Human Reproductive Anatomy and Physiology PDF

Human Reproductive Anatomy and Physiology TEXTBOOK: Introductory Maternity and Pediatric Nursing, Fourth edition, Nancy T. Hatfield, Cynthia A. Kincheloe, Chapters: 3, 4 Tutoring: Monday 1- 2pm Office hours: By appointment 0 ...

Human Reproductive Anatomy and Physiology TEXTBOOK: Introductory Maternity and Pediatric Nursing, Fourth edition, Nancy T. Hatfield, Cynthia A. Kincheloe, Chapters: 3, 4 Tutoring: Monday 1- 2pm Office hours: By appointment 0  Puberty Involves changes in the whole body and psyche - 10-14 years old Secondary sex characteristics appear External physical evidence of sexual maturity NOT essential for reproduction Reproductive system matures and becomes capable of reproduction Ends when Mature sperm are formed in males Regular menstrual cycles in females 0  The Female Estrogen is released by developing ovaries causing secondary sex characteristics: Breast buds develop first (10-12) Growth spurt (ends earlier than the male) Hips broaden Pubic and axillary hair appear Acne (hormones) First menstrual period (menarche) occurs approximately 2 to 2.5 years after breasts (around 12 to 14 years of age) Estrogen is cyclical Terra Fatreleasesestrogen 0  The Male Hormonal changes (testosterone) begin between 10 & 16 years old Secondary sex characteristics caused by testosterone: Increase muscle mass and strength Promotes growth of long bones burned Increases basal metabolic rate (BMR)Amountofenergy Enhances production of RBCs at rest Produces enlargement of vocal cords – deeper voice Affects the distribution of body hair – axillary, pubic, facial, body hair Penis and testes increase in size Testosterone levels become constant Nocturnal emissions (“wet dreams”) may occur 0 They do not contain sperm  Female Reproductive System External Genitalia Collectively called the vulva Includes: Mons pubis Labia majora Labia minora Fourchette Clitoris Vaginal vestibule Perineum 0  External Genitalia (cont) Mons pubis Pad of fat tissue covered by coarse skin and pubic hair Protects symphysis pubis Labiamajora Two folds of fatty tissue on each side of vaginal vestibule Pubic hair Many small glands in this area – oil and sweat glands 0  External Genitalia (cont) Labiaminora Two thin, soft erectile folds of tissue Sensitive to stimulation Secretions from sebaceous glands Bactericidal Lubricate and protect the skin of the vulva Fourchette Fold of tissue just below vagina where the labia majora meet Known as part of the obstetrical perineum 0  External Genitalia (continued) Clitoris Hooded (prepuce) erectile body Most sensitive part of female genitalia produces smegma -a cheese-like secretion of sebaceous glands Perineum Strong muscular area between vaginal opening and anus Allows stretching for birth Site of episiotomy 0  Vaginal vestibule (between the labia majora) Urethral meatus—exit for urine Vaginal introitus—divides the external and internal genitalia Hymen—thin elastic membrane that closes vagina from vestibule Ducts of the Bartholin glands—lubricates introitus during sexual arousal, not normally visible, raise pH to enhance sperm motility Skene’s ducts (paraurethral glands)— lubricates urethra and vaginal orifice, raise pH to enhance sperm motility 0 Side View of the Internal Female Reproductive Organs Vagina Uterus Fallopian tubes Ovaries 0  Internal Genitalia Ovaries - 2 Almond-shaped, walnut size held in place by ovarian and uterine ligaments Functions : Production of hormones estrogen - development of secondary sex characteristics & endometrial growth progesterone – stimulates thickening of uterine lining, decrease causes menses Maturation of ovum during each reproductive cycle 0 At birth, every female has all the ova that she will have throughout her reproductive years (2 million) By adulthood, number is in the thousands By climacteric (menopause), the ovum no longer respond to hormonal stimulation to mature 0  Fallopian Tubes (oviducts) Functions Passageway for sperm to meet the ovum site of fertilization Safe, nourishing environment for the ovum or zygote (fertilized ovum) Means of transporting ovum or zygote to the corpus of the uterus by peristaltic waves of fimbriae Sections: Infundibulum and fimbriae Ampulla Isthmus 0  Uterus Hollow muscular organ Fertilized ovum implants and develops into an embryo Shaped like an upside down pear Lies between the urinary bladder and rectum, above the vagina Supported by large ligaments Autonomic nerve supply Not under voluntary or conscious control 0  Fundus Rounded soft portion on the top Corpus (body of the uterus) Mucosal lining has 4 functions Lubricates vagina Acts as a bacteriostatic agent Provides alkaline environment to shelter deposited sperm Produces a mucous plug in cervical canal during pregnancy 0  Cervix Consists of a cervical canal with an internal opening near uterine corpus (internal os) Opening into vagina (external os) Cervix dips into vagina forming fornices Posterior fornix is larger Posterior wall of vagina 9cm Anterior fornix is smaller Anterior wall is 7cm 0  Layers of the uterus Endometrium— governed by hormone cyclical changes, sloughs off during menstruation Myometrium Muscular layer Perimetrium (Epimetrium) Outer covering layer 0  Ligaments 4 paired ligaments support and hold uterus in place Broad Ligaments Right and left Cardinal Ligaments Round Ligaments Uterosacral Ligaments 0  Vagina Tubular structure Muscle and membranous tissue Connects vulva to uterus Functions of the Vagina Provide passageway for sperm to enter the uterus Allow drainage of menstrual fluids and other secretions Provide a passageway for delivery of fetus During reproductive years, pH 4 to 5 Rugae Enables stretching during sexual intercourse Delivery of fetus 0 Blood circulation The uterus, vagina, cervix, fallopian tubes and ovaries are very vascular. A woman can bruise easily and lose blood from this area quickly which can cause death 0  Functions of the Bony Pelvis Parts Two innominate bones, sacrum, and coccyx Support and distribute body weight Support and protect pelvic organs Form the birth passageway Pelvic Floor Strong muscles that stabilize reproductive organs Levator Ani Muscle that supports urethra, vagina and rectum Kegel exercises strengthen this muscle 0  Types of Pelvis Gynegoid Most favorable for delivery Android Wedge Shaped/Narrow anterior segment more common in males 0 True and False Pelvis False pelvis Supports the enlarging uterus Guides fetus into true pelvis True pelvis Dictates the bony limits of the birth canal 0  Breasts Accessory organs of reproduction Produce milk after birth Provides nourishment / maternal antibodies to infant Nipple Toughened protruding structure at the end of the breast where milk is expressed Areola Darkened pigmented skin around the nipple. Protects the nipple while baby is sucking 0  Structures of breast Tubercles of Montgomery Small sebaceous glands within the areola Secrete a substance to lubricate and protect breasts during lactation Breast has 15- 24 lobes Lobes are separated by fat and fibrous tissues (Coopers Ligaments) Coopers Ligaments support the breast 0  Lactiferoius ducts Alveolar glands pass milk though lactiferous ducts Ducts opens at the nipple Production of milk is under hormonal control 0  Hormones of the breast During Pregnancy –high level of progesterone and estrogen prepare the glands for milk delivery After Delivery – estrogen and progesterone drop which causes prolactin secretion from anterior pituitary stimulates milk production While nursing the hypothalmus causes impulse to secrete oxytocin Oxytocin stimulates the release of the milk (oxytocin causes the uterus to contract) 0  Menstruation Cycle Ovulation Mature ovum released from follicle about 14 days before onset of menstrual period Corpus luteum(follicle) turns yellow Secretes increased quantities of progesterone Discharge can be slippery and stretchy (spinnbarkeit) Corpus luteum degenerates if the ova not fertilized Progesterone and estrogen levels decrease Causes endometrium to breakdown Results in menstruation New cycle begins again 0  Female Reproductive and Menstruation Cycle Cycle consists of regular changes in secretions of the anterior pituitary gland, ovary and endometrial lining of uterus 4 hormones needed (hypothalamus – GnRH (gonadotropin releasing hormone)– anterior pituitary) FSH – follicle stimulating hormone – matures egg LH – luteinizing hormone - ovulation Estrogen (ovary) Progesterone (ovary-corpus luteum) FSH and LH stimulate maturation of ovarian follicle Maturing ovum and corpus luteum produce increased amount of estrogen and progesterone Surge of LH stimulates final maturation Release of ovum 0 0  Four Phases in Uterine cycle Menstrual Phase Luteal or Secretory Phase Day 1 – 5 Day 15 -26 follicle Endometrium sloughs off Progesterone increasing (corpus Progesterone & Estrogen are luteum) to thicken endometriumletter low (ALL hormones are low) (estrogen increases as well) releas Drop FSH and LH egg Proliferative Phase Pro life Day 6- 14 Ischemic Phase (Premenstrual) FSH increasing causing Day 27 -28 (if no fertilization) increased Estrogen levels Progesterone/estrogen levels which grow and thicken decreasing causing endometrium endometrium to become ischemic (Approx day 14 ovulation) (no other hormones) LH will be released at the end of this stage (egg is almost mature) 0  Ovarian Cycle Follicular Phase starts around day 6 of uterine cycle Follicle in ovary is maturing under the influence of FSH As follicle matures, estrogen level increases (thickens endometrium) Increased estrogen level signals anterior pituitary to secrete LH – LH causes ovulation Ovulation divides the two phases Body temperature drops and then rises by 0.5°F–1°F around the time of ovulation. Luteal Phase Follicle ruptures – becomes corpus luteum which secretes progesterone – thickens endometrium – no pregnancy, corpus luteum degenerates – progesterone level drops - menstruation 0  Male Reproductive System External Genitalia Penis Expels urine from bladder Deposit sperm into female’s vagina Contains 3 cylinders of erectile tissue Corpus cavernosum (2) Corpus spongiosum Blood is trapped within the spongy erectile tissue to enable erection Glans penis – sensitive head Prepuce – foreskin 0 Urethra  External Genitalia Scrotum Sac that contains the testes, epididymis and spermatic cord Divided into 2 compartments Suspended from the perineum Keeps the testes cooler that the rest of the body Necessary for spermatogenesis 0  Internal Genitalia Testes Manufacture male germ cells Spermatozoa or sperm in the Seminiferous tubules Secrete male hormones which promotes development of sperm - Testosterone Epididymis One from each testicle Stores and carries sperm to the penis Stores sperm for 2 to 10 days 0  Spermatic Cord Contains the Vas deferens, nerves, arteries and veins Vas deferens Mature sperm go here next Ejaculatory duct Formed where seminal vesicle joins vas deferens Urethra transports both urine (from the bladder) and semen (from the prostate) to be expelled But not at the same time Seminal vesicles Adds alkaline, thick, fructose rich fluid into ejaculatory ducts 0  Accessory Glands Prostate gland - muscular Provides thin alkaline fluid and helps with ejaculation Bulbourethral glands (Cowpers) produce thick secretions to clean the urethra of urine All these fluids help: Enhance motility of sperm Nourish sperm Protect from acidic vagina Semen is seminal plasma and sperm together “The Sailor and the Ocean” 0  The hypothalamus makes 3 cells in seminiferous tubules: gonadotropin-releasing Spermatocyte (needs testosterone hormone (GnRH), and FSH) to create sperm Anterior pituitary produces ICSH and FSH Leydig (needs ICSH) to create FSH stimulates testosterone Spermatocyte to produce of sperm Sertoli cells are stimulated to nourish Sertoli (needs FSH with an sperm indication of testosterone) to create Interstitial cell- stimulating hormone nutrients for sperm in epididymis causes Leydig cells to produce testosterone Sperm travel from seminiferous tubules through Rete Testis into Epididymis and are stored until ejaculation (2-10 days to mature). 0  Male hormone control ICSH-Interstitial cell stimulating hormone Interstitial Cell produces testosterone Spermatozoa Spermatocyte (sperm producing cell (Sustendacular cells) under the influence0 of Testosterone) Semen and sperm Semen- mixture of sperm and fluid Each ejaculation app 2-4 ml and contains 50 – 150 million sperm/ml 100-600 million sperm per ejaculation Can survive for 72 hours in the vagina, 3-5 days in the uterus Head- nucleus ( 23c -DNA), contains acrosome which allows egg to be penetrated Midpiece- mitochondria 0 Tail – Flagellum for movement Menstrual disorders 0  Amenorrhea the absence or abnormal stoppage of menses can be caused by Hormones nutritional or emotional factors malformations of female organs Athletes pregnancy Treatment based on cause 0  Dysmenorrhea painful menstruation Normal menstruation is not painful Causes can be: Constipation insufficient exercise poor posture Fatigue improper tampon placement increase in prostaglandin secretion or can be symptom of medical issue Fibroids, endometriosis 0 0  Mittelschmerz “middle pain” , pain experienced midway through menstrual cycle or around the time of ovulation 0  Premenstrual Syndrome also known as Premenstrual Tension, cycling emotional and physical symptoms, occurs beginning between day 14-21 and ends with onset of menses Symptoms include: Irritability sadness, depression, suicidal ideation, moodiness Abdominal distention, back pain, migraine, general edema, abnormal sleep patterns, acne, visual disturbances, food cravings, occasional vomiting Mastalgia – breast pain Treatable with medication and dietary changes 0  Menopause Cessation of menstruation, usually Vaginal dryness and atrophy occurs between ages 45-50 weight gain Ovulation ceases and estrogen and skin dryness progesterone production stopped sagging breasts and signs of Normal body change calcium deficiency (osteoporosis) flow lessens Quality of life can change cycle becomes irregular, then Insomnia stops. Fatigue crying spells and mood swings Hot flashes with perspiration depression palpitations Fatigue 0  Fibroids leiomyomas or myomas -muscular tumors 30-40 years old More common in Black women Overweight or obese, hypertension Heavy bleeding or painful periods Bleeding between periods Pressure, pain, or fullness in your lower pelvis Enlarged abdomen or uterus Constipation Urinary frequency or retention Pain during sex Miscarriages or infertility 0  NCLEX STYLE QUESTIONS You are informing a male client about the male reproductive system. You ask him which gland provides the sugar needed to give the sperm energy to move. Which answer indicates that he correctly understands the information? Bartholin gland Bulbourethral gland Prostate gland Seminal vesicles 0 Seminal vesicles 0  The vagina is a hostile environment for sperm. What characteristic of semen protects sperm from the vaginal environment? Acidic fluid Alkaline fluid Presence of testosterone secretions from the seminiferous tubules 0 Alkaline fluid 0  You are preparing to perform a urinary catheterization on a female client. In which location will you expect to find the urinary meatus? above the clitoris Below the vaginal opening On the perineum Within the vestibule 0 Within the vestibule 0  Which ovarian hormone regulates the proliferative phase of the uterine cycle? FSH LH Estrogen Progesterone 0