Download NU 545 Pathophysiology Unit 3 Study Guide: Sexually Transmitted Infections and more Exams Pathophysiology in PDF only on Docsity!
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NU 545 Pathophysiology Unit 3 Study
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What is an STI? (affect more than 20 million Americans per year, and 1/2 are younger than 25 years. Hidden epidemic. - ANSWER-STI: is the general term for any disease that can be spread by intimate and/or sexual contact. Includes systemic diseases such as hepatitis and tuberculosis Is prevalent in all socioeconomic and racial or ethnic groups Individuals who have unprotected nonmonogamous sex have the greatest risk for STI exposure and infection. Types of sexually transmitted urogenital infections - ANSWER-Bacterial - (gonorrhea- syphilis-chancroid-granuloma inguinale-bacterial vaginosis) Viral Protozoal Parasitic Fungal Gonorrhea (Bacterial infection) - ANSWER-Disseminated gonococcal infection (DGI) •Rare systemic complication brought about by the spread of infection through the bloodstream •Life-threatening condition causing a generalized rash and severe joint pain Perihepatitis •Spread of N. gonorrhoeae to the liver Ophthalmia neonatorum •Gonococcal eye infection in an infant from an infected mother (most states require prophylactic opthalmic antibiotics to prevent gonococcal eye infection. Topical antibiotics may not be effective in eliminating neonatal infection and systemic tx. is indicated for all newborns with known exposure. (onset of symptoms 1-12 days) Newborns may also develop gonorrheal rhinitis. Gonnorhea (Bacterial infection) - ANSWER-Is caused by Neisseria gonorrhoeae. Transmission generally requires the contact of epithelial surfaces such as vaginal, oral, or anal intercourse, and infection in the adults can be in the vagina, rectum, oropharynx, and the urethra.
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Pregnant woman can pass gonorrhea to her fetus through infected cervical and vaginal secretions, and a mother can pass it to her newborn child. Following vertical transmission, the newborn eyes can be infected and result in blindness if untreated. Humans are the only natural hosts. Presence of pili helps N. gonorrhoeae attach to the epithelial cells of mucous membranes. Why is treatment for gonorrhea becoming more difficult? - ANSWER-because of rapidly developing resistance to antibiotics. CDC and WHO advise dual drug treatment to treat the infection and staunch increasing resistance. Antibiotic resistance is most common in those who frequently have oral and anal intercourse (men with men) CDC says gonorrhea likely to become resistant to all antibiotics in the near future. Common sites/complications of gonorrhea (Bacterial infection) - ANSWER- •Endocervical canal (inner portion of the cervix): most common site for women •Urethra •Skene and/or Bartholin glands •Urethra or rectum: most common site for men Complications: •Pelvic inflammatory disease (PID) •Sterility •Disseminated infection Clinical manifestations of gonorrhea (Bacterial infection) - ANSWER-•Men: sudden onset of painful urination or purulent penile discharge, or both (within a week from infection) •Women (within 10 days of exposure or 1-2 days after the next period. More than half are asymptomatic Symptoms often do not appear until they have spread to the upper reproductive tract (uterus, fallopian/uterine tubes, and ovaries) Dysuria (difficult/painful urination) Increased vaginal discharge, increased flow or dysmenorrhea, dyspareunia (painful sex) , lower abdominal and/or pelvic pain Fever; mucopurulent discharge from the cervical os treatment for gonorrhea (Bacterial infection) - ANSWER-•Antibiotic (ceftriaxone) •Multidrug administration to reduce resistance •Resistant to many antibiotics •Treatment of partners •Avoidance of sex until infection resolved, then usage of condoms
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Develops 6 weeks after the first appearance of the chancre Low-grade fever, malaise, sore throat, hoarseness Anorexia, generalized adenopathy, headache, joint pain, and skin or mucous membrane lesions or rashes Condylomata lata (a raised growth on the skin resembling a wart typically in the genital region) Stage 3, Latent syphilis - ANSWER-Latent syphilis: May be subdivided into early and late stages; however serologic studies show that syphilis is present, but there are no clinical manifestation. Transmission remains possible at this phase. Duration: as short as 1 year or as long as a lifetime Divided into early and late stages Medical evidence of the infection; asymptomatic individual Stage 4, Tertiary syphilis - ANSWER-Tertiary syphilis: Is the most severe stage, involving significant morbidity and mortality. The pathogenesis of syphilitics manifestations at this phase remain unclear. The destructive skin, bone, and soft lesions (called gummas) of tertiary syphilis probably are caused by a severe hypersensitivity reactions to the microorganisms. Within the cardiovascular system, infection with T. Pallidum may cause aneurysms, heart valve insufficiencies, and heart failure. Appearing after the latent stage Most severe stage Formation of gummas: destructive skin, bone, and soft tissue lesions Destructive systemic manifestations Neurosyphilis: tabes dorsalis (loss of coordination of movement general paresis (muscular weakness) Congenital Syphilis - ANSWER-Congenital caused by the passage of spirochete across the plasma membrane to affect any or all fetal tissues. The infection can cause fetal death or growth abnormalities, including changes in fetal bones, teeth and neurologic system. Affected Newborns can have growth abnormalities, rashes, hepatosplenomegaly, jaundice, CNS involvement including blindness and deafness. A classically reported late manifestation of congenital syphilis is notched incisors. While now rare, this stigma is used in historical studies of syphilis. •Vasculitis, necrosis, fibrosis, and distribution of Treponema pallidum throughout the tissues •Early and late stages Tests
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•Venereal Disease Research Laboratory (VDRL) antigen and the rapid plasma reagin (RPR) tests, both tests can have false positives so a Treponemal test is used to verify when positive. Treatment •Parenteral injection of benzathine penicillin G Penicillin also used for infants •Treatment of sexual partners •Condoms recommended until effective treatment is verified chancroid (bacterial infection) - ANSWER-Chancroid, or soft chancre is an acute infectious disease that was first differentiated from syphilis in 1852. It is caused by Haemophilus ducreyi, is a gram-negative bacillus with rounded ends. It is commonly observed in small chains or clusters along mucous strands under a microscope. Transmission can occur through sexual contact and autoinoculation, but there is no evidence of vertical transmission. The incidence of chancroid is decreasing worldwide, and is infrequent in the US. Sporadic outbreaks occur across the world and tend to be associated with prostitution and illicit drug use, when individuals continue to engage in intercourse despite a painful genital lesion. Chancroid is a risk factor for HIV acquisition. Where are the chancroid lesions found? (bacterial infection) - ANSWER-In the genital area. Initially the papulae enlarges, it then erodes into a soft, circumscribed ulcer containing superficial exudate of varying size and presentation. Beneath the ulcer is a lesion characterized by edema, endothelial proliferation, and a base of granulation tissue. Adjacent lymph nodes are acutely inflamed and full of polymorphonuclear leukocytes and necrotic cells. How long is the incubation period for Chancroid? (bacterial infection) P.875 - ANSWER- 3 - 10 days Women are generally asymptomatic but, depending on the site of infection, can present with less obvious symptoms (dysuria, dyspareunia, vaginal discharge, pain on defecation, rectal bleeding. Men: unilateral, painful genital ulcers, local lymphadenopathy, inguinal buboes Treatment: single- or multiple-dose antibiotics; treatment of partners; condom use Granuloma Inguinale (Bacterial Infection) (P.876) - ANSWER-Granuloma inguinale (donovanosis) Chronic, progressive, and destructive bacterial infection Cause: Klebsiella granulomatis; a Gram-negative, non-spore-forming, encapsulated bacteria Mildly contagious; repeated exposure required Concurrent infection with syphilis is common.
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Gonorrhea is a sexually transmitted disease that can be? - ANSWER-local or systemic. Complications include PID, sterility, and disseminated infection. Can gonorrhea be passed to the fetus from the mother? - ANSWER-Yes, and it typically manifests as an eye infection 1-12 days after birth. Opthalmic antibiotic prophylaxis alone is not enough to prevent vertical transmission. Why is multidrug therapy recommended to treat gonorrhea? - ANSWER-Because gonorrhea is rapidly becoming resistant to antibiotics. Does congenital syphilis contribute to prematurity of the newborn? - ANSWER-Yes, due to bone marrow depression, CNS, involvement, renal failure, and introuterine growth retardation. How is syphilis diagnosed? - ANSWER-serologic testing and treated with injectable penicillin. Which bacterial infection is often asymptomatic in women and men may develop inflamed, painful genital ulcers and inguinal buboes? - ANSWER-Chancroid infection Incubation period: 1-14 days. Treatment: Single dose therapy with injectable cefttriaxone or oral azithromycin for BOTH partners is reccommened. Persons with HIV may require a longer treatment. Granuloma inguinale (donovanosis) is rare in the US. What type of bacteria are they? - ANSWER-Gram negative and they survive with macrophages. Localized nodules coalesce to form granulomas and ulcers on the penis in men and on the labia in women. Antibiotics provide effective treatment. What is lymphogranuloma venereum? (Chlamydial infections) - ANSWER- Lymphogranuloma venereum is : Cause: C. trachomatis Chronic STI Begins as a skin lesion; spreads to lymphatic tissue• Inflammation, necrosis, buboes, and abscesses• Can spread to the CNS Primary lesions: incubation period of 5-21 days •Male lesions: penis and scrotum •Female lesions: cervix, vaginal wall, and labia Uncommon in the US, the lesion begins as a skin infection and spreads to the lymph, secondary lesions involve inflammation and swelling of lymph nodes that rupture and drain.
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A 21 day or longer oral doxycycline or ertithromycin is needed for treatment. Treatment for sexual partners is recommended. A woman has chlamydial cervicitis. What will the nurse typically find upon assessment? 1.Yellow mucopurulent discharge 2.Buboes 3.Thin, gray malodorous discharge 4.Abnormal menses (increased flow or dysmenorrhea) - ANSWER-Women with chlamydial cervicitis may be asymptomatic or may have a yellow mucopurulent discharge from the cervical os. Genital herpes (Viral infections) - ANSWER-PAINFUL BLISTERS (cold sores) Two serotypes •Herpes simplex virus (HSV) type 1 (lesions most common around mouth) •HSV type 2 (most common in the genital area) Is not a reportable disease Is transmitted through contact with a person who is shedding the virus Can be intrapartally transmitted Herpes simplex virus (HSV) can pass from mother to fetus; thus women with active lesions should give birth by C-section to avoid vertical transmission. Lifelong infection and contagious during outbreaks. Acyclovir reduces symptoms but does not cure the disease.. Recurrent infections are most often attributable to HSV-2 and are generally milder and of shorter duration. Genital herpes Clinical manifestations - ANSWER-•First-episode primary genital infection: no antibodies, small vesicular lesions with fever and malaise. •First-episode nonprimary HSV: preexisting antibodies, systemic symptoms fewer •Recurrent infections: mild local symptoms •Newborn: local infection of eyes, skin, or mucous membranes to severe disseminated infection with CNS involvement Treatment: no cure •Symptom management and viral suppression treatments with oral antivirals, especially acyclovir Genital herpes (viral infections) - ANSWER-Initial virus replication occurs locally. Virus spreads to contiguous cells and into the sensory nerves. Virus is transported intraaxonally to the dorsal root. Virus remains latent until reactivated. Lesions initially appear as groups of vesicles that progress to ulceration with pain, lymphadenopathy, and fever.
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What are scabies? PARASITIC INFECTIONS - ANSWER-Cause: Sarcoptes scabiei, the adult female itch mite Transmission: prolonged and close skin-to-skin contact •Typically occurs among family members or between sexual partners Classic symptom: intense pruritus Treatment: topical application of PEDICULICIDE treatment for partners and family members; treatment of clothing and bedding Scabies is a parasitic infection that spreads by skin to skin and sexual contact. The scabies mite burrows through the skin, depositing eggs, causing intense pruiritis, especially at night. pediculosis pubis (crabs) (Parasitic infections) - ANSWER-Pediculosis pubis Cause: Phthirus pubis, the crab louse Called "crabs" Transmission: intimate sexual contact or contact with infected bed linens or clothing Crab louse's life cycle: 25-30 days •Stages: egg or nit, three nymphal stages, and an adult stage Clinical manifestations •Mild-to-severe itching, allergic sensitization, and secondary infections from scratching Treatment: creme rinse, shampoo, lotion; treatment of clothes and bedding Common, lice bite into skin for nutrition STI-HEP B - ANSWER-HEP B TRANSMISSION Needle Puncture, Blood transfusion, Cuts in the skin, Contact with Infected body fluids CAN BE SEXUALLY TRANSMITTED pathology: After exposure, passes through the bloodstream to the liver, where it infects liver cells and multiplies CLINICAL MANIFESTATIONS- Asymptomatic: result in permanent immunity- Symptomatic: anorexia, nausea, vomiting, headache, fever, dark urine, JAUNDICE and moderate liver enlargement/tenderness- Poses significant health risks: Chronic liver disease and hepatocellular carcinoma TREATMENT Supportive and relief of symptoms PERINATAL TRANSMISSION High risk for babies of HBV-infected mother unless they receive immunoglobulin and vaccination STI- Other body systems - ANSWER-1. HIV
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- cytomegalovirus infection (CMV)
- Epstein barr (MONO) Zika virus Single-strand RNA Transmitted through bites from infected mosquitos Also transmitted sexually Infection during pregnancy may cause severe fetal infection and CNS abnormalities •Microcephaly Can douching and vaginal deodorants lead to infertility? - ANSWER-Yes, Douching and vaginal deodorants increase a woman's vaginal pH which decreases the levels of L. acidophilus thus lowering vaginal defenses against infection. Can urethritis lead to infertility? - ANSWER-Yes, Urethritis is an inflammatory process of the urethra without concurrent bladder infection. A urethral stricture is a fibrotic narrowing of the urethra caused by scarring from trauma or untreated severe urethral infections. This may lead to obstructed ejaculation. Where is the most common place to find scabies? - ANSWER-The most common places for scabies to burrow are on the hands (between the fingers) and on the flexor surfaces of the wrists and the extensor surfaces of the elbows. Where do pubic lice usually go? - ANSWER-2. Pubic lice usually infect the perineal and axillary hair and occasionally the hair of the trunk, beard, scalp, and eyelashes. STI QUESTIONS Which statement is true regarding hepatits?
- there are 5 types of the HSV?
- Hepatitis D is known to be sexually transmitted
- each type of hepatitis virus causes icteric liver inflammation
- three types of the viruses have possible cures - ANSWER-3. each type of hepatitis causes icteric liver inflammation. Which statement is true regarding fitz hugh curtis syndrome - ANSWER-extremely rare in men, and perihepatitis is a result of gonorrheal infection STI QUESTION which STI is likely to cause small punctate marks on the cervix?
- Human papillomavirus
- trichomoniasis
- molluscum contagiosum
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endometrial carcinoma - ANSWER-Endometrial carcinomas: Arise from glandular epithelium of uterine lining. Primary risk factor is prolonged exposure to estrogen without presence of progesterone (known as unopposed estrogen). Risk factors: postmenopausal women, with peak incidences in 50-60s. Incidence is higher in white women than black however; mortality rates in black women are nearly twice as high, primarily because cancers are likely to be diagnosed in later stages. Other risk factors include obesity, diabetes, gallbladder disease, and hypertension. About 75% endometrial cancers are adenocarcinomas. Clinical manifestation: most common is abnormal vaginal bleeding. polycystic ovary syndrome (PCOS) LEADING CAUSE OF INFERTILITY IN US - ANSWER-most common cause of anovulation (lack of ovulation or release of an egg)and ovulatory dysfunction in women. Defined as: Having at least 2 of the 3 following features: irregular ovulation, elevated levels of androgens (testosterone), and the appearance of polycystic ovaries on ultrasound. strong genetic component Treatment •Combined oral contraceptives (COCs), antiandrogens, fertility agents, insulin sensitizers •Weight loss Those with this syndrome have a three times greater chance of uterine cancer later in life Why is polycystic ovary syndrome (PCOS) difficult to diagnose? - ANSWER-Because the syndrome must have at least two of the following signs present: irregular ovulation/anovulation elevated androgens or clinical signs of hyperandrogenism polycystic ovaries (alone is not enough for diagnosis) CLINICAL MANIFESTATIONS: usually w/ in 2 years of puberty by can present after normal menstruation function and pregnancy. What does prolonged anovulation lead to? - ANSWER-infertility menstrual bleeding disorders hirsutism (abnormal hair growth on a womans face) acne endometrial hyperplasia cardiovascular disease diabetes
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What is primary amenorrhea? - ANSWER-Primary amenorrhea is the continued absence of menarche (first period) by 13 years of age without the development of secondary sex characteristics, or by age 15 if these changes have occurred. What is secondary amenorrhea? - ANSWER-The absence of regular menses for 3 months, or 6 months of irregular menses in women who have previously menstruated. Secondary amenorrhea is usually associated with anovulation. Amenorrhea is divided into compartments that reflect the underlying disorder: Compartment 2 - ANSWER-Compartment 2: DISORDERS OF THE OVARY (etiology of primary amenorrhea) disorders involve the ovary and are often linked with genetic abnormalities. These include gonadal dysgenesis (Turner syndrome), androgen insensitivity syndrome or male pseudohermaphroditism. PUBERTY - ANSWER-Involves the hypothalamic-pituitary-gonadal (HPG) axis, central nervous system (CNS), and endocrine system •Estradiol: breast development; maturation of the vagina, uterus, and ovaries; fat deposit in the hips in girls •Estrogen and increased production of growth factors: rapid skeletal growth in both boys and girls •Testosterone: growth of testes, scrotum, and penis •Positive feedback loop: created to produce more sex hormones What are the signs of puberty in girls? A series of hormonal events promote sexual maturation - ANSWER-Age of puberty is multifactorial, involving genetic and environmental components. Normal range for girls : 8-9 years with thelarche. Obese girls mature earlier, perhaps due to higher estrogen levels related to leptin and gonadotropin secretion. Girls of African and Hispanic descent may appear up to one year earlier Onset of puberty is marked by: thelarche , or breast development by age 13. Delayed puberty is marked by no breast development by age 13. Pubic hair may be present. Female puberty is complete at the first ovulatory menstrual period. What are the signs of puberty in boys? A series of hormonal events promote sexual maturation - ANSWER-Begins at approximately 11 years of age (earlier with increased weight and body mass index Testosterone secretion causes growth of the testes, scrotum, and penis. The scrotal skin thins and testes begin to produce mature sperm. Increased production of growth factors cause rapid skeletal growth.
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Testes (male) - ANSWER-the essential organs of reproduction. They produce 1.) gametes (sperm) 2.) sex hormones (androgens and testosterone). Epidymis (male) - ANSWER-comma shaped structure that curves over the posterior portion of each testis and consists of a single highly packed and markedly coiled duct whose structural function is to conduct sperm from the efferent tubules to the vas deferens. Vas deferens - ANSWER-continuous with the tail of the epididymis, a duct with muscular layers capable of powerful peristalsis that transports sperm toward the urethra. Scrotum - ANSWER-encloses the testes, epididymides, and spermatic cord. It is a skin- covered fibro-muscular sac. Skin is thin and has rugae (wrinkles or folds) that enable is to enlarge or relax away from the body depending on temperature. The tunica dartos forms a septum that separates the two testes. Cold temperatures cause the tunica dartos to contract and pull the testes close to the body. The scrotum keeps the testes at optimal temp (33.8-35.6 F)...lower than body temp by contracting in cold environments and relaxing in warm environments. Penis - ANSWER-delivery of sperm to the vagina and elimination of urine. Internal ducts of penis - ANSWER-consists of the two vasa deferentia, ejaculatory duct, and the urethra. They conduct sperm and glandular secretions from the testes to the urethral opening of the penis. The ejaculatory duct contracts rhythmically during emission and ejaculation. Glands - ANSWER-consists of the prostate gland, two seminal vesicles, and two Cowper (bulbourethral) glands. They secrete fluids that sever as a vehicle for sperm transport and create an alkaline, nutritious medium that promotes sperm motility and survival. How is sexual intercourse made possible? - ANSWER-By the erectile reflex, in which tactile or psychogenic stimulation of the parasynthetic nerves causes arterioles in the corpora cavernosa and corpus spongiosum to dilate and fill with blood, causing the penis to enlarge and become firm. What is the prostate gland and its function? - ANSWER-its the size of a walnut and surrounds the urethra. Prostatic secretions are alkaline and contribute to the ejaculate.
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female sex hormones - ANSWER-Estrogens Estradiol: is the most potent and plentiful Estrone: converted from androgens in the ovaries Estriol: is the peripheral metabolite of estradiol and estrone Progesterone Needs LH (luteinizing hormone) Is the hormone of pregnancy Androgens Are mainly male sex hormones Are produced in small amounts in women Where are female sex hormones produced? - ANSWER-ovaries are the site of 2.) ovum maturation and release b.) production of female sex (estrogen and progesterone) and male (androgens) hormones Female sex hormones predominate and are involved in sexual differentiation and development, the menstrual cycle, pregnancy, and lactation. What do androgens in women contribute to? - ANSWER-prepubertal growth spurt pubic and axillary hair growth activation of sebaceous (hair oil) glands adipose tissue Lactobacillus acidophilus - ANSWER-.maintains an acidic pH in the vagina. The ducts of Skene glands - ANSWER-(also called the lesser vestibular or paraurethral glands) open on both sides of the urinary meatus and lubricates the meatus and vestibule. Bartholin glands - ANSWER-secrete mucus to lubricate the inner labial surfaces as well as enhance the viability and motility of sperm. menstrual cycle - ANSWER-Menarche: first menstruation Menopause: cessation of flow Normal cycle: 28 days Phases of menstruation (menses) Follicular or proliferative phase are the first days of the cycle. Ovulation is the beginning of the luteal or secretory phase. If no implantation occurs, then menses begins. menstrual cycle - ANSWER-Follicular or proliferative phase
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Is stimulated as a result of feedback mechanisms originating in the dominant follicle, which is determined in the first 5-7 day of the cycle. GnRH is secreted by the hypothalamus and travels to the anterior pituitary, which stimulates luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Early Follicular Phase of Menstruation - ANSWER-Estrogen levels low; minute amount of progesterone secreted; GnRH, FSH, and LH levels are low. Late Follicular Phase (preovulatory) of Menstruation - ANSWER-estrogen levels high; progesterone increases with small surge before ovulation; GnRH, FSH, and LH all surge (LH dominates). Ovulatory Phase of Menstruation - ANSWER-estrogen levels dip, progesterone levels begin to rise; GnRH, FSH, and LH all fall sharply. Early Luteal Phase of Menstruation - ANSWER-estrogen and progesterone levels high, progesterone dominates; GnRH, FSH, and LH all gradually decline. Late luteal phase and menstruation - ANSWER-estrogen and progesterone levels fall sharply; GnRH, FSH, and LH all rise slightly. menstrual phase - ANSWER-the phase of the menstrual cycle during which menstruation occurs. estrogen levels low; minute levels of progesterone secreted; GnRN, FSH, and LH levels all low. ovulation phase - ANSWER-The second stage of the general menstrual cycle, when the ovum is released. marks the beginning of the luteal/secretory phase of the menstrual cycle. Pulsatile secretion of LH stimulated corpus luteum to secrete progesterone Fertilization of the egg - ANSWER-HCG is secreted 3 days after fertilization and maintains the corpus luteum once implantation occurs at about day 6 or 7. The production of estrogen and progesterone continues until the placenta can adequately maintain hormone production. No fertilization of the egg - ANSWER-corpus luteum degenerates and ceases production of progesterone and estrogen- endometrium becomes ischemic- menstruation occurs. perimenopause - ANSWER-Period that lasts 2-8 years prior to menopause. Hallmark of impending menopause: Increase in FSH, normal LH.
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Perimenopause transition lasting 2-8 years; erratically higher estradiol levels; decreased progesterone levels; disturbed ovarian-pituitary-hypothalamic feedback relationship with higher LH levels; estradiol levels remain in the normal to slightly elevated range until approx. 1 year before menopause. menopause - ANSWER-the cessation of ovulation due to loss of ovarian follicles resulting in reduced ovarian production of estradiol, increased FSH and LH, and decreased inhibin (inhibits release of FSH). characterized by loss of ovarian function, low estradiol and progesterone levels, high FSH and LH levels, and decreased follicular inhibin secretion. Less androgens are produced but sensitivity to them is increased because of lost opposition of estrogen. Dysmenorrhea - ANSWER-Dysmenorrhea
- Attributed to excessive endometrial prostaglandin production (10 times as much as normal) which cause uterine hyper contractility- decreased blood flow- pain• Up- regulated cyclo-oxygenase (COX) enzyme activity- increased synthesis of prostaglandins• Leukotriene production elevated- pain Mons Pubis (female) - ANSWER-fatty layer of tissue over the pubic symphysis- protects the pubis symphysis during intercourse. Labia Majora - ANSWER-the larger outer folds of the vulva. 2 folds of skin that arise at the mons pubis and extend back to the fourchette, forming a cleft- principal function is to protect the inner structures of the vulva. labia minora - ANSWER-Labia Minora 2 smaller, thinner folds of skin lie within the labia majora- glands secrete bactericidal fluid that has distinctive odor and lubricated and waterproofs the vulvar skin. Clitoris - ANSWER-a richly innervated, erectile organ that lies anterior between the labia minora- secretes a fluid (smegma) which has a unique odor and may be erotically stimulating to the male. Vestibule - ANSWER-Vestibule an area protected by the labia minora and contains the external opening of the vagina (introitus). Hymen may cover the interiotus. Also contains the urinary meatus. Structures are covered lubricated by 2 pairs of glands (Skene and Bartholian glands) help lubricate in response to sexual stimulation.
