Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=The Vagina.=—The vagina is a hollow organ, about four inches long,
attached to the cervix above and the vulva below. It is an elastic
sheath bounded in front by the bladder and behind by the rectum. Under
normal conditions, this tube easily admits one or two fingers, but
during labor it dilates enormously to allow the head to pass. The vagina
is lined with a thick mucous membrane, ridged and roughened by folds,
which are called rugæ. Thus a continuous channel connects the ovary with
the outside and through it pass, at appropriate times, the ovule, the
menstrual blood, the uterine secretions, the child, the placenta, and
the lochia.
=The Uterus.=—The uterus (womb) is a pear-shaped organ, flattened from
before backward, and composed of unstriped or involuntary muscle cells
and connective tissue. Normally the virgin uterus measures from two and
one-half to three inches in length, and weighs about two ounces. It is
suspended in the middle of the pelvis by strong ligaments, so that the
fundus inclines gently forward against the bladder. When the bladder
fills, the uterus is pushed backward. Most of the organ is internal, but
a small part of the lower pole is grasped by the vagina, in which the
lower end with its invaluable aperture, the os, dips and swings. The
part above the vagina is called the body or fundus, and is covered with
the serous membrane (peritoneum) that lines the abdominal cavity. Below
the fundus is the cervix or neck, which lies partly above and partly
within the vagina. The cavity of the uterus is usually closed by the
apposition of the walls. The inner surface is covered with a peculiar
kind of membrane called the endometrium, which is highly vascular. The
uterine cavity opens into the vagina through the os, which is small and
round in the nulliparous woman, and slit-shaped or gaping in the woman
who has borne a child.
[Illustration: Fig. 4.—Uterus and appendages. On either side of the
uterus will be seen the ovary, the fimbriated extremity of the tube, the
tube, and the round ligament. The vagina lies open below. (Lenoir and
Tarnier.)]
=Fallopian Tubes.=—On either side of the upper end of the uterus are the
orifices of the Fallopian tubes, through which the egg, escaping from
the ovary, finds access to the uterine cavity. These tubes extend
outward from the uterus about four inches, and terminate in a
bell-shaped opening with long, ragged fingers which hang loosely down
toward the ovary. The tubes are lined by epithelial cells having
hair-like projections, (ciliæ) which wave automatically toward the
uterus. Thus impelled by a gentle current, the egg moves definitely
along the tube toward the uterus and against this current the
spermatozoa force their way to meet and fertilize the egg.
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