of the perineal body, or if a “complete tear” will
extend all the way through the perineum and completely through the
sphincter ani. Such a tear is lamentable, as a break in the ring-shaped
sphincter muscle guarding the anal opening robs a woman of control of
her bowels, and is repaired with difficulty.
Public-domain text, read in full here on John Shaqi.
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