repoducctor organo of the woman
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repoducctor organo of the woman
Feminine reproductive apparatus The feminine external reproductive organs (genital) have two functions: to allow the entrance of the sperm in the body and to protect the internal genital organs of the infectious agents. Because the feminine genital apparatus has an orifice that communicates it with the outside, the microrganismos that cause diseases (pathogenic) can enter and cause gynecological infections. These pathogens are transmitted, in general, during the sexual act. The internal genital organs form an apparatus that begins in the ovaries, in charge of the liberation of ova, and it is followed by the tubes of Fallopian tube (oviductos), where the fertilization of an ovum takes place; next it follows the uterus, where the embryo becomes fetus, and finishes in the cervical channel (vagina), that allows the lighting of a completely developed baby. The sperm can cross all the apparatus in ascending direction towards the ovaries and ova in opposite sense. External genital organs The external genital organs (vulva) are bordered by the greater lips (literally, great lips), that are quite voluminous, fleshy and comparable to escroto in the men. The greater lips contain sebaceous glands sudoríparas and (that secretan oil); after the puberty, they are covered of hair. The smaller lips (literally, small lips) can be very small or until of six centimeters wide. They are located within the greater lips and they surround the orifices by the vagina and uretra. The orifice of the vagina receives the introito name and the zone with form of average moon that is after that orifice knows like bracket to vulvar. Through tiny conduits that are located next to the introito, the glands of Bartholin, when they are stimulated, secretan a flow (snot) that lubricates the vagina during the sex. Uretra, that transports tinkles it from vejiga towards the outside, has its orifice of exit in front of the vagina. External genital organs of the woman Both smaller lips have their point of contact in clítoris, a small and sensible analogous protuberance to the penis in the man who is covered by a layer of skin (prepucio) similar to the skin that is in the end of the masculine member. Like this one, clítoris is very sensible to the stimulation and can have erection. The greater lips are in the inferior part, in the perineo, a zone to fibromuscular located between the vagina and the anus. The skin (epidermis) that covers the perineo and the greater lips are similar to the one of the rest of the body (heavy, dry and it can be descamar). On the contrary, the coating of the smaller lips and the vagina are a mucous membrane; although their internal layers are of structure similar to epidermis, its surface stays thanks to the liquid of the blood vessels of the layers deeper humid than it crosses the weave. Its great amount of blood vessels gives a pink color him. The vaginal orifice is surrounded by the hymen (or virginal membrane). In the virgin woman, the hymen can cover the orifice completely, but in general it surrounds it as a fit ring. As the adjustment degree varies between the women, the hymen can withdraw in the first attempt to maintain a relation sexual or can be so soft and flexible that tear does not take place some. In a woman who is not virgin, the hymen is like a small weave appendix that surrounds the vaginal orifice. Internal genital organs The walls previous and later of the vagina normally are touched to each other, so that it is not left space in the vagina except when it dilates, for example, during a gynecological examination or a sexual relation. In the adult woman, the vaginal cavity has a length of 9 to 12 centimeters. The inferior third of the vagina is surrounded by muscles that control their diameter, whereas third both superior they are united over these muscles and they can stretch with facility. The cervix (the mouth and the neck of the uterus) is in the superior part of the vagina. During the fertile years of the woman, the mucous coating of the vagina has a rough aspect, but before the puberty, and after the menopause (if estrogens are not taken), the mucosa is smooth. Internal feminine genital organs The uterus is an organ with pear form located in the superior part of the vagina, between vejiga urinary ahead and the rectum behind, and is in favor subject of six ligaments. The uterus is divided in two parts: the uterine neck or cervix and the main body (corpus). The uterine neck, the inferior part of the uterus, is opened within the vagina. The uterus normally is something doubled towards ahead by the zone where the neck is united to the body. During the fertile years, the body is twice more length than the uterine neck. The body is an organ with abundant musculatura that enlarges to lodge the fetus. Their muscular walls are contracted during the childbirth to impel outside to the baby towards by the fibrous uterine neck and the vagina. The uterine neck contains a channel that allows to the entrance of the sperm in the uterus and the exit of the menstrual secretion to the outside. Except during the menstrual period or the ovulation, the uterine neck is in general a good barrier against the bacteria. The channel of the uterine neck is too narrow so that the fetus crosses it during the pregnancy but during the childbirth it is high and mighty so that it is possible the lighting. During a pelvic examination, the doctor can observe the portion of cervix that excels and enters the superior end of the vagina. Like the vagina, this part of the uterine neck is covered of mucosa, although this one is of smooth type. The channel of the uterine neck is covered of glands that secretan a thick snot and impenetrable for the right sperm until the moment at which the ovaries release an ovum (ovulation). During the ovulation, the consistency of the snot changes so that the sperm can cross it and fertilize the ovum. At the same time, the snot which these glands of the uterine neck secretan has the capacity to maintain the alive sperm during 2 or 3 days. Later this sperm can move upwards and, crossing the body of the uterus, enter the tubes of Fallopian tube to fertilize the ovum; consequently, sex made 1 or 2 days before the ovulation can finish in a pregnancy. Because some women do not ovulate regularly, the pregnancy can take place at different moments after the last menstrual period. The inner coating of the body of the uterus (endometrium) is every month made more thickness after the menstrual period (menstruation). If the woman is not left pregnant woman during that cycle, most of the endometrium is given off and taken place a hemorrhage, that constitutes the menstrual period. The tubes of Fallopian tube have a length of 6 to 9 centimeters from the superior ends of the uterus to the ovaries. The end of each tube is high and mighty and adopts a funnel form, constituting an orifice of greater diameter to facilitate the fall of the ovum in its interior when this one is released by the ovary. The ovaries are not united to the tubes of Fallopian tube, but they are closely together suspended of them thanks to a ligament. The ovaries, of color to per it, have an oblong form and are something smaller than a cooked egg. The cilia (prolongations of the cells, similars to hairs that move in swing) which they cover the tubes of Fallopian tube and the muscles of their walls downwards impel the ovum through these tubes. When an ovum finds a spermatozoon in the tube of Fallopian tube and is fertilized by this one, it begins to divide itself. In a period of 4 days, the tiny embryo continues dividing itself while it moves slowly downwards by the tube until arriving at the uterus. The embryo adheres to the uterine wall, where it is fixed; this process denominates implantation or anidación. Each feminine fetus count with 6 or 7 million oocitos (ovular cells developing) to the 20 weeks of pregnancy and is born with around two million oocitos. In the puberty, they only are between 300 000 and 400 000 to mature and to become ova. The thousands of oocitos that they do not complete the maturation process degenerate gradually and, after the menopause, it is not left any. Gynecological evaluation In the first place, the woman would have to choose a doctor with whom she can speak with confidence of certain delicate subjects, like sex, the birth control and the pregnancy. The gynecologist must be prepared to approach familiar problems, like the physical and emotional abuse, and the drug consumption; all the information that receives will have confidential character. In certain countries laws exist that demand the consent of the parents to treat the minors (in general below 18 years). During a gynecological visit, the doctor (gynecologist, internista, pediatra or doctor of family), the nurse or the midwife must be prepared to respond to questions about the sexual and reproductive functions, including which they talk about to the practice of sex with security guarantees. Gynecological clinical history The gynecological evaluation begins with a series of questions (gynecological history clinical) that, in general, they are centered in the reason for the visit. A complete ginecólogica clinical history includes questions about the age of beginning of the menstruation (menarquía), its frequency, regularity, duration and amount of flow, as well as the dates of both last menstrual periods. Also questions about an abnormal, excessive or little hemorrhage, or episodes of abnormal menstruation usually become. Also it is possible to investigate about the sexual activity to determine the presence of gynecological infections, injuries and the possibility of a pregnancy. It is asked to him the patient if it uses or it wishes to use methods for the birth control and if it interests to him to receive advising or another information. The number of pregnancies is registered, the dates in which took place, the result and the complications that appeared. The medical question to the woman if it feels pain during the menstruation, the sex or in other circumstances, with what intensity appears and how manages to calm it. Also it affects the questions that concern to the problems of the breasts (spontaneous pain, bulks, pain when touching itself, reddening and secretion by the nipples). Finally, it is found out if it practices autoexamen of breasts, with what frequency and if it needs instructions to know his technique. Harvesting of cervical cells for a Pap From the revision of the file of the gynecological diseases, a medical and surgical file is obtained complete that includes health problems which they are not strictly gynecological. It is necessary to know all the drugs that the woman consumes, including prescribed medicines or of free sale, as well as drugs, tobacco and alcohol, since many of them affect to the gynecological function and the general health. The questions related to the mental, physical or sexual abuse in the present or the past are of extreme importance. Some questions are centered in aspects that concern to tinkles it, to discover if the woman presents/displays some infection or if she has incontinencia, that is to say, involuntary loss of tinkles. Gynecological exploration Some women feel uncomfortable before a gynecological examination. Such circumstance is due to communicate the doctor beforehand, so that this one can take more time and to make sure to respond to all the questions. In general, one indicates the woman who tinkles before the physical exploration and that gathers a sample for its evaluation in the laboratory. The examination of breasts can take place before or after the pelvic examination. Being the seated woman, the doctor examines the breasts to discover irregularities, retractions or adhesions of the skin, bulks and secretion of any type. Next, still seated or fallen down, with the arms in jar or on the head, the doctor feels each breast with the flat hand and examines each armpit in search of lymphatic ganglia increased of size. The doctor also explores the neck and the gland thyroid in search of bulks and anomalies. The doctor smoothly feels all the zone between the ribs and pelvis (the abdomen) in search of tumoraciones or of abnormalitys in the size of the organs, special the liver and bazo. Although the woman can feel certain malaise when the doctor makes a palpación deep, the examination would not have to cause pain to him. The fact to strike with the fingers (percussion) while the difference between the areas that sound to hollow and those is heard that emit a sound more dull aid to establish the size of the liver and bazo. In order to be able to identify anomalies that are not within reach of the palpación, it is listened to with fonendoscopio the abnormal activity of the intestine and noises that could make the blood when circulating around narrow blood vessels. During the pelvic exploration, the woman recuesta mouth arrives with the hips and the flexionadas knees and the rumps placed in the edge of the stretcher. Most of these habitually they count on stirrups for the heels or the knees that help to hold that position. If the patient wishes it, can observe the exploration while she is being made, by means of the positioning of mirrors; also he can provide to it him all type of explanations and diagrams. In order to facilitate this interchange he is recommendable to communicate to the doctor ahead of time desire to have this information. Next, a visual inspection of the zone of the external genitals takes place and it lends attention to the distribution of the hair and any other anomaly, alterations of the coloration, flow or inflammation. This examination can confirm that everything is or or indicating, on the contrary, hormonal upheavals, physical cancer, infections, injuries or abuses. Using gloves, the doctor opens the lips to examine the orifice of the vagina. With espéculo (a metallic instrument or of plastic that separates the walls of the vagina), to suitable and lubricated temperature with water, is examined the deepest areas of the vagina and the uterine neck. This last one is explored with well-taken care of detecting signs of irritation or cancer. In order to make a test of Papanicolaou (Pap), cells of the surface of the uterine cervix with a small aplicador of wood very similar to a spatula are scraped, with the purpose of obtaining cells. Next, a small brush can be used to obtain a sample of cells of the uterine neck. The patient note sensations, but these procedures do not cause pain to him. The cells extracted with the brush or the aplicador of wood are placed on portaobjetos, that are sprinkled with a fijadora substance, and it is sent to the laboratory, where it is examined to the microscope in search of signs of cervical cancer. The Pap, the best method to detect cervical cancer, identifies between a 80 and 85 percent of these cancers, even in his first stage. The test is more precise if the woman does not wash nor uses medication by vaginal route at least during the 24 previous hours. If the medical suspicion that exists other upheavals, other tests can be made. For example, if indications of an infection exist, the vagina rubs and the uterine neck with a brush and obtains a small amount of vaginal secretion for its culture and microscopic evaluation in the laboratory. In this first stage, the force and the resistance of the vaginal wall with the objective are evaluated to detect any protrusión of vejiga urinary in the frontal part of the wall of that one (cistocele), a protrusión of the rectum in the later part (rectocele) or a protrusión of the intestine in the superior vertex of the vagina (enterocele). Legrado expansion and (D and C) After clearing espéculo, the doctor makes a manual exploration, that is to say, he introduces the forefingers and means of a hand within the vagina and places the fingers of the other on the inferior part of the abdomen over the púbico bone. In this position, the uterus feels as a structure with pear form, smooth and consistent, and, in addition, it is possible to determine his position, size, alteration of the consistency and if its palpación is painful. Soon, the hand is tried to feel the ovaries more moving on the abdomen towards the sides and pressing a little. As the ovaries are small and much more difficult to perceive that the uterus, more pressure is needed; the woman can notice a somewhat disagreeable sensation. The doctor determines the size of the ovaries and if the zone is painful; also, he looks for painful irregularities or areas within the vagina. Finally, the doctor places the forefinger within the vagina and the middle finger within the rectum to carry out a rectovaginal examination. This way, the later wall of the vagina is examined to detect masses or thickenings. In addition, it is examined the rectum in search of hemorroides, fissures, polyps and bulks, and the depositions with the purpose of discovering the existence of nonperceivable blood at first are analyzed (it hides). Also it is possible to give to the woman an equipment so that in his address it verifies in several occasions that hidden blood in its lees does not exist. Sometimes it is needed to make more complex tests. In order to examine the internal genital organs, several techniques are used, including instruments that apply optical fiber technology. The optical fibers are thin and flexible strips made of plastic or crystal that transmits light. With a cable of optical fiber connected to a tube of visualization or laparoscopio it is possible to examine the uterus, the tubes of Fallopian tube or the ovaries with no need to make a great incision. Laparoscopio also facilitates the practice of surgical procedures in the genital apparatus. clítoris Clítoris, is an organ constituted by a pair of cavernous bodies and glande. He is riquísimo in nervous completions still more that the vaginal orifice and of depends its excitabilidad there. The cavernous bodies are formed by two cylindrical bodies with the sharpened extremities. One of the extremities goes united to the isquiopubiana branch, the other is going to be united with the analogous extremity of the other cavernous body, these two extremities is united intimately and given life to a unique and medium organ, the body of clítoris Where is clítoris? On the external feminine genitals (vulva) it includes pubis, the greater lips the smaller lips, clítoris and the lobby that the opening of uretra contains and the one of the vagina. The smaller or inner lips megre above, forming a species of hood that covers clítoris, this is an organ of the great sensitivity, whose only function is to receive eróticas sensations. With the stimulation of clítoris it is arrived at orgasmo? The orgasmica answer of the woman depends to a great extent on the excitation of clítoris more than in the penetration. Since most of the women they can get to have orgasmo totally placentero through the stimulation of clítoris during the sexual relation without mediating the penetration. Its stimulation can be manually, orally or by the simple pressure of the penis when the sex. Clítoris has a great amount of nervous completions that turn it an extremely sensible organ to the tact, the pressure and to the temperature. Sicóloga Maria Carmen Hernandez To send Consultation