Reproductive Development (PDF)

oligospermia-lack/absence of sperm REPRODUCTIVE DEVELOPMENT Maria Leonora D. De Leon, RN MAN  * now an individual was formed INTRAUTERINE DEVELOPMENT...

oligospermia-lack/absence of sperm REPRODUCTIVE DEVELOPMENT Maria Leonora D. De Leon, RN MAN  * now an individual was formed INTRAUTERINE DEVELOPMENT inside XX-female xy- male z Chromosomes The sex of an individual is determined at the moment of conception by the chromosome information supplied by the particular ovum and sperm that joined to create the new life. cortex - controls reproduction advenal thatprodee ovary organ A GONAD is a body organ that produces the cells necessary-for reproduction (the ovary for the females and the testis in males).  INTRAUTERINE DEVELOPMENT At week 5 of intrauterine life, gonadal tissue is already formed. In both sexes, two undifferentiated ducts (1) the mesonephric (wolffian), and (2) gives rise to male paramenosephric (mullerian) ducts. sender reveals internal genitall : usually 6 mos. Of pregnancy gives rise to female * at first , these 2 ducts look 2 mos. Of internal genitalia pregnancy similar - At week 7 or 8, in chromosomal males this early gonadal differentiates into primitive testes and begins formation of testosterone. responsible for the secondary sex characteristics of a male  INTRAUTERINE DEVELOPMENT hormone male Presence of Testosterone influences the mesonephric duct to develop into male reproductive organs, and the paramesonephric duct regresses. 3 mos. female hormone ~ - Absence of Testosterone at week 10, the gonadal tissue differentiates into ovaries and the paramesonephric duct develops into② female reproductive organs.  INTRAUTERINE DEVELOPMENT immature eggs 2-3 million decreases to 200 - 500K(puberty) - lat birth ALL of the OOCYTES (cells that will develop into eggs throughout the woman’s mature years) are already formed in ovaries at week 10 of intrauterine development. 3 mos does the sperm and urine of the tube come out same ? 5 - 6 months best for ultrasound isn't urine acidic 4 mos. - sperm = alkaline environment At week 12, the external genitals develop. In males, under the influence of testosterone, penile tissue elongates and the urogenital fold on the ventral surface of the penis closes to form the urethra.  INTRAUTERINE DEVELOPMENT In females, with the absence of Testosterone, the urogenital fold remains open to form the labia minora. What would be formed as scrotal tissue in the male becomes the labia majora in the female.  INTRAUTERINE DEVELOPMENT biglang meron and biglang wald When testosterone is* halted it results to a chromosomal male with female-appearing genitalia. If a woman is prescribed with testosterone during pregnancy or due metabolic abnormality, produces a - high testosterone it results to a chromosomal female with male-appearing genitalia. buntis + pills (increases testosterone) which in result to a female with male appearing genitalia * navuna mag develop males  PUBERTAL DEVELOPMENT Puberty is the anterior gland pituitary secretes stage of life at which secondary sex changes when begin. happens only oocytes exist even at reproductive organs birth matured (puberty don't stop unlike sebaceous glands = body odor in females (menopause( PUBERTAL DEVELOPMENT What hormone is responsible in the secondary sex characteristics of females ?  PUBERTAL DEVELOPMENT ROLE OF ANDROGEN Androgenic hormones are responsible for muscular development, physical growth, and the increase in sebaceous gland secretions that causes acne in both boys and girls. In males, androgenic hormones are produced by the adrenal cortex and the testes. In females, by the E adrenal cortex and the ovaries. it is a GONAD  Females are the first to PUBERTAL DEVELOPMENT ROLE OF ANDROGEN mature than males. * mas namuna tumangkad ang girls Testosterone – the primary androgenic hormone. Testosterone is low in males until pubertyO (12-14 years). Testosterone levels rise to influence the development of the testes, scrotum, penis, prostate, seminal vesicles, pubic hair, axillary and facial hair, laryngeal enlargement, voice change, maturation of spermatozoa, and closure of growth in long bones.  PUBERTAL DEVELOPMENT responsible fora both male secondary fies ROLE OF ANDROGEN femalecharacteris sex In girls, testosterone influences the enlargement of the labia majora and clitoris and formation of axillary and pubic hair. Adrenarche – term used to describe the development of pubic and axillary hair.  PUBERTAL DEVELOPMENT ROLE OF ESTROGEN follicle stimulating found in 0 varies ; unmatured eggs hormone At puberty, ovarian follicles are triggered by FSH and begins to excrete a high level of the hormone I from APG estrogen. in ovulation , vital tion menstrua ↑ Estrogen is consists of three compounds: (estrone [E1], estradiol [E2], and estriol [E3]), but a single substance in terms of action. chine check for invitro  PUBERTAL DEVELOPMENT ROLE OF ESTROGEN hormones are in complete harmony High levels of estrogen in girls at puberty influences the development of the uterus, fallopian tubes, and vagina, fat distribution, hair patterns, breast development, and closes the epiphyses of long bones. that is why girls are earlier to stop growing than boys Thelarche is the term used to describe breast development. * also manifests in males  PUBERTAL DEVELOPMENT SECONDARY CHARACTERISTICS GIRLS BOYS Growth spurt Increase in weight Increase in the transverse Growth of testes diameter of the pelvis Growth of face, axillary and Breast development pubic hair Growth of pubic hair Voice changes Onset of menstruation Penile growth Growth of axillary hair Increase in height Vaginal secretions Spermatogenesis (Production of sperm)  PUBERTAL DEVELOPMENT SECONDARY CHARACTERISTICS usually irregular at first. GIRLS regravity comes 2 years after BOYS Menarche (1st menstrual Spermatozoa are produce in period) occurs at average age a continuous process. of 12.4 years. Or it may Sperm production continuous occur as early as age 9 or as from puberty throughout the late as age 17.grade male’s life. 3/4 Menstruation is not dependent on ovulation.  PUBERTAL DEVELOPMENT SECONDARY CHARACTERISTICS GIRLS Menstruation becomes regular until ovulation occurs consistently with them. It happens 1-2 years after menarche. immature days and 28 Ova is produced in a cycle pattern. 28 - 1 Ova stops to be produced at menopause (the end of the fertile period in females). ANATOMY & PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM  Reproductive structures of the female and male are homologous. They arise from the same matched embryonic origin. Gynecology – the study of female reproductive organs. Andrology – the study of the male reproductive organs.  Y. 3 months of 2 a fet us Kulang lang sa distinction 6-7 mos.  MALE REPRODUCTIVE SYSTEM madaming folds MALE EXTERNAL STRUCTURES I (1) Scrotum is rugated, skin-covered muscular pouch suspended from the perineum. Chindi nandoon and testis puede maipit - 4 Spermatozoa Scrotum’s functions are to O warm = kills the sperm support the testes, help regulate the temperature of sperm. In cold weather, it contracts to bring the testes closer to the body, in hot weather, the muscle relaxes allowing the testes to fall away from the body – This will keep the temperature of the testes as even as possible to promote the production and - viability of sperm. capability  Leydig's cells maturation of sperm 20ft I (long) * all structures are needed for the full maturation of sperm 68 days full maturation of sperm =  MALE REPRODUCTIVE SYSTEM MALE EXTERNAL STRUCTURES (2) Testes are two ovoid glands that lie in the scrotum. For each is encased by white fibrous capsule, composed of several lobules with each lobule contains interstitial cells (Leydig’s cells) and seminiferous ② tubule. Seminiferous tubules produce spermatozoa. Leydig’s cells are responsible for the production of testosterone.  MALE REPRODUCTIVE SYSTEM MALE EXTERNAL STRUCTURES (TESTES) Testes form in the pelvic cavity; descends at 34th to 38th week (late in pregnancy) into the scrotal sac during intrauterine life. pag hindi bumaba hernia = ability = inguinal to produce hernia children is not viable Infants need to be monitored with undescended testes because testicular descent does not readily occur in extrauterine life as it does in utero. Testes that remain in the pelvic cavity may not produce viable sperm and associated with testicular cancer.  MALE REPRODUCTIVE SYSTEM MALE EXTERNAL STRUCTURES (TESTES) Sperm production starts when the hypothalamus releases GnRH which in turn influences the APG to release FSH and LH. FSH releases Androgen-Binding Protein. LH releases testosterone. And the binding of ABP and testosterone promotes sperm formation. you need both LH and FSH to produce sperm As testosterone increases, a feedback effect on the hypothalamus and APG is created hence slows down the production of FSH and LH and ultimately decreases or regulates sperm production.  Wro this , no stimulation of the APG  MALE REPRODUCTIVE SYSTEM MALE EXTERNAL STRUCTURES (TESTES) In most males, one testis is slightly larger than the other and is suspended slightly lower in the scrotum than the other (usually the left one). very sensitive any sperm sa temp. Spermatozoa do not survive at temperature as high as that of the body. The location of the testes outside of the body is 1degree F lower than the body temp. Normal testis is feel firm, smooth, and egg-shaped  MALE REPRODUCTIVE SYSTEM MALE EXTERNAL STRUCTURES (3) The Penis is composed of three cylindrical masses of erectile tissue in the penis shaft: two termed the corpus cavernosa, and a third termed the corpus spongiosum. It serves as the outlet for both the urinary and the reproductive tracts in men. Urethra passes through these erectile tissue.  MALE REPRODUCTIVE SYSTEM MALE EXTERNAL STRUCTURES (PENIS) With sexual excitement, nitric oxide is released from endothelium of blood vessels and an increase in blood flow to the arteries of the penis (engorgement). The ischiocavernosus muscle at the base of the penis then contracts, trapping both venous and arterial in the three sections of erectile tissue and leading to distention and erection of the penis. Kailangan 3 mabilis straight , days lang nag-iintay and orum # Penile erection is stimulated by the parasympathetic nerve innervation.  MALE EXTERNAL STRUCTURES (PENIS) At the distal end of the is a bulging, sensitive ridge of tissue – the glans. A retractable casing of skin, the prepuce, protects the nerve-sensitive glans at - prepare of the skin birth. Surgical removal of the prepuce tissues is called circumcision.  MALE REPRODUCTIVE SYSTEM MALE INTERNAL STRUCTURES (1) Epididymis is the seminiferous tubule of each testis, and tightly coiled. It is responsible for conducting sperm from the tubule to the vas deferens – the next step in the passage to the outside. each testis has this structure it takes time should be continuous as 20 feet long and some sperm stored in the epididymis. for sperm to develop bakit Kailangan mahaba ? neutralizes the environment as urine is too acidic Alkaline fluid, semen or seminal fluid (basic sugar & mucin, a form of protein) that surrounds sperm at maturity is produced by the cells lining of epididymis.  MALE INTERNAL STRUCTURES (EPIDIDYMIS) At the epididymis level, sperm are immobile and incapable of fertilization. It takes 12-20 days for the sperm to travel the length of the tube. A total of 64 days for the sperm to mature. Aspermia (absence of sperm) and Oligospermia (less than 20million sperm/ml) are problems that do not respond to therapy but only after 2months.  MALE INTERNAL STRUCTURES * nag mamature na (2) Vas Deferens (Ductus Deferens) is a hollow tube surrounded by arteries and veins and protected by a thick fibrous coating. It carries sperm from the epididymis through the inguinal canal into the abdominal cavity where it ends at the seminal vesicles and the ejaculatory ducts. Sperm mature as they pass through the vas deferens. Still immobile because of the fairly acidic medium of the semen produced at this level.  MALE INTERNAL STRUCTURES (VAS DEFERENS) Spermatic cord consists of the blood vessels and the vas deferens. Varicocele or varicosity of the internal spermatic vein appears to make a little difference with subfertility. irreversible Vasectomy (severing of the vas deferens to prevent passage of sperm). A popular means of male birth control.  MALE INTERNAL STRUCTURES (3) Seminal Vesicles are two convoluted pouches that lie along the lower portion of the posterior surface of the bladder and empty into the urethra by way of the ejaculatory ducts. need to survive ↑ They secrete a viscous alkaline liquid that has a high sugar, protein, and prostaglandin content. urethra = acidic Sperm become increasingly motile with this added fluid because it surrounds them with nutrients and more favorable pH.  MALE INTERNAL STRUCTURES (4) Ejaculatory Ducts are two ducts that passes through the prostate glad and join the seminal vesicles to the urethra.  MALE INTERNAL STRUCTURES (5) Prostate Gland is a chestnut-sized gland that lies just below the bladder. The urethra passes through the center of it, like the hole in a doughnut. It secretes a thin, alkaline fluid and it further protects sperm from being immobilized by the naturally low pH level of the urethra. In middle life, men develop benign prostate hypertrophy – swelling that interferes with both fertility and urination.  MALE INTERNAL STRUCTURES (6) Bulbourethral Glands or Cowper’s glands lie beside the prostate gland and empty via short ducts into the urethra. Likewise secretes alkaline fluid that helps counteract the acid secretion of the urethra and ensure safe passage of spermatozoa. Semen, is derived from the prostate gland (60%), the Calkaline seminal vesicles (30%), the epididymis (5%), and the bulbourethral glands (5%). fid  MALE INTERNAL STRUCTURES (7) Urethra is a hollow tube leading from the base of the bladder. After passing the prostate gland, continues to the outside through the shaft and glans of the penis. It is approximately 8 in (18 to 20 cm long). It is lined with mucous membrane.  FEMALE REPRODUCTIVE SYSTEM  FEMALE EXTERNAL STRUCTURES asection The Vulva Femalereproductive s (from the latin word for - “covering”) are the structures that form the female EXTERNAL genitalia.  FEMALE EXTERNAL STRUCTURES (1) Mons Veneris is a pad of adipose tissue located over symphysis pubis, the pubic bone joint. It is covered by a triangle of coarse, curly hairs. Its purpose is to protect the junction of the pubic bone from trauma. need in labor para hindi mawarak/laceration  FEMALE EXTERNAL STRUCTURES (2) Labia Minora is just posterior to the mons veneris spread two hairless folds of connective tissue. - BEFORE MENARCHE, these folds are fairly small. At childbearing age, they are firm and full. AFTER Eit MENOPAUSE, they atrophy and again become smaller. Normally it is pinkish, internal surface is covered with mucous membrane and external with skin. The area is abundant with sebaceous glands. L sperm survival  FEMALE EXTERNAL STRUCTURES (3) Labia Majora are two folds of adipose tissue covered by loose connective tissue and epithelium that are positioned lateral to the labia minora. Covered by pubic hair to serve as a protection for the external genitalia and the distal urethra and vagina.  FEMALE EXTERNAL STRUCTURES (4) Other External Organs (4a) Vestibule is the flattened, smooth surface inside the labia. The openings to the bladder (urethra) and the uterus (the vagina) both arise from here. to stimulate the sebaceous glands X dry (4b) Clitoris is a small (1 to 2 cm), rounded organ of erectile tissue at the forward junction of the labia minora. Covered by a fold skin, the prepuce. It is sensitive to touch and temperature and is the center of sexual arousal and orgasm in a woman.  FEMALE EXTERNAL STRUCTURES (4c) Skene’s glands (parauretral glands) are located lateral to the urinary meatus, one on each side. Their ducts open into the urethra. (4d) Bartholin’s glands (vulvovaginal glands) are located just lateral to the vaginal opening on both sides. Their ducts open into the distal vagina. ② Secretions from both of these glands help to lubricate the external genitalia during coitus. protect The alkaline pH of their secretions helps to improve sperm survival in the vagina.  FEMALE EXTERNAL STRUCTURES (4e) The② Fourchette is the ridge of tissue formed by the posterior joining of the two labia minora and the labia majora. This the structure that is sometimes cut (episiotomy) during childbirth to enlarge the vaginal opening. - (4f) Perineal muscle or perineal body is a muscular area and it is easily stretched during childbirth to allow enlargement of the vagina and passage of the fetal head. Pregnancy exercises (Kegel’s, squatting and tailor- sitting) make the perineal muscle more flexible.  nawawala if active FEMALE EXTERNAL STRUCTURES sa sports/ uses tampons (4g) The Hymen is a tough but elastic semicircle tissue that covers the opening of the vagina in childhood. It is torn during the time of first sexual intercourse. Many girls do not have an intact hymen because of the use of tampons and active sports participation. Imperforate hymen that is so complete that it does not allow the menstrual blood to flow or for sexual relations until it is surgically incised.  FEMALE EXTERNAL STRUCTURES bloodsupplyforstet the (5) Vulvar Blood Supply is the blood supply of the external genitalia coming from the pudendal artery and a portion of the inferior rectus artery. Venous return is through the pudendal vein. Pressure on this vein by the fetal head can cause- extensive - back-pressure and development of varicosities (distended veins) in the labia majora. It is rich with blood supply, hence subject to hematomas due to trauma or childbirth. Blood supply contributes to the rapid healing of any tears in the area of childbirth.  and part FEMALE EXTERNAL STRUCTURES a conly -not the motor in this area anesthesia hindi masakit ↑ to kill nerve supplyI para manganak) (6) Vulvar Nerve Supply is the anterior portion of the vulva that derives its nerve supply from the ilioinguinal and genitofemoral nerves (L1 level). The posterior vulva are supplied by the pudendal nerve (S3 level). A rich nerve supply makes the area extremely sensitive to touch, pressure, pain and temperature. Normal stretching of the perineum with childbirth causes temporary loss of sensation in the area. Anesthesia is administered locally to block the pudendal nerve, eliminating pain at the perineum during childbirth. FEMALE INTERNAL STRUCTURES The Internal Organs of the Female are ovaries, fallopian tubes, uterus and the vagina.  it mature FEMALE INTERNAL STRUCTURES clear liquid-makes (1) Ovaries are approximately 4cm long by 2cm in diameter and approximately 1.5 cm thick, or the size and shape of almonds. Grayish white and appear pitted, or with minute indentations on the surface. An unruptured, glistening, clear, fluid-filled graafian follicle (an ovum to be discharged) or a miniature yellow corpus luteum (the structure left behind after the ovum has been discharged) can be observed on the surface of ovary.  too like FEMALE INTERNAL STRUCTURES ~ suspended Ovaries are located close to and on both sides of the uterus in the lower abdomen. Their function (female gonads) is to produce, mature, and discharge ova (egg cells). They produce estrogen and progesterone and initiate and regulate - menstrual cycles. After menopause, or cessation of ovarian function, the uterus, breasts, and ovaries all undergo atrophy or a - reduction in size because of lack of estrogen.  FEMALE INTERNAL STRUCTURES Ovarian function is necessary for maturation and maintenance of secondary sex characteristics in females. Ovaries secretes estrogen The estrogen secreted by the ovaries is important to prevent osteoporosis or weakness of bones because of withdrawal of calcium from the bones (happens after menopause). The production of estrogen keeps the cholesterol level reduced thus limiting atherosclerosis (artery disease).  FEMALE INTERNAL STRUCTURES The ovaries are held suspended and in close contact with the end of fallopian tubes by three supporting ligaments attached to the uterus or the pelvic wall. They are not covered by a layer of peritoneum and in this way, ova can escape from them and enter the uterus by way of fallopian tubes.  FEMALE INTERNAL STRUCTURES Ovaries have THREE Principal Divisions: 1. Protective layer of surface epithelium 2. Cortex, where the immature (primordial) oocytes mature into ova and large amounts of estrogen and - progesterone are produced. 3. Central Medulla, which contains the nerves, blood vessels, lymphatic tissue, and some smooth muscle tissue.  DIVISION OF REPRODUCTIVE CELLS (GAMETES) o At birth, each ovary has 2 million immature ova (oocytes), formed during the 1st five months of intrauterine life.mitotic division meiosis-reduces - multiply /duplicate the number of chromosomes o These cells have the unique ability to produce a new individual but contain the usual components of cells: a cell membrane, an area of clear cytoplasm, and a nucleus containing chromosomes.  DIVISION OF REPRODUCTIVE CELLS immature orum (GAMETES) - o The oocytes, like the sperm differ from all other body cells in the number of chromosomes they contain in the nucleus. meiosis-reduction process - 23 chromosomes ①  DIVISION OF REPRODUCTIVE CELLS (GAMETES) o Oocytes before ovulation and spermatozoa before it - matures, both will undergo meiosis (reduction division). o After reduction division, an ovum has 22 autosomes and an X sex chromosome. An spermatozoon has 22 autosomes and either an X or a Y sex chromosome. o A new FEMALE individual = union of an ovum and an X- carrying spermatozoon (an XX chromosome pattern). o A new MALE individual = union of an ovum and a Y- carrying spermatozoon (an XY chromosome pattern)  MATURATION OF OOCYTES o Primordial Follicle is a protective sac or thin layer of cells that surrounds oocytes. o Between 5 to 7 million ova form in the utero. o Majority never developed, by birth only 2 million are present. o By age 7 years, only approximately 500,000 are present in each ovary; by 22 years there are approximately 300,000, and by menopause none are left. o Menopause is the point at which no functioning oocytes remain in the ovaries.  where FEMALE INTERNAL STRUCTURES structure place takes /fertilization (2) Fallopian Tubes arise from each corner of the uterine body and extend outward and backward until each opens at its distal end, the ovary. It is 10 cm long in a mature woman. Their function is to convey the ovum from the ovaries to the uterus and to provide a place for fertilization of the ovum by sperm. The isthmus portion of the tube is cut or sealed in a tubal ligation. The ampulla is where fertilization of an ovum occurs.  FEMALE INTERNAL STRUCTURES The lining of the fallopian tube is composed of mucous membrane – contains mucus-secreting and ciliated (hair covered) cells. The muscle layer produces the peristaltic motions that help the ovum travel along the length of the tube. Migration of the ovum is also aided by the action of the ciliated lining and the mucus which acts as a lubricant. The mucus serves as a source of nourishment for the fertilized egg, because it contains protein, water and salts.  FEMALE INTERNAL STRUCTURES hair-like structure A direct pathway from sucking motion contraction for vagina, uterus, and tubes to ovum the to enter fallopian tube the peritoneum. This pathway makes conception wider possible. & ofe will be implanted where takes fertilization place This pathway is susceptible to infection and diseases so endometrium wilthicken myometrium will contract progesterone clean technique must be during childbirth used during pelvic opercul um 2 should be passive examinations or treatment. or else And sterile technique is protection barrier early birth done during vaginal examination to ensure no organisms can enter.  FEMALE INTERNAL STRUCTURES (3) The Uterus is a hollow, muscular, pear-shaped organ located in the lower pelvis, posterior to the bladder and anterior to the rectum. With maturity, the uterus is 5 cm to 7 cm, 5 cm wide, 2,5 cm deep. Its function is to receive the ovum from the fallopian tube; provide a place for implantation and nourishment; furnish protection to a growing fetus, and at maturity of the fetus, expel it from a woman’s body. After pregnancy, the uterus never return to its nonpregnant size (9cm long, 6cm wide, 3cm thick).  FEMALE INTERNAL STRUCTURES (3a) The body or corpus is the uppermost part and forms the bulk of the organ. During pregnancy, the body expands to contain the growing fetus. The fundus is the portion of the body between the points of attachment with the fallopian tubes. This part can be palpated abdominally to determine the amount of uterine growth, to measure the force of uterine contractions during labor, and to assess that the uterus is returning to its nonpregnant state after childbirth.  FEMALE INTERNAL STRUCTURES (3b) The Isthmus is a short segment between the body and the cervix. It is 1-2 min length. This enlarges during pregnancy to aid in accommodating the growing fetus. It is the portion of the uterus that is most commonly cut when a fetus is born by a caesarian birth.  FEMALE INTERNAL STRUCTURES (3c) The Cervix is the lowest portion of the uterus. It is 1/3 of the total size of the uterus (2-5 cm long). Cervical canal is the central cavity of the cervix. Internal Cervical Os is the opening of the canal at the junction of the cervix and isthmus. External Cervical Os is the distal opening to the vagina. The level of the external os is at the level of the ischial spines (an important relationship in estimating the level of the fetus at the birth canal).  UTERINE AND CERVICAL COATS The uterine wall consists of three separate coats of layers of tissue: an inner fluid one of mucous membrane ovum with = graafian follicle corpus (the endometrium), a middle one of a muscle luteum crich in progesterone) On the 14th I day thickening of fibers (the myometrium), covulation) endometrium and an outer one of a connective tissue (the perimetrium).  UTERINE AND CERVICAL COATS (1) Endometrium layer is important for menstrual function. The inner layer of the endometrium is highly sensitive and responsive to hormones estrogen and progesterone. It grows and becomes thick and capable in supporting a pregnancy. When pregnancy does not occur, this layer shed as the menstrual flow.  UTERINE AND CERVICAL COATS (1a) Endocervix is the mucous lining of the cervix. It is also affected by hormones. The cells at the cervical lining secretes mucus to provide a lubricated surface so that spermatozoa can readily pass through the cervix. At the peak estrogen during a menstrual cycle, as much as 700ml of mucus is produced. When at its lowest, only a few ml are produced. These mucus are alkaline, decreasing the acidity of the upper vagina, aiding sperm survival. During pregnancy, endocervix becomes plugged with mucus, forming a seal (operculum) to keep out ascending infections.  UTERINE AND CERVICAL COATS (2) The Myometrium or muscle layer of the uterus composed of three interwoven layers of smooth muscle, the fibers of which are arranged in longitudinal, transverse, and oblique directions. This network offers extreme strength to the organ. Its function is to constrict the tubal junctions and preventing regurgitation of menstrual blood into the tubes. It also holds the internal cervical os closed during pregnancy to prevent preterm birth.  UTERINE AND CERVICAL COATS (2) The Myometrium or muscle layer of the uterus composed of three interwoven layers of smooth muscle, the fibers of which are arranged in longitudinal, transverse, and oblique directions. This network offers extreme strength to the organ. Its function is to constrict the tubal junctions and preventing regurgitation of menstrual blood into the tubes. It also holds the internal cervical os closed during pregnancy to prevent preterm birth.  UTERINE AND CERVICAL COATS The muscle layers of myometrium have an equal pressure to expel the fetus. This equal pressure is possible due to the unique arrangement of the muscle fibers. After childbirth this network of fibers will constrict the blood vessels through the layers, thereby limiting blood loss in the woman. (3) The Perimetrium or the outermost layer of the uterus serves as an additional support and strength to the structure.  UTERINE BLOOD SUPPLY The large DESCENDING abdominal aorta divides to form two iliac arteries; main divisions of the iliac arteries are the hypogastric arteries. These further divide to form the arteries and supply to the uterus. Because the uterine blood supply is not far removed from the aorta, it is abundant and adequate to supply the growing needs of the fetus.  UTERINE BLOOD SUPPLY As an additional safeguard, after supplying the ovary with blood, the ovarian artery (direct subdivision of the aorta), joins the uterine artery as a fail-safe system to ensure that the uterus will have an adequate supply.  UTERINE BLOOD SUPPLY after birth , amount of urine output is checked The blood vessels that supply because the be affected wreter during might labor the cells and lining of the uterus are tortuous in nonpregnant women. As uterus enlarges with pregnancy, the vessels “unwind” and so can stretch to maintain an adequate blood supply.  UTERINE BLOOD SUPPLY QUESTION: Susan Mateo decides to have a tubal ligation (clamping of the fallopian tubes after the birth of her baby. Why is observing her for urine output after this this tube surgery is always a critical assessment? Answer: A ureter may be injured by a clamp if bleeding is controlled by clamping of the uterine or ovarian vessels.  UTERINE NERVE SUPPLY The uterus is supplied by efferent (motor) and afferent (sensory nerves). The efferent nerves arise from the T5 through T10 spinal ganglia while afferent nerves at the T11 and T12. The sensory innervation of the uterus registers lower in the spinal column, so this is why anesthetic solution can be injected near T11 and T12 to control pain of uterine contractions at labor, without stopping motor control – PRINCIPLE OF EPIDURAL and SPINAL ANESTHESIA.  UTERINE DEVIATIONS puede Several uterine deviations (shape and position) may · hindi magbunt is interfere with fertility or · need clear passage pregnancy. A female fetus, the uterus forms with a septum or fibrous division, separating it into two portions. As the fetus matures, this septum dissolves, so at birth no remnant of the division remains. These deviations may decrease the ability to conceive or carry a pregnancy to term.  UTERINE DEVIATIONS A. Anteversion – entire uterus is tipped far forward. mahihirapan magbuntis dahil sobrang forward B. Anteflexion – the body of the uterus is bent sharply forward at the junction with the cervix.  UTERINE DEVIATIONS C. Retroversion – entire uterus is tipped forward D. Retroflexion – the body is bent sharply back just the cervix. These positions can interfere fertility by blocking the migration of sperm.  FEMALE INTERNAL STRUCTURES (4) Vagina is a hollow, musculomembraneous canal located posterior to the bladder and anterior to the rectum.It extends from the cervix of the uterus to the external vulva. Its function is to act as the organ of intercourse and to convey sperm to the cervix so that sperm can meet with the ovum in the fallopian tube. With childbirth, it expands to serve as the birth canal. Doderlein’s Bacillus is the lactose-fermenting bacteria causing lactic acid to formed, makes the pH of the vagina acidic detrimental to pathologic bacteria, preventing vaginal infections. FEMALE INTERNAL STRUCTURES (5) The mammary lactation glands, or breasts colostrum = panlaban sa temporary mga sakit remain halted in size and development until a rise of estrogen at puberty. The size increase due to fat depositions. FEMALE INTERNAL STRUCTURES Milk glands of the breasts are divided into approximately 20 lobes. All of the glands in each lobe produce milk by ACINAR CELLS and deliver it to nipple through lactiferous duct.  FEMALE INTERNAL STRUCTURES The nipple erects on manual or sucking stimulation. On stimulation, it transmits sensations to the PPG to release oxytocin to constrict milk glands and push milk forward into the ducts to the nipple. Areola is the round, dark pigmentation surrounding the nipples. Montgomery’s Tubercles are the area appears rough surfaces because it contains many sebaceous glands.  FEMALE INTERNAL STRUCTURES The blood supply to the breasts is profuse and being supplied by thoracic branches of the axillary, internal mammary, and intercostal arteries. This blood supply is important in bringing nutrients to the milk glands, making it possible a plentiful supply of milk for breastfeeding.  MENSTRUATION (PHYSIOLOGY OF MENSTRUATION) Maria Leonora D. De Leon, RN MAN