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16. Hymen Injury – continued.
ANO-GENITAL EXAMINATION: HYMEN – continued
• Ecchymosis or bruise – Hemorrhagic area on the hymen due to extravasation of blood into a
mucous membrane
• Hematoma – Mass of usual clotted blood that forms in a tissue, organ or body space as a
result of a broken blood vessel
• Laceration – Injury or tear of tissue.
• Healing time is affected by a variety of factors, including age, nutrition, individual
healing capacity and the extent of the wound. Descriptions, such as those listed below,
serve as guidelines only; they are not intended to be definitive measurements.
�� Fresh (presence of fresh blood, edema): injury occurred within past 24 hours
�� Healing (presence of granulation, no blood): injury occurred between 48
hours and 21 days
�� Healed (with scar): injury cannot be dated accurately
• Notch – Angular or “V”-shaped indentation on the edge of the hymenal membrane and may
extend to the muscular attachment of the hymen
• If notch is greater than 50 percent of the hymen’s diameter and is present in the kneechest
postion, classify as “suggestive of abuse”
• Transection – Tear or laceration through the entire width of the hymenal membrane
Notch
NOTCHED HYMEN
Hymen