Basic Sciences for Obstetrics and Gynaecology by Tim Chard MD, FRCOG, Richard Lilford MB, BCh, MRCOG, MRCP,

By Tim Chard MD, FRCOG, Richard Lilford MB, BCh, MRCOG, MRCP, PhD (auth.)

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Thereafter they atrophy in the male and hypertrophy to form the sinovaginal bulbs and later the upper vagina of the female External genitalia develop clear-cut features of gender Mid-gut withdrawn from umbilical cord The Placenta Structure of the Mature Placenta The placenta is composed of some 200 'lobules'. Each of these represents the system arising from a primary stem villus. The _tertiary stems are arranged in circles around a hollow core. There is no relation between lobules or groups of The Placenta 25 lobules and the 'cotyledons' viewed as part of the gross morphology of the placenta.

The venous drainage forms a plexus with extensive anastomoses to surrounding areas. 2. 1. Anatomy Nerve supply to the vulva Labia majora Anterior hypogastric branch of iliohypogastric Ilio-inguinal Genitofemoral (supplying dartos muscle) Sacral plexus: Posterior femoral cutaneous nerve Pudendal nerve Origin T-12, L-1 L-1 L-1, L-2 S-l to S-3 S-l to S-4 Labia Minora As for labia majora, plus perineal branch of pudendal S-l to S-4 Clitoris Terminal branch of pudendal S-l to S-4 Vestibule Perineal branch of pudendal S-l to S-4 Labia Minora The labia minora split into two parts anteriorly, one covering the clitoris and the prepuce and the other forming the ventral skin covering or frenulum.

At a distance from organ innervated) Ganglia situated immediately adjacent to or in the wall of the organ supplied Preganglionic nerve terminal releases acetylcholine (nicotinic receptor); postganglionic releases noradrenaline (except supply to sweat glands, which is cholinergic) Pre- and postganglionic terminals release acetylcholine (ganglionic receptor is nicotinic) Peripheral receptors are: a (vasoconstrictor, iris dilatation, bladder sphincter contraction, f3I (increased heart rate, lipolysis) or f32 (vasodilatation, bronchodilatation, uterine relaxation, glycogenolysis) Peripheral receptors are muscarinic (visceral; blocked by atropine) or nicotinic (neuromuscular junctions) 51 The Pelvic Skeleton The Pelvic Skeleton The bony pelvis is made up by the innominate bone, the sacrum and the fifth lumbar vertebra.

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