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Chapter 5 The Nursing Role in Reproductive and Sexual Health Learning Outcomes  Describe anatomy and physiology pertinent to reproductive and sexual health clients  Use critical thinking to analyze ways in which clients reproductive and sexual health can be improved for healthier chi...

Chapter 5 The Nursing Role in Reproductive and Sexual Health Learning Outcomes  Describe anatomy and physiology pertinent to reproductive and sexual health clients  Use critical thinking to analyze ways in which clients reproductive and sexual health can be improved for healthier childbearing and adult health within a family-centered framework  Assess a couple for anatomic and physiologic health, biologic gender, gender role, gender identity and readiness for childbearing  Integrate knowledge of reproductive health and sexuality with nursing process to achieve quality maternal and child health nursing care. Copyright © 2018 Wolters Kluwer · All Rights Reserved A CONCEPT OF UNITIVE AND PROCREATIVE HEALTH Copyright © 2018 Wolters Kluwer · All Rights Reserved WHAT CAN YOU SAY ABOUT THE PICTURE? Copyright © 2018 Wolters Kluwer · All Rights Reserved What is a family? Copyright © 2018 Wolters Kluwer · All Rights Reserved Family The family is a It is generally accepted that the family very important is the first and oldest social institution social in society. The family consist of parents institution and children who interact with one another. Through this socialization process, parents are able to hand down socially accepted cultural practice that serves as initial training for the young to become future responsible citizen in the future. Copyright © 2018 Wolters Kluwer · All Rights Reserved Family Refers to a group of people united by ties of marriage, blood or adoption. As a group, the members of the family live together under one roof and that they constitute a single housekeeping unit. It is a universal institution that has the following common characteristics; Associate with one another in their As the members of the family enjoy respective roles as husbands and life together playing the different wife, mother and father, son and roles, they tend to create a daughter or brother and sisters common culture Copyright © 2018 Wolters Kluwer · All Rights Reserved Family Consist of those Friedman (1992) individuals, male or defined family as female , youth or According to “two or more persons Basic social adult, legally or not MURDOK is a social who are joined legally related, group characterized institution and the genetically or not by common together by bonds of primary group in genetically related residence, economic sharing and society. emotional closeness who are considered cooperation and and who identify by the others to reproduction. themselves as being represent their part of the family. significant persons. Copyright © 2018 Wolters Kluwer · All Rights Reserved Family Code ( E.O. 2009) Section 1. The state recognizes the Filipino family as the foundation of the nation. Accordingly, It shall strengthen its solidarity and Section 2. Marriage ,as an actively promote its total inviolable social institution, is the development. foundation of family and shall be protected by the state. Copyright © 2018 Wolters Kluwer · All Rights Reserved Characteristics Of Family The family as a social group is universal and significant element in man’s social life It is the The family first social is very group to close and which the intimate individual group. is exposed. Family contact and relationship are repetitive and continuous. Copyright © 2018 Wolters Kluwer · All Rights Reserved Five Universal Characteristics of Family A family moves through A family ls A family stages in a social has its life system structure cycle A family A family perform has its certain own basic cultural function values and rules Copyright © 2018 Wolters Kluwer · All Rights Reserved Functions of the Family Maintenance Provision of Reproduction of physical Socialization motivation needs and morale Assistance Maintenance with fitting Allocation Division of of order of labor into the larger resources society Copyright © 2018 Wolters Kluwer · All Rights Reserved Family Structures Different structures emanates due to chang1ng famlly patterns and cultural: variations practiced by family members in a given society. Classifications Conjugal Family or of Family Based Nuclear Family on Internal Extended Family Organization: Classification of Patrilineal Family Family Based Matrilineal Family on Family Bilateral Family Descent: Patriarchal Family Classification of Matriarchal Family Family Based Egalitarian Family on Authority Matricentic Family PATRILOCAL Residence Classification of MATRILOCAL Residence Family Based BILOCAL Residence on Residence NEOLOCAL Residence AVUNCULOCAL Residence Copyright © 2018 Wolters Kluwer · All Rights Reserved Types Of Families In Today’s Society Traditional family- is viewed as autonomous unit in which both Nuclear family- parents reside in Two- career Extended a family structure the home with family- in two family- compose of parents and their children, the career or dual of relatives of their offspring. mother often career families, nuclear families, Also known as assuming the both partners are such as primary or nurturing role and employed. They grandparents or elementary the father may or may not aunts and uncles. family. providing the have children. necessary economic resources. Copyright © 2018 Wolters Kluwer · All Rights Reserved Single –parent family- single parenthood includes death of spouse ,separation. Divorce, birth of a child to an unmarried woman. Or adoption of child by single man or woman. Adolescent family- young parents that are often developmentally ,physically, emotionally and financially ill prepared to undertake the responsibility of parenthood. Foster family with or without their own children may house more than one foster child at a time or different children over many years. Copyright © 2018 Wolters Kluwer · All Rights Reserved Intragenerational family- children Blended family- existing continually live with their family units who join parents even after having together to form new their own children or the families. Also called as grand parents may move step or reconstituted in with their grown families. children’s families after some years of living apart. Cohabitating family- also called as communal families consists of unrelated individuals or families who live under one roof. Reasons for cohabitating may be need for companionship, a desire to achieve a sense of family, testing a relationship or commitment or sharing expenses and household management. Copyright © 2018 Wolters Kluwer · All Rights Reserved Family Structures Alternative Families Cohabitation Foster Family refers to the Communal children live in unmarried Family several temporary individuals in a people together. arrangement with committed Gay or Lesbian They often strive paid caregivers. partnership living Family intimate to be self- These children together with or partners of the sufficient and are meant to without children. same sex may minimize contact return to their People may live live together or with the outside family of origin in cohabitation own property society. Members when condition arrangement, together. share financial permits or to before in resources, work otherwise be between or as an and child care placed for alternative to responsibilities. adoption. marriage. Copyright © 2018 Wolters Kluwer · All Rights Reserved Characteristics of a Healthy Family Healthy families maintain a spiritual foundation Healthy families make the family the top priority Healthy families ask and give respect Healthy families communicates and listen Healthy families values service to others Healthy families expect and offer acceptance Copyright © 2018 Wolters Kluwer · All Rights Reserved Stages of Family Development Stage One: Single young adults leave home Stage two: The new couple joins their families through marriage or living together Stage Three: Families with young children Stage Four: Families with adolescents Stage Five: Launching children and moving on Stage Six: Families in later life Copyright © 2018 Wolters Kluwer · All Rights Reserved GENOGRAM Genograms are a visual representation of a person's family, relationships between members, and medical and mental health histories. It is more in-depth than a family tree because it provides more extensive information about the family and each member. Copyright © 2018 Wolters Kluwer · All Rights Reserved Genogram Example Copyright © 2018 Wolters Kluwer · All Rights Reserved Genogram Symbols Copyright © 2018 Wolters Kluwer · All Rights Reserved Genogram Symbols Copyright © 2018 Wolters Kluwer · All Rights Reserved Social Changes Affecting The Family Increase Husband and number of wife are More women single parent working work outside blended and abroad. home extended family Migration and Both husband and Husband stay at urbanization which wife working home and perform result to housing outside and still the tasks that shortage, the wife will be were traditionally overcrowding and the one doing the for women poor environment household chores. sanitation which resulted to health problems. Copyright © 2018 Wolters Kluwer · All Rights Reserved Unitive and Procreative Health Intercourse by its nature is LOVE UNITIVE – it brings PROCREATIVE – by the couple together bringing the sperm to unlike any other act the egg, it has can. It is love giving potential to be life- -union of two giving individual that is -create and produce mutually agreed to another life become one Copyright © 2018 Wolters Kluwer · All Rights Reserved Unitive and Procreative Health Marriage Needs to be open Man and woman to possibility of unite as one flesh having children (sex is unitive) (sex is procreative) Copyright © 2018 Wolters Kluwer · All Rights Reserved Unitive And Procreative Aspect Of Sexuality In Marriage A sexual relationship in marriage has 2 purposes Strengthen the couple and allow them to Leads to the creation of express their love for new life. each other in a powerful (PROCREATIVE) way (UNITIVE) Copyright © 2018 Wolters Kluwer · All Rights Reserved Unitive and Procreative Health TAKING OUT THE UNITIVE We do this when we use artificial means to procreate – such as artificial insemination and any act that takes the couple out of the picture and replaces then with technology. Many new lives are destroyed in this process. Copyright © 2018 Wolters Kluwer · All Rights Reserved PROMOTION OF REPRODUCTIVE AND SEXUAL HEALTH Copyright © 2018 Wolters Kluwer · All Rights Reserved Assessment Problems of sexual or Good follow- If the problem is Difficult for Any change in reproductive through and ignored or people to bring physical health may not planning is forgotten – up the topic appearance be evident on important unsolved first meeting Copyright © 2018 Wolters Kluwer · All Rights Reserved Needs to be assessed for problems regarding sexual role as well as other important areas of reproductive functioning. 1. The person with a sexually transmitted infection (STI) 2. Excessive weight loss or gain 3. A disfiguring scar from surgery or an unintentional injury 4. Hair loss such as occurs with chemotherapy 5. Surgery, inflammation, or infection of reproductive organs 6. Chronic fatigue or pain 7. Spinal cord injury or the presence of a retention catheter Copyright © 2018 Wolters Kluwer · All Rights Reserved Common nursing diagnoses used with regard to reproductive health include Nursing Health-seeking behaviors related to reproductive Diagnosis functioning Anxiety related to inability to conceive after 6 months without contraception Pain related to uterine cramping from menstruation Disturbance in body image related to early development of secondary sex characteristics Copyright © 2018 Wolters Kluwer · All Rights Reserved Risk for infection related to high-risk sexual behaviors Diagnoses relevant to sexual health may include: Nursing Altered sexuality patterns related to chronic illness Diagnosis Self-esteem disturbance related to recent reproductive tract surgery Altered sexuality patterns related to fear of harming a fetus Anxiety related to fear of contracting an STI Health-seeking behavior related to learning responsible sexual practices Copyright © 2018 Wolters Kluwer · All Rights Reserved Outcome Identification And Planning Design care that Plan health demonstrates teaching acceptance Empower patients to feel control over their bodies. Copyright © 2018 Wolters Kluwer · All Rights Reserved Implementation Health Education Patients are more comfortable asking questions to nurses Contraception or fertility needs, STI preventions, congenital health conditions Copyright © 2018 Wolters Kluwer · All Rights Reserved Outcome Evaluation Health Evaluation education Increased must be needs to maturity ongoing change with circumstances Copyright © 2018 Wolters Kluwer · All Rights Reserved Reproductive Development During early fetal life, The Females have At 5th weeks primordial The Gonads is chromosomal XX primitive germ cells are a body organ sex or biologic chromosomes gonadal tissue formed in the that produces sex is formed and male XY is already 6th and 10th sex cells at fertilization. chromosomes formed week in the yolk sac. Copyright © 2018 Wolters Kluwer · All Rights Reserved Meiosis Prophase I Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Metaphase I Copyright © 2018 Wolters Kluwer · All Rights Reserved Anaphase I Copyright © 2018 Wolters Kluwer · All Rights Reserved Telophase 1 Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Metaphase II Copyright © 2018 Wolters Kluwer · All Rights Reserved Anaphase II Copyright © 2018 Wolters Kluwer · All Rights Reserved Telophase II Copyright © 2018 Wolters Kluwer · All Rights Reserved At 8th to 10th week, the human embryo has neutral gonads The internal genitalia with two pairs of forms at around 13th duct system. The If the germ cell are If the germ cell is the week from the MULLERIAN ducts XX the gonads XY the gonads mullerian (female) (Paramesonephric) become the Ovaries become the testes and the wollfian and the WOLLFIAN (male) ducts. Ducts (Mesonephric) joined at the lower end Copyright © 2018 Wolters Kluwer · All Rights Reserved At 8th to 10th week, the human embryo has neutral gonads The internal genitalia with two pairs of forms at around 13th duct system. The If the germ cell are If the germ cell is the week from the MULLERIAN ducts XX the gonads XY the gonads mullerian (female) (Paramesonephric) become the Ovaries become the testes and the wollfian and the WOLLFIAN (male) ducts. Ducts (Mesonephric) joined at the lower end Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Mullerian duct inhibited which cause mullerian duct to self destruct and disappear a process called as APOPTOSIS. If the embryo is Testosterone produced by the Leydig cells which causes wollfian duct to develop into XY, the gonads sperm transport system epididymis, vas secretes the deferens and seminal vesicle following The conversion of testosterone to DHT (dihydrotestosterone) causes development of hormones: the prostate gland. DHT is also responsible for the development of the male external genitalia Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Mullerian ducts develop into oviducts, uterus, and upper vagina. The wollfian ducts disappear without If the embryo is stimulation from testosterone. XX, no hormones When ovaries form, all of the are released. oocytes (cells that will develop into eggs throughout the woman’s mature years) are already present Copyright © 2018 Wolters Kluwer · All Rights Reserved Puberty Both boys and girls begin The hypothalamus Is the stage of life at dramatic development apparently serves as and maturation of which secondary sex reproductive organs at gonadostat or is set changes begins. approximately 12 – 13 to “turn on” gonad years functioning. Under the stimulation The first sign of Puberty ends with of hypothalamus, the pubescence in menarch which pituitary glands females is usually occurs approximately release breast bud two years after GONADOTROPIN formation. thelarche hormones Copyright © 2018 Wolters Kluwer · All Rights Reserved The Role of Androgen Androgenic hormones are the hormones In males, responsible for androgenic muscular hormones are development, produced by the physical growth, adrenal cortex and the increase and the testes in sebaceous and, in females, gland secretions by the adrenal that cause typical cortex and the acne in both boys ovaries. and girls during adolescence. Copyright © 2018 Wolters Kluwer · All Rights Reserved The level of the primary androgenic hormone, testosterone, is low in males until puberty (between ages 12 and 14 years) when it rises to influence pubertal changes in the testes, scrotum, penis, prostate, and seminal vesicles; the appearance of male pubic, axillary, and facial hair; laryngeal enlargement with its accompanying voice change; maturation of spermatozoa; and closure of growth plates in long bones (termed adrenarche). In girls, testosterone influences enlargement of the labia majora and clitoris and the formation of axillary and pubic hair. Copyright © 2018 Wolters Kluwer · All Rights Reserved The Role of Estrogen When triggered at puberty by FSH, ovarian follicles in females begin to excrete a high level of the hormone estrogen. This increase influences the development of the uterus, fallopian tubes, and vagina; typical female fat distribution; hair patterns; and breast development. It also closes the epiphyses of long bones in girls the same way testosterone closes the growth plate in boys. The beginning of breast development is termed thelarche, which usually starts 1 to 2 years before menstruation. Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Secondary Sex Characteristics Growth spurt Increase in the transverse diameter of In girls, the pelvis pubertal Breast development changes Growth of pubic hair typically Onset of menstruation occur as: Growth of axillary hair Vaginal secretions Copyright © 2018 Wolters Kluwer · All Rights Reserved Menstrual periods do not become The average age regular until at which ovulation occurs menarche (the consistently, and first menstrual this does not tend period) occurs is to happen until 1 12.4 years of to 2 years after age. menarche It may occur as The production of early as age 9 ova stops at years or as late as menopause. age 17 years, however, and still be within a normal age range Copyright © 2018 Wolters Kluwer · All Rights Reserved Increase in weight Growth of testes Secondary sex Growth of face, axillary, and pubic hair characteristics of boys usually Voice changes occur in the order of: Penile growth Increase in height Spermatogenesis (production of sperm) Copyright © 2018 Wolters Kluwer · All Rights Reserved Spermatozoa in boys do not begin in intrauterine Sperm production life and is not produced continues from puberty in a cyclic pattern; throughout the male’s rather, they are produced life. in a continuous process. Copyright © 2018 Wolters Kluwer · All Rights Reserved Fertility and Fertilization Female Fertility Once a girl has started to menstruate (have her period), she is physically able to become pregnant. A girl can become pregnant before her first period if she has already become fertile. It is called the menstrual cycle because it repeats continuously, except during pregnancy, until menopause. The menstrual cycle starts at puberty and ends at menopause. Having a period means that a girl is becoming a woman. Every woman in the world has her period. This is nothing to worry about. Copyright © 2018 Wolters Kluwer · All Rights Reserved Female Fertility Some women get heavy secretion; some get very light secretions or none at all. Having secretions do not mean that a woman’s vagina is dirty. It just means that her body is going through its normal, constant menstrual cycle changes. If secretions suddenly change color or smell, this might mean that a woman has an infection, and she should see a health provider. Most women do not have secretions all the time – just on some days of the menstrual cycle Copyright © 2018 Wolters Kluwer · All Rights Reserved Male Fertility A boy cannot control when he will have an erection or wet dream. Erections and wet dreams are completely normal. It means a boy is becoming a man. Boys do not have to ejaculate each time they have an erection. Semen leaves the body during ejaculation. Ejaculation means a boy is able to get a girl physically pregnant. Copyright © 2018 Wolters Kluwer · All Rights Reserved True or False 1. Sperms are produced in the penis. 2. “Wet dreams” are common for boys during puberty. 3. Semen contains seminal fluid and sperm. 4. When a boy or man has an erection, he always needs to ejaculate. 5.Men usually stop having ejaculations when they are around 60 years old. 6.During puberty a boy’s shoulders broaden and he begins to grow taller. 7.Circumcision is an operation performed only on boys. 8.New thoughts and feelings accompany the physical changes of puberty. 9.At puberty, a boy is capable of becoming a father. 10.If a girl does not get her period by the time she is 14, there is something wrong with her. 11.If a woman misses a period, she could be pregnant. 12.The period or menstruation always lasts five days. 13.All women have a menstrual cycle that lasts 28 days. 14.Ejaculation happens only during sexual intercourse. 15.Both men and women masturbate. 16.Masturbation can cause people to go crazy. 17.A girl can get pregnant the first time she has sex. 18. Sexual intercourse is a physical act in which the man’s penis enters the woman’s vagina. 19.During puberty, body hair does not grow in new places. 20. During puberty, rapidCopyright changes in height and weight take place in boys and © 2018 Wolters Kluwer · All Rights Reserved Anatomy and Physiology of the Reproductive System Copyright © 2018 Wolters Kluwer · All Rights Reserved Quiz no. 3 2 1 3 4 5 Copyright © 2018 Wolters Kluwer · All Rights Reserved 6 7 10 9 8 Copyright © 2018 Wolters Kluwer · All Rights Reserved 2 1 3 4 5 Copyright © 2018 Wolters Kluwer · All Rights Reserved 6 7 10 9 8 Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 1: Relaxing with Words 1. In this activity I will be showing words or phrases. 2. I will be asking you to write a word or phrase that you can associate with the word. 3. I encourage you to write all the words you know: local terms, informal words even if you think of them as “bad.” 4. Are you ready? Copyright © 2018 Wolters Kluwer · All Rights Reserved Vagina Copyright © 2018 Wolters Kluwer · All Rights Reserved Penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Breast Copyright © 2018 Wolters Kluwer · All Rights Reserved Sex Copyright © 2018 Wolters Kluwer · All Rights Reserved Analysis 1. How do you find the different words? Were you embarrassed by some of those words? Were you uncomfortable reading some of them? Which words were you embarrassed or uncomfortable with? Why? 2. Are there words you find harsh and offensive? Why do you feel that way? 3. What does it mean when people use harsh and offensive words? Why do you think this happens? 4. Which of the words do you consider as “good”? Why do you say so? 5. Which ones do you consider as “bad”? Why do you say so? 6. When do you use the “good” words? Why? 7. How about the “bad” words, when do you use them? Why? 8. In this class, which words do you want us to use when talking about sexual and reproductiveparts? Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Activity 2: Crossword Puzzle Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a U woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Across 5. The place where a baby develops 7. Forceful release of semen from the penis 8. Time in life when a woman’s menstruation ends 9. The part of the woman that takes the egg from the ovaries to the uterus (two Down words) 1. Passing of semen during sleep (2 words) 2. Release of an egg from an ovary 3. Place where sperm is produced 4. A thick fluid that is discharged from the penis during ejaculation. 6.Process of becoming an adult 7. Hardening of the penis Copyright © 2018 Wolters Kluwer · All Rights Reserved Anatomy and Physiology of the Reproductive System: The Male Andrology: study of the male reproductive system Copyright © 2018 Wolters Kluwer · All Rights Reserved Anatomy and Physiology of the Reproductive System: The Male External structures Internal structures Scrotum Epididymis Testes Vas deferens Penis Seminal vesicles Prostate gland Bulbourethral glands Urethra Copyright © 2018 Wolters Kluwer · All Rights Reserved Functions of the Male Reproductive Organs The Reproductive organs are adapted for producing The Testes produces The Ducts transport, store, new individuals and sperm and the male sex and assist in maturation in passing on genetic hormone testerone. Sperm. material from one generation to the next. The Penis contains the The Accessory Sex Glands Urethra, a passageway for secrete most of the liquid ejaculation of Semen and portion of the Semen. excretion of Urine. Copyright © 2018 Wolters Kluwer · All Rights Reserved External Male Reproductive Organs Scrotum Function: Supports the Testes and helps regulate the temperature of the Sperm. Copyright © 2018 Wolters Kluwer · All Rights Reserved Scrotum Copyright © 2018 Wolters Kluwer · All Rights Reserved Testes Description: The Testes form in Utero in the Pelvic Cavity. Descending late in intrauterine life (about the 34th to 38th week) into the Scrotal sac, normal Testes feel firm, smooth, and egg- shaped. Responsible for the production of Testosterone. Lobules consist: - cells Leydig’s - Seminiferous tubule Leydig’s Cell - Interstitial cells in each lobule. Testosterone - The most prevalent androgen. - It promotes the development of masculine characteristics. - Promotes a libido. man’s Seminiferous tubules - It produces spermatozoa (Spermatogenesis) Copyright © 2018 Wolters Kluwer · All Rights Reserved Penis It is the organ of Copulation Copulation - medical term for Sexual Intercourse. Has 3 Cylindrical Masses of Erectile tissue - The Corpus Spongiosum expands to form the glans penis which covers the distal ends of the Corpora Cavernosa. Prepuce or the Foreskin - The hood-like fold of the skin that covers the glans. Urethra - It passes through these layers of the Erectile tissue. The Penis serves as the outlet for both the urinary and the reproductive tracts in men. Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Distention and Erection of the Penis: Stimulus: (+) Sexual Excitement Trapping of both the Nitric oxide is Venous and the Distention and released from the Arterial blood in the erection of the Endothelium of the 3 Sections of the Penis Blood vessels Erectile tissue Contraction of the Dilation of the Ischiocenovernosus Blood vessels muscle at the base of the penis Increase in the blood flow to the Engorgement arteries of the Penis Copyright © 2018 Wolters Kluwer · All Rights Reserved SPERM PRODUCTION FSH release of LH release of SPERMATOZOA ABP testosterone ABP and Release FSH Hypothalamus testosterone and LH then combine to promote Anterior Releases GnRH sperm pituitary gland formation Copyright © 2018 Wolters Kluwer · All Rights Reserved Trivia One testis is slightly larger than the other and is suspended slightly lower in the scrotum than the other. Copyright © 2018 Wolters Kluwer · All Rights Reserved Internal Male Reproductive Organs Epididymis Comma shaped organ about 4 cm long that lies along the posterior border of each Testis Consists mostly of ductus Epididymis tightly coiled approximately 20 ft long. Function: Responsible for conducting Sperm from the testes to Vas Deferens. Absorption of fluid and addition of substances to the seminal fluid to nourish the maturing sperm. It takes at least 12 to 20 days for them to travel the length of the Epididymis, total of 64 days for them to reach Maturation Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Vas Deferens (Ductus Deferens) Carries sperm from the Epididymis through the Inguinal Canal the Abdominal Cavity. in It ends at the Seminal Vesicles and Ejaculatory Ducts. Copyright © 2018 Wolters Kluwer · All Rights Reserved Seminal Vesicles 2 convoluted pouches. Lie on the lower portion of the posterior surface of the Urinary Bladder. Empty into the Urethra by way of the Ejaculatory Ducts. Function: Secretes viscous portion of the semen: High in sugar Protein Prostaglandins Sperm becomes increasingly motile because of the nutrients and more favorable pH Copyright © 2018 Wolters Kluwer · All Rights Reserved Ejaculatory Ducts 2 Ejaculatory Ducts pass through the Prostate Gland and join the Seminal Vesicles to the Urethra. Terminate in the Prostatic Urethra Function: Eject Sperm and Seminal Vesicle secretions just before the release of Semen from the Urethra to the exterior Copyright © 2018 Wolters Kluwer · All Rights Reserved Prostate Gland Chestnut sized gland. Lies below the Urinary Bladder. Urethra passes through the center of it, like the hole in a doughnut. Function: Secretes thin, Alkaline fluid. Added to the secretion from the Seminal Vesicles and the accompanying sperm from the Epididymis. Alkaline fluid further protects sperm from being immobilized by the naturally low pH level of the Urethra. Contribute to Sperm motility and viability. Hypertrophy of the Prostate interferes with both Fertility and urination Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Bulbourethral Glands 2 Bulbourethral Glands (Cowper's glands). Lie beside the Prostate Gland. Empty into the Urethra Function: Secrete an alkaline fluid that helps counteract the acid secretion of the urethra. Ensure the safe passage of Spermatozoa. Copyright © 2018 Wolters Kluwer · All Rights Reserved Semen Mixture of Sperm and Seminal fluid. Seminal fluid consists of the secretions: Epididymis (5%) Seminal vesicles (30%) Prostate gland (60%) Bulbourethral gland (5%) Copyright © 2018 Wolters Kluwer · All Rights Reserved Copyright © 2018 Wolters Kluwer · All Rights Reserved Urethra Hollow tube leading from the base of the Bladder Passes through the Shaft and Glans of the Penis continues to the outside. 8 inches (18 to 20 cm) long. Copyright © 2018 Wolters Kluwer · All Rights Reserved Anatomy and Physiology of the Reproductive System: The Female Gynecology: study of the female reproductive system Copyright © 2018 Wolters Kluwer · All Rights Reserved Anatomy and Physiology of the Reproductive System: The Female External structures o Mons veneris o Labia minora o Labia majora o Vestibule Collectively o Clitoris known as the o Skene glands Vulva or o Bartholin glands Pudendum. o Fourchette o Hymen Copyright © 2018 Wolters Kluwer · All Rights Reserved Anatomy and Physiology of the Reproductive System: The Female Copyright © 2018 Wolters Kluwer · All Rights Reserved Mons Veneris Rounded, soft, fullness over the symphysis pubis. Covered with coarse dark hair during functional years and things after Menopause. It is a pad of adipose tissue located over the symphysis pubis, the pubic bone joint. Covered by a triangle of coarse, curly hairs. The purpose of the mons veneris is to protect the junction of the pubic bone from trauma. Copyright © 2018 Wolters Kluwer · All Rights Reserved Labia Majora 2 fatty tissue containing folds of skin that extend downward from the Mons Veneris around the external vaginal opening terminating in the Perineum Copyright © 2018 Wolters Kluwer · All Rights Reserved Labia Minora Narrow folds of skin and fibrous- areolar tissue extending from the Clitoris to the fourchette. Structure that is sometimes cut (Episiotomy) during childbirth to enlarge the vaginal opening. Episiotomy - It is also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by a midwife or obstetrician. Episiotomy is usually performed during the second stage of labor to quickly enlarge the opening for the baby to pass through Copyright © 2018 Wolters Kluwer · All Rights Reserved Clitoris Homologous to the Penis. Erectile organ fixed beneath the arc of the pubis Above the Urethral Meatus. Highly sensitive to temperature, touch and pressure sensation. Serves as a landmark in locating the Urethral meatus for female catheterization. Copyright © 2018 Wolters Kluwer · All Rights Reserved Bulbs of the Vestibule Paired elongated masses of Erectile tissue. Located at the sides of the Vaginal orifice The vestibule is the flattened, smooth surface inside the labia. The openings to the bladder (the urethra) and the uterus (the vagina) both arise from this space. Copyright © 2018 Wolters Kluwer · All Rights Reserved Urethral Meatus Pink, reddened, slit like opening. Marks the terminal or distal Urethra. Copyright © 2018 Wolters Kluwer · All Rights Reserved Paraurethral Glands (Skene’s Glands) 2 very short tubular structures. Located posterolateral inside the Urethral Meatus Copyright © 2018 Wolters Kluwer · All Rights Reserved Perineum Diamond shape is medial to the thighs and Buttocks of both males and females. It contains the external Genitalia and Anus. Full dilatation of the birth canal during delivery. Several muscles: Transverse Bulbocavernosus Sphincter ani externus Levator ani Perineal Copyright © 2018 Wolters Kluwer · All Rights Reserved Bartholin glands (vulvovaginal glands) located on each side of the vaginal opening with ducts that open into the proximal vagina near the labia minora and hymen Copyright © 2018 Wolters Kluwer · All Rights Reserved Fourchette ridge of tissue formed by the posterior joining of the labia minora and the labia majora. This is the structure that sometimes tears (laceration) or is cut (episiotomy) during childbirth to enlarge the vaginal opening. Copyright © 2018 Wolters Kluwer · All Rights Reserved Hymen a tough but elastic semicircle of tissue that covers the opening to the vagina during childhood. It is often torn during the time of first sexual intercourse. Copyright © 2018 Wolters Kluwer · All Rights Reserved Anatomy and Physiology of the Reproductive System: The Female Internal structures o Ovaries  Maturation of oocytes o Fallopian tubes o Uterus  Uterine wall layers  Uterine blood supply  Uterine nerve supply  Uterine supportive structures o Vagina Copyright © 2018 Wolters Kluwer · All Rights Reserved Vagina It extends from the Introitus to the Cervix. Measures about 10cm in length and 14 cm width. Situated between Bladder and Rectum. Acid medium (ph 4-5). Tends to inhibit the growth of the organisms Doderlein's Bacilli – It is a normal bacterial flora of the vagina that maintains its acidity. Functions: Passageway for the sperm’s entrance the to Uterus. For copulation Passageway for menses Copyright © 2018 Wolters Kluwer · All Rights Reserved Uterus Hollow muscular organ shaped like a flattened pear. Located inside the true pelvis between the bladder (anterior) and the rectum (posterior). Weight nonpregnant uterus 60 grams. Parts of the Uterus: Fundus Corpus Isthmus Cervix Copyright © 2018 Wolters Kluwer · All Rights Reserved Cervix - Neck or mouth of the Parts of the cervix uterus External Os ➔ Small, round distal opening to the vagina ➔ After childbirth it is a transverse slit. ➔ At the level of the Ischial spine. ➔ Ischial spine – an important relationship in estimating the level of the fetus in the birth canal. Internal Os Opening of the canal at the junction of the Cervix and Isthmus. Cervical Canal Space between external os and internal os Operculum a – Cervical plug or mucous produced by the cervical glands (Naboth) that prevents ascending infection. Copyright © 2018 Wolters Kluwer · All Rights Reserved Isthmus A constricted area immediately above the Cervix. It descends and softens during pregnancy (Hegar’s Sign) and forms the lower segment of the Uterine segment 1-2 mm in length in non pregnant state. The portion of the uterus most commonly cut/incised during cesarean birth. Copyright © 2018 Wolters Kluwer · All Rights Reserved Corpus The body of the Uterus. Uppermost part and forms the bulk of the organ. Top portion of the Uterus Highly contractile portion. Fundus Point of attachment of the Fallopian tube. Copyright © 2018 Wolters Kluwer · All Rights Reserved Layers of the Uterus: Perimetrium Layer of the peritoneum which covers the Uterus except at the sides. Broad ligaments arise from the sides of the Uterus. Myometrium Middle layer Made up of muscles with very great expansile properties Endometrium Inner lining of uterus Rich supply of blood about 1.5 mm thick. - Decidua – after implantation the endometrium. After delivery it is shed-off known as Lochia Copyright © 2018 Wolters Kluwer · All Rights Reserved Position of the Uterus Anteversion: Fundus is tipped forward. The normal. Retroversion: Fundus is tipped back Retroflexion: The body is bent sharply just above the Cervix Extreme abnormal flexion or version positions may interfere with fertility. It may block the deposition or migration of sperm Copyright © 2018 Wolters Kluwer · All Rights Reserved Ligaments: Broad Ligament - A double fold peritoneum extending outwards from the Uterus attached to the side walls of the Pelvis. Round Ligament - It has a little support but maintains the normal position of the Uterus (Anteversion). Utero-Sacral Ligaments - Consists of folds of Peritoneum extending backward from the sides of the Isthmus and attached to the Sacrum. Copyright © 2018 Wolters Kluwer · All Rights Reserved Functions of uterus Organ of Reproduction. Organ of Menstruation Nourishes and protects the fertilized ovum for 40 weeks. It expels the products of conception. Copyright © 2018 Wolters Kluwer · All Rights Reserved Fallopian Tubes Approximately 10 cm in length. Conveys the ovum from the ovaries to the uterus.

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