Exam 25 - Intro to Reproductive System

• ELO A: Introduction to the Reproductive System

The Male Reproductive System

• Testes Structure: Two oval-shaped structures, about 5cm long and 3cm in diameter, suspended by the spermatic cord and enclosed in the scrotum.
• Testes Function: produce sperm cells and testosterone, responsible for the development of male secondary sex characteristics.
• Epididymis Structure: A tightly coiled tube superior to the testes, leading into the ductus deferens.
• Epididymis Function: stores sperm cells until they mature.
• Ductus (Vas) Deferens Structure: Muscular tube about 46 cm long, enclosed in a connective tissue sheath with nerves and blood vessels, ending behind the urinary bladder.
• Ductus (Vas) Deferens Function: transports sperm.
• Seminal Vesicle Structure: A pair of convoluted, sac-like structures about 5 cm long attached to each vas deferens at the base of the bladder.
• Seminal Vesicle Function: secretes a slightly alkaline fluid rich in fructose and other nutrients for sperm cells, producing 60% of the semen volume.
• Ejaculatory Duct Structure: Short tube, about 1 inch long, beginning at the seminal vesicle and ending in the prostate gland.
• Ejaculatory Duct Function: transports sperm and seminal fluid to the urethra.
• Prostate Gland Structure: Firm, chestnut-sized structure surrounding the beginning of the urethra, composed of muscular and glandular tissue.
• Prostate Gland Function: secretes a thin, milky, alkaline fluid that enhances sperm motility and neutralizes the acidic secretions of the vagina.
• Cowper's Glands (Bulbourethral Glands) Structure: Two pea-sized structures located below the prostate gland under the male urethra.
• Cowper's Glands (Bulbourethral Glands) Function: secretes a mucus-like fluid that partly lubricates the end of the penis in preparation for intercourse.
• Scrotum Structure: Sac-like structure suspended from the exterior abdominal region behind the penis, subdivided into two chambers, each enclosing a testis.
• Scrotum Function: provides a cooler environment (20 - 30 F lower than body temperature) for sperm survival.
• Penis Structure: Cylindrical shape composed of three columns of erectile tissue - corpora cavernosa (pair of dorsally located cylinders) and corpus spongiosum (single cylinder surrounding the urethra).
• Penis Structure: The distal end has an enlarged glans with a foreskin or prepuce.
• Penis Function: Conveys urine and semen, and is specialized for erection during sexual intercourse.
• Male Climacteric: Phase of aging, between 55-70 years, marking the transition from reproductive to non-reproductive life with a gradual decrease in testosterone.
• Male Climacteric Clinical Manifestations: include decreased erections, prostate enlargement, diminished secretions, hair loss, flushing, chilling, and decreased muscle tone.
• Male Climacteric Assessment: includes subjective reports of decreased sexual needs and objective assessment of behaviors, feelings of self-worth, and hormone levels.

The Female Reproductive System

• Ovaries Structure: Solid, ovoid-shaped glands subdivided into the inner medulla and outer cortex, located bilaterally to the uterus inferior to the fallopian tubes.
• Ovaries Function: produce progesterone and estrogen, and release a mature egg cell during the menstrual cycle.
• Uterine (Fallopian) Tubes or Oviducts Structure: Pair of ducts about 4 inches (10cm) long, opening into the fundus, forming a funnel-shaped infundibulum near the ovary with fimbriae.
• Uterine (Fallopian) Tubes or Oviducts Function: assist the egg cell into the uterine tube via fimbriae movement and cilia, transporting it to the uterus.
• Uterus Structure: Muscular, hollow, pear-shaped organ between the urinary bladder and the rectum, composed of the body, fundus, cervix, and layers of the uterine wall.
• Uterus Function: receives the embryo and sustains its life during development, capable of enlarging up to 500 times during pregnancy.
• Vagina Structure: Thin-walled muscular tube about 3 inches (7.5cm) long, lined with mucus membranes and rugae.
• Vagina Function: receives the erect penis during intercourse, conveys uterine secretions, and transports offspring during birth.
• Vulva (External Genitalia): includes the mons pubis, labia majora, labia minora, clitoris and vestibule.
• Mons Pubis: rounded mound of fatty tissue superior to the symphysis pubis, covered with coarse hair.
• Labia Majora: large, rounded folds of fatty tissue containing sensory nerve endings.
• Labia Minora: smaller flattened, longitudinal folds protecting the openings of the vagina and urethra.
• Clitoris: Small projection composed of erectile tissue and nerve fibers.
• Vestibule: Space enclosing structures beneath the labia minora.
• Accessory Glands: include paraurethral (Skene's) glands and Bartholin's glands for lubrication.
• Perineum: Diamond-shaped area located between the symphysis pubis and anus.
• Mammary Glands Structure: Located in the subcutaneous tissue of the superior anterior thorax, composed of 15-20 lobes with milk-producing cells, separated by connective and adipose tissues.
• Mammary Glands Function: Specialized to secrete milk following pregnancy, influenced by prolactin and oxytocin.
• Perimenopause: Transition to menopause, potentially starting as early as the 30's.
• Female Climacteric: Cessation of menses, with an average age of 51 years.
• Artificial Menopause: Can be caused by surgical removal, irradiation, chemotherapy, illness, or drugs.
• Clinical Manifestations: shrinkage of vulval structures, atrophic vulvitis, shortness of the vagina, dryness of the vaginal wall, relaxation of supporting pelvic structures, changes in urinary system, loss of skin turgor and elasticity.
• Medical Management: may include hormone replacement therapy (HRT), calcium and vitamin D supplements, herbal and dietary modifications, SSRIs, clonidine, and gabapentin

Human Sexuality

• Sexuality: A sense of being a woman or a man influenced by biological, psychological, social, and ethical factors.
• Sex: Biological aspects, such as genital sexual activity, for pleasure or reproduction.
• Gender Identity: Sense of being feminine or masculine.
• Gender Role: Societal norms of how a person acts as a woman or man.
• Sexual Orientation: Erotic desire for one sex or another.
• Transgendered: Inward sense of sexual identity differs from biologic body.
• Sexual Health: A key aspect of a complete health care program.
• Taking a Sexual History: Indicates permission for patients to discuss sensitive topics, using patient-friendly language while staying non-judgmental.
• Illness and Sexuality: Various factors such as illness, medications, stress, fatigue, depression, and alcohol abuse can impact sexual functioning and libido.

Diagnostic Tests for the Reproductive System for Women

• Colposcopy: Direct visualization of the cervix and vagina using a colposcope.
• Colposcopy Guidelines: Not performed during menstruation with no douching or intercourse required 24 hours prior.
• Culdoscopy: Minimally-invasive surgical procedure for visualizing the uterus and uterine appendages.
• Laparoscopy: Examination of abdominal cavity using a laparoscope, often with CO2 insufflation.
• Papanicolaou Test (Pap Smear): Procedure to detect cervical cancer.
• Pap Smear Guidelines: Specimens should be labeled with date, time, last menstrual period, and hormone status.
• Biopsy: Tissue samples are taken for evaluation.
• Dilation and Curettage (D&C): Surgical procedure to scrape the uterine lining for tissue biopsy.
• Cultures and Smears: Used to identify infectious processes, abnormal cells, and hormonal changes.
• Schiller's Iodine Test: Staining of the cervix to detect abnormal cells.
• Hysterograms and Hysterosalpingograms: Radiographic images of the uterus and fallopian tubes.
• Mammography: Radiography of soft tissues to identify benign and neoplastic processes.
• Pelvic Ultrasonography: Evaluates pelvic structures and detects foreign bodies or ectopic pregnancies using high-frequency sound waves.
• Tubal Insufflation (Rubin's test): Assesses fallopian tube patency with carbon dioxide.
• Pregnancy Tests: Detect human chorionic gonadotropin (hCG) in urine or blood.
• Serum CA-125: Tumor antigen associated with ovarian cancer which can also be associated with other conditions.

Diagnostic Tests for the Reproductive System for Men

• Testicular Biopsy: Biopsy of testicular tissue.
• Semen Analysis: Analysis to evaluate fertility, effectiveness of a vasectomy, detecting specimen on a suspected sexual assault victim, or determining paternity.
• Prostatic Smears: Used to detect and identify microorganisms, tumor cells, and even tuberculosis in the prostate.
• Cystoscopy: Examination of the prostate and bladder using a lighted cystoscope.
• Rectal Digital Examination: To detect enlarged or abnormal prostate.
• Serum Prostate-Specific Antigen: Elevated in presence of benign prostatic hyperplasia and cancer of the prostate.