1 Fundamentals of Civil Procedure by Willard Riano

Vulva
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From Wikipedia, the free encyclopedia

For other uses, see Vulva (disambiguation).

Vulva
2 Fundamentals of Civil Procedure by Willard Riano

Examples of different human vulvas (pubic

hair removed in some cases)

Details

Precursor Genital tubercle, urogenital folds

System Reproductive system

Artery Internal pudendal artery

Vein Internal pudendal veins

Nerve Pudendal nerve

Lymph Superficial inguinal lymph nodes

Identifiers

Latin vulva, pudendum muliebre, pudendum

femininum

MeSH D014844

TA98 A09.2.01.001

TA2 3547

FMA 20462
3 Fundamentals of Civil Procedure by Willard Riano

Anatomical terminology

[edit on Wikidata]

In mammals, the vulva (pl.: vulvas or vulvae) consists of the external female genitalia.
The human vulva includes the mons pubis (or mons veneris), labia majora, labia
minora, clitoris, vestibular bulbs, vulval vestibule, urinary meatus, the vaginal opening, hymen,
and Bartholin's and Skene's vestibular glands. The urinary meatus is also included as it opens into
the vulval vestibule. Other features of the vulva include the pudendal cleft, sebaceous glands,
the urogenital triangle (anterior part of the perineum), and pubic hair. The vulva includes the entrance
to the vagina, which leads to the uterus, and provides a double layer of protection for this by the folds
of the outer and inner labia. Pelvic floor muscles support the structures of the vulva. Other muscles of
the urogenital triangle also give support.

Blood supply to the vulva comes from the three pudendal arteries. The internal pudendal veins give
drainage. Afferent lymph vessels carry lymph away from the vulva to the inguinal lymph nodes. The
nerves that supply the vulva are the pudendal nerve, perineal nerve, ilioinguinal nerve and their
branches. Blood and nerve supply to the vulva contribute to the stages of sexual arousal that are
helpful in the reproduction process.

Following the development of the vulva, changes take place at

birth, childhood, puberty, menopause and post-menopause. There is a great deal of variation in the
appearance of the vulva, particularly in relation to the labia minora. The vulva can be affected by
many disorders which may often result in irritation. Vulvovaginal health measures can prevent many
of these. Other disorders include a number of infections and cancers. There are several vulval
restorative surgeries known as genitoplasties, and some of these are also used as cosmetic surgery
procedures.

Different cultures have held different views of the vulva. Some ancient religions and societies have
worshipped the vulva and revered the female as a goddess. Major traditions in Hinduism continue
this. In Western societies, there has been a largely negative attitude typified by the medical
terminology of pudenda membra, meaning parts to be ashamed of. There has been an artistic
reaction to this in various attempts to bring about a more positive and natural outlook, such as work
from British, American, and Japanese artists. While the vagina is a separate part of the anatomy, it
has often been used synonymously with vulva.

Structure
4 Fundamentals of Civil Procedure by Willard Riano

Labeled image of a vulva, showing external

and internal views Vulva with visible parts of the clitoris and the parts
lying under the skin

The main structures of the vulva are: the mons pubis, the labia – labia majora and labia minora, the
external parts of the clitoris – the clitoral hood and the glans, the urinary meatus, the vaginal
opening and hymen, and Bartholin's and Skene's vestibular glands.[1] Other features include the
pudendal cleft, pubic hair, sebaceous glands, the vulval vestibule, and the urogenital triangle.[2]

Mons pubis

The mons pubis is the soft mound of fatty tissue at the front of the vulva, in the pubic region covering
the pubic bone.[3] Mons pubis is Latin for "pubic mound" and is present in both sexes to act as a
cushion during sexual intercourse, and is more pronounced in the female.[4] The variant term mons
veneris ('mound of Venus') is used specifically for females.[5][4] The lower part of the mons pubis is
divided by a fissure – the pudendal cleft – which separates the mons pubis into the labia majora. After
puberty, the clitoral hood and the labia minora can protrude into the pudendal cleft in a variable
degree.[6] The mons and labia majora become covered in pubic hair at puberty.[7]

Labia

The labia majora and the labia minora cover the vulval vestibule.[8] The outer pair of folds, divided by
the pudendal cleft, are the labia majora (Neo-Latin for "larger lips"). They contain and protect the
other structures of the vulva.[8] The labia majora meet at the front at the mons pubis, and meet
posteriorly at the urogenital triangle (the anterior part of the perineum) between the pudendal cleft
5 Fundamentals of Civil Procedure by Willard Riano

and the anus.[9][6] The labia minora are often pink or brownish black, relevant to the person's skin
color.[10]

The grooves between the labia majora and labia minora are called the interlabial sulci, or interlabial
folds.[11] The labia minora (smaller lips) are the inner two soft folds, within the labia majora. They have
more color than the labia majora[3] and contain numerous sebaceous glands.[12] They meet posteriorly
at the frenulum of the labia minora, a fold of restrictive tissue. The labia minora meet again at the
front of the vulva to form the clitoral hood, also known as the prepuce.[13]

The visible portion of the clitoris is the clitoral glans. Typically, this is roughly the size and shape of
a pea, and can vary in size from about 6 mm to 25 mm.[13] The size can also vary when it is erect.
[6] The clitoral glans contains as many nerve endings as the much larger homologous glans penis in
the male, which makes it highly sensitive.[13] The only known function of the clitoris is to focus sexual
feelings.[13] The clitoral hood is a protective fold of skin which varies in shape and size, and it may
partially or completely cover the clitoris.[14] The clitoris is the homologue of the penis,[8] and the clitoral
hood is the female equivalent of the male foreskin,[14] and may be partially or completely hidden within
the pudendal cleft.[15]

Vestibule

The area between the labia minora where the vaginal opening and the urinary meatus are located is
called the vulval vestibule, or vestibule of the vagina. The urinary meatus is below the clitoris and just
in front of the vaginal opening which is near to the perineum. The term introitus is more technically
correct than "opening", since the vagina is usually collapsed, with the opening closed. The introitus is
sometimes partly covered by a membrane called the hymen. The hymen will usually rupture during
the first episode of vigorous sex, and the blood produced by this rupture has been seen to
signify virginity. However, the hymen may also rupture spontaneously during exercise or be stretched
by normal activities such as the use of tampons and menstrual cups, or be so minor as to be
unnoticeable, or be absent.[13] In some rare cases, the hymen may completely cover the vaginal
opening, requiring a surgical procedure called a hymenotomy.[16] On either side of the back part of the
vaginal opening are the two greater vestibular glands known as Bartholin's glands. These glands
secrete mucus and a vaginal and vulval lubricant.[17] They are homologous to the bulbourethral
glands in the male.[2] The lesser vestibular glands known as Skene's glands, are found on the anterior
wall of the vagina. They are homologues of the male prostate gland and are also referred to as the
female prostate.[18]

Muscles

Muscles underlying the vulva and perineum

6 Fundamentals of Civil Procedure by Willard Riano

Pelvic floor muscles help to support the vulvar structures. The voluntary, pubococcygeus muscle, part
of the levator ani muscle partially constricts the vaginal opening.[19] Other muscles of the urogenital
triangle support the vulvar area and they include the transverse perineal muscles,
the bulbospongiosus, and the ischiocavernosus muscles.[20] The bulbospongiosus muscle decreases
the vaginal opening.[9] Their contractions play a role in the vaginal contractions of orgasm by causing
the vestibular bulbs to contract.[21]

Blood, lymph and nerve supply

The tissues of the vulva are highly vascularised and blood supply is provided by the three pudendal
arteries.[22] Venous return is via the external and internal pudendal veins.[23] The organs and tissues
of the vulva are drained by a chain of superficial inguinal lymph nodes located along the blood
vessels.[24]

The ilioinguinal nerve originates from the first lumbar nerve and gives branches that include
the anterior labial nerves which supply the skin of the mons pubis and the labia majora.
[25] The perineal nerve is one of the terminal branches of the pudendal nerve and this branches into
the posterior labial nerves to supply the labia.[25] The pudendal nerve branches include the dorsal
nerve of clitoris which gives sensation to the clitoris.[25] The clitoral glans is seen to be populated by a
large number of small nerves, a number that decreases as the tissue changes towards the urethra.
[26] The density of nerves at the glans indicates that it is the center of heightened sensation.
[26] Cavernous nerves from the uterovaginal plexus supply the erectile tissue of the clitoris.[27] These
are joined underneath the pubic arch by the dorsal nerve of the clitoris.[28] The pudendal nerve enters
the pelvis through the lesser sciatic foramen and continues medial to the internal pudendal artery.
The point where the nerve circles the ischial spine is the location where a pudendal block of local
anesthetic can be administered to inhibit sensation to the vulva.[29] A number of smaller nerves split
off from the pudendal nerve. The deep branch of the perineal nerve supplies the muscles of the
perineum and a branch of this supplies the bulb of the vestibule.[30][31]

Variations