Anatomy Matters in Sexual Assault Cases
The female genital anatomy is commonly misidentified and misunderstood to the general population, but when it comes to the intricacies of sexual assault, one needs to be well versed.
But, for example, what does it mean when there is a laceration noted at 6 o’clock at the posterior fourchette? Where is that? Understanding anatomical landmarks will assist you!
One common misunderstanding is that females have three orifices/openings versus the two a male has. A female has one each for the urethra, vagina, and anus. In the instance of a sexual assault, one must ask where penetration occurred and with what object (penial, oral, digital, inanimate object).
Key Anatomical Terms
- Vulva: the external part that includes the labia, clitoris, vaginal opening, and the urethral opening
- Mons Pubis: is the area above the vulva, usually where pubic hair is seen after puberty, that protects the pubic bone
- Clitoris/Clitoral Hood: the clitoral hood serves as a protective cover for the clitoris. The clitoris is an erectile organ for pleasure.
- Urethral Opening: where urine is released from the body
- Labia Majora: outer fold of skin that covers the vaginal opening
- Labia Minora: these are the inner folds of skin which meet at the clitoris and end at the vaginal opening.
- Hymen: a thin, fleshy tissue that covers the vaginal opening. There are various shapes and thickness levels of the hymen.
- Vaginal Opening: also called the introitus, is where a baby is delivered, blood exits during the menstrual cycle, and where vaginal penetration occurs.
- Vagina: is a muscular tube that connects the cervix and the labia
- Fossa navicularis: a depression at the base of the labia between the vaginal opening and the posterior fourchette. (Bottom of the vestibule in the photo)
- Posterior Fourchette: is a small piece of tissue that connects the labia minora. This is the most common location for genital injuries to be found.
- Perineum: the area of skin that connects the genitals to the anus
- Anus: is the opening to the rectum.
What Our Nurses Can Do For You
When an alleged victim of sexual assault undergoes an exam, a skilled provider will assess the anogenital region using a clock face technique. This is usually a nurse who has been trained to examine and collect physical evidence, called a Sexual Assault Nurse Examiner (SANE). If you need someone to help you understand the report generated and the anatomical terms, our nurses are ready to consult and testify on your case! We now have five SANE nurses – including two that are certified and available for testimony in either adult or pediatric cases.
Figure 1 https://www.uptodate.com/contents/image?imageKey=OBGYN%2F72614 (free/open image)
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