The vagina

The vagina is situated between the rectum (the opening from the bowel) and the urethra (the opening from the bladder). It is the structure via which the uterine secretions shed during menstruation are conveyed to the outside. Vaginal tissue, being primarily muscular, can also stretch to many times its normal size during the birth of a baby and then return to normal.

The upper portion of the vagina surrounds the cervix, somewhat like an umbrella, and the recesses that are created between the vaginal wall and the cervix are called the fornices. A fornix (plural fornices) is an arch-like space or recess formed between two structures. The fornices are important because they are relatively thin-walled and allow the internal abdominal organs to be felt during a physical examination (sometimes called internal palpation). The posterior fornix, which is formed by the back wall of the vagina and the cervix, is longer than the other fornices and is called the pouch of Douglas. See Figures 2.2 and 2.3.

The pouch of Douglas is lined with peritoneum. This is a common place for endometrial tissue to grow when a woman has endometriosis. Infected fluid or pus can also collect in the pouch of Douglas if a woman has a pelvic infection.

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