Introduction	
  Introduction
  About the Authors	
  Acknowledgements	
Tutorial	
  Tutorial	
Technical Conduct of the Anogenital Exam	
  Anatomical Map	
  Visualization Techniques	
    Frog-leg position	
    Supine labial separation	
    Supine labial traction	
    Supine knee-chest genital exam	
    Supine knee-chest perianal exam	
    Prone knee-chest genital exam	
    Prone knee-chest perianal exam	
    Supine vs. prone position	
    Saline irrigation	
    Foley catheter	
    Q-tips	
    Vital dyes	
Female Genital Anatomy	
  Clitoris / Clitoral Hood	
    Congenital Variations	
      clitoral nevus	
      generalized clitoral pigmentation	
  Labia Majora	
    Congenital Variations	
      labia majora hemangioma	
    Non-Traumatic Pathology	
      diaper dermatitis	
      chronic dermatitis	
      lichen sclerosis et atrophicus	
      Fordyce's Granules	
    Trauma	
      Acute/Recent Injury	
        labia majora ecchymosis	
  Labia Minora	
    Normal Anatomy	
    Congenital Variations	
      labia minora hemangioma	
      labia minora pigmentation	
    Non-specific findings	
      labia minora varicosity	
    Non-Traumatic Pathology	
      labial adhesions	
      labial adhesion friability	
      lichen sclerosis et atrophicus	
    Trauma	
      Acute/Recent Injury	
        labia minora abrasion	
        labia minora hemorrhage	
        labia minora avulsion	
        labia minora trauma with straddle injury	
        severe labia minora trauma	
  Vestibule	
    Non-specific Findings	
      Erythema	
      Hemangioma	
  Urethra	
    Congenital Variations	
      periurethral bands	
    Non-specific Findings	
      urethral dilatation	
      urethral / periurethral inflammation	
    Non-traumatic Pathology	
      urethral prolapse	
    Trauma	
      Acute/Recent Injury	
        periurethral contusion	
      Non-acute Injury	
        traumatic urethral hypospadius	
  Hymen	
    Normal Anatomy	
      hymenal configuration	
        annular hymen	
        transitional hymen	
        crescentic hymen	
        fimbriated (denticular) hymen	
        tulip hymen	
        imperforate hymen	
        microperforate hymen	
        cribriform hymen	
      folded hymenal edges	
      rolled hymenal edges	
      velamentous hymen	
      hymenal elasticity	
      hymenal redundancy	
    Congenital Variations	
      anterior hymenal cleft	
      anterior placed hymenal opening	
      lateral placed hymenal opening	
      hymenal duplication	
      hymenal hemangioma	
      hymenal mound	
      hymenal pigmentation	
      hymenal septum	
      hymenal septal remnant	
      hymenal tag	
      hymens in identical twins	
      perihymenal bands	
      hymenal external ridge	
    Developmental Variations	
      hymenal changes with estrogen	
        general hymenal changes with estrogen	
        Hymenal 'Wings'	
        scalloped hymenal edges	
      hymenal vertical elongation with obesity	
    Non-specific Findings	
      perihymenal erythema	
    Trauma	
      Acute/Recent Injury	
        hymenal petechiae	
        hymenal abrasion	
        hymenal ecchymosis	
        hymenal hemorrhage	
        hymenal edema	
        hymenal transection	
        hymenal partial tear	
        perihymenal laceration	
      Non-acute Injury	
        post-traumatic lateral hymenal cleft	
        post-traumatic posterior hymenal cleft	
        hymenal rim narrowing (attenuated)	
        key-hole hymen	
  Vagina	
    Normal Anatomy	
      Intravaginal Longitudinal Ridges (ILR)	
      Intravaginal Column	
        anterior intravaginal column	
        posterior intravaginal column	
    Congenital Variations	
      vaginal septum	
      vaginal septal remnant	
      vaginal prolapse	
    Developmental Variations	
      Vaginal Changes With Estrogen	
        physiologic leukorrhea	
    Non-traumatic Pathology	
      vaginal foreign body	
  Fossa Navicularis (Posterior perihymenal fossa)	
    Normal Anatomy	
    Congenital Variations	
      fossa navicularis pigmentation	
      fossa navicularis groove	
      linea vestibularis	
      fossa navicularis midline defect	
    Non-specific Findings	
      fossa navicularis pallor	
      fossa navicularis asymmetry	
    Trauma	
      Acute/Recent Injury	
        fossa navicularis laceration	
  Posterior Fourchette (posterior commissure)	
    Normal Anatomy	
    Trauma	
      Acute/Recent Injury	
        posterior fourchette abrasion	
        posterior fourchette laceration	
      Non-acute Injury	
        posterior fourchette scar	
  Perineum	
    Congenital Variations	
      median raphe	
      failure of midline fusion	
      perineal nevus	
    Trauma	
      Acute/Recent Injury	
        acute perineal trauma	
Male Genital Anatomy	
  Normal Anatomy	
    penile urethral meatus	
  Congenital Variations	
    median raphe	
    Penile Hemangioma	
    periurethral cysts	
  Non-Traumatic Pathology	
    Paraphimosis	
    penile lichenification	
  Trauma	
    Acute/Recent Injury	
      acute penile / scrotal trauma	
      balanitis	
      penile burn	
      penile ligature	
    Non-acute Injury	
      penile scars	
Anal/Perianal Anatomy	
  Normal Anatomy	
    anal verge	
    pectinate line	
    perianal skin folds (rugal folds)	
  Congenital Variations	
    anal skin tag	
    Midline Anterior Perianal Protuberance (MAPP)	
    diastasis ani	
    failure of anal fusion	
  Non-Specific Findings	
    Anal Dilatation	
      external sphincter	
      internal sphincter	
    hyperpigmentation	
    chronic anal fissure	
    Perianal Venous Congestion	
    Perianal Venous Engorgement in Adolescence	
    perianal postmortem findings	
    prominent anal verge	
  Non-traumatic Pathology	
    Hemorrhoids	
      external	
      internal	
    lichen sclerosis et atrophicus	
    perianal cellulitis	
    perianal skin maceration	
    rectal prolapse	
  Trauma	
    Acute Anal / Perianal Trauma	
    Non-acute Injury	
      perianal venous engorgement	
      rapid anal dilatation	
      anal / perianal scars	
      perianal skin fold hypertrophied/thickerned	
Related Trauma Findings	
  Intragluteal Trauma	
  Thigh Trauma	
  Suction Petechiae	
  Neck Trauma	
  Cigarette Burn	
Infectious Anal/Genital Findings	
  Sexually Transmitted Diseases	
    Human Papilloma Virus (HPV)	
      oral condylomata acuminata	
      genital condylomata acuminata	
      anal / perianal condylomata acuminata	
    Neisseria Gonorrhoeae Vaginitis	
    Chlamydia Vaginitis	
    Syphilis	
    Trichomonas vaginitis	
    Herpes Simplex	
      vulvar	
      penile	
      perianal	
    Gardnerella (bacterial vaginosis)	
  Other Infections	
    Streptococcal	
      group A streptococcal vaginitis	
      group B streptococcal vaginitis	
    staphylococcal vulvovaginitis	
    hemophilus influenza vaginitis	
    varicella	
      genital varicella	
      perianal varicella	
    candida vaginitis	
    molluscum contagiosum, perianal	
    non-specific vulvovaginitis	
    pinworm	
    shigella vaginitis	
    Genital/Perianal Warts, Non-HPV	
Morphs	
  Female Anatomy	
    Labia Minora	
      Trauma	
        Acute/Recent Injury	
          labia minora abrasion	
          labia minora trauma with straddle injury	
    Hymen	
      Normal Anatomy	
        hymenal configuration	
          annular hymen	
      Trauma	
        Acute/Recent Injury	
          hymenal hemorrhage	
          hymenal ecchymosis	
          hymenal edema	
          hymenal transection	
          hymenal partial tear	
        Non-acute Injury	
          post-traumatic posterior hymenal cleft	
    Fossa Navicularis (Posterior perihymenal fossa)	
      Trauma	
        Acute/Recent Injury	
          fossa navicularis laceration	
    Posterior Fourchette (posterior commissure)	
      Trauma	
        Acute/Recent Injury	
          posterior fourchette laceration	
  Anal Anatomy	
    Non-Specific Findings	
      Perianal Venous Congestion	
    Trauma	
      Acute/Recent Injury	
        acute anal / perianal trauma	
      Non-acute Injury	
        non-acute anal / perianal injuries	
          rapid anal dilatation	
  Infectious Anal/Genital Findings	
    Sexually Transmitted Diseases	
      Human Papilloma Virus (HPV)	
        perianal condylomata acuminata	
      Herpes Simplex	
        perianal	
All References	
APSAC Glossary	
Index	
  Acute Male Genital Trauma	
  Anal Dilatation, External	
  Anal Dilatation, Internal	
  Anal Fissure, Chronic	
  Anal Scar	
  Anal Skin Tag	
  Anal Venous Engorgement in Adolescence	
  Anal Verge	
  Balanitis	
  Burn, Cigarette	
  Candida Vaginitis	
  Chlamydia Vaginitis	
  Condylomata Acuminata, Genital	
  Condylomata Acuminata, Oral	
  Condylomata Acuminata, Perianal	
  Dermatitis, Labia Majora	
  Diaper Dermatitis	
  Diastasis Ani	
  Failure Of Fusion, Anal	
  Foley Catheter	
  Fordyce's Granules	
  Foreign Body, Vagina	
  Fossa Navicularis Asymmetry	
  Fossa Navicularis Groove	
  Fossa Navicularis Laceration	
  Fossa Navicularis Midline Defect	
  Fossa Navicularis Pallor	
  Fossa Navicularis Pigmentation	
  Frog-Leg, Supine	
  General Hymenal Changes With Estrogen	
  Genital/Perianal Warts (non-HPV)	
  Gluteal Cleft Fissure	
  Hemangioma, Labia	
  Hemangioma, Vestibule	
  Hemorrhoid, External	
  Hemorrhoid, Internal	
  Herpes Simplex, Penile	
  Herpes Simplex, Perianal	
  Herpes Simplex, Vulva	
  Hymen, Keyhole	
  Hymen, Annular	
  Hymen, Anterior Placed Opening	
  Hymen, Crescentic	
  Hymen, Cribriform	
  Hymen, Elastic	
  Hymen, External Ridge	
  Hymen, Fimbriated	
  Hymen, Folded Edges	
  Hymen, Imperforate	
  Hymen, Lateral Placed Opening	
  Hymen, Microperforate	
  Hymen, Rolled Edges	
  Hymen, Scalloped Edges	
  Hymen, Transitional	
  Hymen, Tulip Configuration	
  Hymen, Velamentous	
  Hymenal Abrasions	
  Hymenal Cleft, Anterior	
  Hymenal Duplication	
  Hymenal Ecchymosis	
  Hymenal Edema	
  Hymenal Elongation & Obesity	
  Hymenal Hemangioma	
  Hymenal Hemorrhage, Acute	
  Hymenal Mound	
  Hymenal Petechiae	
  Hymenal Pigmentation	
  Hymenal Redundancy	
  Hymenal Rim Narrowing	
  Hymenal Septal Remnants	
  Hymenal Septum	
  Hymenal Tag	
  Hymenal Transection, Acute	
  Hymenal Wings	
  Hymens, Identical In Identical Twins	
  Intravaginal Longitudinal Ridges	
  Labia Majora Ecchymosis	
  Labia Minor Hemangioma	
  Labia Minora Abrasions	
  Labia Minora Avulsion	
  Labia Minora Hemorrhage	
  Labia Minora Trauma , Severe	
  Labia Minora Varicosity	
  Labia Minora, Normal	
  Labial Adhesion Friability	
  Labial Adhesions	
  Labial Separation, Supine	
  Labial Traction, Supine	
  Lichen Sclerosis Et Atrophicus	
  Lichen Sclerosis et Atrophicus	
  Linea Vestibularis	
  Median Raphe, Female	
  Median Raphe, Male	
  Midline Anterior Perianal Protuberance (MAPP)	
  Molluscum Contagiosum, Perianal	
  Neck Trauma	
  Neisseria Gonorrhoeae Vaginitis	
  Nevus, Clitoris	
  Nevus, Labia Minora	
  Nevus, Perineum	
  Normal Fossa Navicularis	
  Normal Posterior Fourchette	
  Partial Hymenal Tear	
  Pectinate Line	
  Penile Burn	
  Penile Hemangioma	
  Penile Lichenification	
  Penile Ligature	
  Penile Paraphimosis	
  Penile Scar	
  Penile Urethral Meatus	
  Perianal Cellulitis	
  Perianal Hyperpigmentation	
  Perianal Postmortem Findings	
  Perianal Skin Folds Hypertrophied, Thickened	
  Perianal Skin Maceration	
  Perianal Trauma	
  Perianal Venous Congestion	
  Perianal Venous Engorgement, Localized	
  Perihymenal Bands	
  Perihymenal Erythema	
  Perihymenal Laceration	
  Perineal Trauma, Acute	
  Perineum, Failure Of Midline Fusion	
  Periurethral Bands	
  Periurethral Contusion	
  Periurethral Cysts	
  Periurethral Inflammation	
  Physiologic Leukorrhea	
  Pigmentation, Labial/Clitoral	
  Pinworm	
  Posterior Fourchette Abrasion	
  Posterior Fourchette Laceration, Acute	
  Posterior Fourchette Scar	
  Post-Traumatic Lateral Hymenal Cleft	
  Post-Traumatic Posterior Hymenal Cleft	
  Prominent Anal Verge	
  Prone Knee-Chest Genital Exam	
  Prone Knee-Chest Perianal Exam	
  Q-Tips	
  Rapid Anal Dilatation	
  Rectal Prolapse	
  Rugal Folds	
  Saline Irrigation	
  Straddle Injury, Labia Minor Trauma	
  Suction Petechiae	
  Supine Knee-Chest Genital Exam	
  Supine Knee-Chest Perianal Exam	
  Supine vs. Prone	
  Syphilis	
  Thigh Trauma	
  Trichomonas Vaginitis	
  Urethral Dilatation	
  Urethral Hypospadias	
  Urethral Prolapse	
  Vaginal Column, Anterior	
  Vaginal Column, Posterior	
  Vaginal Prolapse	
  Vaginal Septal Remnant	
  Vaginal Septum	
  Vaginitis, Gardnerella	
  Vaginitis, Group A Strep	
  Vaginitis, Group B Strep	
  Vaginitis, Hemophilus Influenza	
  Vaginitis, Shigella	
  Varicella, Perianal	
  Varicella. Genital	
  Vestibule, Erythema	
  Vital Dyes	
  Vulvovaginitis, Non-Specific	
  Vulvovaginitis, Staphylococcal