In this note, we will consider the anatomy of the vagina (vagina).

It is an organ of the female reproductive system.

The vagina connects the uterus with the external genitals; it serves for sexual intercourse, menstrual blood excretion, and fetal birth.

Holotopy

This organ is located in the pelvic cavity.

Skeletotopy

The vagina is located at the level between the third sacral and first coccygeal vertebrae (S3-Co1).

Syntopy

Let’s consider which anatomical structures and organs adhere to the vagina.

• The rectum is located posteriorly.

• Anteriorly to the vagina, there is the urethra and the fundus of the bladder.

• The venous vaginal plexus and the pelvic part of the ureter are located laterally from the vagina in the cellular tissue.

Inferiorly, the vagina passes through the perineum.

Macroscopic structure

The vagina has two walls:

• The anterior wall (paries anterior)

• The posterior wall (paries posterior)

The vaginal fornix (fornix vaginae) is the space between the cervix of the uterus and the walls of the vagina. The fornix has 4 parts:

1. The anterior part (pars anterior)

2. The posterior part (pars posterior), which is the deepest

3. Lateral parts (partes laterales)

The vaginal orifice (ostium vaginae) opens into the vestibule of the vagina.

In virgins, it is covered by a fold of the mucous membrane called the hymen (hymen).

The vaginal wall consists of several layers.

The mucous membrane (tunica mucosa).

It is lined with a non-keratinized stratified squamous epithelium and does not contain glands. This membrane forms a number of rugae.

• Transverse vaginal rugae (rugae vaginales).

• Closer to the median line, the transverse vaginal rugae become higher and form longitudinally oriented columns of rugae (columnae rugarum).

• The anterior column of the rugae (columna rugarum anterior), which is more pronounced.

Inferiorly, it forms a longitudinally oriented protrusion called the urethral carina of the vagina (carina urethralis vaginae), which corresponds to the urethra adhering to the vagina.

• The anterior and posterior columns are located on different sides of the median plane.

The muscular coat / layer (tunica muscularis)

It consists of two layers of smooth muscles:

1. Circular layer (stratum circulare), which is an internal layer
2. Longitudinal layer (stratum longitudinale), which is an external layer

In the area of the vaginal orifice, there is a cluster of striated circular fibers of the perineal muscles.

This is the vaginal sphincter (m. sphincter vaginae).

The outer sheath consists of the peritoneum and adventitia.

In relation to the peritoneum, the organ lies extraperitoneally, it is covered with the peritoneum only within the recto-uterine pouch.

Blood supply

Arterial blood flows through the branches of the internal iliac artery (a. iliaca interna):

• The uterine artery (a. uterina);
• The inferior vesical artery (a. vesicalis inferior);
• The middle rectal artery (a. rectalis media);
• The internal pudendal artery (a. pudenda interna).

Venous drainage

Venous blood drains through the eponymous veins to:

• The vaginal venous plexus (plexus venosus vaginalis);
• The vesical venous plexus (plexus venosus vesicalis);
• The uterine venous plexus (plexus venosus uterinus);
• The rectal venous plexus (plexus venosus rectalis).

Lymph drainage

Lymph drains mainly into:

• The internal iliac lymph nodes (nodi lymphatici iliaci interni);
• The deep inguinal lymph nodes (nodi lymphatici inguinales profundi);
• The superficial inguinal lymph nodes (nodi lymphatici inguinales superficiales);
• The pelvic lymph nodes (nodi lymphatici sacrales).

Innervation

Along the course of the organ, nerve fibers form the so-called vaginal plexus (plexus vaginalis), which is part of the uterovaginal plexus (plexus uterovaginalis).

• Afferent innervation is provided by the sensitive fibers of the sacral spinal nerves.
• Parasympathetic innervation is provided by the fibers of the pelvic splanchnic nerve.
• Sympathetic innervation is provided by the fibers of the hypogastric plexus.

Dictionary

Anatomy of the vagina

Female genitalia

organa genitalia feminina

Ovaries

ovarium

Uterus

uterus

Uterine tubes

tuba uterina

Vagina

vagina

Mons pubis

mons pubis

Labia majora

labia majora pudendi

Labia minora

labia minora pudendi

Greater vestibular glands

glandulae vestibulares majores

Lesser vestibular glands

glandulae vestibulares minores

Bulb of the vestibule

bulbus vestibuli

Clitoris

clitoris

Hymen

hymen

Mammary gland

mamma

Anterior wall

paries anterior

Posterior wall

paries posterior

Fornix of the vagina

fornix vaginae

Anterior part

pars anterior

Posterior part

pars posterior

Lateral parts

partes laterales

Vaginal orifice

ostium vaginae

Transverse vaginal rugae

rugae vaginales

Vaginal columns

columnae rugarum

Anterior vaginal column

columna rugarum anterior

Urethral carina of the vagina

carina urethralis vaginae

Mucous membrane

tunica mucosa

Muscular layer

tunica muscularis

Circular layer

stratum circulare

Longitudinal layer

stratum longitudinale

Sphincter muscle of the vagina

m. sphincter vaginae

Uterine artery

a. uterina

Inferior vesical artery

a. vesicalis inferior

Middle rectal artery

a. rectalis media

Internal pudendal artery

a. pudenda interna

Vaginal venous plexus

plexus venosus vaginalis

Vesical venous plexus

plexus venosus vesicalis

Uterine venous plexus

plexus venosus uterinus

Rectal venous plexus

plexus venosus rectalis

Internal iliac lymph nodes

nodi lymphatici iliaci interni

Deep inguinal lymph nodes

nodi lymphatici inguinales profundi

Superficial inguinal lymph nodes

nodi lymphatici inguinales superficiales

Pelvic lymph nodes

nodi lymphatici sacrales

Vaginal plexus

plexus vaginalis

Uterovaginal plexus

plexus uterovaginalis