1.-B-ANATOMY.pptx

 Grading:  Attendance/ Assignment 10%  Quizzes 20%  Mastery Exams 30%  Term Exams 40%  TotaL 100%   TRENDS IN MATERNAL AND CHILD CARE 1.FAMILIES ARE SMALLER IN SIZE THAN IN PREVIOUS DECADES 2.SINGLE PARENTS ARE INCREASING IN NUMBER...

 Grading:  Attendance/ Assignment 10%  Quizzes 20%  Mastery Exams 30%  Term Exams 40%  TotaL 100%   TRENDS IN MATERNAL AND CHILD CARE 1.FAMILIES ARE SMALLER IN SIZE THAN IN PREVIOUS DECADES 2.SINGLE PARENTS ARE INCREASING IN NUMBER 3.AN INCREASING NUMBER OF MOTHERS ARE WORKING OUTSIDE THE HOME 4.FAMILIES ARE MORE MOBILE THAN PREVIOUSLY 5.ABUSE IS MORE COMMON THAN EVER BEFORE  FEMALE REPRODUCTIVE SYSTEM: EXTERNAL STRUCTURES ( VULVA/ PUDENDUM) A. MONS PUBIS OR MONS VENERIS = PAD OF FAT OVER THE SYMPHYSIS PUBIS. HAIRLESS & SMOOTH IN CHILDHOOD, IT IS COVERED BY DARK & CURLY HAIR CALLED ESCUTCHEON AFTER PUBERTY. HAIR PATTERN IS TRIANGULAR WITH BASE UP. B. LABIA MAJORA = LENGTHWISE, TWO THICK FOLDS OF FATTY SKIN EXTENDING FROM THE MONS TO THE PERINEUM THAT PROTECTS THE LABIA MINORA, URINARY MEATUS AND VAGINAL MUCOSA. C. LABIA MINORA = THINNER, LENGTHWISE FOLDS OF HAIRLESS SKIN, ENCIRCLING THE CLITORIS ANTERIORLY (PREPUCE) AND UNITE POSTERIORLY ( FOURCHETTE).BELOW THE PREPUCE IS CALLED FRENULUM. HIGHLY SENSITIVE TO MANIPULATION AND TRAUMA, THE REASON WHY IT IS OFTEN TORN DURING DELIVERY. D. VESTIBULE = TRIANGULAR SPACE LOCATED BETWEEN THE LABIA MINORA CONTAINING VAGINAL INTROITUS, URETHRAL MEATUS BARTHOLIN’S & SKENE’S GLANDS E. GLANS CLITORIS = SMALL ERECTILE STRUCTURE; CONTAINS NERVE ENDINGS, SENSITIVE TO TEMPERATURE AND TOUCH. IT IS THE SEAT OF SEXUAL AROUSAL AND EXCITEMENT IN FEMALES. IT IS THE MOST SENSITIVE PART OF A WOMAN’S BODY. IT IS ALSO THE STRUCTURE THAT GUIDES THE NURSE TO THE URINARY MEATUS. F. URETHRAL MEATUS = THE EXTERNAL OPENING OF THE URETHRA. SLIGHTLY BEHIND AND TO THE SIDE ARE THE OPENINGS OF THE SKENE’S GLANDS (PARAURETHRAL GLANDS); THE SECRETIONS OF WHICH HELP TO LUBRICATE THE EXTERNAL GENITALIA. THE SHORTNESS OF THE FEMALE URETHRA MAKES WOMEN MORE SUSCEPTIBLE TO UTI THAN MEN G. HYMEN. = A TOUGH BUT ELASTIC SEMICIRCLE OF TISSUE THAT PROTECTS THE OPENING TO THE VAGINA. = CAN BE STRETCHED OR TORN DURING PHYSICAL ACTIVITY, TAMPON INSERTION OR SEXUAL INTERCOURSE = THE REMNANT OF THE HYMEN IS CALLED CARUNCULAE MYRTIFORMIS. ( MYRTIFORMES CARUNCLES) = SEPARATES INTERNAL FROM EXTERNAL REPRODUCTIVE ORGANS H. VAGINAL ORIFICE / INTROITUS = EXTERNAL OPENING OF THE VAGINA, COVERED BY A THIN MEMBRANE ( HYMEN) IN VIRGINS.LOCATED LATERAL TO THE VAGINAL OPENING ON BOTH SIDES ARE THE BARTHOLIN’S GLANDS ( VULVOVAGINAL GLANDS). IT LUBRICATES THE EXTERNAL VULVA DURING COITUS AND THE ALKALINE PH OF THEIR SECRETION HELPS TO IMPROVE SPERM SURVIVAL IN THE VAGINA. THE GRAFENBERG OR G-SPOT IS A VERY SENSITIVE AREA LOCATED AT THE INNER ANTERIOR ASPECT OF THE VAGINA. I. FOURCHETTE = THIN FOLD OF TISSUE FORMED BY MERGING OF THE LABIA MAJORA AND LABIA MINORA BELOW THE VAGINAL ORIFICE. J. PERINEUM = MUSCULAR SKIN COVERED AREA BETWEEN VAGINAL OPENING AND ANUS.  INTERNAL STRUCTURES: A.VAGINA HOLLOW MEMBRANOUS & MUSCULAR CANAL, 3-4 INCHES LONG,DILATABLE, CONTAINS RUGAE (WHICH PERMITS CONSIDERABLE STRETCHING WITHOUT TEARING).IT IS LOCATED IN FRONT OF THE RECTUM & BEHIND THE BLADDER. = PASSAGEWAY OF MENSTRUATION = PASSAGEWAY OF FETUS (NSD) = ORGAN OF COPULATION = SEMEN DEPOSITORY ** DODERLIEN’S BACILLUS MAINTAINS THE NORMAL FLORA OF THE VAGINA, WHICH MAKES THE pH OF VAGINA ACIDIC, DETRIMENTAL TO THE GROWTH OF PATHOLOGIC BACTERIA. pH 4-5 : acidic RUGAE – TRANSVERSE FOLDS OF SKIN IN THE VAGINAL WALL THAT IS ABSENT IN CHILDHOOD, APPEAR AFTER PUBERTY & DISAPPEARS AT MENOPAUSE. FORNIX-FORNICES= THE CERVIX PROJECTS TO THE VAGINA FORMING FOUR RECESSES OR DEPRESSION AROUND ITS UPPER PORTION CALLED FORNICES: ANTERIOR FORNIX, LATERAL FORNICES, POSTERIOR FORNIX. B. UTERUS = HOLLOW, MUSCULAR PEAR SHAPED ORGAN LOCATED IN THE PELVIS, WEIGHING 50-60 g IN A NON-PREGNAT WOMAN. HELD IN PLACE BY BROAD LIGAMENTS. ABUNDANT BLOOD SUPPLY COMES FROM UTERINE AND OVARIAN ARTERIES. - DURING PUBERTY, IT INCREASES IN SIZE & REACHES ITS MAXIMUM SIZE AT 17 YRS OLD - FUNCTONS: a. ORGAN OF IMPLANTATION ( NIDATION) AND MENSTRUATION b. RECEIVES THE FERTILIZED OVUM FROM THE FALLOPIAN TUBE c. FURNISHES PROTECTION FOR A GROWING FETUS - DURING PUBERTY, IT INCREASES IN SIZE & REACHES ITS MAXIMUM SIZE AT 17 YRS OLD - FUNCTONS: a. ORGAN OF IMPLANTATION ( NIDATION) AND MENSTRUATION b. RECEIVES THE FERTILIZED OVUM FROM THE FALLOPIAN TUBE c. FURNISHES PROTECTION FOR A GROWING FETUS  DIVISIONS OF THE UTERUS 1.CERVIX = LOWER PORTION CALLED THE NECK a. EXTERNAL CERVICAL OS = DISTAL OPENING TO THE VAGINA b. CERVICAL CANAL = THE CAVITY c. INTERNAL CERVICAL OS = OPENING TO THE UTERUS 2. FUNDUS = UPPERMOST CONVEX PORTION AND CAN BE PALPATED TO DETERMINE UTERINE GROWTH DURING PREGNANCY , TO ASSESS UTERINE CONTRACTIONS DURING LABOR,& INVOLUTION DURING THE POSTPARTUM PERIOD = MOST VASCULAR PORTION = NORMAL IMPLANTATION SITE 3. Isthmus = the constricted portion immediately above the cervix. The lower uterine segment; It distends during pregnancy It is the portion that is incised during caesarean section. 4. CORPUS – BODY OF THE UTERUS WHICH MAKES UP 2/3 OF THE SAID ORGAN. HOUSES THE FETUS DURING PREGNANCY 5.CORNUA – THE UPPER PORTION WHERE THE FALLOPIAN TUBES ARE ATTACHED. LAYERS / COATS: 1.PERIMETRIUM = OUTERMOST LAYER, IT IS ATTACHED TO THE BROAD LIGAMENTS & OFFER ADDED SUPPORT TO THE UTERUS 2. MYOMETRIUM = MIDDLE LAYER , EXPELS FETUS DURING BIRTH PROCESS THEN CONTRACTS AROUND BLOOD VESSELS TO PREVENT HEMORRHAGE (OXYTOCIN SITE) 3. ENDOMETRIUM = INNERMOST LAYER; THIS LAYER UNDERGO CHANGES IN RESPONSE TO THE HORMONES AT VARIOUS PHASES OF THE MENSTRUAL CYCLE & DURING PREGNANCY; IT CONSISTS OF TWO LAYERS: GLANDULAR LAYER – PEELS OFF DURING MENSTRUATION & THICKENS DURING THE PROLIFERATIVE & SECRETORY PHASE BASAL LAYER – LAYER ADJACENT TO THE MYOMETRIUM & GIVES RISE TO THE NEW ENDOMETRIUM AFTER MENSTRUATION & DELIVERY. Class V: Septated uterus (uterine septum or partition). Class VI: DES uterus. The uterine cavity has a "T-shape" as a result of fetal exposure to diethylstilbestrol. UTERINE LIGAMENTS: 1.BROAD LIGAMENT – SUPPORTS THE SIDES OF THE UTERUS & ASSISTS IN HOLDING THE UTERUS IN ITS NORMAL ANTEVERSION AND ANTEFLEXION POSITION. 2. CARDINAL LIGAMENT ( TRANSVERSE CERVICAL LIGAMENT) – LOWER PORTION OF THE BROAD LIGAMENT. IT IS THE MAIN SUPPORT OF THE UTERUS.DAMAGE TO THIS LIGAMENT WILL RESULT TO UTERINE PROLAPSE. 3. UTEROSACRAL LIGAMENT – CONNECTS UTERUS TO THE SACRUM 4. ANTERIOR LIGAMENT –PROVIDES SUPPORT TO THE UTERUS IN CONNECTION WITH THE BLADDER. OVERSTRETCHING OF THIS LIGAMENT WILL LEAD TO HERNIATION OF THE BLADDER TO THE VAGINA ( CYSTOCELE). 5. POSTERIOR LIGAMENT – FORMS THE CUL- DE-SAC OF DOUGLAS. DAMAGE TO THIS LIGAMENT WILL LEAD TO HERNIATION OF THE RECTUM TO THE VAGINA. ( RECTOCELE) C. FALLOPIAN TUBES / OVIDUCTS / UTERINE TUBES = TWO SLENDER MUSCULAR TUBES WHICH ARISES FROM EACH OF THE UPPER CORNER OF THE UTERINE BODY AND EXTEND OUTWARD. PROVIDES A PLACE FOR FERTILIZATION ( CONCEPTION, FECUNDATION, IMPREGNATION) OF OVA BY THE SPERM. PARTS: 1.INTERSTITIAL =( 1cm) LIES WITHIN THE UTERINE WALL. IT HAS THE SMALLEST LUMEN. 2. ISTHMUS =( 2cm) PORTION CUT OR SEALED DURING TUBAL LIGATION.( BTL) 3. AMPULLA =( 5cm) LONGEST PORTION, EXACT SITE OF FERTILIZATION ( DISTAL 3RD, OUTER 3RD) 4. INFUNDIBULUM =MOST DISTAL PORTION; RIM OF THE FUNNEL IS COVERED BY FIMBRAE THAT HELPS GUIDE THE OVA INTO THE FALLOPIAN TUBE. FUNCTION: TRANSPORT FERTILIZED OVUM FROM OVARY TO THE UTERUS SITE OF FERTILIZATION D. OVARIES = ALMOND SHAPED ORGANS LOCATED ON EITHER SIDE OF THE UTERUS. BEFORE PUBERTY, THE OVARIES ARE SMOOTH, FLAT & OVOID ORGANS. AFTER OVULATIONS, THEY ASSUME A NODULAR & PITTED APPEARANCE. FUNCTIONS: = RESPONSIBLE FOR THE PRODUCTION, MATURATION AND DISCHARGE OF OVA AND SECRETION OF ESTROGEN AND PROGESTERONE = ORGAN OF OVULATION OVARIES  Gamete – sex cell  Female gamete = ovum  Male gamete = sperm  Gonad – organ that produces the sex cell  Female gonad – ovary  Male gonad – testes  Oocyte – oogenesis  Spermatocyte – spermatogenesis  Gametogenesis LAYERS OF THE OVARY: 1.TUNICA ALBUGINEA - THE OUTERMOST PROTECTIVE LAYER SURROUNDED BY A SINGLE LAYER OF CUBOIDAL EPITHELIUM. 2. CORTEX - THE FUNCTIONAL LAYER WHICH IS THE SITE OF OVUM FORMATION & MATURATION. IT CONTAINS THE PRIMORDIAL FOLLICLES, GRAAFIAN FOLLICLES, CORPUS LUTEUM & CORPUS ALBICANS. - 5 months intrauterine = 5 TO 7 MILLION - at birth = 2 million oocytes - 7 years = 500,000 - 22 years = 300,000 to 400,000 - 36 years old = 30,000 to 40,000 - menopause = absent 3. MEDULLA - LAYER WHICH CONTAINS THE BLOOD VESSELS, LYMPHATICS, NERVES & MUSCLE FIBERS. MALE REPRODUCTIVE SYSTEM: ANDROLOGY External Structures: A. Scrotum: rugated , skin covered pouch hanging below the penis that contains the testes. Its function is to regulate the temperature of the sperm. In very cold weather, the dartos & cremasteric muscle contracts to bring the testes closer to the body wrinkling its outer surface. In very hot weather or in the presence of fever, the scrotal muscles relaxes, allowing the testes to fall away from the body. - sebaceous glands open directly into scrotum secretions w/ distinct odor DEGREE OF WRINKLING - smooth in preterm, wrinkled in full term newborns - greatest wrinkling in young men & at cold temperature - least wrinkling in older men & at warm temperature Assessment of a new male newborn should include palpating the scrotum to detect if testes has descended from the abdominal cavity. Spermatogenesis will not occur if the testes fail to descend because they will be subjected to body temperature ( it is cooler in the scrotum). To enhance spermatogenesis & have adequate viable sperms, avoid tight undergarments & pants & prolonged sitting. B. TESTES = TWO OVOID SHAPED BODY THAT LIE INSIDE THE SCROTUM = ENCASED BY A PROTECTIVE WHITE FIBROUS CAPSULE AND COMPRISES A NUMBER OF LOBULES ( 250-400) = EACH LOBULE CONTAINS INTERSTITIAL CELLS ( LEYDIG’S CELLS) AND 1 to 3 SEMINIFEROUS TUBULES = SEMINIFEROUS TUBULES PRODUCE SPERMATOZOA = LEYDIG’S CELLS PRODUCE THE HORMONE TESTOSTERONE FUNCTIONS OF THE TESTES: 1.SPERMATOGENESIS = PROCESS BY WHICH THE SPERMATOCYTES ARE DEVELOPED INTO MATURE SPERMATOZOA 2. HORMONE PRODUCTION a. TESTOSTERONE = AN ANDROGEN OR MUSCULINIZING HORMONE RESPONSIBLE FOR 1. GROWTH & DEVELOPMENT OF SECONDARY SEX CHARACTERISTICS - increase in height, size & number of muscles & bone growth cessation - Deepening of the voice - Growth of penis, testes, scrotum, seminal vesicle, prostate gland - Growth of hair on face, chest, axilla and pubis b. FSH = FOLLICLE STIMULATING HORMONE = TOGETHER W/ TESTOSTERONE CAUSES RAPID SPERM PRODUCTION BY THE SEMINEFEROUS TUBULE c. ( LH ) ICSH – INTERSTITIAL CELL STIMULATING HORMONE = STIMULATES LEYDIG’S CELLS TO INCREASE TESTOSTERONE PRODUCTION - Sertoli cells – thought to provide structural & metabolic support to the developing sperm cell. FUNCTIONS: - maintain the environment necessary for development & maturation - secrete supporting testicular fluid - The testes first form in utero. They start to descend at 28 weeks and is present in the scrotal sac late in intrauterine life ( 34 th to 38th week). Because this descent occurs late in pregnancy, many male preterm infants are born with undescended testes.( Cryptorchidism) In most males, one testis is slightly larger than the other & is suspended slightly lower in the scrotum than the other ( left). Because of this, the testes tend to slide past each other more readily on sitting or muscular activity, & there is less possibility of trauma to them Sperms do not survive at a temperature as high as that of the body. The location of the testes outside the body, where the temp is approximately 1F lower than body temp provides protection for sperm survival. TESTICULAR SELF EXAM In early adolescence, boys need to learn testicular self-examination so that they can detect tenderness or any abnormal growth. Normal testes feel firm, smooth and egg shaped Ideally performed monthly, after a warm shower or bath when scrotal skin is relaxed Most testicular cancers, the most common cancer in young men between ages 15 & 34 are found by men themselves when doing TSE WARNING SIGNS THAT MEN SHOULD LOOK FOR: 1. Hard lump 2. Painless swelling, pain in a testicle or scrotum 3. Feeling of heaviness 4. Sudden collection of fluid in the scrotum Dull ache in the lower abdomen or groin C. Penis: the male organ of copulation; composed of 3 cylindrical masses of erectile tissue in the penis shaft termed : a. corpora cavernosa -two lateral columns of erectile tissue b. corpus spongiosum - encases the urethra Parts: 1.The glans penis, a cone-shaped expansion of the corpus spongiosum that is highly sensitive in males. 2. Shaft or body 3. Prepuce or Foreskin – retractable skin covering the glans & removed during circumcision. Unretractable or tight foreskin is called PHIMOSIS. Male B. Internal Structures 1. Epididymis: serves as reservoir for sperm storage and maturation. Approximately 20 ft. it takes 12-20 days for the sperm to travel the length of Epididymis. A total of 64 days before they reach maturity. (“Treatment= 2 months”). Aspermia - (absence of sperm) Oligospermia- if < 20 million sperm/ ml 2. Vas deferens: a duct extending from epididymis to the ejaculatory duct and seminal vesicle, providing a passageway for sperm. Varicocele- varicosity of internal spermatic cord Vasectomy (male birth control) 3. Seminal vesicle: are two convoluted pouches that lie along the lower portion of the bladder and empty into the urethra by the way of ejaculatory ducts MALE REPRODUCTIVE SYSTEM: 4. Ejaculatory duct: the canal formed by the union of the vas deferens and the excretory duct of the seminal vesicle, which enters the urethra at the prostate gland. 5. Prostate Gland: located just below the urinary bladder. Secretes alkaline and most of the seminal fluid. 6. Bulbourethral glands or Cowper’s Gland: adds alkaline fluid to the semen. Counterpart of the Bartholin’s glands in females. 7. Urethra: the passageway for both urine and semen, extending from the bladder to the urethral meatus. (8 inches in long) Stimulation from the parasympathetic nerves causes contraction of the ischiocavernous muscle which prevents the return of venous blood from the cavernous sinuses. The blood vessels engorge, the penis becomes elongated, thickened & stiff, a phenomenon called ERECTION. If stimulation is intense , there is rhythmic contractions of penile muscles resulting in forceful & sudden expulsion of semen , a phenomenon called EJACULATION. SEMINAL FLUID / SEMEN: = A GRAYISH WHITISH SUBSTANCE CONTAINING SPERMATOZOA AND FRUCTOSE RICH SUBSTANCES. = AT THE TIME OF EJACULATION, APPROXIMATELY 3-5 ML OF SEMEN IS SECRETED WITH ABOUT 100 MILLION SPERMATOZOA PER ML, OR ABOUT 250-500 MILLION SPERMATOZOA AT EACH EJACULATION. IF THE SPERM COUNT DROPS TO LESS THAN 20 MILLION PER ML OF SEMEN, or 50 million per ejaculation, THE RATE IS CONSIDERED INFERTILE.