External Genitalia

EXTERNAL GENITALIA

Q. 1

Which of the following about lymphatlcs of vulva is true :

 A

Do not cross the labiocrural lold

 B

Traverse labia from medial to lateral

 C

Drain directly into deep femoral glands

 D

Do not traely communicale with each other

Q. 1

Which of the following about lymphatlcs of vulva is true :

 A

Do not cross the labiocrural lold

 B

Traverse labia from medial to lateral

 C

Drain directly into deep femoral glands

 D

Do not traely communicale with each other

Ans. B

Explanation:

Traverse labia from medial to lateral

Special features of Vulval lymphatics are as follows :

The lymhatics of each side freel communicate with each other.

The lymphatics hardly cross beyond labiocrural fold.

Vulval lymphatics also anastomose with lymphatics of lower 1/3 of vagina and drain into external iliac nodes.

Superficial lymph nodes are the primary lymph nodes that act as sentinel glands of vulva. Deep inguial nodes are secondarily involved. It is unusual to find pelvic glands without metastasis in inguinal nodes.Glands of cloquet or Rosenmuller which is the uppermost deep femoral gland is absent in 50% of cases.

“From the upper 2/3 of the left and right labia majora superficial lymphatics pass towards the symphasis and turn laterally to joint the medial superficial inguinal nodes.”                                                                       

Hence they traverse labia from medial to lateral.


Q. 2

commonest reason of adherent labia minora in a newborn is :

 A

Female pseudohermaphroditism

 B

Testicular feminisation

 C

Vaginal atresia

 D

Agglutination of labia

Q. 2

commonest reason of adherent labia minora in a newborn is :

 A

Female pseudohermaphroditism

 B

Testicular feminisation

 C

Vaginal atresia

 D

Agglutination of labia

Ans. D

Explanation:

Agglutination of labia


Q. 3

The inner surface of the labia minora medial to the Hart line is lined by which of the following type of epithelium?

 A

Cuboidal epithelium

 B

Columnar epithelium

 C

Squamous epithelium

 D

Stratified squamous epithelium

Q. 3

The inner surface of the labia minora medial to the Hart line is lined by which of the following type of epithelium?

 A

Cuboidal epithelium

 B

Columnar epithelium

 C

Squamous epithelium

 D

Stratified squamous epithelium

Ans. C

Explanation:

The inner surface of the labia minora medial to the Hart line is lined by squamous epithelium that is non keratinized and the lateral portion of the inner surface is covered by stratified squamous epithelium.

Labia minora is a thin fold of tissue, which lies medial to each labia majora.
In males the structure homologous to this is ventral shaft of penis.
Superiorly labia minora divides into two lamella.
The lower pair fuses to form frenulum of the clitoris and upper pair merges to form the prepuce. Inferiorly, labia minora fuses to form the fourchette. 
 
Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 2. Maternal Anatomy. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.

Q. 4

Bartholin’s duct opens and drains its secretion to:

 A

Labia majora and minora

 B

A groove between labia minora and hymen

 C

The lower vagina

 D

The upper vagina

Q. 4

Bartholin’s duct opens and drains its secretion to:

 A

Labia majora and minora

 B

A groove between labia minora and hymen

 C

The lower vagina

 D

The upper vagina

Ans. B

Explanation:

Greater vestibular or Bartholin glands are the homologs of the male bulbourethral or Cowper glands.

They are in contact with and often overlapped by the posterior ends of the vestibular bulbs.

Each gland is connected to the vestibule by an approximately 2-cm long duct.

The ducts open in the groove between the labia minora and the hymen–the vestibule–at approximately 5 and 7 o’clock positions.

The glands contain columnar cells that secrete clear or whitish mucus with lubricant properties.

 
Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.

Q. 5

The embryonic development of the vestibule of the vagina is from which of the following developmental structures?

 A

Genital ridge

 B

Wolffian duct

 C

Urogenital sinus

 D

Mullerian duct

Q. 5

The embryonic development of the vestibule of the vagina is from which of the following developmental structures?

 A

Genital ridge

 B

Wolffian duct

 C

Urogenital sinus

 D

Mullerian duct

Ans. C

Explanation:

Clitoris develops from three swellings of the somato-pleurae known as genital tubercle, urogenital folds and labioscrotal folds, while urethra, vestibule and lower vagina are derived from the urogenital sinus.


Q. 6

Lymphatic drainage of clitoris is to:

 A

Glands of cloquet

 B

Superficial inguinal lymph nodes

 C

Deep inguinal lymph nodes

 D

a and c

Q. 6

Lymphatic drainage of clitoris is to:

 A

Glands of cloquet

 B

Superficial inguinal lymph nodes

 C

Deep inguinal lymph nodes

 D

a and c

Ans. D

Explanation:

A. i.e. Glands of cloquet; C. i.e. Deep injuinal lymph nodes 

–   Glans penis & clitoris drain in deep inguinal lymph nodes of Cloquet or Rosenmuller

Superficial inguinal lymph nodes drain anterior abdominal wall below umbilicus, perineum, anal canal (gluteal region) but not clitoris & toes and fingers.


Q. 7

Scrotum is analogus to-

 A

Labia minor

 B

Labia majora

 C

Uterus

 D

Vagina

Q. 7

Scrotum is analogus to-

 A

Labia minor

 B

Labia majora

 C

Uterus

 D

Vagina

Ans. B

Explanation:

B i.e. Labia majora


Q. 8

Clitoris develops from which of the following:

 A

Genital tubercle

 B

Genital ridge

 C

Wolffian duct

 D

Mullerian duct

Q. 8

Clitoris develops from which of the following:

 A

Genital tubercle

 B

Genital ridge

 C

Wolffian duct

 D

Mullerian duct

Ans. A

Explanation:

Phallic tubercle or genital tubercle

  • Present in the development of the urinary and reproductive organs.
  • It forms in the ventral, caudal region of mammalian embryos of both sexes and eventually develops into a phallus.
  • In the human fetus the genital tubercle develops around week 4 of gestation and by week 9 becomes recognizably either a clitoris or penis.
  • This should not be confused with the sinus tubercle which is a proliferation of endoderm induced by paramesonephic ducts.
  • Even after the phallus is developed, the term genital tubercle remains, but only as the terminal end of it, which develops into either the glans penis or the glans clitoridis.

Q. 9

Triangular space between clitoris and hymen ‑

 A

Fourchette

 B

Fossa navicularis

 C

Vestibule

 D

Labia minora

Q. 9

Triangular space between clitoris and hymen ‑

 A

Fourchette

 B

Fossa navicularis

 C

Vestibule

 D

Labia minora

Ans. C

Explanation:

Ans. is ‘c’ i.e., Vestibule

Female genitals :‑

  • The labia mojora are the two elongated folds of skin projecting downwards and backwards from the mons veneris.
  • The labia minora are two thin folds of skin just within labia majora.
  • The lower portions of labia called fourchette.
  • The depression between fourchette and the vaginal orifice is called fossa navicularis.
  • The Vestibule is the triangular surface which extends from clitoris (above) to hymen (below) and labia minora (laterally).
  • Urethral opening is 2.5 cm behind the clitoris, and immediately in front of vaginal opening.
  • Vulva includes mons veneris, clitoris, labia majora, labia minora, vestibule, hymen and urethral opening.

Q. 10

Lymphatic drainage of Vulva is into ‑

 A

Obturator nodes

 B

Internal iliac nodes

 C

Superficial inguinal nodes

 D

Paraaortic nodes

Q. 10

Lymphatic drainage of Vulva is into ‑

 A

Obturator nodes

 B

Internal iliac nodes

 C

Superficial inguinal nodes

 D

Paraaortic nodes

Ans. C

Explanation:

Ans. is ‘c’ i.e., Superficial inguinal nodes

Lymphatics of Vulva drain primarily into superficial inguinal lymph nodes and subsequently to deep inguinal and external iliac ndes. Lymphatics of Clitoris primarily drain into deep inguinal nodes.


Q. 11

The structure  marked with arrow opens and drains its secretion to?

 A

Labia majora and minora

 B

A groove between labia minora and hymen

 C

The lower vagina

 D

The upper vagina

Q. 11

The structure  marked with arrow opens and drains its secretion to?

 A

Labia majora and minora

 B

A groove between labia minora and hymen

 C

The lower vagina

 D

The upper vagina

Ans. B

Explanation:

Ans;B).

This structure is Bartholin gland.

  • The ducts open in the groove between the labia minora and the hymen–the vestibule–at approximately 5 and 7 o’clock positions.
  • The glands contain columnar cells that secrete clear or whitish mucus with lubricant properties.

Q. 12

 Identify the Anatomical structure [Arrow] shown in Photograph 

 A

Labia majora

 B

 Labia minora 

 C

 Mons pubis 

 D

None of the above

Q. 12

 Identify the Anatomical structure [Arrow] shown in Photograph 

 A

Labia majora

 B

 Labia minora 

 C

 Mons pubis 

 D

None of the above

Ans. A

Explanation:

The labia majora are two marked folds of skin that extend from the mons pubis downward and backward to merge with the skin of the perineum. They form the lateral boundaries of the vulval or pudendal cleft, which receives the openings of the vagina and the urethra.



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