The Human Body: Reproductive Systems PDF

CHAPTER 14 Not For Sale THE HUMAN BODY THE REPRODUCTIVE IN HEALTH AND SYSTEMS DISEASE © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cenga...

CHAPTER 14 Not For Sale THE HUMAN BODY THE REPRODUCTIVE IN HEALTH AND SYSTEMS DISEASE © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning does not guarantee this page will contain current material or match the published product. Overvie w of S T R U C T U R E S , C O M B I N I N G F O R M S , AN D F U N C T I O N S OF THE REPRODUCTIVE SYSTEMS Major Structures Related Combining Forms Primary Functions Male Penis pen/i, phall/i Used for sexual intercourse and urination. Testicles orch/o, orchid/o, test/i, Produce sperm and the hormone test/o testosterone. Female Ovaries oophor/o, ovari/o Produce ova (eggs) and female hormones. Fallopian Tubes salping/o Catch the mature ovum (egg) and transport it to the uterus. Also the site of fertilization. Uterus hyster/o, metr/o, metri/o, Protects and supports the developing child. uter/o Vagina vagin/o, colp/o Used for sexual intercourse, acts as channel for menstrual flow, and functions as the birth canal. Placenta placent/o Exchanges nutrients and waste between the mother and fetus during pregnancy. 346  THE REPRODUCTIVE SYSTEMS 347 Vocabulary Related to THE REPRODUCTIVE SYSTEMS This list contains essential word parts and medical & endometriosis (en-doh-mee-tree-OH-sis) terms for this chapter. These and the other important & epididymitis (ep-ih-did-ih-MY-tis) primary terms are shown in boldface throughout & episiotomy (eh-piz-ee-OT-oh-mee) & fibroadenoma (figh-broh-ad-eh-NOH- the chapter. Secondary terms, which appear in cyan italics, clarify the meaning of primary terms. mah) & fibrocystic breast disease (figh-broh-SIS-tick) & galactorrhea (gah-lack-toh-REE-ah) Word Parts & gonorrhea (gon-oh-REE-ah) & hematospermia (hee-mah-toh-SPER-mee-ah) & cervic/o cervix (neck of uterus) & hydrocele (HIGH-droh-seel) & colp/o vagina & hypomenorrhea (high-poh-men-oh-REE-ah) & -gravida pregnant © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning & & hysterectomy (hiss-teh-RECK-toh-mee) gynec/o woman, female & & hysterosalpingography (hiss-ter-oh-sal-pin- hyster/o uterus does not guarantee this page will contain current material or match the published product. & mast/o breast GOG-rah-fee) & men/o menstruation, menses & hysteroscopy (hiss-ter-OSS-koh-pee) & orchid/o testicles & leukorrhea (loo-koh-REE-ah) & ov/o egg, ovum & mastalgia (mass-TAL-jee-ah) & ovari/o ovary & mastopexy (MAS-toh-peck-see) & -para to give birth & menarche (MEN-ar-kee) & -pexy surgical fixation & menometrorrhagia (men-oh-met-roh-RAY- & salping/o fallopian tube jee-ah) & test/i testicle, testis & neonate (NEE-oh-nayt) & & nulligravida (null-ih-GRAV-ih-dah) vagin/o vagina & nullipara (nuh-LIP-ah-rah) & obstetrician (ob-steh-TRISH-un) Medical Terms & oligomenorrhea (ol-ih-goh-men-oh-REE-ah) & abruptio placentae (ah-BRUP-shee-oh plah- & oophorectomy (oh-ahf-oh-RECK-toh-mee) & orchidectomy (or-kih-DECK-toh-mee) SEN-tee) & & orchiopexy (or-kee-oh-PECK-see) amenorrhea (ah-men-oh-REE-ah) & & pelvic inflammatory disease amniocentesis (am-nee-oh-sen-TEE-sis) & & perimenopause (pehr-ih-MEN-oh-pawz) andropause (AN-droh-pawz) & & Peyronie’s disease (pay-roh-NEEZ) Apgar score & & placenta previa (plah-SEN-tah PREE-vee-ah) azoospermia (ay-zoh-oh-SPER-mee-ah) & & polycystic ovary syndrome (pol-ee-SIS-tick) cervical dysplasia (SER-vih-kal dis-PLAY- & preeclampsia (pree-ee-KLAMP-see-ah) see-ah) & priapism (PRYE-ah-piz-em) & cervicitis (ser-vih-SIGH-tis) & primigravida (prye-mih-GRAV-ih-dah) & chlamydia (klah-MID-ee-ah) & primipara (prye-MIP-ah-rah) & chorionic villus sampling (kor-ee-ON-ick & pruritus vulvae (proo-RYE-tus VUL-vee) VIL-us) & salpingo-oophorectomy (sal-ping-goh- oh-ahf & colostrum (kuh-LOS-trum) & -oh-RECK-toh-mee) colpopexy (KOL-poh-peck-see) & syphilis (SIF-ih-lis) & colporrhaphy (kol-POR-ah-fee) & trichomoniasis (trick-oh-moh-NYE-ah-sis) & colposcopy (kol-POS-koh-pee) & uterine prolapse (YOU-ter-ihn proh-LAPS) & dysmenorrhea (dis-men-oh-REE-ah) & varicocele (VAR-ih-koh-seel) & eclampsia (eh-KLAMP-see-ah) & ectopic pregnancy (eck-TOP-ick) & vasovasostomy (vay-soh-vah-ZOS-toh- & endocervicitis (en-doh-ser-vih-SIGH-tis) mee) Not For Sale 348 CHAPTER 14 Not For Sale LEARNING OBJECTIVES On completion of this chapter, you should be able to: 1. Identify and describe the major functions 4. Identify and describe the major functions and structures of the male reproductive and structures of the female reproductive system. system. 2. Recognize, define, spell, and pronounce the 5. Recognize, define, spell, and pronounce the primary terms related to the pathology and primary terms related to the pathology and the diagnostic and treatment procedures of the diagnostic and treatment procedures of the male reproductive system. the female reproductive system and a 3. Name at least six sexually transmitted woman during pregnancy, childbirth, and © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning diseases. the postpartum period. does not guarantee this page will contain current material or match the published product. TERMS RELATED TO STRUCTURES OF THE MALE THE REPRODUCTIVE SYSTEMS REPRODUCTIVE SYSTEM OF BOTH SEXES n The external male genitalia are the penis and the The genitalia (jen-ih-TAY-lee-ah) are the organs of scrotum, which contains two testicles. reproduction and their associated structures. n The internal male genitalia include the remaining n External genitalia are reproductive organs located structures of the male reproductive system outside of the body cavity. (Figures 14.1 and 14.2). n Internal genitalia are reproductive organs protected within the body. The Scrotum and Testicles The perineum (pehr-ih-NEE-um) is the external sur- face region in both males and females between the pubic The scrotum (SKROH-tum) is the sac-like structure that symphysis and the coccyx. surrounds, protects, and supports the testicles. The scro- tum is suspended from the pubic arch behind the penis n The tissue of the male perineum extends from the and lies between the thighs. scrotum to the area around the anus. The testicles, also known as testes, are the two small, n The tissue of the female perineum extends from egg-shaped glands that produce the sperm (singular, the pubic symphysis to the area around the anus. testis). These glands develop within the abdomen of the (Figure 14.6). male fetus and normally descend into the scrotum before or soon after birth. n Sperm are formed within the seminiferous tubules FUNCTIONS OF THE MALE (see-mih-NIF-er-us TOO-byouls) of each testicle (Figure 14.2). REPRODUCTIVE SYSTEM n The epididymis (ep-ih-DID-ih-mis) is a coiled tube The primary function of the male reproductive system is at the upper part of each testicle. This tube runs down to produce sperm and deliver them into the female body the length of the testicle, then turns upward toward the so that one sperm can unite with a single ovum (egg) to body. Here, it narrows to form the tube known as the create a new life. Some structures of the male reproduc- vas deferens. tive system also function as part of the urinary system. n The spermatic cord extends upward from the epidid- These are discussed in Chapter 9. ymis and is attached to each testicle. Each cord  THE REPRODUCTIVE SYSTEMS 349 Ureter Rectum Urinary bladder Seminal vesicle Pubic symphysis Ejaculatory duct Vas Prostate gland deferens © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning Penis does not guarantee this page will contain current material or match the published product. Anus Glans penis Bulbourethral gland Testicle Urethra Epididymis Scrotum FIGURE 14.1 Organs and ducts of the male reproductive system shown in a lateral cross-section. contains a vas deferens plus the arteries, veins, nerves, Urinary bladder and lymphatic vessels required by each testicle. Ureter Semen Formation Seminal vesicle Sperm, also known as spermatozoa, are the male gametes (reproductive cells). Semen (SEE-men) is the Ejaculatory whitish fluid containing sperm that is ejaculated through duct Prostate gland the urethra at the peak of male sexual excitement. The term ejaculate means to expel suddenly. n Spermatogenesis (sper-mah-toh-JEN-eh-sis) is the Vas deferens process of sperm formation (spermat/o means sperm, Penis and -genesis means creation). Bulbourethral gland n The ideal temperature for sperm formation is 93.2°F. The scrotum aids in maintaining this temperature by Epididymis adjusting how closely it holds the testicles to the body. n Sperm are formed in the seminiferous tubules of the testicles. Testicle Urethra Seminiferous tubules n From here, the sperm move into the epididymis where FIGURE 14.2 Structures of the male reproductive system they become motile and are temporarily stored. Motile Not For Sale as shown in an anterior cross-section view. means capable of spontaneous motion. 350 CHAPTER 14 Not For Sale n From the epididymis, the sperm travel upward into the During ejaculation, the prostate gland secretes a body and enter the vas deferens. Here, the seminal thick, alkaline fluid into the semen that aids the motility vesicles and the prostate gland add their secretions to of the sperm. Motility means ability to move. Disorders form semen. and treatment of the prostate gland are discussed in Chapter 9. The Penis The penis (PEE-nis) is the male sex organ that trans- The Bulbourethral Glands ports the sperm into the female vagina. The penis is The two bulbourethral glands (bul-boh-you-REE-thral), composed of three columns of erectile tissue (Figures also known as Cowper’s glands, are located just below 14.1 and 14.2). the prostate gland. One of these glands is located on n During sexual stimulation, the erectile tissue fills with either side of the urethra, and they open into the urethra blood under high pressure. This causes the swelling, (Figures 14.1 and 14.2). © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning hardness, and stiffness known as an erection. During sexual arousal, these glands secrete a fluid n The adjectives penile and phallic both mean relating known as pre-ejaculate. This fluid helps flush out any residual urine or foreign matter in the urethra. It also does not guarantee this page will contain current material or match the published product. to the penis (both pen/i and phall/i mean penis). lubricates the urethra for sperm to pass through. This n The glans penis (glanz PEE-nis), also known as the fluid can contain sperm and is able to cause pregnancy head of the penis, is the sensitive region located at the even if ejaculation does not occur. tip of the penis (Figure 14.1). n The foreskin, also known as the prepuce, is a retract- able double-layered fold of skin and mucous mem- The Urethra brane that covers and protects the glans penis. The urethra passes through the penis to the outside of the body. In the male, the urethra serves both the repro- ductive and the urinary systems. Disorders of the urethra The Vas Deferens, Seminal Vesicles, are discussed in Chapter 9. and the Ejaculatory Duct n The vas deferens (vas DEF-er-enz), also known as the ductus deferens, are the long, narrow continua- MEDICAL SPECIALTIES tions of each epididymis. These structures lead upward and eventually join the urethra (Figures 14.1 RELATED TO THE MALE and 14.2). REPRODUCTIVE SYSTEM n The seminal vesicles (SEM-ih-nal) are glands that A urologist (you-ROL-oh-jist) is a physician who specia- secrete a thick, yellow substance to nourish the sperm lizes in diagnosing and treating diseases and disorders of cells. This secretion forms 60% of the volume of the genitourinary system of males and the urinary system semen. These glands are located at the base of the of females (ur means urine, and -ologist means special- urinary bladder and open into the vas deferens as it ist). The term genitourinary refers to both the genital and joins the urethra. urinary organs. n The ejaculatory duct, which begins at the vas defe- rens, passes through the prostate gland and empties into the urethra. During ejaculation, a reflex action caused by these ducts, semen passes into the urethra, PATHOLOGY OF THE MALE which exits the body via the penis. REPRODUCTIVE SYSTEM The Penis The Prostate Gland n Balanitis (bal-ah-NIGH-tis) is an inflammation of the The prostate gland (PROS-tayt) lies under the bladder glans penis that is usually caused by poor hygiene in and surrounds the end of the urethra in the region men who have not had the foreskin removed by where the vas deferens enters the urethra (Figures 14.1 circumcision (balan means glans penis, and -itis and 14.2). means inflammation).  THE REPRODUCTIVE SYSTEMS 351 n Phimosis (fih-MOH-sis) is a narrowing of the open- n A hydrocele (HIGH-droh-seel) is a fluid-filled sac in ing of the foreskin so it cannot be retracted (pulled the scrotum along the spermatic cord leading from the back) to expose the glans penis. This condition can testicles (hydr/o means relating to water, and -cele be present at birth or become apparent during means a hernia or swelling). Note: The term hydrocele childhood. is also used to describe the accumulation of fluid in n Erectile dysfunction (ED), also known as impotence, any body cavity. is the inability of the male to achieve or maintain a n A spermatocele (sper-MAH-toh-seel) is a cyst that penile erection. A penis that is not erect is referred develops in the epididymis and is filled with a milky to as being flaccid, or limp. fluid containing sperm (spermat/o means sperm, and n Peyronie’s disease (pay-roh-NEEZ), also known -cele means hernia, tumor, or swelling). as penile curvature, is a form of sexual n Testicular cancer is cancer that begins in the dysfunction in which the penis is bent or curved testicles. It is the most common cancer in during erection. American males between the ages of 15 and © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning n Priapism (PRYE-ah-piz-em) is a painful erection 34 years. This cancer is highly treatable when that lasts 4 hours or more but is either not diagnosed early. does not guarantee this page will contain current material or match the published product. accompanied by sexual excitement or does not go n Testicular torsion is a sharp pain in the scrotum away after sexual stimulation has ended. The caused by twisting of the vas deferens and blood ves- condition can be caused by medications or by sels leading into the testicle. Torsion means twisting. blood-related diseases such as sickle cell anemia or n Testitis (test-TYE-tis), also known as orchitis, leukemia. is inflammation of one or both testicles (test n Premature ejaculation is a condition in which the means testicle, and -itis means inflammation) male reaches climax too soon, usually before or shortly (Figure 14.3B). after penetration of the female. n A varicocele (VAR-ih-koh-seel) is a knot of widening varicose veins in one side of the scrotum (varic/o means varicose veins, and -cele means a hernia or The Testicles and Related Structures swelling). Varicose veins are abnormally swollen veins n Andropause (AN-droh-pawz), which is referred to as (Figure 14.3C). ADAM (Androgen Decline in the Aging Male), is marked by the decrease of the male hormone tes- tosterone (andr/o means male or masculine, and Sperm Count -pause means stopping). It usually begins when a A normal sperm count is 20 to 120 million or more sperm man is in his late 40s and progresses very gradually per milliliter (mL) of semen. over several decades. Androgen is a male sex n Azoospermia (ay-zoh-oh-SPER-mee-ah) is the hormone. absence of sperm in the semen (a- means without, zoo n Cryptorchidism (krip-TOR-kih-dizm), also known as means life, sperm means sperm, and -ia means an undescended testicle, is a developmental defect in abnormal condition). which one or both of the testicles fail to descend into n Oligospermia (ol-ih-goh-SPER-mee-ah) is a sperm their normal position in the scrotum (crypt means count of below 20 million/mL (olig/o means few, hidden, orchid means testicle, and -ism means sperm means sperm, and -ia means abnormal condi- abnormal condition). tion). This is also known as a low sperm count and is a n Anorchism (an-OR-kism) is the congenital absence of common cause of male infertility. one or both testicles (an- means without, orch means n Hematospermia (hee-mah-toh-SPER-mee-ah) is the testicle, and -ism means abnormal condition). presence of blood in the seminal fluid (hemat/o n Epididymitis (ep-ih-did-ih-MY-tis) is inflammation of means relating to blood, sperm means sperm, and -ia the epididymis that is frequently caused by the spread means abnormal condition). This condition can be of infection from the urethra or the bladder (epididym caused by infections of the seminal vesicles, prostatitis, means epididymis, and -itis means inflammation) urethritis, or urethral strictures, which are discussed in Not For Sale (Figure 14.3A). Chapter 9. 352 CHAPTER 14 Not For Sale Epididymitis (A) © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning does not guarantee this page will contain current material or match the published product. Varicocele Testitis (B) (C) FIGURE 14.3 Pathology of the testicles. (A) Epididymitis of the left testicle. (B) Testitis of both testicles. (C) Varicoceles affecting both testicles. DIAGNOSTIC PROCEDURES TREATMENT PROCEDURES OF OF THE MALE REPRODUCTIVE THE MALE REPRODUCTIVE SYSTEM SYSTEM General Treatment Procedures n Sperm count, also known as a sperm analysis, is the n Circumcision (ser-kum-SIZH-un) is the surgical testing of freshly ejaculated semen to determine the removal of the foreskin of the penis. This optional pro- volume plus the number, shape, size, and motility of cedure is usually performed within a few days of birth. the sperm. n An orchidectomy (or-kih-DECK-toh-mee), also n Testicular self-examination is a self-help step in early spelled as orchiectomy, is the surgical removal of one detection of testicular cancer by detecting lumps, or both testicles (orchid means testicle, and -ectomy swelling, or changes in the skin of the scrotum. means surgical removal). n Orchiopexy (or-kee-oh-PECK-see) is the repair of an Media Link undescended testicle (orchi/o means testicle, and Watch the Male Reproductive System -pexy means surgical fixation). This is an endoscopic animation on the Online Resources. surgery performed on infants before the age of 1 year to move the testicle into its normal position in the scrotum.  THE REPRODUCTIVE SYSTEMS 353 this reason, all newborns receive an antibiotic oint- ment in each eye within an hour after birth to prevent Vas deferens Incision line ophthalmia neonatorum. This condition is a form of conjunctivitis that is caused by the bacteria responsi- Excised segment ble for chlamydia or gonorrhea. of vas deferens There are more than 20 types of STDs. The following are several of the more common diseases. Testicle Chlamydia FIGURE 14.4 In a vasectomy, a portion of the vas deferens Chlamydia (klah-MID-ee-ah), which is caused by the is removed to prevent sperm from entering the semen. bacterium Chlamydia trachomatis, is the most commonly reported STD in the United States. It is highly contagious © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning n A varicocelectomy (var-ih-koh-sih-LECK-toh-mee) is and requires early treatment with antibiotics. the removal of a portion of an enlarged vein to relieve a n In females, chlamydia can damage the reproductive varicocele (varic/o means varicose vein, cel means does not guarantee this page will contain current material or match the published product. organs. Even though symptoms are usually mild or swelling, and -ectomy means surgical removal). absent, serious complications can cause irreversible damage, including infertility. Male Sterilization n In males, chlamydia is one of the causes of urethritis Sterilization is any procedure rendering an individual (see Chapter 9). (male or female) incapable of reproduction. n Castration (kas-TRAY-shun), also known as bilateral Other Sexually Transmitted Diseases orchidectomy, is the surgical removal or destruction of n Bacterial vaginosis (vaj-ih-NOH-sis) (BV) is a both testicles. condition in women in which there is an abnormal n A vasectomy (vah-SECK-toh-mee) is the male sterili- overgrowth of certain bacteria in the vagina (vagin zation procedure in which a small portion of the vas means vagina, and -osis means abnormal condition or deferens is surgically removed (vas means vas defe- disease). This condition can cause complications during rens, and -ectomy means surgical removal). This pregnancy and an increased risk of HIV infection if prevents sperm from entering the ejaculate but does exposed to the virus. Symptoms sometimes include a not change the volume of semen created by the discharge, odor, pain, itching, or burning. body (Figure 14.4). n Genital herpes (HER-peez) is caused by the herpes n A vasovasostomy (vay-soh-vah-ZOS-toh-mee), also simplex virus type 1 or 2. Symptoms include itching or known as a vasectomy reversal, is a procedure performed burning before the appearance of lesions (sores) on the as an attempt to restore fertility to a vasectomized male genitals or rectum. This condition is highly contagious, (vas/o means blood vessel, vas means the vas deferens, even when visible lesions are not present. Antiviral and -ostomy means surgically creating an opening). drugs ease symptoms and can suppress future out- breaks; however, currently there is no cure. n Genital warts, which are caused by human papillo- SEXUALLY TRANSMITTED maviruses (HPV), are highly contagious. In the male, DISEASES this virus infects the urethra. In the female, it infects the external genitalia, cervix, and vagina. It also Sexually transmitted diseases (STDs), also known as sex- increases the risk of cervical cancer. An HPV vaccine is ually transmitted infections (STIs), are infections caused available to prevent the spread of this disease. It is by either bacteria or a virus that affects both males and recommended that it be administered to all boys and females. These conditions are commonly spread through girls at ages 11 or 12. Young women can be vaccinated sexual intercourse or other genital contact. through age 26, and young men through age 21. n A pregnant woman who is infected with one of these n Gonorrhea (gon-oh-REE-ah) is a highly contagious Not For Sale diseases can transmit it to her baby during birth. For condition caused by the bacterium Neisseria 354 CHAPTER 14 Not For Sale gonorrhoeae. In women, this condition affects the cer- often do not have symptoms; however, when symp- vix, uterus, and fallopian tubes. In men, it affects the toms are present, they include painful urination or a urethra by causing painful urination and an abnormal clear discharge from the penis. discharge. It can also affect the mouth, throat, and anus of both men and women. n The human immunodeficiency virus (HIV) is trans- FUNCTIONS OF THE FEMALE mitted through exposure to infected body fluids, par- REPRODUCTIVE SYSTEM ticularly through sexual intercourse with an infected partner. HIV and AIDS are discussed in Chapter 6. The primary function of the female reproductive system is the creation and support of new life. n Syphilis (SIF-ih-lis), which is caused by the bacterium Treponema pallidum, has many symptoms that are dif- n The ovaries produce mature eggs to be fertilized by the ficult to distinguish from other STDs. Syphilis is highly sperm. contagious and is passed from person to person n The uterus provides the environment and support for © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning through direct contact with a chancre, which is a sore the developing child. caused by syphilis. This condition can be detected n After birth, the breasts produce milk to feed the child. does not guarantee this page will contain current material or match the published product. through the VDRL (Venereal Disease Research Labora- tory) blood test before the lesions appear. The RPR test (Rapid Plasma Reagin) is another blood test for syphilis. STRUCTURES OF THE FEMALE n Trichomoniasis (trick-oh-moh-NYE-ah-sis), also REPRODUCTIVE SYSTEM known as trich, is an infection caused by the parasite Trichomonas vaginalis. One of the most common The structures of the female reproductive system are symptoms in infected women is a thin, frothy, yellow- described as being the external female genitalia and the green, foul-smelling vaginal discharge. Infected men internal female reproductive organs (Figure 14.5). Fallopian tube Ovary Uterus Urinary Cervix bladder Pubic Rectum symphysis Vagina Urethra Clitoris Urethral orifice Anus Labia minora Labia Vaginal majora orifice FIGURE 14.5 Structures of the female reproductive system shown in a lateral cross-section.  THE REPRODUCTIVE SYSTEMS 355 The External Female Genitalia this opening and can be torn either during the first instance of intercourse or other activity. This tissue can The external female genitalia are located posterior to be absent in a woman who has not been sexually the mons pubis (monz PYOU-bis), which is a rounded, active. fleshy prominence located over the pubic symphysis (Figure 14.6). These structures are known collectively as the vulva (VUL-vah) or the pudendum. The vulva consists Breasts of the labia, clitoris, Bartholin’s glands, and vaginal orifice. Breasts are made up of fat, connective tissue, and the n The labia majora and labia minora (LAY-bee-ah mammary glands (the word parts mamm/o and mast/o mah-JOR-ah and LAY-bee-ah mih-NOR-ah) are the both mean breast). Each breast is fixed to the overlying vaginal lips that protect the other external genitalia skin and the underlying pectoral muscles by suspensory and the urethral meatus (singular, labium). The ligaments (Figure 14.7). Breast cancer and its diagnosis urethral meatus, which is the external opening of the and treatment are discussed in Chapter 6. urethra, is discussed in Chapter 9. © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning n Mammary glands, also known as the lactiferous n The clitoris (KLIT-oh-ris) is an organ of sensitive, glands, are the milk-producing glands that develop erectile tissue located anterior to the urethral meatus during puberty. does not guarantee this page will contain current material or match the published product. and the vaginal orifice. n The lactiferous ducts (lack-TIF-er-us), also known as n Bartholin’s glands produce a mucus secretion to milk ducts, carry milk from the mammary glands to lubricate the vagina. These two small, round glands the nipple (lact means milk, and -iferous means car- are located on either side of the vaginal orifice. rying or producing). n The vaginal orifice is the exterior opening of the n Breast milk flows through the nipple, which is sur- vagina. Orifice means opening. The hymen (HIGH- rounded by the dark-pigmented area known as the men) is a thin mucous membrane that partially covers areola (ah-REE-oh-lah). Mons pubis Prepuce of clitoris Bartholin's glands Glans of clitoris Urethral orifice Labium minora Labium majora Vaginal orifice Perineum Hymen Anus Not For Sale FIGURE 14.6 Female external genitalia. 356 CHAPTER 14 Not For Sale Mammary n The ova (OH-vah), also known as eggs, are Nipple glands the female gametes (singular, ovum). These immature ova are present at birth. Normally, after puberty, one ovum matures and is released each month. n The ovaries also produce the sex hormones estrogen and progesterone, which are discussed in Areola Chapter 13. Lactiferous ducts The Fallopian Tubes FIGURE 14.7 Structures of the breast. There are two fallopian tubes (fal-LOH-pee-an), which are also known as uterine tubes. These tubes extend from the © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning upper end of the uterus to a point near but not attached to The Internal Female Genitalia an ovary. The internal female genitalia are located within the pelvic n The infundibulum (in-fun-DIB-you-lum) is the does not guarantee this page will contain current material or match the published product. cavity where they are protected by the bony pelvis. These funnel-shaped opening into the fallopian tube near structures include two ovaries, two fallopian tubes, the the ovary. uterus, and the vagina (Figures 14.5 and 14.8). n The fimbriae (FIM-bree-ee) are the fringed, finger-like extensions of this opening. Their role is to catch the The Ovaries mature ovum when it leaves the ovary (singular, The ovaries (OH-vah-rees) are a pair of small, almond- fimbria). shaped organs located in the lower abdomen, one on n Each month, one of these tubes carries a mature either side of the uterus. ovum from the ovary to the uterus (Figure 14.8). n A follicle (FOL-lick-kul) is a fluid-filled sac containing These tubes also carry sperm upward from the uterus a single ovum (egg). There are thousands of these sacs toward the descending mature ovum so that fertili- on the inside surface of the ovaries. zation can occur. Fallopian tube Fallopian tube (not in cross-section) Fundus of uterus Infundibulum Mature ovum Fimbriae Ovary (not in cross-section) Follicle Ovary Empty follicle Interior of uterus Perimetrium Tissues of Cervical canal the uterus Myometrium Endometrium Vagina FIGURE 14.8 An anterior schematic view of the female reproductive organs. The left ovary, shown here in cross-section, contains developing ova in different stages of maturation. Also shown on the left is a mature ovum that has just been released.  THE REPRODUCTIVE SYSTEMS 357 The Uterus Vagina The uterus (YOU-ter-us), formerly known as the womb, The vagina (vah-JIGH-nah) is the muscular tube lined is a pear-shaped organ with muscular walls and a mucous with mucosa that extends from the cervix to the outside membrane lining filled with a rich supply of blood vessels of the body. The word parts colp/o and vagin/o both (Figure 14.8). mean vagina (Figures 14.7 and 14.8). n The uterus is located between the urinary bladder and the rectum and midway between the sacrum and the pubic bone. Menstruation n In its normal position, which is known as anteflexion Menstruation (men-stroo-AY-shun), also known as (an-tee-FLECK-shun), the body of the uterus is bent menses, is the normal periodic discharge of the endo- forward (ante- means forward, flex means bend, and metrial lining and unfertilized egg from uterus. The -ion means condition) (Figure 14.5). average menstrual cycle consists of 28 days. These © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning days are grouped into four phases and are summarized in Table 14.1. The Parts of the Uterus n Menarche (MEN-ar-kee) is the beginning of does not guarantee this page will contain current material or match the published product. The body of the uterus consists of three major anatomic menstruation (men means menstruation, and areas: -arche means beginning). This begins after the n The fundus (FUN-dus) is the bulging, rounded part maturation that occurs during puberty. In above the entrance of the fallopian tubes. Because the the United States the average age of menarche fundus rises during pregnancy, measuring the fundal is 12. height in relation to the pubic bone helps determine n Menopause (MEN-oh-pawz) is the normal termina- the baby’s growth. tion of menstruation in a woman during middle age n The corpus (KOR-pus), also known as the body of the (men/o means menstruation, and -pause means uterus, is the middle portion. stopping). Menopause is considered to be confirmed n The cervix (SER-vicks), also known as the cervix uteri, when a woman has gone 1 year without having a is the lower, narrow portion that extends into the period. vagina. Within the cervix is the cervical canal, which n Perimenopause (pehr-ih-MEN-oh-pawz) is the ends at the cervical os at the vagina. term used to designate the transition phase between regular menstrual periods and no periods at all (peri- means surrounding, men/o means menstrua- The Tissues of the Uterus tion, and -pause means stopping). During this The uterus is composed of three major layers of tissue: phase, which can last as long as 10 years, changes in n The perimetrium (pehr-ih-MEE-tree-um), also hormone production can cause symptoms, including known as the uterine serosa, is the tough, membra- irregular menstrual cycles, hot flashes, mood swings, nous outer layer (peri- means surrounding, metri and disturbed sleep. means uterus, and -um is a singular noun ending). Membranous means pertaining to a thin layer of tissue. TERMS RELATED TO n The myometrium (my-oh-MEE-tree-um) is the muscular middle layer (my/o means muscle, PREGNANCY AND CHILDBIRTH metri means uterus, and -um is a singular noun ending). Ovulation n The endometrium (en-doh-MEE-tree-um) is the Ovulation (ov-you-LAY-shun) is the release of a mature inner layer, and it consists of specialized epithelial egg from a follicle on the surface of one of the ovaries that mucosa that is rich in blood vessels (endo- means happens on approximately the 13th or 14th day of a within, metri means fallopian uterus, and -um is a woman’s menstrual cycle. singular noun ending). Mucosa means referring to n After the ovum (egg) is released, it is caught up by the Not For Sale mucous membrane. fimbriae of the fallopian tube. Wave-like peristaltic 358 CHAPTER 14 Not For Sale TABLE 14.1 Phases of the Menstrual Cycle Approximately Days 1–5 Menstrual phase. These are the days when the endometrial lining of the uterus is sloughed off and discharged through the vagina as the menstrual flow. Approximately Days 6–12 Postmenstrual phase. After the menstrual period, the pituitary gland secretes follicle-stimulating hormone (FSH), causing an ovum to mature. Estrogen, which is secreted by the ovaries, stimulates the lining of the uterus to prepare itself to receive a zygote (fertilized egg). Approximately Days 13–14 Ovulatory phase. On approximately the 13th or 14th day of the cycle, ovulation occurs. Ovulation is the release of a mature ovum. The mature egg leaves the © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning ovary and travels slowly down the fallopian tube toward the uterus. During this time, the female is fertile and can become pregnant. does not guarantee this page will contain current material or match the published product. Approximately Days 15–28 Premenstrual phase. If fertilization does not occur, hormone levels change to cause the breakdown of the uterine endometrium and the beginning of a new menstrual cycle. actions move the ovum down the fallopian tube n After fertilization occurs in the fallopian tube, the toward the uterus. zygote travels to the uterus where it is implanted. n It usually takes an ovum about 5 days to pass through Implantation is the embedding of the zygote into the the fallopian tube. If sperm are present at that time, lining of the uterus. one will fertilize the ovum within the fallopian tube. n From implantation through the 8th week of pregnancy, n After the ovum has been released, the ruptured follicle the developing baby is known as an embryo (EM- enlarges, takes on a yellow fatty substance, and bree-oh). becomes the corpus luteum. n From the 9th week of pregnancy to the time of birth, n The corpus luteum (KOR-pus LOO-tee-um) secretes the baby in utero is known as a fetus (fet means the hormone progesterone during the second half of unborn child, and -us is a singular noun ending). the menstrual cycle. This maintains the growth of the In utero means within the uterus (Figure 14.9). uterine lining in preparation for the fertilized egg. n If the ovum is not fertilized, the corpus luteum dies, and the endometrium lining of the uterus sloughs off as the menstrual flow occurs. If the ovum is fertilized, Placenta the corpus luteum continues to secrete the hormones Intrauterine cavity required to maintain the pregnancy. Umbilical cord Amniotic fluid Fertilization Chorion Amniotic n During coitus (KOH-ih-tus), also known as sexual sac intercourse or copulation, the male ejaculates approximately 100 million sperm into the female’s vagina. The sperm travel upward through the vagina, into the uterus, and on into the fallopian tubes. n Conception occurs when a sperm penetrates and fer- tilizes the descending ovum. This union, which is the beginning of a new life, forms a single cell known as a FIGURE 14.9 A normal pregnant uterus viewed in cross- zygote (ZYE-goht). section.  THE REPRODUCTIVE SYSTEMS 359 n The placenta also produces hormones necessary to Media Link maintain the pregnancy. These hormones are dis- Watch the Female Reproductive System cussed in Chapter 13. animation on the Online Resources. n After delivery of the newborn, the placenta and fetal membranes are expelled as the afterbirth. Multiple Births The Amniotic Sac If more than one egg is passing down the fallopian tube when sperm are present, the fertilization of more than The amniotic sac (am-nee-OT-ick), which is also known one egg is possible. as the amnion, is the innermost membrane that sur- rounds the embryo in the uterus (Figure 14.9). The com- n Fraternal twins result from the fertilization of separate mon name for this structure is the bag of waters. ova by separate sperm cells. These develop into two separate embryos (Figure 14.10). n The developing embryo is surrounded by the amniotic © 2014 Cengage Learning. All Rights Reserved. This content is not yet final and Cengage Learning cavity. This is the fluid-filled space between the n Identical twins are formed by the fertilization of a embryo and the amniotic sac. single egg cell by a single sperm that divides to form n Amnionic fluid (am-nee-ON-ick), also known as does not guarantee this page will contain current material or match the published product. two embryos. Each of these twins receives exactly the same genetic information from the parents. amniotic fluid, is the liquid that protects the fetus and makes possible its floating movements. n The term multiples is used to describe a birth involv- ing more than two infants. The Umbilical Cord The umbilical cord (um-BILL-ih-kal) is the tube that The Chorion and Placenta carries blood, oxygen, and nutrients from the placenta n The chorion (KOR-ee-on) is the thin outer membrane to the developing baby. It also transports waste from the that encloses the embryo. It contributes to the forma- fetus to be disposed of through the mother’s excretory tion of the placenta (Figure 14.9). system. This cord is cut soon after the birth of the infant n The placenta (plah-SEN-tah) is a temporary organ that and before the delivery of the placenta. forms within the uterus to allow the exchange of nutri- n After birth, the navel, also known as the belly button, ents, oxygen, and waste products between the mother is formed where the umbilical cord was attached to the and fetus without allowing maternal blood and fetal fetus. blood to mix. The placental barrier does not, however, keep chemicals or drugs from reaching the fetus. Gestation Gestation (jes-TAY-shun), which lasts approximately 280 days (40 weeks), is the period of development of the baby Placenta Placenta in the mother’s uterus. Upon completion of this develop- mental time, the fetus is described as being at term and Umbilical should be ready for birth (Figure 14.11). cord Umbilical cord n The term pregnancy, which is often used inter- changeably with gestation, means the condition of