Female Reproductive Anatomy and Physiology (2nd Lecture) PDF

Female Reproductive Anatomy and Physiology 2nd Lecture Female Reproductive System: Anatomy & Physiology Learning Outcomes: 1. Locate and describe the anatomy & functions of the female reproductive organs. 2. Describe female reproduc...

Female Reproductive Anatomy and Physiology 2nd Lecture Female Reproductive System: Anatomy & Physiology Learning Outcomes: 1. Locate and describe the anatomy & functions of the female reproductive organs. 2. Describe female reproductive physiology, including the phases of the menstrual cycle 3. Explain common disorders of the female reproductive systems Maternity and Childhood Nursing Department  The Anatomy & Functions of the Female Reproductive Organs.  The female reproductive system consists of external and internal structures and organs.  Function of Female Reproductive System -Produces sex hormones and functional ova -Protects and supports developing embryo -Nourishes newborn infant Maternity and Childhood Nursing Department  External Sex Organs  Vulva – entire female region of external sex organs  Mons pubis Fatty tissue and skin is covered with pubic hair after puberty. It protects the symphysis pubis during sexual intercourse.  Vestibule. consists of the clitoris, urethral meatus, and the vaginal introitus.  Labia Majora outer lips; tissue folds from mons to perineum surrounding the rest of the female genitals;  Labia Minora inner lips; pink tissue folds between vestibule and labia majora; no hair; They lubricate the vulva, swell in response to stimulation, and are highly sensitive. Maternity and Childhood Nursing Department  External Sex Organs- Cont.  The clitoris is a short erectile organ at the top of the vaginal vestibule whose function is sexual excitation (analogous to the penis). The hood-like covering over the clitoris is the site for female circumcision, which is still practiced in some countries by some cultures.  The urethral meatus is the opening of the urethra.  The vaginal introitus is the vaginal entrance  Perineum. The skin covered muscular area between the vaginal opening (introitus) and the anus. It aids in constricting the urinary, vaginal, and anal opening. The perineum can become lacerated or incised during childbirth and may need to be repaired with sutures. Incising the perineum area to provide more space for the presenting part is called an episiotomy.  Bartholin's Glands. The Bartholin's glands lie on either side of the vaginal opening. They produce a fucoids substance, which provides lubrication for intercourse.  Fourchette:" ridge of tissue formed by the posterior joining 2 labia minora and labia majora and sometimes cut (episiotomy). Trauma provides forensic evidence in rape trials Maternity and Childhood Nursing Department Maternity and Childhood Nursing Department  The hymen  Separate external organ from internal  Stratified squamous epithelium membrane that partially closes (perforated) mucosa-covered tissue across the vaginal introitus.. Congenitally, it may have no opening (imperforate hymen), also rarely it may be absent. The shape and size of the openings vary. It is torn with the first sexual intercourse (unless the opening is unusually large, or the hymen is elastic).  The presence or absence of the hymen can neither confirm nor rule out sexual experience: Heavy physical exertion, use of tampons, or injury to the area can alter the appearance of the hymen in girls and women who have not been sexually active. Maternity and Childhood Nursing Department  The Breasts  The breasts are also part of the external female reproductive system.  Their external structure include the nipple, areola (darker area around the nipples) and Montgomery tubercles (glands that produce a lubricant to keep the nipple soft and supple). Primary function: Lactation Influence of hormones (Estrogen-develop of breasts , Progesterone-secretion of milk) Sucking stimulates pituitary gland to release prolactin (begin milk synthesis) and oxytocin (release of milk) Maternity and Childhood Nursing Department A few days after childbirth, a dark Prolactin: yellow fluid called colostrum is secreted. Colostrum contains more Source: Anterior minerals and protein, but less Pituitary sugar and fat, than mature breast Targets & Functions: milk. Breasts Colostrum secretion may continue Stimulates for approximately a week after alveoli of childbirth, breasts to with gradual conversion to mature produce milk milk. Colostrum is rich in maternal antibodies, especially immunoglobulin A (IgA), which offers protection for the newborn against enteric pathogens. Maternity and Childhood Nursing Department  Internal Female Structures Vagina. Uterus Fallopian tubes. Ovaries. Maternity and Childhood Nursing Department  The Vagina  Elastic, thin-walled muscular accordion-like tube; 3-4 inches long (7.5–9 cm )  Opening is the vaginal orifice covered by the hymen to the cervix  The vagina has an acidic environment, which protects it against ascending infections. Antibiotic therapy, douching, perineal hygiene sprays, and deodorants upset the acid balance within the vaginal environment and can predispose women to infections.  tilted back; Posterior to the bladder/Anterior to the rectum  Function: Receives penis & semen and serves as birth canal & passage for menstrual flow. Maternity and Childhood Nursing Department  Uterus  1-inch thick walls, 3 inches long, 2 inches wide ;hollow, muscular organ lies behind the bladder and in front of the rectum; Normally anteverted anteflexed  3 uterine wall layers: Perimetrium ; Myometrium (muscular middle layer), ; Endometrium (innermost layer),  The major portion of the uterus is called the body or corpus.  The fundus is the superior, rounded region above the entrance of the fallopian tubes.  The cervix is the narrow, inferior outlet that protrudes into the vagina. Os – opening leading into the uterus  The isthmus is the slightly constricted portion that joins the corpus to the cervix. Maternity and Childhood Nursing Department Function: Provides passageway for sperm, receives blastocyst, retains & nourishes fetus & expels fetus at term. Uterus Maternity and Childhood Nursing Department  Fallopian Tubes  Two 4-inch (8 to 13 cm ) length that extend from the sides of the uterus and curve up to and around the ovaries in the pelvic cavity below and to either side of the umbilicus.  Millions of tiny hair-like cilia line the fimbria that beat in waves hundreds of times a second catching the egg at ovulation and moving it through the tube to the uterine cavity (takes 3–4 days). Maternity and Childhood Nursing Department Function: Passageway for oocyte and site of fertilization. 1. Interstitial (lies within the Fallopian Tubes uterine wall), 2. Isthmus (cut or sealed in tubal ligation), 3. Ampulla (longest portion and fertilization of an ovum usually occurs) and 4. Infundibulum (funnel-shaped) finger-like projections at the distal end surrounding the ovaries to collect an egg upon release Maternity and Childhood Nursing Department  The Ovaries  The female sex glands  Are small, almond-shaped organs: near lateral walls of pelvic cavity 5 cm long, 2.5 cm wide, 8mm thick Male Homolog = testes Function: Produce oocytes (ova) & the hormones estrogen and progesterone. Maternity and Childhood Nursing Department  Puberty  The stage at which the individual first becomes capable of sexual reproduction  A girl has entered puberty when she begins to menstruate  A Boy enters puberty when he begins to produce spermatozoa  Puberty occur between 9-14 years  Puberty lasts about 3 to 5 years  Begins when pituitary gland initiates release of FSH and LH, which increases the ovaries production of estrogen & progesterone, which cause the development of female secondary sexual characteristics;  Thelarche: the development of breast buds;  Adrenarche: the appearance of pubic and then axillary hair  Menarche: the start of menstruation in females Maternity and Childhood Nursing Department  Menstruation  Menstruation – uterine lining is shed if no pregnancy; tissue and blood exit the introitus  Four body structures are involved in physiology of MP: Hypothalamus; Ovaries; Pituitary glands; and Uterus  Menstrual cycle has four phases: Follicular phase Ovulation phase Luteal phase Menstrual phase Maternity and Childhood Nursing Department  Normal menstrual cycle  Beginning (menarche )  Average age of onset 12 or 13 , average range is 9-17 years  Interval between cycles  Average 28 days , cycles between 21-36 not unusual  Duration of menstrual  3-7 days , but range from 1-9 days not flow abnormal  Amount of menstrual flow  From 20 – 80 ml per menstrual  Color of menstrual flow  Dark red , combination of blood , mucus , and endiometrical cells  Odor  "similar to that of marigolds" Maternity and Childhood Nursing Department  Hormonal Control of Female Reproduction Hormones control the menstrual cycle. – Estrogen – Progesterone – Luteinizing hormone (L H) – Follicle-stimulating hormone (FSH) – Gonadotropin-Releasing Hormone (GnRH): Secreted from the hypothalamus. It induces the release of FSH and LH to assist with ovulation. Maternity and Childhood Nursing Department  Menstrual Cycle (Days 6 – 13) Preovulatory Phase  Also known as the proliferative phase and/or follicular phase.  A drop in progesterone and estrogen stimulates the release of FSH from the anterior pituitary (under the control of The hypothalamus - releases gonadotropin-releasing hormone (GnRH)  FSH stimulates the maturation of an ovum with graafian follicle.  The growing follicle becomes a temporary endocrine gland, secreting increasing amounts of estrogen which inhibits FSH production in the pituitary.  The follicular phase: During the follicular phase, a certain number of follicles start to grow, and usually only one succeeds to continue through the pre-ovulatory follicle stage. Maternity and Childhood Nursing Department  Menstrual Cycle Day 14 Ovulation  Again, day 14 is only an average; ovulation occurs anywhere from 12 – 16 days before the next menstrual flow.  When estrogen levels reach their peak, the pituitary releases a surge of LH, the release of LH increases causing a release of the ovum, which is known as ovulation.  The lifespan of the ovum is only about 24 hours; unless it meets a sperm on its journey within that time, it will die.  The LH surge signals the onset of ovulation within 12 to 24 hours.  At ovulation, the ruptured follicle (left behind after ovulation) begins to secrete progesterone and backs off on estrogen secretion.  Signs of Ovulation -Increase in body temperature -Changes in cervical mucus -Some women will experience slight pain (mittelschmerz). -Cervix softens Maternity and Childhood Nursing Department  Menstrual Cycle Days 15 - 28 Postovulatory Phase  Also called the luteal or secretory phase because the cells of the follicle remain in the ovary, renamed the “corpus luteum,” where they will produce large amounts of progesterone under the effects of high levels of LH  Progesterone inhibits release of LH from the pituitary gland and continue to rise, maintaining the thickened endometrium in case fertilization occurs Corpus luteum translated means “yellow body.” > This structure forms after the egg is expelled from the follicle. >If pregnancy does not occur it will degenerate (ischemic phase). Maternity and Childhood Nursing Department  Menstrual Cycle Days 1-5 Menses phase. A lack of signal from a fertilized egg influences the drop in estrogen and progesterone production. A drop in progesterone results in the sloughing off of the thick endometrial lining which is the menstrual flow. Menstrual phase – endometrial buildup is expelled through uterine contractions for 3-7 days; volume of menses is about 50 ml blood Maternity and Childhood Nursing Department  Menstrual Cycle: In Summary  Follicular phase Egg matures  Ovulation Egg released  Luteal phase Corpus luteum Endometrium Prep for blastocyst  No Pregnancy Menses Maternity and Childhood Nursing Department Maternity and Childhood Nursing Department  Menstrual Problems – Amenorrhea  Absence of menses during the reproductive. Can be primary or secondary.  Primary amenorrhea defined as absence of menstruation by age of 17. Can be related to anatomical or genetic abnormalities.  Secondary amenorrhea the absence of menses for three cycles or 6 months in women who have previously menstruated regularly, may result from nutritional deficits (anorexia nervosa), excessive exercise, emotional disturbances, endocrine dysfunction, side effects of medication, pregnancy, and lactation. Maternity and Childhood Nursing Department  Menstrual Problems – Premenstrual Syndrome (PMS)  3 to 14 days prior to the menstrual period, during the postovulatory/luteal phase, and are relieved by onset of the menses.  Experienced by one-third to one-half of women between 20 and 50.  Symptoms include weight gain, irritability, mood swings, edema, headache, inability to concentrate, food cravings, acne, and many others.  Can be alleviated by pharmacological interventions, diet, and exercise, Eat ‘real’ food! Eliminate ‘junk’ food (caffeine, soda, alcohol, processed foods, sugar), Decrease salt intake to relieve bloating and edema. Maternity and Childhood Nursing Department  Dysmenorrhea  Painful menstruation, also called “menstrual cramps,” is more common in nulliparous women and in women who are not having intercourse.  S&S sharp, intermittent spasms of pain, usually in the suprapubic area. Pain usually develops within hours of the start of menstruation and peaks as the flow becomes heaviest during the first day or two of the cycle. Systemic symptoms of nausea, vomiting, diarrhea, fatigue, fever, headache, or dizziness are fairly common. Bloating, water retention, weight gain, headache, muscle aches, abdominal pain, food cravings, or breast tenderness.  Management. NSAIDS (nonsteroidal anti inflammatory drugs). Analgesia (aspirin mild prostaglandin inhibitor ; Adequate rest and sleep and regular exercise, showers and heating pad. Maternity and Childhood Nursing Department  Menorrhagia Excessive bleeding during a menstrual period Either in terms of the amount of blood lost or the number of days that bleeding lasts Hormonal disturbances, infections, and growths inside the uterus can cause menorrhagia Excessive bleeding for an extended period of time can cause a woman to become anemic from the chronic blood loss Maternity and Childhood Nursing Department  Metrorrhagia  Is bleeding between menstrual period  Its normal in some adolescence whose spotting at the time of ovulation  It may occur in client on oral contraceptive drugs  Vaginal irritation from infection may cause mid cycle spotting  low level of progesterone production and endometrial sloughing Maternity and Childhood Nursing Department  Inflammatory Disorders: Toxic Shock Syndrome (TSS)  A condition most often associated with Staphylococcus aureus, which enters the bloodstream.  A strong relationship found between the use of tampons during menstruation and the onset of TSS symptoms.  Symptoms include fever, vomiting, diarrhea, and progressive hypotension (flu-like symptoms).  TSS can lead to death if not treated properly. Maternity and Childhood Nursing Department  Care of Female Reproductive Organs  Wash outer genitalia regularly and thoroughly  Don’t use feminine hygiene spray  Go to a doctor if infection  Don’t use douches  Change pads and tampons regularly during menstruation  Genital self-exams are recommended for women to be familiar with their genitals and any possible abnormalities  Routine gynecological examinations recommended once menstruating Maternity and Childhood Nursing Department Maternity and Childhood Nursing Department