It is formed from the tubercle of the undifferentiated common tissue anlagen in the embryo. The corpora cavernosa of the shaft do not extend into the glans.Īlthough the erogenous function of this organ has been known since antiquity, remarkably, the detail of its highly vascular anatomical structure is still in dispute. Nevertheless, human clitoral erectile tissue has the capacity to develop drug-induced priapism which responds by detumescing following administration of a-adrenergic agonists. Because the shaft and the glans of the clitoris have no subalbugineal layer between the erectile tissue and the tunica albuginea the organ becomes tumescent or swollen with effective sexual stimulation but does not become erect or rigid. These studies, which revealed a strong link between increase in age and decreased clitoral cavernosal smooth muscle fibers, illustrate that aging women undergo histologic changes in clitoral cavernosal erectile tissue which may play an as yet undetermined pathophysiology in age-associated female sexual dysfunction. The percentage of clitoral cavernosal smooth muscle in age group of 6 months to 15 years was 65 ± 1.5, in 44 to 54 years was 50 ± 1.2 and in 55 to 90 years was 37 ± 1.3 (ANOVA, p=0.0001). The clitoral cavernosal erectile tissue consists of smooth muscle and connective tissue. The erectile tissue of the clitoral shaft consists of two parallel corpora cavernosa surrounded by a fibrous sheath (tunica albuginea). The glans is covered by a clitoral hood formed in part by the fusion of the upper part of the two labia minora. The clitoris is capped externally with a glans about 20 -30mm long with a similar diameter. The clitoris consists of a midline shaft lying in the medial sagittal plane about 2-4 cm long and 1-2 cm wide which bifurcates internally into paired curved crura 5-9 cm long (attached to the under surface of the pubic symphisis). The clitoris is formed from the tubercle of the undifferentiated common tissue anlagen in the embryo. The autonomic efferent motor innervation occurs via the cavernosal nerve of the clitoris arising from the pelvic and hypogastric plexus. The arteries include the dorsal and clitoral cavernosal arteries, which arise from the iliohypogastric pudendal bed. The body of the clitoris consists of two paired erectile chambers composed of endothelial-lined lacunar spaces, trabecular smooth muscle and trabecular connective tissue (collagen and elastin) surrounded by a fibrous sheath, the tunica albuginea. The corpora cavernosa of the clitoris measures up to 5 inches in length. The labia minora are smaller folds covered by non-bearing skin laterally and by vaginal mucosa medially, that fuses anteriorly to forms the prepuce of the clitoris, and posteriorly in the fossa navicularis. The labia majora are fatty folds covered by hair-baring skin that fuses anteriorly with the mons verenis, or anterior prominence of the symphysis pubis, and posteriorly with the perennial body or posterior commissure. The vulva includes the labia minora, labia majora, the clitoris, the urinary meatus, the vaginal opening, and the corpus spongiosum erectile tissue (vestibular bulbs) of the labia minora. Three sets of skeletal muscles surround the vagina including the ischiocavernosum, bulbocavernosus, transverse perinei and levator ani and pubococcygeus muscles. There is a deeper surrounding fibrous layer above the muscularis which provides structural support to the vagina, and is rich is collagen and elastin, to allow for expansion of the vagina during sexual stimulation. Deep to the epithelium lies the smooth muscles of the muscularis. This epithelium undergoes hormone-related cyclical changes including slight keratinization of the superficial cells during the menstrual cycle. The vaginal wall consists of an inner glandular mucous type stratified squamous cell epithelium supported by a thick lamina propia. The vagina consists of a tube of autonomically-innervated smooth muscle (longitudinal outer, inner circular layer) lined by stratified squamous epithelium and a sub-dermal layer rich in capillaries. There are also multiple non-genital peripheral anatomic structures involved in female sexual responses such as salivary and sweat glands, cutaneous blood vessels and nipples. There are multiple anatomical structures which comprise the internal and external female genital tract such as the clitoris, labia minora and corpus spongiosum (vestibular) erectile tissue, peri-urethral glans, urethra, G-spot, Halban’s fascia, anterior fornix erogenous zone, pubococcygeus muscle and cervix.
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