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The patient with acute renal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The bladder is a hollow, muscular bag, located behind the symphysis pubis and in front of the rectum. In females, it rests on the anterior vagina and in front of the uterus, whereas, in males, it is situated above the prostate gland. The wall of the bladder is made up of three different layers: The tunica mucosa: this has folds, called rugae, in it and they allow the bladder to distend, while acting as a reservoir for urine before it is excreted from the body.The tunica muscularis: this consists of three layers of meshed smooth muscle. In this area, a network of muscle fibres cross over one another in different directions and these are known collectively as the detrusor muscle.The tunica serosa or adventitia: this outer layer moistens the tissues and lubricates surfaces so that, when the bladder is full, it does not compress other organs.
The context of birth
Published in Helen Baston, Midwifery, 2020
The rugae or ridges of the vagina disappear during a vaginal birth. After about three weeks, the vagina becomes shorter and the rugae begin to return, returning to pre-pregnancy size by six weeks. The rugae become less pronounced with repeated childbirth.
Anatomy and Embryology of the Mouth and Dentition
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The periphery of the hard palate surrounding the necks of the teeth is termed the gingiva and a zone similarly lacking submucosa runs anteroposteriorly in the midline as a narrow, low ridge; the palatine raphe. At the anterior extremity of the raphe behind the incisor teeth is a small prominence, the incisive papilla that covers the incisive fossa at the oral opening of the incisive canal. Radiating outwards from the palatine raphe in the anterior half of the hard palate are irregular transverse ridges or rugae. The pattern of rugae is unique for the individual and has been used in forensic science to identify a dead individual.
Clinical manifestations and evaluation of postmenopausal vulvovaginal atrophy
Published in Gynecological Endocrinology, 2021
Faustino R. Pérez-López, Pedro Vieira-Baptista, Nancy Phillips, Bina Cohen-Sacher, Susana C. A. V. Fialho, Colleen K. Stockdale
Clinical findings more specific of VVA in postmenopausal women include scarce pubic hair, loss of vulvar adiposity in the labia majora and labia minora, and loss of the clitoral protective covering. The vaginal surface may appear thin and pale with a decrease of elasticity and secretion and increased friability. Loss of vaginal rugae may make the vaginal walls appear smooth and shiny. There may be uterine descent due to decreased collagen in the uterosacral and cardinal ligaments. Superficial pain/discomfort during vaginal speculum placement, vaginal digital examination, or ultrasound probe placement may be present and will vary in relation to the severity of VVA. The diagnosis of vulvodynia requires an exhaustive genital assessment and evaluation of comorbid pain syndromes [42,43]. Postmenopausal women's clinical signs of VVA in the gynecological examination may be associated with alterations in quality of life and all FSFI domains and the Female Sexual Distress [51,52].
Sexual Function in Postmenopausal Women and Serum Androgens: A Review Article
Published in International Journal of Sexual Health, 2019
Soheila Nazarpour, Masoumeh Simbar, Fahimeh Ramezani Tehrani
In postmenopausal women, the vaginal mucus weakens, the rugae disappear, and, because of reduced vascularity, the vagina yields a pale and almost transparent appearance. Tissue elasticity is decreased and the loss of subcutaneous fat makes the labia majora and minora seem wrinkled. In addition, estrogen deficiency in the postmenopausal period is known to cause atrophic changes, which is associated with symptoms of urogenital atrophy such as dyspareunia, itching, vaginal burning, vaginal dryness, and vaginismus (Nazarpour, 2012; Robinson, Toozs-Hobson, & Cardozo, 2013). The International Society for the Study of Women's Sexual Health and the North American Menopause Society has introduced the “genitourinary syndrome of menopause” (GSM) as a comprehensive term that encompasses symptomatic vulvovaginal atrophy and lower urinary tract symptoms related to low estrogen levels (Portman, Gass, & Vulvovaginal Atrophy Terminology Consensus Conference, 2014). GSM can cause significant physical problems and sexual dysfunction, and can interfere with intimate personal relationships (Pinkerton, Bushmakin, Komm, & Abraham, 2017).
Thermosensitive hydrogels a versatile concept adapted to vaginal drug delivery
Published in Journal of Drug Targeting, 2018
Sebastien Taurin, Aliyah A. Almomen, Tatianna Pollak, Sun Jin Kim, John Maxwell, C. Matthew Peterson, Shawn C. Owen, Margit M. Janát-Amsbury
Histologically, the vaginal wall consists of three layers: the mucosa, the muscularis and adventitia [9]. The mucosa consists of non-keratinised stratified squamous epithelium that lies over the lamina propria, a loose fibroelastic connective tissue layer rich in small blood vessels (Figure 1(B)). The mucosa layer forms multiple ridges, known as rugae, that expand during copulation or parturition. The rugae have an average surface area of 66–107 cm2 [16]. The number of cell layers and differentiation pattern of the non-keratinised stratified squamous epithelium changes in response to hormone levels and is likely to influence the drug delivery (Figure 1(B)). Premenopausal vaginal epithelium thickness varies between 0.15 and 2 mm during ovulation and reduces to about half during menses [7,11] whereas postmenopausal epithelium width is rather consistent around 0.11 mm [11] (Table 1, Figure 1(B)).