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Child's Hymen

This document discusses child maltreatment and the examination of a child's hymen for signs of sexual abuse. It notes that child maltreatment can include physical or psychological abuse and neglect, and that the boundaries between these areas can be indistinct. Sexual abuse is considered a type of physical abuse with strong emotional components. Both physical abuse and neglect can have short- and long-term psychological consequences that may persist after physical wounds have healed. The document then focuses on the anatomy of the prepubertal female genitalia and hymen, noting the range of normal variations in hymenal openings and membranes. It stresses that any examination for possible sexual abuse should document both positive and negative clinical findings.

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649 views9 pages

Child's Hymen

This document discusses child maltreatment and the examination of a child's hymen for signs of sexual abuse. It notes that child maltreatment can include physical or psychological abuse and neglect, and that the boundaries between these areas can be indistinct. Sexual abuse is considered a type of physical abuse with strong emotional components. Both physical abuse and neglect can have short- and long-term psychological consequences that may persist after physical wounds have healed. The document then focuses on the anatomy of the prepubertal female genitalia and hymen, noting the range of normal variations in hymenal openings and membranes. It stresses that any examination for possible sexual abuse should document both positive and negative clinical findings.

Uploaded by

Anonymous 6Burk8G
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Childs Hymen

The spectrum of child maltreatment.


Child maltreatment encompasses acts of commission, abuse, and
acts of omission or neglect by a caretaker that adversely affect
children.
The act can be physical or psychologic.
The boundaries between these areas are indistinct and
psychologic; physical abuse and neglect overlap and may exist at
the same time or various times in a childs life.
Sexual abuse may be considered a specific type of physical abuse
that has strong emotional components.
Physical abuse and neglect invariably have short- and long-term
psychologic consequences.
Psychologic consequences may persist long after the physical
wounds heal.
Triage protocol for children with suspected sexual abuse.
Female prepubertal genital anatomy. A, Inset shows the region defined as the
posterior hymenal rim, between the 4 and 8 oclock positions, shaded blue. B,
There is a range of normal anatomic variations in hymenal openings. Crescentic
and annular are 2 of the most common shapes. C, The photographs illustrate the
range of normal prepubertal hymenal membranes. In most children, the hymen
becomes thicker and more redundant during puberty. (From Berkoff MC, Zolotor
AJ, Makoroff KL, et al: Has this prepubertal girl been sexually abused? JAMA
300:27792792, 2008.)
Hymenal membrane characteristics.
When considering the possibility of sexual abuse during an
examination, the examiner should document pertinent
positive and negative findings.
In addition to the clinical signs depicted in the figure, other
possible findings include prominent hymenal vessels,
bumps, tags, longitudinal intravaginal ridge, external ridge,
periurethral bands, or vestibular bands.
Perforation of the hymen is not a finding commonly
discussed in the literature.
(From Berkoff MC, Zolotor AJ, Makoroff KL, et al: Has this
prepubertal girl been sexually abused? JAMA 300:2779
2792, 2008.)

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