Structural Abnormalities and Reproductive System PDF

Structural Abnormalities *genetic defects; pg 757* Horseshoe kidney Fused kidneys causing a single U-shape; usually asymptomatic Hypospadias Urethral meatus is located on the ventral side or undersurface of the penis Chordee →penile rotation or “bowing” to either the right or left Su...

Structural Abnormalities *genetic defects; pg 757* Horseshoe kidney Fused kidneys causing a single U-shape; usually asymptomatic Hypospadias Urethral meatus is located on the ventral side or undersurface of the penis Chordee →penile rotation or “bowing” to either the right or left Surgery between 6-12 months of age to correct Epispadias Urethral opening is on the dorsal (top) surface of the penis Exstrophy of the bladder Herniation of the bladder through the abdominal wall Ideally, should be fixed before the infant is 72 hours old Nephroblastoma (Wilms tumour) An embryonal tumour of the kidney; peak incidence between age 2-3 Clinical Manifestations - Enlarging asymptomatic abdominal mass; usually found by parent - Vague abdominal pain, hematuria, anemia, fever - Hypertension → due to excessive renin secretion by the tumour Diagnosis: surgical biopsy, imaging to evaluate presence of metastasis Treatment: surgery, chemotherapy, radiation Survival is >90%, although higher risk for HF, kidney failure, and HTN in the long-term Childhood Incontinence (Enuresis) Involuntary passage of urine by a child who is Theories: beyond the age (~5 years old) when voluntary - Organic causes (UTIs, congenital defects) bladder control should have been acquired - Factors that increase urine production (diabetes, sickle cell disease - Primary Enuresis: the child has never - Maturational lag (developmental delay) been continent - Genetic factors - Secondary Enuresis: the child has been - Sleep patterns (obstructive sleep apnea) - Psychosocial theories (ADHD, stress (new continent for at least 6 months before sibling)) incontinence recurs - Daytime or Nighttime Diagnosis: history, urinalysis, physical exam Treatment: therapeutic management; education, implementation of timed voiding, fluid management, UTIs Medications are also available for overactive bladders  Structure and Function of the Reproductive System Chapter 32 Learning Objectives Discuss factors related to altered puberty Identify common uterine disorders in women Describe benign and malignant uterine growths Identify causative factors related to male and female sexual dysfunction Discuss the pathophysiology of male and female reproductive disorders Describe structural male reproductive disorders Discuss the prevalence, treatment, and complication of STIs Describe medical treatment for male and female disorders Identify male and female breast disorders Identify risk factors related to the development of reproductive cancers in men and women Review signs, symptoms, and complications of cancer affecting the reproductive organs Development of the Reproductive System Dependant on sex hormones - Males: testosterone - Needed in utero to differentiate into external male genitalia - Production of sperm begins at puberty - Females: estrogen, progesterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) - Production of ova occurs only during fetal life; one gamete matures per menstrual cycle Female Reproductive System External Genitalia (vulva): mons pubis, labia majora, labia minora, clitoris, perineum Internal Genitalia: vagina, cervix, uterus, fallopian tubes, ovaries Female Sex Hormones Estrogen: a generic term for 3 similar hormones derived from cholesterol; estradiol, estrone, and estriol - Maturation of reproductive organs, development of secondary sex characteristics, and maintenance of pregnancy require estrogen Androgen: produced by the adrenal cortex and ovaries; contribute to skeletal growth, pubic hair growth, and activate sebaceous glands (acne), and play a role in libido Progesterone: controls the menstrual cycle (along with estrogen); “hormone of pregnancy” as it; 1. Maintains the thickened endometrium 2. Relaxes smooth muscle to help the uterus expand 3. Thickens the myometrium which prepares it for labour 4. Promotes lactation Menstrual Cycle Menarche: first menstruation Menopause: cessation of menstrual flow for 1 year Cycle average is 28 days, with day 1 being the first day of menses Phases Menstruation (menses); shedding of the functional layer of the endometrium Follicular/Proliferative; maturation of a follicle and proliferation of the endometrium Ovulation; release of an ovum from mature follicle Luteal/Secretory; follicle turns into a corpus luteum (secretes progesterone)... the endometrium is ready for implantation ○ If fertilized, human gonadotropin (hCG) supports the corpus luteum (hCG is detectable in the urine) ○ If no conception of implantation, the corpus luteum degenerates, progesterone levels drop, and the endometrium lining is shed Follicle Development After ovulation, the follicle develops into the corpus luteum. If fertilization occurs, the corpus luteum enlarges and begins to secrete hormones that maintain and support pregnancy. If fertilization does not occur, the corpus luteum secretes these hormones for approximately 14 days and then degenerates, which triggers the maturation of another follicle. Male Reproductive System External Genitalia: scrotum, testes, epididymis, vas deferens and penis Internal Genitalia: ducts (vas deferens, ejaculatory, and urethra), and glands (seminal vesicles, prostate, cowper) Male Sex Hormones Androgens Primary androgen—testosterone Produced mainly in the Leydig cells of the testes Testosterone ○ Sexual differentiation ○ Urogenital system development ○ Nervous and skeletal tissue development ○ Libido