NCMA217 Maternal Health Standards PDF
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This document outlines standards of care for maternal and child health nursing practice. It covers topics like health promotion, health maintenance, health restoration, and health rehabilitation. The document emphasizes the importance of evidence-based practice and WHO guidelines in providing quality care for women and newborns.
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PRELIM: NCMA217 (MATERNAL) - — 1.4: Women with pre-eclampsia or eclampsia STANDARD 4: Communication with women MODULE #1: FRAMEWORK FOR promptly receive appropriate interventions, and their families is effective and responds to M...
PRELIM: NCMA217 (MATERNAL) - — 1.4: Women with pre-eclampsia or eclampsia STANDARD 4: Communication with women MODULE #1: FRAMEWORK FOR promptly receive appropriate interventions, and their families is effective and responds to MATERNAL AND CHILD HEALTH according to WHO guidelines. their needs and preferences. NURSING MARIEL GUIAO. — 1.5: Women with postpartum hemorrhage — 4.1: All women and their families receive promptly receive appropriate interventions, information about the care and have effective STANDARDS OF MATERNAL AND CHILD according to WHO guidelines. interactions with staff. HEALTH NURSING PRACTICE. — 4.2: All women and their families experience 1. HEALTH PROMOTION STANDARD 2: The health information system coordinated care, with clear, accurate information — Educating clients to be aware of good health enables use of data to ensure early, appropriate exchange between relevant health and social care through teaching and role modeling action professionals. 2. HEALTH MAINTENANCE — 2.1: Every woman and newborn has a — Intervening to maintain health when risk of complete, accurate, standardized medical record STANDARD 5: Women and newborns receive illness is present during labor, childbirth and the early postnatal care with respect and preservation of their 3. HEALTH RESTORATION period. dignity. — Promptly diagnosing and treating illness using — 2.2: Every health facility has a mechanism for — 5.1: All women and newborns have privacy interventions that will return client to wellness data collection, analysis and feedback as part of around the time of labor and childbirth, and their most rapidly. its activities for monitoring and improving confidentiality is respected 4. HEALTH REHABILITATION performance around the time of childbirth.to — 5.2: No woman or newborn is subjected to — Preventing further complications from an improve the care of every woman and newborn. mistreatment, such as physical, sexual or verbal illness; bringing an ill client back to an optimal abuse, discrimination, neglect, detainment, state of wellness or helping a client to accept STANDARD 3: Every woman and newborn with extortion or denial of services. inevitable death condition(s) that cannot be dealt with effectively — 5.3: All women have informed choices in the with the available resources is appropriately services they receive, and the reasons for STANDARDS OF CARE AND MEASURES referred. interventions or outcomes are clearly explained. OF QUALITY (WHO). — 3.1: Every woman and newborn is STANDARD 1: Every woman and newborn appropriately assessed on admission, during labor STANDARD 6: Every woman and her family are receives routine, evidence-based care and and in the early postnatal period to determine provided with emotional support that is sensitive management of complications during labor, whether referral is required, and the decision to to their needs and strengthens the woman’s childbirth and the early postnatal period, refer is made without delay. capability. according to WHO guidelines. — 3.2: For every woman and newborn who — 6.1: Every woman is offered the option to — 1.1: Women are assessed routinely on requires referral, the referral follows a experience labor and childbirth with the admission and during labor and childbirth and are pre-established plan that can be implemented companion of her choice. given timely, appropriate care. without delay at any time. — 6.2: Every woman receives support to — 1.2: Newborns receive routine care — 3.3: For every woman and newborn referred strengthen her capability during childbirth. immediately after birth. within or between health facilities, there is — 1.3: Mothers and newborns receive routine appropriate information exchange and feedback STANDARD 7: For every woman and newborn, postnatal care. to relevant health care staff. competent, motivated staff are consistently available to provide routine care and manage ADVANCED-PRACTICE ROLES FOR practitioners as they play pivotal roles in today’s complications. NURSES IN MATERNAL AND CHILD health care system. — 7.1: Every woman and child has access at all HEALTH. — Women’s Health Nurse Practitioner - has times to at least one skilled birth attendant and CLINICAL NURSE SPECIALIST advanced study in the promotion of health and support staff for routine care and management of — Are nurses prepared at the master’s or prevention of illness in women. Such a nurse complications. doctorate degree level who are capable of acting plays a vital role in educating women about their — 7.2: The skilled birth attendants and support as consultants in their area of expertise, as well as bodies and sharing with them methods to prevent staff have appropriate competence and skills mix serving as role models, researchers, and teachers illness; in addition, they care for women with to meet the requirements of labor, childbirth and of quality nursing care. illnesses such as sexually transmitted infections, the early postnatal period. — Neonatal Nurse Specialists - manage the care and offer information and counsel them about — 7.3: Every health facility has managerial and of infants at birth and in intensive care settings; reproductive life planning. clinical leadership that is collectively responsible they provide home follow-up care to ensure the — Pediatric Nurse Practitioner (PNP) - is a for developing and implementing appropriate newborn remains well. nurse prepared with extensive skills in physical policies and fosters an environment that supports — Childbirth Educators - teach families about assessment, interviewing, and well-child facility staff in continuous quality improvement. normal birth and how to prepare for labor and counseling and care. In this role, a nurse birth. interviews parents as part of an extensive health STANDARD 8: The health facility has an — Lactation Consultants - educate women history and performs a physical assessment of the appropriate physical environment, with adequate about breastfeeding and support them while they child. water, sanitation and energy supplies, medicines, learn how to do this. — If the PNP determines that a child has a supplies and equipment for routine maternal and — Genetic Nurse Counselors - consult with common illness (such as iron deficiency anemia), newborn care and management of complications. families about patterns of inheritance and offer he or she orders the necessary laboratory tests — 8.1: Water, energy, sanitation, hand hygiene support to families with a child who has inherited and prescribes appropriate drugs for therapy. and waste disposal facilities are functional, a genetic disorder. — If the PNP determines that the child has a reliable, safe and sufficient to meet the needs of — Case Manager - a graduate-level nurse who major illness (such as congenital subluxated hip, staff, women and their families. supervises a group of patients from the time they kidney disease, heart disease), he or she consults — 8.2: Areas for labor, childbirth and postnatal enter a health care setting until they are with an associated pediatrician; together. care are designed, organized and maintained so discharged from the setting. Case management that every woman and newborn can be cared for can be a vastly satisfying nursing role, because if NEONATAL NURSE PRACTITIONER according to their needs in private, to facilitate the healthcare setting is “seamless,” or one that — Is an advanced-practice role for nurses who the continuity of care. follows people both during an illness and on their are skilled in the care of newborns, both well and — 8.3: An adequate stock of medicines, supplies return to the community. ill. NNPs may work in level 1, level 2, or level 3 and equipment is available for routine care and newborn nurseries, neonatal follow-up clinics, or management of complications NURSE PRACTITIONER physician groups. — Are nurses educated at the master’s or doctoral level. Recent advances in technology, FAMILY NURSE PRACTITIONER research, and knowledge have amplified the need — (FNP) is an advanced-practice role that for longer and more in-depth education for nurse provides health care not only to women and children but also to the family as a whole. — In conjunction with a physician, an FNP can — Adolescents who support themselves or who — Serve as important resources for families provide prenatal care for a woman with an are pregnant are termed “emancipated minors” during childbearing and childrearing uncomplicated pregnancy. or “mature minors” and have the right to sign — Personal, cultural, and religious attitudes and for their own health care beliefs influence the meaning and impact of CERTIFIED NURSE-MIDWIFE childbearing and childrearing on families. — (CNM) is an individual educated in the two ETHICAL CONSIDERATIONS OF — Circumstances such as illness or pregnancy disciplines of nursing and midwifery and PRACTICE. are meaningful only in the context of a total life. licensed. — Some of the most difficult ethical quandaries — Maternal and child health nursing is a — Plays an important role in assisting women in healthcare today are those that involve children challenging role for nurses and a major factor in with pregnancy and childbearing. Either and their families. keeping families well and optimally functioning independently or in association with a physician, Examples are: the nurse-midwife assumes full responsibility for Conception issues, especially those related to in vitro STATISTICAL TERMS USED TO REPORT the care and management of women with fertilization, embryo transfer, ownership of frozen MATERNAL AND CHILD HEALTH. oocytes or sperm, cloning, stem cell research, and uncomplicated pregnancies surrogate mothers — Birth Rate - number of individuals born in a Abortion, particularly partial-birth abortions population in a given amount of time LEGAL CONSIDERATIONS OF Fetal rights versus rights of the mother — Fertility Rate - number of children that MATERNAL-CHILD PRACTICE. Use of fetal tissue for research would be born to a woman if she were to live to — Care is often given to an “unseen client”—the Resuscitation (for how long should it be continued?) the end of her childbearing years and bear fetus—or to clients who are not of legal age for Number of procedures or degree of pain that a child children in accordance with age specific fertility giving consent for medical procedures. should be asked to endure to achieve a degree of better rates of the specified year. health - What's the difference between birth — Labor and birth of a neonate are considered Balance between modern technology and quality of life “normal” events, so the risks for a lawsuit are and fertility rates? The fertility rate measures the greater when problems arise (O’Grady et al., number of live births per 1000 women within the PHILOSOPHY OF MATERNAL AND childbearing age range, often 15-44 years old. The birth 2007 CHILD HEALTH NURSING. rate is given as the number of live births per 1000 people — Nurses are legally responsible for protecting — Is family centered - assessment must include both in the population. The birth rate is not specific to women the rights of their clients. family and individual assessment data. or to women of a certain age group, like the fertility rate. — Understanding the scope of practice and — Is community centered - he health of families — Fetal Death Rate - number of fetal deaths standards of care can help nurses practice within depends on and influences the health of communities weighing more than 500g per 1000 live births. appropriate legal parameters — Is evidence based - this is the means whereby critical — Neonatal Death Rate - number of deaths per — Documentation is essential for protecting a knowledge increases — Serves as an advocate to protect the rights of all 1000 live births occurring at birth or in the first nurse and justifying his or her actions. family members, including the fetus 28 days of life. — Nurses need to be conscientious about — Includes a high degree of independent nursing — Perinatal Death Rate - number of deaths of obtaining informed consent for invasive functions because teaching and counseling are major fetuses weighing more than 500 grams within the procedures and determining that pregnant women interventions. 28 days of life per 1000 live births. are aware of any risk to the fetus associated with — Promoting health and disease prevention are — Maternal Mortality Rate - number of a procedure or test. important nursing roles maternal deaths per 100,000 live births. — Infant Mortality Rate - number of deaths per — Philippines maternal mortality ratio was at #ENVISION2030. 1000 live births occurring in the first 12 months level of 121 deaths per 100,000 live births in The year 2016 marks the first year of the of life. 2017, down from 124 deaths per 100,000 live implementation of the SDGs. At this critical — Childhood Mortality Rate - probability of births previous year, this is a change of 2.42% point, #Envision2030 will work to promote the dying between the exact age 1 and age 5, defined mainstreaming of disability and the as the number of deaths of children aged 1-4 THE 17 SUSTAINABLE DEVELOPMENT implementation of the SDGs throughout its years per 1000 children surviving to age 12 GOALS BY UN 15-year lifespan with objectives to: months. — Raise awareness of the 2030 Agenda and the achievement of the SDGs for persons with INFANT MORTALITY RATE. disabilities; — The infant mortality rate for Philippines in — Promote an active dialogue among 2019 was 19.239 deaths per 1000 live births, a stakeholders on the SDGs with a view to create a 2.16% decline from 2018 better world for persons with disabilities; and — The top three leading causes of infant — Establish an ongoing live web resource on mortality were Pneumonia (3,146; 14.3%); each SDG and disability. Bacterial sepsis of newborn (2,731; 12.4%); and — The campaign invites all interested parties in Respiratory distress of newborn (2,347; 10.7%). sharing their vision of the world in 2030 to be inclusive of persons with disabilities PRELIM: NCMA217 (MATERNAL) - COMPONENTS OF CONCEPT MAP 4. MEDICAL AND SURGICAL MODULE #2: CASE MAPPING 1. RISK FACTORS MANAGEMENT MARIEL GUIAO. — Are conditions that increase your risk of — MEDICAL - A medical condition involves a developing a disease. more systemic, pharmaceutical approach to CONCEPT MAPPING. — 1.1. Modifiable risk factors - meaning you treatment. — A visual representation that allows you can take measures to change them. — SURGICAL - A surgical disease is one that graphically show the connections between a Examples: requires some form of localized intervention such client's many problems. Alcohol consumption as, of course, surgery, although various vascular — An effective learning strategy to understand Overweight and obesity interventions and radiation techniques would also the relationship that exists between client Physical activity fall into this category. problems. Healthy eating — Allows the student to organize and link — 1.2. Non modifiable risk factor - which 5. SIGNIFICANCE/PERTINENT information about a client in unique and means they cannot be changed. FINDINGS meaningful ways. Examples: — History and Physical Examination that Age, according to American Heart Association formulate a differential diagnosis Application to Nursing Practice: computations, about 80 percent of people who — For example: if the patient's chief complaint is — A concept map allows the student to organize die from cardiovascular disease are 65 years and chest pain, pertinent findings would include and link information about a client in unique older. things like: and meaningful ways. Gender - Heart disease has long been — Positive Findings - Clinical significance is — The relationship seen between multiple considered to be primarily a men's disease essentially a subjective interpretation of research nursing diagnoses allows students to plan Family history findings as meaningful for patient under care, and interventions that are therapeutic for more than Race therefore likely to influence the behavior of one problem area. healthcare provider — Use of concept maps helps students to reflect 2. PATHOPHYSIOLOGY and critically think about relationships between — is the study of the physical and biological 6. NURSING DIAGNOSIS clinical information in a way that promotes abnormalities occurring within the body as a — Is a clinical judgment concerning human clinical decision making result of the disease. response to health conditions/life processes ETIOLOGY 3. MEDICAL DIAGNOSIS 7. EXPECTED OUTCOMES — Is defined as the science of finding causes — The process of identifying a disease, — Are forecasted results-related directly to and origins. condition, or injury from its signs and symptoms. program goals and objectives. — An example of etiology is knowing that some — A health history, physical exam, and tests, of the causes of high blood pressure are such as blood tests, imaging tests, and biopsies, 8. NURSING INTERVENTIONS smoking, lack of exercise, stress and a diet high may be used to help make a diagnosis. — Are the actual treatments and actions that are in salt and fats — 3.1 Diagnostic Test - is any approach used to performed to help the patient to reach the goals gather clinical information for the purpose of that are set for them. making a clinical decision. — Types of Nursing Interventions: — The act or process of treating a person or disease with medicine Environment — Means anything that surrounds us. — It includes physical, chemical and other natural forces. Spirituality –- Involves the recognition of a feeling or sense or belief that there is something greater than Health Teaching/Health Education myself. — Is a social science that draws from the — An opening of the heart is an essential aspect biological, environmental, psychological, of true spirituality. physical and medical sciences to promote health Discharge Planning and prevent disease, disability and premature — Is when the patient. career, family and any death. staff involved make the necessary arrangements — Through education - driven voluntary to ensure there is a smooth transition from behavior change activities hospital to home, residential care or somewhere — GOAL: to promote, maintain, and improve else. individual and community health through the — It involves taking into account things like educational process. follow-up tests and appointments. Exercise — Outpatient follow up - was defined as an — Bodily or mental exertion, especially for the office visit with any primary care or specialist sake of training or improvement of health physician — Example: Walking is good exercise. Diet TYPES OF MAPPING –- The sum of food consumed by a person. — Often implies the use of specific intake of nutrition for health or weight-management reasons (with the two often being related). Treatment — An act or manner of treating. — Action or behavior toward a person, animal, etc. management in the application of medicines, surgery, etc. Medications –- a substance used in treating disease or relieving pain Example of a Concept Mapping: — Altered Bowel Elimination PRELIM: NCMA217 (MATERNAL) - Gender Sexuality - deals w/ the — IN WOMEN, this vasocongestion causes the MODULE #3: HUMAN SEXUALITY social & emotional aspects of being a man or a clitoris to increase in size and mucoid fluid to MARIEL GUIAO. woman. appear on vaginal walls as lubrication. Erotic Sexuality - refers to sexual - vagina widens in diameter and HUMAN SEXUALITY. love and arousing sexual desires increases in length. The nipples — Is a multidimensional concept. become erect. — It can be defined broadly by stating that TYPES OF SEXUAL ORIENTATION sexuality integrates the somatic (bodily), HETEROSEXUALITY emotional, intellectual, & social aspects of being — One who finds sexual fulfillment with a a human sexual being. member of the opposite gender. — It involves the anatomy & physiology of the HOMOSEXUALITY human body, as well as one's attitudes & feelings — A person who finds sexual fulfillment with a about oneself member of his or her own sex, — Usually they prefer to be called as "gay" for BIOLOGIC GENDER men & "lesbian" for women — Is the term used to denote chromosomal BISEXUALITY sexual development: male (XY) or female (XX) — People are bisexual if they achieve sexual SEXUAL OR GENDER IDENTITY satisfaction from both homosexual and — Is the inner sense a person has of being male heterosexual relationships. or female — IN MEN, penile erection occurs as both sexes, TRANSEXUALITY GENDER ROLE there is an increase in heart and respiratory rates — Is an individual who, although one biologic — Is the behavior a person conveys about being a and BP. gender, feels as is he or she should be of the male or female opposite gender — Sex change operations (synthetic SEX VS. GENDER vagina/penis) — Sex and gender are not the same. In general terms, SEX refers to a person’s physical HUMAN SEXUAL RESPONSE CYCLE. characteristics at birth, and GENDER 1. EXCITEMENT encompasses a person’s identities, expressions, — Occurs with physical and psychological and societal roles. stimulation (sight, sound, emotion or thought) that causes parasympathetic nerve stimulation. COMPONENTS OF SEXUALITY — This leads to arterial dilation and venous Reproductive Sexuality - involves constriction in the genital area. the biological aspects of conception & — The resulting increased blood supply leads to 2. PLATEAU procreation. vasocongestion and increasing muscular tension. — IN WOMAN, the clitoris is drawn forward and retracts under the clitoral prepuce. The lower part of the vagina becomes extremely congested and there is increased nipple elevation. EROTIC STIMULATION - is the use of visual materials such as magazines or photographs - for sexual arousal. FETISHISM - is sexual arousal resulting from the use of certain objects or situations. TRANSVESTISM - is an individual who dresses to take on the role of the opposite sex. VOYEURISM - obtaining sexual arousal by looking at another's person's body. — IN MEN, the vasocongestion leads to SADOMASOCHISM - involves distention of the penis. inflicting pain (sadism) or receiving pain - HR - increases to 100 to 175 bpm — IN MEN, muscle contractions surrounding the (masochism) to achieve sexual satisfaction. - RR - approximately 40 rpm seminal vessels and prostate project semen into EXHIBITIONISM - revealing one's the proximal urethra. genitals in public. — Contractions are followed immediately by PEDOPHILES - individuals who are three to seven propulsive ejaculatory interested in sexual encounters with children. contractions, occurring at the same time interval as in the woman, which force semen from the DISORDERS OF SEXUAL FUNCTIONING. penis. ERECTILE DYSFUNCTION — Shortest stage in sexual response cycle. — Formerly referred to as impotence — Inability to produce or maintain an erection long enough for vaginal penetration or partner satisfaction. PREMATURE EJACULATION 3. ORGASM — Ejaculation before penile contact. — IN WOMAN, the body suddenly discharges — Can be unsatisfactory and frustrating to both accumulated sexual tension. partners — A vigorous contraction of muscles in the — Can be psychological pelvic area expels or dissipates blood and fluid FAILURE TO ACHIEVE from the area of congestion. ORGASM (Anorgasmia) — The average number of contractions for the TYPES OF SEXUAL EXPRESSION. — Can be due to poor sexual technique or woman is 8 to 15 contractions at intervals of CELIBACY - abstinence from sexual possible negative attitudes toward sexual one every 0.8 seconds activity. Ex. Priest relationships. MASTURBATION - self-stimulation for erotic pleasure. VAGINISMUS — Involuntary contraction of the muscles at the outlet of the vagina when coitus is attempted. — Muscle contraction prohibits penile penetration. DYSPAREUNIA — Pain during coitus can be due to endometriosis INHIBITED SEXUAL DESIRE — Lack of desire for sexual relations may be a concern of young or middle-aged adults. — Support or a caring sexual partner or relief of the tension causing the stress allows a return to sexual interest. PRELIM: NCMA217 (MATERNAL) - — Under the influence of testosterone, the MODULE #4: REPRODUCTIVE mesonephric duct begins to develop into the DEVELOPMENT MARIEL GUIAO. male reproductive organs, and the paramesonephric duct regresses. DEVELOPMENT OF REPRODUCTIVE — If testosterone is not present by week 10, the SYSTEM. gonadal tissue differentiates into ovaries, and the GONADS refers to the organs in which paramesonephric duct develops into female FEMALE AND MALE REPRODUCTIVE gametogenesis occurs. reproductive organs. SYSTEM HOMOLOGUES - a body organ that produces sex cells — All of the oocytes (cells that will develop into FEMALE - Female gonad - ovary eggs throughout the woman's mature years) are 1. Clitoris Glans - Male gonad - testis already formed in ovaries at this stage (MacKay, 2. Clitoris Shaft — At approximately week 5 of intrauterine life, 2009). 3. Labia Majora primitive gonadal tissue is already formed. — At about week 12, the external genitals 4. Ovaries — Male and female gonads appear as gonadal develop. 5. Skene’s Glands ridges — In males, under the influence of testosterone. 6. Bartho;in Glands — In both sexes, two undifferentiated ducts, the 1. Penile tissue elongates MALE mesonephric (wolffian) and paramesonephric 2. Urogenital fold on the ventral surface 1. Penile Glans (müllerian) ducts, are present. of the penis closes to form the urethra: 2. Penile Shaft — In females, with no testosterone present 3. Scrotum 1. Urogenital fold remains open to form 4. Testes the labia minora 5. Prostate 2. What would be formed as scrotal 6. Cowper’s Glands tissue in the male becomes the labia majora in the female. PHYSIOLOGY OF ONSET. PUBERTY - is initiated by hypothalamic pituitary - gonad complex. — Sequence of events by which a child is transformed into a young adult. — Puberty usually starts in: - Girls - 10-13 y/o - Boys - 12-14 y/o — By week 7 or 8, in chromosomal males, this early gonadal tissue differentiates into primitive testes and begins formation of testosterone. — Voice changes 2. Fertilization - enables union of the — Penile growth oocyte by the sperm. — Increase in height — Spermatogenesis 3. Development and nourishment of a new individual - nurtures the developing fetus in the uterus until birth and provides nourishment (breast milk) after birth GIRLS ESTROGEN ROLE OF ANDROGENS 4. Production of sex hormone - — Growth Spurt Androgenic hormones - responsible for Hormones produced by the reproductive system — Increase in the transverse diameter of the muscular development, physical growth control its development and the development of pelvis — An increase in sebaceous gland secretions the gender-specific body form. — Breast development causing typical acne in both boys & girls. — Growth of pubic hair — Produced by adrenal cortex & testes (males) — Onset of menstruation — Growth of axillary hair — Vaginal secretions MALE REPRODUCTIVE SYSTEM. Consists of THE TESTES, a series of ducts, accessory glands, and supporting structures. FUNCTIONS. — DUCTS - the epididymis, the ductus REPRODUCTION - is an essential deferens/vas deferens, and the urethra. characteristic of living organisms functional male — ACCESSORY GLANDS - the seminal and female reproductive systems are necessary vesicles, the prostate gland, and the bulbourethral for humans to reproduce glands. BOYS (TESTOSTERONE) 1. Production of Gametes - — SUPPORTING STRUCTURES - include — Increase in weight — Gametogenesis - is the production of gametes the scrotum and the penis — Growth of testes — GAMETES - reproductive cells that are — Growth of face, axillary & pubic hair produced in the gonads. — CREMASTER MUSCLES CONTRACT, SPERMATOGENESIS. which pulls the testes closer to the body, which Formation of sperm cells increases the testes' temperature — Spermatogonia - most peripheral germ cells WARM WEATHER OR EXERCISE: that divide through mitosis — Dartos and cremaster muscles relax, skin of — Primary spermatocytes – other daughter the scrotum loose and thin cells that divide by meiosis and become sperm — Testes descend away from the body, which cells lowers their temperature. — Secondary spermatocytes - product of first meiotic division TESTES - also called male gonads; oval organs — Spermatids - product of secondary meiotic within the scrotum division. — Seminiferous tubules - where sperm cells — Sperm cell/ Spermatozoan - developed SCROTUM - Sac-like structure containing the develop spermatid with a head, midpiece, and flagellum. testes — Interstitial cells / Leydig cells - endocrine — Dartos Muscle - layer of Smooth Muscle cells that secrete testosterone ACROSOME - vesicle; anterior to the nucleus beneath the skin of the scrotum. — Sustentacular cells / Sertoli - are large and - Contains enzymes that are released — Cremaster Muscles - extensions of nourish the germ cells; produce a number of during the process of fertilization. abdominal muscles into the scrotum. hormones. - Necessary for the sperm cell to penetrate the oocyte or egg cell Germ cells are partially embedded in the sustentacular cells. The most peripheral germ cells are spermatogonia, which divide through mitosis 1. Spermatogonia are the cells from which sperm cells arise. The spermatogonia divide by mitosis. One daughter cell remains a spermatogonium that - Dartos and Cremaster muscles - can divide again by mitosis. One daughter cell BOTH regulates the temperature in becomes a primary spermatocyte. the testes 2. The primary spermatocyte divides by meiosis COLD TEMPERATURES: to form secondary spermatocytes. — DARTOS MUSCLE CONTRACTS, causing 3. The secondary spermatocytes divide by the skin of the scrotum to become firm and meiosis to form spermatids. wrinkled and reducing the overall size of the 4. The spermatids differentiate to form sperm scrotum. cells. MALE REPRODUCTIVE SYSTEM: DUCTS. Divided into three parts: EPIDIDYMIS - A tightly coiled series of 1. Prostatic urethra - passes through the prostate threadlike tubules that farm a comma-shaped gland structure. 2. Membranous urethra - passes through the — Maturation site of sperm cells, developing the floor of the pelvis; surrounded by the external capacity to swim and the ability to bind to the oocyte. urinary sphincter 3. Spongy urethra - extends the length of the RETE TESTIS - path where each seminiferous penis and opens at its end tubule empty into in tubular networks EFFERENT DUCTULES - carry sperm cells from the testis to the epididymis CAPACITATION - final changes in sperm cells that occur after ejaculation of semen into the vagina and prior to fertilization DUCTUS DEFERENS / VAS DEFERENS - Emerges from the epididymis and ascends along the posterior side of the testis — contains smooth muscle, which contracts in peristaltic waves to propel the sperm cells from the epididymis through the ductus deferens. SPERMATIC CORD - consists of the ductus deferens, testicular artery and veins, lymphatic vessels, and testicular nerve AMPULLA OF THE DUCTUS DEFERENS - where the ductus deferens increases in diameter SEMINAL VESICLE - sac-shaped gland EJACULATORY DUCT - formed by the ducts from the seminal vesicle and the ampulla of the ductus deferens URETHRA - about 20 cm long and extends from the urinary bladder to the distal end of the penis — passageway for both urine and male reproductive fluids MALE REPRODUCTIVE SYSTEM: PENIS. REGULATION OF SEX HORMONE SECRETION PENIS - Male organs of copulation Four primary functions of the Bulbourethral — Gonadotropin-Releasing Hormone (GnRH) — Function in transfer of sperm cells from the glands and the mucous glands of the urethra - produced in hypothalamus; stimulates release of male to the female LH and FSH from the anterior pituitary — contains three columns of erectile tissue 1. Lubrication of the urethra Erection - process of the engorgement of 2. Neutralization of the contents of the normally — Luteinizing Hormone (LH) - stimulates the erectile tissue with blood that causes the acidic urethra interstitial cells to produce testosterone penis to enlarge and become firm 3. Providing a small amount of lubrication during intercourse — Follicle-Stimulating Hormone (FSH) - binds — Corpora Cavernosa - two columns of erectile 4. Reduction of acidity in the vagina to sustentacular cells and stimulates tissue that form the dorsal portion spermatogenesis and secretion of inhibin — Corpus Spongiosum - third, small erectile Substances from secretions include: column that occupies the ventral portion of the 1. FRUCTOSE - nourish the sperm cells as they — Testosterone - has a negative-feedback effect penis move through the female reproductive tract. on GnRH, LH, and FSH — Glans Penis - a formed cap. Tip of the penis 2. COAGULATION PROTEINS - help thicken — External Urethral Orifice - spongy urethra the semen, which keeps the sperm cells in the — Inhibin - has a negative-feedback effect on that opens to the exterior part vagina for a longer period of time. FSH secretion (granulosa and theca cells of the — Prepuce / Foreskin - loose fold of skin that 3. ENZYMES. - destroy abnormal sperm cells. ovary and by the Sertoli cells of the testis) covers the glans penis 4. PROSTAGLANDINS - stimulate smooth muscle contractions of the female reproductive CLINICAL IMPACT. MALE REPRODUCTIVE SYSTEM: GLANDS. ERECTILE DYSFUNCTION (ED) - tract to propel sperm cells through the tract. — Prostate Gland - consists of glandular; impotence; failure to achieve erections muscular tissue & empties into the urethra. — Infertility in Males Function of Prostate Gland Secretes fluid that nourishes and protects — Common cause is a low sperm cell count 1. Regulate pH sperm. — prostate secretions are alkaline. — neutralizes the acidity of the male urethra, the INFERTILITY - is the inability or the reduced — Bulbourethral Glands / Cowper Glands - a ability to produce offspring. secretions of the testes, the secretions of the pair of small, mucus-secreting glands that empty seminal vesicles, and the vagina into the urethra OLIGOSPERMIA - low sperm count 2. Liquefy the coagulated semen. AZOOSPERMIA - semen contains no sperm SECRETIONS. Artificial insemination - concentrating — prostate gland secretions contain proteolytic SEMEN - is a mixture of sperm cells and the sperm cells and inserting them into enzymes that break down the coagulated secretions from the male reproductive glands. the female's reproductive tract proteins; make the semen more liquid. 1. Seminal vesicles produce about 60%of the fluid 2. Prostate gland contributes approximately 30% 3. Testes contribute 5% 4. Bulbourethral glands contribute 5%. FEMALE REPRODUCTIVE SYSTEM. OOGENESIS AND FERTILIZATION. FOLLICLE DEVELOPMENT. — consist of the ovaries, the uterine tubes (or OOGONIA - the cells form which oocytes PRIMORDIAL FOLLICLE - primary oocyte fallopian tubes), uterus, the vagina, the external develop surrounded by granulosa cells (single layer of flat genitalia, and the mammary glands cells) — Internal reproductive organs of the female are — Primary oocyte - oogonia that has stopped in located within the pelvis, between the urinary prophase I PRIMARY FOLLICLES - oocyte enlarges and bladder and the rectum — Secondary oocyte - released when the first the single layer of granulosa cells become — UTERUS AND THE VAGINA are in the meiotic division is complete enlarged and cuboidal midline, with an ovary to each side of the uterus — Ovulation - release of an oocyte from an ovary ZONA PELLUCIDA - a layer of clear material FEMALE REPRODUCTIVE SYSTEM: OVARIES. Corpus leum that is deposited around the primary — Fertilization - when a sperm cell penetrates BROAD LIGAMENT - spreads out on both oocyte the cytoplasm of a secondary oocyte sides of the uterus and attaches to the ovaries and — Zygote - 23 chromosomes from the sperm + uterine tubes SECONDARY FOLLICLE - fluid-filled 23 chromosomes from the female gamete vesicles appear and a theca forms around the OVARY - is a small organ suspended in the follicle pelvic cavity by two ligaments 1. Suspensory ligament - extends from each — Vesicles - Fluid filled spaces - ovary to the lateral body wall — Theca - a capsule that forms around the , 2. Ovarian ligament - attaches the ovary to the — Antrum - a single, fluid-filled chamber superior margin of the uterus — Cumulus cells - mass of granulosa cells Mesovarium - folds of peritoneum — Graafian follicle - mature follicle — Corpus luteum - remaining cells of the ruptured follicle are transformed into a glandular structure Human Chorionic Gonadotropin Hormone (hCG) - the corpus luteum enlarges in response to this hormone UTERINE TUBES. FALLOPIAN TUBE / OVIDUCT - Receive the secondary oocyte — Fimbriae - long, thin processes that surrounds each the opening of each uterine tube — Cilia on fimbriae - sweep the oocyte into the uterine tube — Retroversion- a condition in which the entire Hymenectomy is a minor procedure to surgically — Ampulla - where fertilization usually occurs uterus is tipped backward remove or open the hymen. Implantation - process wherein the — Retroflexion- a condition in which the body is fertilized oocyte embeds itself in the bent sharply back just above the cervix uterine wall FEMALE REPRODUCTIVE SYSTEM: UTERUS. — Fundus - superior to the entrance of the uterine tubes — Body - main part of the uterus — Cervix - inferiorly, narrower part the lowest portion of the uterus represents approximately one third of EXTERNAL GENITALIA. the total uterus size VULVA - pudendum; external female genitalia cervical canal — Vestibule - the space into which the vagina Prolapsed uterus - occurs when the uterus FEMALE REPRODUCTIVE SYSTEM: VAGINA. and urethra open extends inferiorly into the vagina VAGINA — Labia minora - longitudinal skin folds 1. female organ of copulation — Clitoris - small, erectile structure; well Layers of the Uterus: 2. it receives the penis during intercourse supplied with sensory receptors, made of erectile - Perimetrium - outer layer; serous layer of the 3. It also allows menstrual flow and childbirth tissue uterus formed from visceral peritoneum due to smooth muscle + elastic fibers — Greater vestibular glands - produce a - Myometrium - middle layer; muscular layer can increase in size to accommodate lubricating fluid that helps maintain the that accounts for the bulk of the uterine wall the penis during intercourse, and it moistness of the vestibule - Endometrium - innermost layer; consists of can stretch greatly during childbirth — Labia majora - prominent, rounded folds of simple columnar epithelial cells with an — Ph is acidic due to the action of skin underlying CT layer Doderlein'sbacillus — Mons pubis - an elevation of tissue over the pubic symphysis UTERINE DEVIATIONS — Hymen - thin mucous membrane inside the — Pudendal cleft - space between the labia Ordinarily, the body of the uterus is tipped opening of the vagina majora slightly forward. Rarely, completely close the vaginal — Clinical perineum - region between the — Anteversion- a condition in which the entire orifice and it must be removed to vagina and the anus uterus is tipped far forward allow menstrual flow. Episiotomy - an incision made in the — Anteflexion - a condition in which the body More commonly, the hymen is clinical perineum to avoid tearing of the uterus is bent sharply forward at the perforated by one or several holes. during childbirth junction with the cervix greatly enlarged during the first sexual intercourse MAMMARY GLANDS. HORMONES. 1. Organs of milk production ESTROGEN & PROGESTERONE 2. Located in the breasts Aid in uterine and mammary gland development 3. Modified sweat glands and function, external genitalia structure, secondary sexual characteristics. sexual behavior, — Areola - a circular, pigmented area that menstrual cycle surrounds the nipple — Estrogen - is the hormone that regulates the — Glandular lobes - covered by adipose tissue; menstrual cycle gives the breast its form — Progesterone - is the hormone that supports — Lactiferous duct - opens independently to the pregnancy. surface of the nipple — Myoepithelial cells - surround the alveoli and HUMAN CHORIONIC GONADOTROPIN contract to expel milk from the alveoli (HCG) Stimulate production of estrogen and Gynecomastia - occurs when the breasts of a progesterone male become permanently enlarged; results from — created by trophoblast tissue, tissue typically hormonal imbalance and the abuse of anabolic found in early embryos steroids — stimulates the corpus luteum to produce — caused by male estrogen levels that are too progesterone to maintain the pregnancy. high OXYTOCIN DEFINITION OF TERMS RELATED TO stimulates labor by increasing uterine FEMALE REPRODUCTION. contractions — MENARCHE - first episode of the menstrual — increased milk expulsion from mammary bleeding (first occurrence) glands — MENSTRUAL CYCLE - series of changes that occur in sexually mature, non-pregnant PROLACTIN females, and that culminate in menses Aids in the development of breast during — MENSES - a period of mild hemorrhage; part pregnancy of the endometrium is sloughed and expelled — Stimulates milk production and prolongs from the uterus; day 1 - 4: menstrual fluid is progesterone secretion produced by degeneration of the endometrium — AMENORRHEA - absence of a menstrual cycle — ECTOPIC PREGNANCY - implantation occurs anywhere other than in the uterine cavity PRELIM: NCMA217 (MATERNAL) - 2. They help regulate fluid and electrolyte MODULE #5: MENSTRUATION balance. MARIEL GUIAO. 3. They stimulate protein synthesis 4. They lower blood cholesterol levels MENSTRUATION. 5. Spinnbarkeit and ferning — Is the monthly menstrual bleeding also called 6. Thickening of the endometrium menstruation or menstrual period) that you have from your early teen years until your menstrual PROGESTERONE. periods end around age 50 — Is secreted mainly by the corpus luteum and — About once a month, the uterus grows a new, works with estrogen to prepare the endometrium thickened lining (endometrium) that can hold a for implantation and mammary glands for fertilized egg. lactation. — When there is no fertilized egg to start the — Decrease GI motility uterus then sheds its lining. — Increase permeability of kidney to lactose & — The menstrual cycle is measured from the first dextrose day of menstrual bleeding, Day 1, up to Day 1 of — Responsible for the mood swings of the your next menstrual bleeding. mother — A teen's cycles tend to be long (up to 42 — Mammary gland development days), growing shorter over several years. — The average menstrual period is 5 days. OVARIAN CYCLE. — The amount of blood loss every menstrual — LH (Luteinizing Hormone): a hormone that FOLLICULAR PHASE period is 30 to 80 ml. becomes most active at the midpoint of the cycle — Days 1 through 13 — The normal color of the menses is dark red & is responsible for ovulation or release of the — In response to follicle stimulating hormone that contains mucus and endometrial cells. mature egg cell from the ovary, and growth of (FSH) released from the pituitary gland in the uterine lining brain, ultimately one egg matures. ORGANS INVOLVED IN MENSTRUATION. OVARIES OVULATION PHASE HYPOTHALAMUS — One ovum matures in one or the other ovary — Day 14 — Stimulates the anterior pituitary gland to begin & is discharge from it each month — At about day 14, in response to a surge of production of gonadotropic hormones. UTERUS luteinizing hormone, the egg is released from PITUITARY GLAND — Stimulation from the hormones produced by the ovary. — Under the influence of LHRH, the anterior the Ovaries causes specific monthly effects on — The egg travels through the fallopian tube pituitary gland produces 2 hormones that act on the uterus toward the uterus. the ovaries to further influence menstruation. LUTEAL PHASE — FSH (Follicle Stimulating Hormone): a ESTROGEN (HORMONE FOR WOMEN). — Days 14 through 28 hormone that is active early in a cycle & is 1. Stimulate the growth, development, and — The remains of the follicle become the corpus responsible for maturation of the ovum maintenance of female reproductive structures, luteum which releases progesterone. secondary sex characteristics and the breast. TIME OF OVULATION. — An easy way to approximate the time of ovulation for women with regular cycles is to subtract 16 from the number of days in the cycle and then add 4. This will calculate the span of days in which ovulation is most likely to occur. ***For example: August 1 start ng menstruation cycle mo, then every 28 siya nagkakaroon so subtract mo to 16 then add 4, then every day 16 ng menstruation cycle siya nag o-ovulation. SIGNS & SYMPTOMS OF OVULATION PROCESS OF FERTILIZATION. — Mittelschmerz Sign - abdominal tenderness FERTILIZATION (Conception, Fecundation) UTERINE CYCLE. on left/right iliac regions, brought about by — Is the union of an ovum and a spermatozoon. PROLIFERATIVE PHASE peritoneal irritation due to blood coming out from This usually occurs in the outer third of the — Days 5-14 the graafian follicle. fallopian tube. — The uterine lining increases rapidly in — Spinnbarkeit Sign - vaginal secretion is clear — Usually only one of a woman’s ova will reach thickness, and the uterine glands proliferate and & transparent maturity each month. Once the mature ovum is grow. released, fertilization must occur fairly quickly SECRETORY PHASE Other Signs: because an ovum is capable of fertilization for — Days 14 through 28 — Change in vaginal mucus only 24 hours (48 hours at the most). — When an egg is not fertilized, the corpus — Goodel's sign - cervix becomes soft, cervix — After that time, it atrophies and becomes luteum gradually disappears, estrogen and connects your uterus to the vagina. nonfunctional. Because the functional life of a progesterone levels drop, and the thickened — Mood changes spermatozoon is also about 48 hours, possibly as uterine lining is shed. This is menses (your — Breast tenderness long as 72 hours, the total critical time span period). — Increased levels of Progesterone during which sexual relations must occur for — Change in basal body temperature fertilization to be successful is about 72 hours (48 hours before ovulation plus 24 hours afterward). ANTEPARTAL PERIOD. — As the ovum is extruded from the graafian 1. OVUM - from ovulation to fertilization follicle of an ovary with ovulation, it is 2. ZYGOTE - from fertilization to implantation surrounded by a ring of mucopolysaccharide 3. EMBRYO - from implantation to 5-8 weeks fluid (the zona pellucida) and a circle of cells (the 4. FETUS - from 5-8 weeks until term corona radiata). 5. CONCEPTUS - Developing embryo or fetus — The ovum and these surrounding cells (which —- And placental structure throughout increase the bulk of the ovum and serve as pregnancy protective buffers against injury) are propelled into a nearby fallopian tube by currents initiated by the fimbriae—the fine, hairlike structures that If an X-carrying spermatozoon enters the ovum, inner cell mass. At this stage, the structure line the openings of the fallopian tubes. A the resulting child will have two X becomes a blastocyst. It is this structure that combination of peristaltic action of the tube and chromosomes and will be female (XX). attaches to the uterine endometrium. The cells in If a Y-carrying spermatozoon fertilized the movements of the tube cilia help propel the ovum ovum, the resulting child will have an X and a Y the outer ring are trophoblast cells along the length of the tube. chromosome and will be male (XY). — Implantation or contact between the growing — At the time of ovulation, there is a reduction structure and the uterine endometrium occurs in the viscosity (thickness) of the cervical mucus, approximately 8 to 10 days after fertilization. which makes it easy for spermatozoa to penetrate — Apposition - the blastocyst brushes against it. Sperm transport is so efficient close to the rich uterine endometrium ovulation that spermatozoa deposited in the — Adhesion - it attaches to the surface of the vagina generally reach the cervix within 90 endometrium seconds and the outer end of a fallopian tube — Invasion - the blastocyst settles down into its within 5 minutes after deposition. soft folds. — Spermatozoa move through the cervix and the ***Once the zygote is implanted it is an body of the uterus and into the fallopian tubes, EMBRYO. toward the waiting ovum by the combination of — The blastocyst is able to invade the movement by their flagella (tails) and uterine endometrium because, as the trophoblast cells on contractions. the outside of the structure touch the — Capacitation - is a final process that sperm endometrium, they produce proteolytic enzymes must undergo to be ready for fertilization. that dissolve any tissue they touch. This action This process, which happens as the sperm allows the blastocyst to burrow deeply into the moves toward the ovum, consists of changes in IMPLANTATION. endometrium and receive some basic the plasma membrane of the sperm head, which nourishment of glycogen and mucoprotein from reveal the sperm-binding receptor sites. — Once fertilization is complete, a zygote migrates over the next 3 to 4 days toward the the endometrial glands. As invasion continues, — Hyaluronidase - (a proteolytic enzyme) is body of the uterus, aided by the currents initiated the structure establishes an effective released by the spermatozoa and dissolves the by the muscular contractions of the fallopian communication network with the blood system of layer of cells protecting the ovum. Under ordinary circumstances, only one tubes. During this time, mitotic cell division, or the endometrium. spermatozoon is able to penetrate the cell cleavage, begins. membrane of the ovum.Once it penetrates the — The first cleavage occurs at about 24 hours; cell, the cell membrane changes composition to cleavage divisions continue to occur at a rate of become impervious to other spermatozoa. about one every 22 hours. By the time the zygote Immediately after penetration of the ovum, the reaches the body of the uterus, it consists of 16 to chromosomal material of the ovum and spermatozoon fuse to form a zygote. 50 cells. At this stage, because of its bumpy Because the spermatozoon and ovum each outward appearance, it is termed a morula (from carried 23 chromosomes (22 autosomes and 1 the Latin word morus, meaning “mulberry”) sex chromosome), the fertilized ovum has 46 — Large cells tend to collect at the periphery of chromosomes. the ball, leaving a fluid space surrounding an PRELIM: NCMA217 (MATERNAL) - Upon fertilization: sex of the baby is MODULE #6: HUMAN GENETICS determined by the sperm cell. The baby is: MARIEL GUIAO. — MALE if the oocyte is fertilized by a Y-carrying sperm cell DEFINITIONS. — FEMALE if it is fertilized by an X-carrying INHERITED OR GENETIC sperm cell. — Facial characteristics of a boy with Cri Du DISORDERS Chat Syndrome showing low-set ears, — Are disorders that can be passed from one Phenotype - is a person's outward appearance. strabismus, short philtrum, broad flat nasal generation to the next. Genotype - refers to the actual gene composition. bridge, and pronounced hypertelorism. — Result from some disorder in gene or Karyotype - is a graphic representation of the chromosome structure and occur in 5% to 6% of chromosomes that are present. TERATOGEN SEVERITY OF DAMAGE TO newborns. THE UNBORN DEPENDS ON: : — May occur at the moment an ovum and sperm NATURE OF INHERITANCE. — Dose fuse or even earlier, in the meiotic division phase — A person's genome is the complete set of — Length of exposure of the gametes (ovum and sperm). genes present (about 50,000 to 100.000). — Time of exposure — Some genetic abnormalities are so severe that — A normal genome is abbreviated as 46XX or — Critical period: a fixed time period during normal fetal growth cannot continue past that 46XY (designation of the total number of which certain experiences or events can have a point. chromosomes plus a graphic description of the long-lasting effect on development GENETICS sex chromosomes present). — Is the study of the way such disorders occur. — If a chromosomal aberration exists, it is ALCOHOL CYTOGENETICS listed after the sex chromosome pattern. — No alcohol consumption during pregnancy is — Is the study of chromosomes by light — In such abbreviations, the letter p stands for safe to fetus microscopy and the method by which short arm defects and q stands for defects on the — Fetal alcohol syndrome: abnormalities in chromosomal aberrations are identified. long arm of the chromosome. newborn due to mother's heavy use of alcohol in GENES — The abbreviation 46XX5p, for example, is the pregnancy: — Are the basic units of heredity that determine abbreviation for a female with 46 total - Facial deformities (small eyes, thin lips, both the physical and cognitive characteristics of chromosomes but with the short arm of small head) people. chromosome 5 missing (cri-du-chat syndrome). - Defective limbs, face, heart - Most have below-average intelligence; — In Down syndrome, the person has an extra some are mentally retarded HUMAN GENETICS. chromosome 21, which is abbreviated as Most human cells contain 46 chromosomes: 47XX21+ or 47XY21+ NICOTINE — 22 pairs of chromosomes called autosomes. — Maternal smoking can negatively influence — + 2 sex chromosomes (X,Y): prenatal development, birth, and postnatal - XY in males. development - XX in females. — Associated with: — Preterm births and low birth weight — Fetal and neonatal death — Respiratory problems — SIDS (Sudden Infant Death Syndrome) MATERNAL STRESS — ADHD (Attention Deficit Hyperactivity Disorder — Cortisol can pass through the placenta to the fetus. PRESCRIPTION AND — High levels of maternal stress hormones NON-PRESCRIPTION DRUGS during a pregnancy have been associated with a — Sulfonamides - antibacterial slower growth rate in the fetus and lower birth — Aminoglycoside - antibacterial weight and with temperamental difficulties in — Fluoroquinolones - antibacterial infants — Erythromycin - antibiotic — Metronidazole - antiprotozoal CAFFEINE — Tetracyclines - antiprotozoal — Small risk of miscarriage and low birth weight — Ribavirin - antiviral for those consuming more than 200 mg. daily — Griseofulvin - antifungal — Increased risk of fetal death for those — Chloramphenicol & Clarithromycin consuming more than 300 mg. Daily. — Mnemonic - SAFE Moms Take Really Good Care ILLEGAL DRUGS — Cocaine, Methamphetamine, Marijuana , Heroin - A mother taking illegal drugs during pregnancy increases her risk for anemia, blood and heart infections, skin infections, hepatitis, and other infectious diseases. — Marijuana use during pregnancy may be linked to cognitive and behavioral problems in the baby. — Cocaine use can lead to miscarriage, preterm ENVIRONMENTAL HAZARDS delivery of the fetus. premature detachment of — Radiation the placenta, high blood pressure, and stillbirth. — Environmental pollutants and toxic wastes MATERNAL DISEASE — Sexually transmitted diseases (Syphilis, Genital herpes, HIV) — Rubella (German measles) — Varicella (chickenpox) — Toxoplasmosis PRELIM: NCMA217 (MATERNAL) - — Also, the soles of their feet are often rounded instead KLINEFELTER SYNDROME MODULE #7: COMMON CHROMOSOMAL of flat (rocker-bottom feet). As in trisomy 13 (47XXY) DISORDERS MARIEL GUIAO. syndrome, most of these children do not survive beyond — Infants with Klinefelter early infancy. syndrome are males with an COMMON CHROMOSOMAL DISORDERS. extra X chromosome. CRI-DU-CHAT SYNDROME — Characteristics of the TRISOMY 13 SYNDROME (46XX5P OR 46XY5P) syndrome may not be (47XY13 OR 47XX13) — Cri-du-chat syndrome is the noticeable at birth. — Trisomy 13 syndrome result of a missing portion of — At puberty, secondary sex (Patau syndrome), the child has chromosome 5. characteristics do not develop; an extra chromosome 13 and is — In addition to an abnormal the child has small testes that severely cognitively challenged. cry, which sounds much more produce ineffective sperm — Midline body disorders such like the sound of a cat than a — Affected individuals tend as cleft lip and palate, heart human infant's cry, children to develop gynecomastia (increased breast size) and defects, particularly ventricular with cri-du-chat syndrome have an increased risk of male breast cancer septal defects, and abnormal tend to have a small head, genitalia are present wide-set eyes, and a downward — Other common findings TURNER AND KLINEFELTER slant to the palpebral fissure of the eye. include microcephaly with — They are severely cognitively challenged SYNDROME CHARACTERISTICS: abnormalities of the forebrain and forehead; eyes that are smaller TURNER SYNDROME (45X0) than normal (microphthalmos) — A child with Turner or absent; and low-set ears. syndrome (gonadal — Most of these children do not survive beyond early dysgenesis) has only one childhood functional X chromosome. — Hairline at the nape of the TRISOMY 18 SYNDROME neck is low set, and the neck (47XY18 OR 47XX18) may appear to be webbed and — Children with trisomy 18 short. syndrome have three copies of — A newborn may have chromosome 18. appreciable edema of the — Children are severely hands and feet and a number cognitively challenged and of congenital anomalies, most tend to be small for gestational frequently coarctation FRAGILE X SYNDROME age at birth, have markedly (stricture) of the aorta and low-set ears, a small jaw, kidney disorders. — Fragile X syndrome is the most common cause of congenital heart defects, and — The disorder can be identified with an ultrasound cognitive challenge in males. usually misshapen fingers and during pregnancy because of the increased neck folds — It is an X-linked disorder in toes (the index finger deviates which one long arm of an X or crosses over other fingers). chromosome is defective which results in inadequate protein synaptic responses. — Before puberty, boys with fragile X syndrome typically may demonstrate maladaptive behaviors such as hyperactivity and autism. — They may have reduced intellectual functioning, with marked deficits in speech and arithmetic — They may be identified by the presence of a large head, a long face with a high forehead, a prominent lower jaw, and large protruding ears. — Hyperextensive joints and cardiac disorders may also be present. — After puberty, enlarged testicles may become evident. Affected individuals are fertile and can reproduce. — Carrier females may show some evidence of their physical and cognitive characteristics. — Intellectual function from the syndrome cannot be improved DOWN SYNDROME (TRISOMY 21, 47XY21 OR 47XX21) — Trisomy 21, the most frequently occurring chromosomal abnormality — The number of children born with the disorder is considerably less as many women choose to end pregnancies when the diagnosis is made — This extra chromosome causes problems as the brain and physical features develop. — In all cases of reproduction, both parents pass their genes on to their children. PRELIM: NCMA217 (MATERNAL) - cannot enter the uterus or fallopian tubes and — For example** your menstrual cycle starts at MODULE #8: REPRODUCTIVE LIFE fertilize the ovum. august 1 then count ka to 28 (august 28) then subtract PLANNING MARIEL GUIAO. 1. Chemical Barriers - spermicide is an agent 16 (august 12) then add 4 (august 16), so mataas ang chance na pwede kang mabuntis around august 12-16 that causes the death of spermatozoa before (ovulation phase) kaya hindi advisable na makipag REPRODUCTIVE LIFE PLANNING. they can enter the cervix. sex around that time if ayaw mag conceive. — Includes all the decisions an individual or 2. Mechanical Barriers - work by blocking couple makes about having children. the entrance of sperm into the cervix BASAL BODY TEMPERATURE HORMONAL METHODS METHOD Important THINGS TO REMEMBER IN — Use of hormones that cause fluctuations in a — The woman takes her temperature each CHOOSING contraceptives: