Female Reproductive System Review

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What is the function of the external os in the female reproductive system?

To prevent vaginal flora from ascending into the uterus

What is the main function of the ovaries in the female reproductive system?

To produce ova and estrogen and progesterone hormones

What is amenorrhea in the context of menstrual disorders?

Absence of menstruation

What is the function of the cervix in the female reproductive system?

To open into the uterus and neck of the uterus

What is the term for the uterine displacement or prolapse where the cervix lies at the opening to the vagina?

Second-degree prolapse

What is the term for the uterine displacement or prolapse where the uterus and cervix protrude through the vaginal orifice?

Third-degree prolapse

What is the function of the adipose tissue in the female reproductive system?

None of the above

What is the main function of the fallopian tubes in the female reproductive system?

To connect the ovaries to the uterus

What is Fibrocystic Breast Disease characterized by?

A broad range of breast changes and increased density of breast tissue

What is the most common location for breast tumors?

Upper outer quadrant

What is the characteristic of advanced stages of uterine displacement or prolapse?

Discomfort, infection, and decreased mobility

What is dysmenorrhea primarily caused by?

Excessive release of prostaglandins

What is the term for bleeding between menstrual cycles?

Metrorrhagia

What is a key factor in the growth of breast cancer cells?

Estrogen receptors

What is a common predisposing factor for breast cancer?

Having a first-degree relative with the disease

What is the term for endometrial tissue occurring outside the uterus?

Endometriosis

What is the primary way that breast cancer metastasizes?

Via the lymphatic system

What is the primary symptom of pelvic inflammatory disease (PID)?

Pelvic pain

What is the term for benign tumors of the myometrium?

Leiomyoma

What is the purpose of hormone blocking agents in breast cancer treatment?

To target estrogen receptors in tumor cells

What is the primary cause of most cases of cervical cancer?

Human papillomavirus (HPV) infection

What is the primary characteristic of polycystic ovarian disease?

Thickening of the fibrous capsule around follicles

What is the typical age range for the diagnosis of carcinoma of the uterus?

50-70 years

What is the term for premenstrual syndrome with more severe symptoms?

Premenstrual dysphoric syndrome

What is the primary cause of candidiasis?

Fungal infection

What is the primary method of detection for carcinoma of the uterus?

Painful vaginal bleeding or spotting

What is the term for the growth of a sac containing old blood on the ovary?

Chocolate cyst

What percentage of ovarian cancer cases are diagnosed in early stage?

25%

What is the name of the protein whose high levels indicate ovarian cancer?

CA125

What is a risk factor for ovarian cancer?

Early menarche

What is the usual treatment for ovarian cancer?

Surgery and chemotherapy

What is a common cause of infertility in women?

All of the above

What is the name of the bacterium that causes chlamydial infections?

Chlamydia trachomatis

What is a complication of untreated gonorrhea in newborns?

Ophthalmia neonatorum

What is the primary stage of syphilis characterized by?

A presence of chancre at the site of infection

What is a congenital condition caused by syphilis?

All of the above

What is the primary cause of genital herpes?

HSV-1 or HSV-2

What is the characteristic of lesions in genital herpes?

Painful and preceded by a tingling sensation

What is the common trigger for reactivation of genital herpes?

Illness, stress, and menstruation

What is the treatment for genital herpes?

Antiviral drugs for treatment and prevention of transmission

What is the characteristic of genital warts?

Cauliflower-like and varying in appearance

What is the common way of transmission of genital warts?

Through sharing towels and non-sexual contact

What is the consequence of having genital warts?

Increased risk of cervical or vulvar cancer

What is the characteristic of trichomoniasis?

Localized infection and asymptomatic in men

What is the treatment for trichomoniasis?

Systemic treatment for both partners

Study Notes

Female Reproductive System

  • The uterus is a muscular organ where a fertilized ovum may implant and develop.
  • The cervix is the opening into the uterus and the neck of the uterus.
  • The external os is the opening from the vagina, filled with thick mucus, which prevents vaginal flora from ascending into the uterus.
  • The internal os is the opening of the fallopian tubes (oviducts) from the ovaries to the uterus.
  • Ovaries produce ova and estrogen and progesterone hormones.
  • Breasts consist of glands that produce colostrum and milk for newborns, and adipose tissue.

Structural Abnormalities

  • Uterine displacement or prolapse occurs when the cervix or uterus drops into the vagina.
  • First-degree prolapse: cervix drops into the vagina.
  • Second-degree prolapse: cervix lies at the opening to the vagina.
  • Third-degree prolapse: uterus and cervix protrude through the vaginal orifice.
  • Early stages of prolapse may be asymptomatic, while advanced stages cause discomfort, infection, and decreased mobility.

Menstrual Disorders

  • Amenorrhea: absence of menstruation, which may be primary or secondary.
  • Primary form may be genetic.
  • Menstrual abnormalities include:
    • Dysmenorrhea: painful menstruation caused by excessive release of prostaglandins.
    • Premenstrual syndrome (PMS): symptoms include breast tenderness, weight gain, abdominal distension, irritability, emotional liability, sleep disturbances, depression, headache, and fatigue.
    • Abnormal bleeding: menorrhagia, metrorrhagia, polymenorrhea, and oligomenorrhea.

Carcinoma of the Breast

  • Incidence increases after age 20 years.
  • Most cases occur in women between ages 50 and 69 years.
  • Can metastasize quickly to brain, lungs, bone, and liver.
  • Most tumors are unilateral and occur in the upper outer quadrant.
  • Types of carcinoma:
    • Ductal carcinoma: most common type, arising from ductal epithelial cells.
    • Lobular carcinoma: arising from lobular epithelial cells.
  • Predisposing factors:
    • First-degree relative with the disease.
    • Strong genetic predisposition (BRCA1 and BRCA2).
    • Longer and higher exposure to estrogen.
    • Nulliparous or late first pregnancy.
    • Lack of exercise.
    • Smoking.
    • High-fat diet.
    • Radiation therapy to the chest.
    • Cancer of the uterus, ovaries, or pancreas.

Carcinoma of the Cervix

  • Most cases are caused by human papillomavirus (HPV) infection.
  • Vaccines now exist against the causative strains of HPV.
  • Routine Pap smears of cervical cells are important in identifying early, treatable stages of the disease.
  • Development of carcinoma:
    • In situ: non-invasive stage.
    • Cervical intraepithelial neoplasia (CIN): stage 3.

Carcinoma of the Uterus

  • Most common in postmenopausal women.
  • Early indicator is painless vaginal bleeding or spotting.
  • Risk factors:
    • Age > 50 years.
    • High-dose estrogen hormone treatment without progesterone.
    • Obesity.
    • Diabetes.
  • Pap smear does not detect this cancer.
  • Types of carcinoma:
    • Adenocarcinomas: arising from glandular epithelium.
    • Leiomyosarcomas: arising from connective tissue or muscle, with a poor prognosis.

Endometriosis

  • Endometrial tissue occurs outside the uterus.
  • Ectopic endometrium responds to cyclical hormone changes.
  • Bleeding leads to inflammation and pain.
  • Fibrous tissue may cause adhesions and obstructions of the involved structures.
  • Treatment:
    • Hormonal suppression.
    • Surgical removal of ectopic tissue.

Infections

  • Candidiasis (vaginitis): causes red and swollen, intensely pruritic mucous membranes and a thick, white, curdlike discharge.
  • Pelvic inflammatory disease (PID):
    • Infection of uterus, fallopian tubes, and/or ovaries.
    • May be acute or chronic.
    • Infection usually originates as an ascending infection from the lower reproductive tract.
    • Most infections arise from sexually transmitted diseases, nonsterile abortions, or childbirth.
  • Signs and symptoms:
    • Pelvic pain (lower abdominal).
    • Increased temperature.
    • Pain increases with walking.
    • Guarding (tensing the abdominal wall).
    • Nausea and vomiting.
    • Leukocytosis.
    • Purulent discharge may be present.

Ovarian Cysts

  • A variety of types occur.
  • Physiological type lasts about 8 to 12 weeks and disappears without complications.
  • Usually multiple, small, fluid-filled sacs.
  • Go away on their own usually.
  • If bleeding occurs, more serious inflammation occurs.
  • Requires surgical intervention.
  • Ultrasound or laparoscopy for identification.

Ovarian Cancer

  • No reliable screening available.
  • Large mass detected by pelvic examination.
  • Transvaginal ultrasound.
  • Only 25% are diagnosed in early stage.
  • Considered a silent tumor.
  • Few diagnosed in the early stage.
  • Research is ongoing to identify markers for serum diagnosis.
  • Types of carcinoma:
    • Serous: most common type.
    • Mucinous: second most common type.
    • Endometrioid: third most common type.
  • Risk factors:
    • Obesity.
    • BRCA1 gene.
    • Early menarche.
    • Nulliparous or late first pregnancy.
    • Use of fertility drugs.
    • Oral contraceptives containing progesterone are somewhat protective.

Infertility

  • Cause may be a female condition, male condition, or a combination of both.
  • Associated with hormonal imbalances.
  • Age of parents.
  • Structural abnormalities-small or divided uterus.
  • Infections (STDs for example).
  • Chemotherapy-can reduce viability of sperm or egg.
  • Change in vaginal pH due to too much douching, thick cervical mucus, antibodies against sperm.
  • Idiopathic (no known cause).
  • Smoking/secondhand smoke.

Bacterial Infections

  • Chlamydial infections:
    • Caused by Chlamydia trachomatis.
    • Treatment is doxycycline and azithromycin.
    • Males-urethritis and epididymitis.
    • Females-often asymptomatic until PID or infertility develops.
    • Newborns may be infected during birth.
  • Gonorrhea:
    • Caused by Neisseria gonorrhoeae.
    • Many strains have become resistant to penicillin and tetracycline.
    • Males-most common site is urethra, which is inflamed.
    • Females-frequently asymptomatic (infects endocervical canal).
    • PID and infertility are serious complications.
    • May infect the eyes of the newborn, causing irreversible damage and blindness.
  • Syphilis:
    • Caused by Treponema pallidum, a spirochete.
    • Primary stage-presence of chancre at site of infection.
    • Genital region, anus, oral cavity.
    • Painless, firm, ulcerated nodule.
    • Occurs about 3 weeks after exposure.
    • Lesion heals spontaneously but client is still contagious.
    • Secondary stage-if untreated, a flulike illness occurs, with a widespread symmetrical rash.
    • Latent stage-may persist for years.
    • Transmission may occur in the first few years of this stage.
    • Tertiary syphilis-irreversible changes.
    • Gummas in organs and major blood vessels.
    • Dementia, blindness, motor disabilities.

Viral Infections

  • Genital herpes:
    • Caused by HSV-2 or HSV-1.
    • HSV-1 possible with oral sex.
    • Lesions similar to HSV-1.
    • Recurrent outbreaks of blister-like vesicles on the genitalia.
    • Preceded by tingling or itching sensation.
    • Lesions are extremely painful.
    • After acute stage, virus migrates back to dorsal root ganglion.
    • Infectivity greater when symptoms are present.
    • Reactivation is common and may be associated with stress, illness, menstruation.
    • Antiviral drugs are used for treatment and prevention of transmission.
    • Infection is considered lifelong.
  • Condylomata acuminata (genital warts):
    • Caused by HPV.
    • Incubation period may be up to 6 months.
    • Disease may be asymptomatic.
    • Warts vary in appearance.
    • Warts can appear wherever contact with virus has occurred.
    • Warts can be removed by different methods.
    • May predispose to cervical or vulvar cancer.
    • Most common STD and can be spread in non-sexual ways.
  • Trichomoniasis:
    • Caused by Trichomonas vaginalis, a protozoan parasite.
    • Localized infection.
    • Men-usually asymptomatic.
    • Women-may be subclinical.
    • Flares up when microbial balance in vagina shifts.
    • Causes intense itching.
    • Yellow/green discharge, foul smelling.
    • Systemic treatment necessary for both partners.

This quiz covers the components of the female reproductive system, including the uterus, cervix, fallopian tubes, and ovaries. It reviews the functions and features of each part, including the roles of estrogen and progesterone. Test your knowledge of the female reproductive system!

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