Human Anatomy: Female Reproductive System

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Questions and Answers

What is the primary drug used for treating dysfunctional uterine bleeding?

Clomiphene

Progesterone

Depo Pro-Vera (correct)

Estrogen

During which phase does the corpus luteum in the ovary begin to regress?

Follicular Phase

Menstrual Phase

Luteal Phase

Ischemic Phase (correct)

What describes the period of 'viability' for a fetus?

Period from conception until 8 weeks

Capable of living outside the uterus (correct)

Time during which the embryo develops organs

Time from birth until 24 weeks

At what gestational age is chorionic villi sampling typically performed?

8 to 10 weeks Signup and view all the answers

What condition is suggested by elevated alpha-fetoprotein levels?

Neural Tube Defect Signup and view all the answers

What terminology refers to the total number of pregnancies reaching viability, regardless of outcome?

Gravida Signup and view all the answers

Which of the following is NOT a component of the TPAL acronym?

L - live births Signup and view all the answers

What occurs to the endometrium during the ischemic phase?

It degenerates and sloughs off. Signup and view all the answers

What is the primary function of the uterus?

To serve as the passageway for menstruation and fetus Signup and view all the answers

What is the length of the posterior wall of the vagina?

8-9 cm Signup and view all the answers

Which layer of the uterus is the muscle layer responsible for contractions during labor?

Myometrium Signup and view all the answers

What component of the vagina allows it to stretch without tearing?

Rugae Signup and view all the answers

Which portion of the uterus is most commonly cut during a Cesarean section?

Isthmus Signup and view all the answers

What is the weight of a non-pregnant uterus?

60 g Signup and view all the answers

Which type of decidua lies directly under the embryo?

Decidua basalis Signup and view all the answers

Which structure is primarily composed of membranous tissue that covers the vaginal orifice?

Hymen Signup and view all the answers

What is the normal size range for ovaries in centimeters?

4 cm by 2 cm Signup and view all the answers

Which layer of the uterus is the innermost layer?

Endometrium Signup and view all the answers

What is the primary psychological task of a mother during the second trimester?

Acceptance of the baby Signup and view all the answers

Which theory of parturition suggests that the level of progesterone decreases as the pregnancy approaches term?

Progesterone withdrawal theory Signup and view all the answers

What characterizes the android pelvis in relation to childbirth?

Narrow pubic arch Signup and view all the answers

Which term describes the condition where the fetal head is incongruent with the maternal pelvis?

Cephalopelvic disproportion Signup and view all the answers

What reflects the mother's concern for her well-being during the third trimester?

Concern is less towards the baby Signup and view all the answers

Which pelvic type is considered the ideal for childbirth?

Gynecoid pelvis Signup and view all the answers

What hormone's receptors increase in the uterus as delivery approaches?

Oxytocin Signup and view all the answers

Which factor does NOT affect the labor process?

Maternal age Signup and view all the answers

What characterizes a threatened abortion?

Vaginal bleeding without cervical dilation Signup and view all the answers

Which type of abortion is defined as the end of a pregnancy before fetal viability?

Induced abortion Signup and view all the answers

In an ectopic pregnancy, where does the implantation most commonly occur?

Ampulla of Fallopian tube Signup and view all the answers

Which factor is the most common predisposing factor for ectopic pregnancy?

Pelvic Inflammatory Disease Signup and view all the answers

Which symptom is NOT part of the triad manifestations of ectopic pregnancy?

Severe headaches Signup and view all the answers

What is the primary use of methotrexate in the context of ectopic pregnancy?

To shrink and absorb products of conception Signup and view all the answers

What indicates a complete abortion?

All products of conception have passed Signup and view all the answers

Which of the following is a clinical manifestation of ectopic pregnancy?

Abdominal rigidity Signup and view all the answers

What does the term 'bloody show' refer to during labor?

Expulsion of the mucus plug from the cervical canal Signup and view all the answers

What is the primary purpose of the Nitrazine test during labor?

To identify the presence of amniotic fluid Signup and view all the answers

Which phase of the first stage of labor involves cervical dilation of 4 to 7 cm?

Active phase Signup and view all the answers

What is the recommended duration of the latent phase for a nullipara?

6 hours Signup and view all the answers

During which stage of labor does the actual delivery of the fetus occur?

Second stage Signup and view all the answers

What should be avoided if the cervix is not fully dilated and there are no contractions?

Encouraging pushing Signup and view all the answers

What are the characteristics of uterine contractions during the transition phase?

Strongest with brief intervals Signup and view all the answers

What risk arises if the membrane has ruptured for more than 24 hours without birthing?

Infection requiring immediate Cesarean Section Signup and view all the answers

Study Notes

External Genitalia

Vaginal Orifice: The external opening of the vagina.
Hymen: Membranous tissue covering the vaginal orifice.
Perineum: Muscular structure between the vagina and anus.

Internal Genitalia

Vagina: Passageway for menstruation and fetus, 6-7 cm (anterior wall), 8-9 cm (posterior wall), with dilatable canal.
- Rugae: Thick folds of membranous stratified epithelium allowing stretching without tearing.
Uterus: Hollow, muscular, pear-shaped organ for containing and nourishing the fetus.
- Functions: Menstruation, pregnancy, and labor.
- Dimensions (non-pregnant): 2.5 cm thick, 5 cm wide, 5-7 cm long.
- Shape (non-pregnant): Pear shape.
- Shape (pregnant): Ovoid.
- Weight:
  - Non-pregnant: 60 g.
  - Pregnant: 1000 g.
- Uterine Anatomy:
  - Fundus: Upper cylindrical layer, palpable for uterine growth during pregnancy.
  - Isthmus: Short segment between the body and cervix, commonly cut during Cesarean section.
  - Corpus (Body): Portion that expands to contain the growing fetus.
  - Cervix: Lower uterine segment, half above the vagina, half extending into it.
- Uterine Layers:
  - Endometrium: Innermost layer, composed of basal and glandular layers.
  - Myometrium: Muscular layer of the uterus, constricts tubal junctions, prevents menstrual blood regurgitation, contracts during labor and delivery.
  - Perimetrium: Outermost layer, adds strength and support.
Decidua: Latin for "falling off".
- Types:
  - Decidua basalis: Endometrium directly under the embryo.
  - Decidua capsularis: Portion of the endometrium encapsulating the trophoblast surface.
  - Decidua vera: Remaining portion of the uterine lining.
Ovaries: Almond-shaped, grayish-white, female sex gonads producing progesterone and estrogen.
- Dimensions: 4 cm long, 2 cm diameter, 1.5 cm thick.
- Depo Pro-vera: Progesterone-containing drug for dysfunctional uterine bleeding.

Menstrual Cycle

Ischemic Phase:
- Corpus luteum in the ovary regresses after 8-10 days without fertilization.
- Progesterone and estrogen production decreases.
- Endometrium degenerates.
- Capillaries rupture with minute hemorrhages.
- Endometrium sloughs off.
Menstrual Phase:
- Low levels of estrogen and progesterone.
- Passage of menstrual flow.

Pregnancy Terminology

Zygote: Product of fertilization, less than 2 weeks after ovulation.
Embryo: Intrauterine growth period from implantation until organogenesis is complete, 2 to less than 8 weeks after ovulation.
Fetus: 8 weeks from conception to birth.
Viability: Fetus can be delivered and survive outside the uterus. Period of viability is 24 weeks and above.
Gravida: Number of pregnancies reaching the age of viability, regardless of outcome.
TPAL:
- T: Term pregnancies.
- P: Preterm pregnancies.
- A: Abortions.
- L: Living children.

Pregnancy Tests

Urine Pregnancy Test: Detects human chorionic gonadotropin (hCG) in urine.
- Sensitivity: Can detect hCG levels as low as 25 mIU/ml.
- Accuracy: Highly accurate, more so when taken after missed period.
Blood Pregnancy Test: Detects hCG in blood.
- Sensitivity: Can detect hCG levels as low as 5 mIU/ml.
- Accuracy: More accurate than urine tests, detectable earlier in pregnancy.
Quantitative hCG Tests:
- Purpose: Determines the exact amount of hCG in the bloodstream.
- Uses: Monitor the development of pregnancy, diagnose ectopic pregnancy, and monitor viability.
Ultrasound:
- Uses: Confirm pregnancy, determine gestational age, monitor fetal growth, detect abnormalities.
- Early ultrasound: Visible at 4-5 weeks, heartbeat at 6 weeks.

Chorionic Villi Sampling

Purpose: Retrieval and analysis of chorionic villi from the placenta for chromosomal or DNA analysis.
Timing: 8 to 10 weeks of pregnancy.
Post Procedure: Instruct to report chills or fever suggestive of infection or threatened miscarriage.

Alpha-fetoprotein (AFP)

Purpose: A glycoprotein produced by the fetal liver, detectable in maternal serum.
Peak Level: Between the 13th and 32nd week of pregnancy.
Results:
- Elevated: Neural tube defects.
- Decreased: Fetal chromosomal disorders (e.g., Down syndrome).

Psychological Tasks of the Mother

First Trimester:
- Acceptance of pregnancy.
- Mother's concern for herself is greater than concern for the baby.
Second Trimester:
- Acceptance of the baby.
- Concern for self is equal to concern for the baby.
Third Trimester:
- Acceptance of parenthood.
- Concern for self is less than concern for the baby.

Theories of Parturition:

Fetal Sign: The baby feels capable of living outside the uterus.
Oxytocin Theory of Parturition: Increased oxytocin receptors in the uterus as term approaches.
Progesterone Withdrawal Theory: Progesterone levels decrease as term approaches, causing uterine contraction.
Prostaglandin Theory: Prostaglandins stimulate uterine contraction.

Factors Affecting Labor

Pelvic Dimension:
- Android Pelvis: Male-like pelvis, narrow lower dimensions.
- Anthropoid Pelvis: Narrow transverse diameter, larger anteroposterior diameter at the inlet.
- Gynecoid Pelvis: "Normal" female pelvis, well-rounded inlet, ideal for childbirth.
- Platypelloid Pelvis: Flattened pelvis, oval inlet, shallow anteroposterior diameter.
Fetal Dimensions:
- Fetal Size: Correlation between baby size and pelvic size.
- Cephalopelvic Disproportion (CPD): Fetal head is incongruent with the maternal pelvis, head is larger than the pelvis.

Signs of Approaching Labor

Bloody Show: Cervical softening and ripening expels the mucus plug (operculum).
Rupture of Membranes: Sudden gush or slow seeping of clear fluid from the vagina.
Cervical Dilation: Opening of the cervix.

Stages of Labor

First Stage: True contractions to 10 cm cervical dilation.
- Phases:
  - Latent Phase: Mild contractions, 20-40 seconds every 5-10 minutes.
    - Cervical dilation: 0 to 3 cm.
    - Nullipara: 6 hours.
    - Multipara: 4.5 hours.
  - Active Phase: Moderate contractions, 40-60 seconds every 3-5 minutes.
    - Cervical dilation: 4 to 7 cm.
  - Transition Phase: Strongest contractions, 60-90 seconds every 2-3 minutes.
    - Cervical dilation: 8 to 10 cm.
Second Stage: Full cervical dilation (10 cm) to delivery of the fetus.
- Primigravida: 1-4 hours.
- Mutigravida: 20-45 minutes.

Nitrzine Test

Purpose: Determine if fluid is amniotic.
Process: Nitrazine paper contacts vaginal secretions.
Results:
- Blue (alkaline): Amniotic fluid.
- Red (acidic): Urine.

Important Concepts (Labor)

If membranes rupture for greater than 24 hours without delivery, infection is likely, requiring immediate Cesarean section.
Do not encourage pushing if the cervix is not fully dilated or there are no contractions.

Types of Spontaneous Abortion

Threatened Abortion: Vaginal bleeding, no cervical dilation or effacement.
Inevitable/Imminent Abortion: Vaginal bleeding, cervical dilation and effacement.
Complete Abortion: All products of conception pass through the vagina.
Incomplete Abortion: Some products of conception pass through the vagina.
Habitual Abortion: Three or more consecutive miscarriages.

Induced Abortion

Purpose: Termination of pregnancy before fetal viability.
Types:
- Therapeutic Abortion: Performed for medical reasons.
- Illegal Abortion: Performed without legal or medical justification.

Ectopic Pregnancy:

Definition: Implantation outside the uterine cavity.
Most Common Site: Ampulla of the Fallopian tube.
Predisposing Factor: Pelvic inflammatory disease (PID).
Other Factors:
- Previous surgery.
- Intrauterine device (IUD).
- History of previous ectopic pregnancies.
Triad Manifestations:
- Amenorrhea.
- Vaginal bleeding or spotting.
- Unilateral lower abdominal pain/tenderness.
Clinical Manifestations:
- Severe, sharp, knife-like pain.
- Unilateral pain.
- Abdominal rigidity.
- Bleeding inside.
- Hemoperitoneum.
- Peritonitis.
- Cullen's Sign: Ecchymosis around the umbilicus due to hemoperitoneum.
- Decreased blood pressure.
- Excruciating pain with movement (wriggling tenderness.)
Diagnosis: Culdocentesis.
Medical Management:
- Methotrexate: Sclerosing agent to shrink and absorb the products of conception; chemotherapeutic agent to destroy fast-growing cells. Given intramuscularly.

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Explore the structures of the female reproductive system, including both external and internal genitalia. This quiz covers important components such as the vaginal orifice, hymen, uterus, and their respective functions and dimensions. Test your knowledge on the anatomy and physiological roles of these organs.