. Atlas and epitome of gynecology . ittle later,—from the fourth to the sixthweek,—and certain invagina-tions or openings of one hollow7viscus into another do notoccur, resulting in atresiavulvse, atresia ani, or atre=sia urethrse. Fig. 3.—Atresia ani ; con- rrn - ±- genitfl rectovaginal fistula These malformations may (above the hymen). occur alone or in combination with o t h e r d e velopm e n talerrors, such as a persistent cloaca : L e\, that embryoniccavity that connects the bladder with the rectum and isclosed externally. (Fig. 12.) The external opening firstappears when the rectovesica
. Atlas and epitome of gynecology . ittle later,—from the fourth to the sixthweek,—and certain invagina-tions or openings of one hollow7viscus into another do notoccur, resulting in atresiavulvse, atresia ani, or atre=sia urethrse. Fig. 3.—Atresia ani ; con- rrn - ±- genitfl rectovaginal fistula These malformations may (above the hymen). occur alone or in combination with o t h e r d e velopm e n talerrors, such as a persistent cloaca : L e\, that embryoniccavity that connects the bladder with the rectum and isclosed externally. (Fig. 12.) The external opening firstappears when the rectovesical septum, containing theMullerian ducts, grows down and forms the perineum.(Figs. 12 to 16.) Certain atresias combined with con=genital fistulas may be traced back to this embryonicperiod—atresia ani with a rectovaginal fistula = atresiaani vaginalis. (Fig. 3.) Imperfect closure of the primitive urethra toward thevagina gives rise to the rare condition known as femi=nine hypospadias (to be explained on etiologic and ana-. ATRESIAS. 23 tomic grounds different from those of a similar conditionin the male). Imperfect closure toward the clitoris—feminine epispadias—is still rarer, and is usually asso-ciated with a fissured clitoris, a cleft symphysis (pelvisfissa), and inversio (ectopia)vesicae : i. e., absence of theanterior wall of the bladder,the posterior wall beingplainly visible. (c) The fistula rectohy=menalis or rectovestibu=laris (Fig. 6) springs froma later period of the em-bryonic cycle, and differsfrom the rectovaginal fistulain that the opening is in the vulva, outside of the hymen. It dates from the forma-tion of the perineum (consequently, later than the cloaca),which is formed by the union of the septum urogenito-
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