Figure Legends
Figure 1. The gross and topographic anatomy of the vaginal
outletA. The specimen of the 10-year-old subject depicts the vaginal
outlet wall (the yellow arrow). The horizontal location of the vaginal
wall and the vertical position of the vaginal outlet are noticeable.
B. Three anatomical architecture and orientation of the vaginal outlet
in the vertical position are presented: a) the hymeneal membrane is the
superficial soft tissue layer-the black arrow; b) the green arrow shows
the hymeneal ring-cartilage; c) the yellow arrow indicates the hymeneal
plate and the visible groove between the hymeneal ring and the hymeneal
plate structures.
C. The V-shape excised fragment of the vaginal outlet
anatomical structures. The black arrow indicates the soft tissue
superficial layer (the hymeneal membrane) of the vaginal outlet; the
green arrow represents the middle layer - the hymeneal ring (cartilage);
the yellow arrow depicts the deep layer of the hymeneal plate.
Figure 2. Microscopic characteristic features of the vaginal
outlet wall
The microscopic architecture of the vaginal outlet wall consists of
three layers – superficial, intermediate, and deep. The superficial
layer (the hymeneal membrane) is the mucosal type of tissue. The
epithelium that covers the hymen membrane is a nonkeratinized striated
squamous cell arranged in roses of epithelial cells, on an average of
three roses. The elastic lamina propria consisted of a dense connective
fibers layer projecting papillae into the overlying epithelium with the
capillary blood vessel network and nerve endings. Beneath the lamina
propria was a strip of columnar epithelial cells. In addition, the
parabasal, basal cells, and basal lamina were identifiable. The
intermediate-hymeneal ring was composed of dense connective fibers with
a network of arterial blood vessels, veins, nerve endings, and muscle
fibers.
The deep layer of the vaginal outlet wall (the hymeneal plate) was
composed of predominantly longitudinal smooth muscles and connective
tissues. This stratum was connected to the longitudinal vaginal wall
muscles.
Figure 3. The clinical function of the vaginal outlet wall
selected examplesA. Resistance force of the hymeneal outlet wall structure on
the anterior vaginal wall prolapse (prolapse cystocele),B. The vaginal outlet wall resists the fetal head passing
during vaginal delivery,C. The defective vaginal outlet wall causes the
posterior-distal vaginal wall to descend.