Male and Female Reproductive Anatomy PDF

Batang Ina reviewer MALE and FEMALE repro anatomy - **Male reproductive anatomy** - **External structures** - **Penis** -- organ of copulation - **Scrotum** - darker than normal skin because scrotal temperature is 1 deg. Fahrenheit LOWER than body temperature as sperms is heat-s...

Batang Ina reviewer MALE and FEMALE repro anatomy - **Male reproductive anatomy** - **External structures** - **Penis** -- organ of copulation - **Scrotum** - darker than normal skin because scrotal temperature is 1 deg. Fahrenheit LOWER than body temperature as sperms is heat-sensitive - **Testes** - Male gonad/sex gland - ***What do you call the cells inside the testes that nourish the sperm? Laydig's cells; gives glucose and fructose.*** - **Vas deferens** - pathway of sperm epididymis to the ampulla. - **Epididymis** - Storage for growth and maturation of sperm - ***It will take how many days for the sperms to grow in the Epididymis? 64 (or 2 months minimum) to 75 days.*** - **Seminal fluid** -- lubrication of sperm - Structures that produce this fluid (with % of how one structure produces): - 1\. Epididymis - 5% - 2\. Seminal Vesicle - 30% - 3\. Prostate Gland - 60% (main producer of seminal fluid) - 4\. Cowper's Gland - 5% - ***Two structures that provide alkaline to the sperm: PROSTATE GLAND and COWPER'S GLAND.*** - **Ampulla** - At the end of vas/ductus deferens - **Ejaculatory duct** - This is the duct where lubricated sperms go through after the seminal vesicle. - **Male urethra** - Connected to the urinary bladder, prostate gland, and Bulbourethral/Cowper's gland. It is 5-9 inches in length, and average of 7 inches. - **Prepuce** - Skin covering an uncircumcised penis - **Smegma** is a buildup composed of sweat and urine - The penis is not highly muscular. It is composed more of ligaments. The ligaments being the following: - **1. Corpora Cavernosa** - it is harder, more during erection. - **2. Corpus Spongiosum** - in the middle and inside of it, the urethra is located. The end of it is called Glans Penis, which is highly sensitive to stimulation - mL of semen /ejaculation: 3-5 mL - sperm count /mL: 20 million (minimum or at least) to 150 million sperm count /ejaculation: 400 million Lifespan after ejaculation in the fallopian tubes: 3-5 days / 72 hrs pH: 7-8 (alkaline) - Morphology: 30% (shape and size, normal or defective) - Motility: 50% (actively moving sperm) - Viability: 50% (survivability) - **Note: SPERM MORPHOLOGY** - 1\. **Gynosperm** - big-headed and long-tailed, slow-moving, higher alkaline thus more acid-resistant. - 2\. **Androsperm** - small-headed and long-tailed, fast-moving, lower alkaline thus weaker to acidity - **Oligospermia** - low sperm count, sperm count is less than 20 million per mL - **Aspermia** - No presence/absence of sperm - **CLOMID** or **Clomiphene Citrate** is a fertility drug - VASECTOMY - The ligation or cutting of the vas deferens to effect sterilization. - **FEMALE REPRODUCTIVE ANATOMY** - Collectively this is called the vulva. - ***What do you call the space inside the Labia minora? VESTIBULE.*** - Females develop Smegma in the Vestibule - ***What do you call the gland that lubricates the urethra? SKENE'S GLAND*** - ***What do you call the pair of glands that lubricate the vaginal canal? BARTHOLIN'S GLANDS.*** - ***What do you call the area where the Labia majora and Labia minora meet? FOURCHETTE.*** - ***What do you call the area between the fourchette and anus? PERINEUM.*** - Counterpart of **LABIA** to the male is **SCROTUM**. - Counterpart of the **VAGINA** is the **PENIS**. - Counterpart of the **CLITORIS** is the **GLANS** **PENIS**. - The female reproductive internal structures are composed of the following: The vaginal canal, the uterus, the fallopian tubes, and the ovaries. - Vagina -- length 3 -- 4 - Copulation - Passageway of menstrual discharge - Birth canal - **Acidic pH 4-5 duoderleine bacili** - Vaginal canal is rugated - **Duoderlein Bacilli** - Normal flora of the vaginal canal that produces lactic acid. - **Uterus** - between the urinary bladder in front and the rectum - Size 3 x2 x1 - Weight 50 -- 60 grams - Pear shape - POSSIBLE POSITIONS OF THE UTERUS - 1\. **Anteverted position** - Slightly leaning forward (normal). - 2\. **Anteflexion position** - Sharply leaning forward. - 3**. Retroverted position** - During pregnancy (normal). - 4\. **Retroflexion position** - abnormal positioning. - If a non-pregnant uterus is anteflexed, it protrudes towards the urinary bladder and it is called **CYSTOCELE**. - If a non-pregnant uterus is retroflexed, the uterus protrudes to the rectal wall and it is called **RECTOCELE** - ***When will the uterus assume the retroverted position? What trimester of pregnancy? ANSWER: AT THE SECOND TRIMESTER OF PREGNANCY*** - ***What is the site of implantation? ANSWER: Up to the endometrium only, at the upper uterine segment, at the upper posterior of the uterus*** - **Perimetrium** - outer - **Myometrium** -- middle, thickest layer - **Endometrium** - inner - **PLACENTA ACCRETA** - When the placenta is attached to the myometrium, - **PLACENTA PREVIA** - The condition where the placenta is attached at the lower uterine segment - **Parts of uterus** - Fundus - Corpus - Isthmus - Cervix - ***Where is the thickest layer of the myometrium? IN THE FUNDUS, which is in the upper uterine segment*** - **2 GROUPS OF DRUGS THAT STIMULATE THE CONTRACTION AND PREVENT THE CONTRACTION:** - 1\. **Oxytocic** - **Stimulant**, stimulates contraction (e.g. Syntocinon, Pitocin, Oxytocin, Methergine). - 2\. **Tocolytic** - **Prevent**, relieve contraction (e.g. Duvadilan, Dactil OB, Yutopar, Bricanyl or Terbutaline, Magnesium Sulfate). - **Common site of fertilization is Ampulla** - Lifespan of OVUM in the Ampulla: 1 to 2 days - Hormone of PRegnancy, PRevents contraction, and PROvides nourishment: **Progesterone.** - Hormone that causes Palmar Erythema and Epistaxis in pregnant women: **Estrogen.** - Hormone that Enlarges the uterus, Encourages contraction: Estrogen. - **Chadwick sign** - bluish/purplish discoloration of the vaginal mucosa. - **Goodell sign** - softening of the cervix thanks to Estrogen. - **Hegar sign** - on the isthmus, softening of the lower uterine segment - ***How soft is a non-pregnant cervix? As soft as the tip of your nose.*** - ***How is the cervix during early pregnancy? As soft as the ear lobule/earlobe.*** - ***How soft is the cervix during late pregnancy? As soft as the lips.*** - DURATION OF LABOR AND DELIVERY - **1. PRIMI** - 12 to 16 hours average of 14 hours. - **2. MULTI** - 6 to 8 hours, average of 7 hours. - **Counterparts** - **Penis** - **Vagina**: Organs of copulation. - **Glans** **Penis** - **Glans Clitoris**: Sites of sexual excitement. - **Scrotum - Labia** - **Vas Deferens - Fallopian Tubes**: Surgical sites of ligation. - **Testes - Ovaries**: Gonads. - **Testosterone - Estrogen and Progesterone:** Sex hormones. - **Sperm - Ovum/Egg:** Sex cells/gametes. **BREAST PELVIS AND FETAL SKULL** - **Breast** -- mammary gland -- milk production - **Prolactin** - Stimulates the breast to produce milk. Secreted by the anterior pituitary gland. - **Oxytocin** - Causes the let-down reflex of the breast. Secreted by the posterior pituitary gland - **Acinar/ acini cells** - Cells found inside the lobes of the breast responsible for milk production - **Lactiferous duct** - Connected to the lobes of the breast - **PELVIS** - Inlet - yung lining ng butas - Cavity - yung pinakabutas - Outlet - sa may bandang baba - ***What are the two types of pelvis that can support pregnancy, labor, and delivery? GYNECOID and ANTHROPOID*** - **Gynecoid** - **True female** pelvis Well rounded - **Android** - **True male** pelvis Heart-shaped and triangular - **Anthropoid** - Oblong - **Platypelloid** - Flat pelvis - Fetal positions - Cephalic - **Most ideal** - Breech - Transverse - Longitudinal - Occiput = ulo Mento = chin/face Sacro = buttock - 1\. Occiput Anterior (OA) - 2\. Occiput Posterior (OP) - 3\. Right Occiput Posterior (ROP) - 4\. Right Occiput Anterior (ROA) - 5\. Right Occiput Transverse (ROT) - 6\. Left Occiput Posterior (LOP) - 7\. Left Occiput Anterior (LOA) - 8\. Left Occiput Transverse (LOT) - 9\. Mento Anterior (MA) - 10\. Mento Posterior (MP) - 11\. Right Mento Posterior (RMP) - 12\. Right Mento Anterior (RMA) - 13\. Right Mento Transverse (RMT) - 14\. Left Mento Posterior (LMP) - 15\. Left Mento Antetior (LMA) - 16\. Left Mento Transverse (LMT) - 17\. Sacro Anterior (SA) - 18\. Sacro Posterior (SP) - 19\. Right Sacro Posterior (RSP) - 20\. Right Sacro Anterior (RSA) - 21\. Right Sacro Transverse (RST) - 22\. Left Sacro Posterior (LSP) - 23\. Left Sacro Anterior (LSA) - 24\. Left Sacro Transverse (LST) - **More back pain and prone to laceration: LOP, ROP, OP** - **Ideal position: LOA, ROA, OA** **Menstruation** - Normal blood loss: **30-80cc** - **60cc is equivalent to ¼ cup** - Iron loss: **12-29 mg/less than 30mg** - Iron loss during **normal menstrual period: less than 30m**g. - Usual length of period is **3-5 days; maximum of 7 days.** - Starts from the first day of the period to the first of the next period of the next cycle. - **Average menstrual cycle is 28 days/cycle.** - **Normal range: 23-35; maximum of 40** - **Menarche is not the first sign of female secondary sex development** - **THELARCHE** - breast development - Increase in height - Broadening of the hips - TAMO (thelarche, adrenarche, menarche, and ovulation) - **ADRENARCHE** - appearance of pubic hair, axillary hair - **MENARCHE** - onset of menstruation - **GIRLS** - 1\. Growth spurt - 2\. Increase in the transverse diameter of the pelvis - 3\. Breast development - 4\. Growth of pubic hair - 5\. Onset of menstruation - 6\. Growth of axillary hair - 7\. Vaginal secretions - **BOYS** - 1\. Increase in weight - 2\. Growth of testes - 3\. Growth of face, axillary, and pubic hair - 4\. Voice changes - 5\. Penile growth - 6\. Increase in height - 7\. Spermatogenesis (production of sperm) - The woman ovulates in the middle of the cycle. - The 1st half of the cycle -- menstrual to ovulation - 2nd half of the cycle. Dominated by the hormones progesterone -- ovulation to menstruation - For the nurse to accurately determine the ovulation, she/he must deduct 2 weeks from end of the cycle - Ovulation will happen 2 weeks before the menstruation - 4 structures that control menstrual cycle - Hypothalamus Anterior pituitary gland ovaries Uterus - **Hypothalamus starts the menstrual cycle** - **Hypothalamus stimulates the anterior pituitary gland** - **APG stimulates ovaries** - Ovaries affect the uterus - **Hypothalamus produces GNRH (**gonadotropin-releasing hormone) - **Two types of GNRH** - **FSHRF (follicle stimulating hormone releasing factor)** - **LHRF (luteinizing hormone releasing factor)** - **Anterior pituitary gland produces** - **FSH (follicle stimulating hormone** - FSH, responsible for maturation of the ovum - **LH (luteinizing hormone)** - LH, responsible for ovulation, or release of the mature egg cell from the ovary - **Ovaries produces** - Estrogen - Progesterone - **3rd day of the menstrual cycle** - The level of estrogen is low - **13th day of the menstrual cycle** - The level of estrogen is high - The level of progesterone is low - **14th day of the menstrual cycle** - The level of progesterone is high - **1^st^ half** - 3rd - low estrogen - Low level of estrogen on the 3rd day of the cycle will stimulate the hypothalamus to start the cycle. - Hypothalamus will release FSHRF, stimulating the APG to release the FSH; FSH will stimulates the ovaries to release the estrogen and estrogen will affect the uterus - Once FSH is released, it will cause the maturation of the egg cell or ovum. Second effect of FSH, once FSH stimulates the ovary, the ovary will produce estrogen; estrogen will convert the follicle into GF (graafian follicle) - **GRAAFIAN FOLLICLE** - Is a follicle that contains high levels of estrogen and you can find the maturing egg cells in the graafian follicle - **2^nd^ half** - 13th - low progesterone - Low level of progesterone will stimulate the hypothalamus - Once the LH will go higher, it will cause the ovulation - LH will stimulate the ovary then the ovary will produce progesterone. Progesterone will convert the graafian follicle into corpus luteum. The lifespan of corpus luteum is 14 days or 2 weeks - **INCREASE VASCULARITY** -- temporary increase in endometrium of capillary - ***WHAT STRUCTURES MAINTAIN ON THE EARLY MONTHS OF PREGNANCY -- corpus luteum*** - **WHAT IS THE NO. 1 HORMONE PRODUCED BY THE PLACENTA? - progesterone** - **FIRST PHASE OF MENSTRUAL CYCLE (PROLIFERATIVE)** - Immediately after a menstrual flow (which occurs during the first 4 or 5 days of a cycle), the endometrium, or lining of the uterus, is very thin half of a menstrual cycle is termed interchangeably the proliferative, estrogenic, follicular, or postmenstrual phase - **Follicular Phase is characterized by menstruation**, when the thickened lining of the endometrium is shed because no egg was fertilized or implanted - **SECOND PHASE OF MENSTRUAL CYCLE (SECRETORY)** - **Formation of progesterone in the corpus luteum** (under the direction of LH) causes the glands of the uterine endometrium to become corkscrew or twisted in appearance of glycogen (an elementary sugar) and mucin (a protein) - Second phase of the menstrual cycle is termed the pregestational, luteal, premenstrual, or secretory phase - **Luteal Phase** follows ovulation - **THIRD PHASE OF MENSTRUAL CYCLE (ISCHEMIC)** - If fertilization does not occur, the corpus luteum in the ovary begins to regress after 8 to 10 days. As it regresses, the production of progesterone and estrogen decreases - **FOURTH PHASE OF MENSTRUAL CYCLE (MENSES)** - Menses or the menstrual flow, is composed of: - Blood from the ruptured capillaries - Mucin from the glands - Fragments of endometrial tissue - The microscopic, atrophied, and unfertilized ovum - **PREGNANCY** - At conception, a single sperm with 23 chromosomes (carrying genetic information from the father) penetrates/fertilizes a single egg with 23 chromosomes (carrying genetic information from the mother) - **The resulting cell, a zygote, now has 47 chromosomes.** - Embryo is suspended in an amniotic sac surrounded by fluid during the 280 day gestation period - **The 1St trimester, all parts of the embryo are formed** - **Second trimester all parts start to function** - Cephalic delivery, is the most common. Breech-backward presentation; Cesarian is delivery in the abdomen - **CALCULATION OF LMP, EDC, AOG** - Ex: LMP: December 20, 2019 -3 +7 +1 EDC: September 27, 2020 AOG: 29 weeks - **MOTHER'S RESPONSE TO PREGNANCY** - **Ambivalence** is a state of having simultaneous conflicting reactions, beliefs or feelings towards some object - **Mood changes** -- caused by physical stresses, fatigue, changes in your metabolism, or by the hormones estrogen and progesterone - **Introvert** -- someone who finds energy in alone time, isn't the greatest at expressing emotions, and has small group of people they feel most comfortable around - **Changes in Body Image** - **1St Trimester: Accepting the Pregnancy -- 50% of all pregnancies are unintended, unwanted or mistimed** - **2nd Trimester: Accepting the Baby** - **3rd Trimester: Preparing for Parenthood** - **3rd Trimester: Fear of Dying** - **Signs of Pregnancy** - Presumptive (subjective) - Probable (objective) - Positive (diagnostic) - **Presumptive Signs and Symptoms of Pregnancy** - 1\. Amenorrhea (cessation of menstruation) - 2\. Nausea and Vomiting - 3\. Frequency of Voiding - 4\. Breast Changes - 5\. Vaginal Changes - **CHADWICK'S SIGN** - 6\. Vaginal Changes -- **LEUKORRHEA** - 7\. Quickening (feeling of life) - 8\. Skin Changes - **Straie Gravidarum -- (stretch marks)** - **May be seen on a patient with Cushing's disease** - 9\. Skin Changes - **Linea Nigra** - **CHLOASMA -- mask of pregnancy** - **FINGERNAILS --** - 10\. Fatigue - 12\. Positive Home Test - **HEGAR'S SIGN**: This is softening of the lower uterine segment just above the cervix. Hegar's sign is noted by the sixth to eighth week of pregnancy - **BALLOTTEMENT**: This is demonstrated during the bimanual examination done at the 16Th to 20Th week. The fetus floats upwards, then sinks back and a gentle tap is felt on the finger - **ABDOMINAL CHANGES** This corresponds to changes that occur om the uterus. As the uterus grows, the abdomen gets larger. Abdominal enlargement alone is not a sign of pregnancy. Enlargement may be due to uterine or ovarian tumors, or edema - **GOODELL'S SIGN**: The cervix is normally firm like the cartilage at the end of the nose. Goodell's sign occurs when there is marked softening of the cervix. This is present at the 6Th week of pregnancy - **FORMATION OF A MUCOUS PLUG**: This is due to hyperplasia of the cervical glands as a result of increased hormones. It serves to seal the cervix of the pregnant uterus and to protect it from contamination by bacteria in the vagina. The mucous is expelled at the end of pregnancy near or at the onset of labor - **BRAXTON-HICK'S CONTRACTION** - **FETAL HEART SOUNDS**: The fetal heart begins beating by the 24Th day following conception. It is audible with a Doppler by 10 weeks of pregnancy and with a fetoscope after the 16Th week. It is not to be confused with uterine souffle or the swish like tone from pulsating uterine arteries. The normal fetal heart rate is 120 to 160 beats - **SIGNS OF LABOR Preliminary/ Premonitory Signs of Labor** - **1. Lightening** - **2. Braxton HIcks Contraction** - **3. Cervical Ripening** - **4. Bloody show** - **5. Rupture of Membranes** - **6. Sudden Burst of energy** - **7. Other Signs** - **COMPONENTS OF LABOR** - **1. The passage (birth canal)** - **2. The passenger (fetus)** - **3. The relationship between the maternal pelvis and presenting part of the fetus** - **4. The powers of Labor** - **5. Position of the mother** - **6. Psyche/psychological outlook** - **LANDMARKS OF THE FETAL SKULL** - **MENTUM** - fetal chin - **SINCIPUT** - upper part of the skull, especially the anterior portion above and including the forehead. - **BREGMA** - large diamond shaped anterior fontanelle - **VERTEX** - are between the anterior & posterior fontanels. - **POSTERIOR FONTANEL** - **OCCIPUT** - are of the fetal skull occupied by the occipital bone. - **1. LONGITUDINAL/VERTICAL LIE: cephalic or breech** - **2. TRANSVERSE/HORIZONTAL LIE: shoulder** - **3. OBLIQUE LIE: becomes longitudinal or transverse during labor.** - **CEPHALIC:** - **VERTEX - occiput is the presenting part** - **SINCIPUT - fetal head is partially flexed, with the anterior fontanel, or bregma, presenting** - **BROW - fetal head is partially extended; the sinciput (forehead) is the presenting part.** - **FACE - fetal head is hyperextended; the face is the presenting part.** - **BREECH: "buttocks or feet present"** - **COMPLETE - Knees & hips flexed, thighs on abdomen & claves on posterior thighs, buttocks & feet present.** - **FRANK - hips flexed & knees extended, buttocks present** - **FOOTLING - hips & legs extended** - **One foot presents (single footling)** - **Both feet present (double footling)** - **SHOULDER - shoulder presents (most frequent one of the shoulders) , fetal hand, elbow, back, abdomen, or side may present in the maternal pelvis** - **Station** - **Floating (-3) - presenting part above the inlet, in false pelvis** - **Dipping (-2)** - **Minus (-) - presenting part above the IS** - **Fixed (-1) - presenting part below the inlet, in true pelvis, no longer moving but not yet engaged.** - **Station (-5) - presenting part at pelvic inlet** - **engaged/ Station 0 - presenting part at IS** - **Plus (+) station - presenting part below IS** - **(+4) - crowning - presenting part at perineum** - **Station (+5) - presenting part at pelvic outlet** - **Non-pharmacologic pain management** - Cognitive-stimulation methods - Cutaneous stimulation - Thermal stimulation - Breathing techniques - Relaxation - Hypnosis - Therapeutic touch - Music - Aromatherapy - Acupressure - Acupuncture - **Pharmacologic pain management** - Opioid analgesics - Analgesic potentiators - Regional anesthesia and analgesia - Local infiltration anesthesia - **METHODS OF CONTRACEPTION** - **NATURAL** - SDM/calendar - CMT / Billings Test / Creighton's Method / Spinnbarkeit Method - Basal body temp - abstinence - 2-day method - Lactational amenorrhea method/LAM - Symptothermal method - **ARTIFICIAL** - Barrier, chemical, hormonal, surgical - **NATURAL METHOD** - Abstinence - Lactation amenorrhea method (LAM) - Coitus interruptus (withdrawal) - 2-day method - Fertility awareness method (FAM) - **BARRIER METHOD** - condom - male and female - Cervical cap - Diaphragm - IUD-intrauterine device - **HORMONAL METHODS** - Oral pills - combined oral contraceptives (COCP), progestin only pill (POP) or mini pill - COCP - estrogen and progesterone ○ POP - progesterone - Injectable - depo provera and lunelle - Progesterone base - Patch - ortho evra- Progesterone base - Implants - norplant and implanon - Progesterone base - Vaginal ring - Estrogen base - **STERILIZATION** - Vasectomy - Tubal ligation GENES - Deoxyribonucleic acid (DNA) - Chromosomes 46 - Chromosomes 22 pairs of Autosomes (Homologous autosomes) - 1 pair of Sex Chromosomes (No. 23) - Male XY - Female XX - **Phenotype** -- outward appearance of a person - **Genotype** - a person's actual gene composition - **Genome**- complete set of genes. - Example 46XX or 46XY p-short arm defect; q-long arm defect - **Homozygous** - healthy gene + healthy gene - **Heterozygous** -- healthy gene + unhealthy gene - **X-LINKED DOMINANT INHERITANCE** - 1\. All individuals with are affected. - 2\. All female children of affected men are affected all male children of affected men are unaffected. - 3\. It appears in every generation. - 4\. All children of homozygous affected women are affected. Fifty percent of the children of heterozygous affected women are affected. - **X-LINKED RECESSIVE INHERITANCE** - 1\. Only males in the family will have the disorder. - 2\. A history of girls dying at birth for unknown reason often exists (females who had he affected genes on both X chromosomes) - 3\. Sons of an affected man is unaffected. - 4\. The parents of the affected children do not have the disorder. - **Meiosis**- type of cell division which the number of chromosomes in the cell is reduced to haploid (half) number for reproduction. - Nondisjunction -- division is uneven - **Deletion Abnormalities-** part of a chromosome breaks during cell division resulting to normal number of chromosomes plus or minus an extra portion of a chromosome. HUMAN SEXUALITY - **Aspect of human sexuality** - **BIOLOGICAL ASPECTS:** These include the physiological processes involved in sexual reproduction, sexual health, and the influence of hormones on sexual behavior - **PSYCHOLOGICAL ASPECTS**: These cover the emotional and cognitive dimensions of sexuality, such as sexual desire, arousal, and the ways individuals form sexual preferences and attachments. - **SOCIOCULTURAL ASPECTS**: Sexuality is influenced by societal norms, cultural values, religion, and historical contexts - **SEXUAL BEHAVIOR:** This refers to how individuals express their sexuality through actions, which can include masturbation, sexual intercourse, and other forms of sexual activity - **SEXUAL HEALTH:** Sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality. - **SEXUAL ETHICS AND MORALITY**: This aspect involves the ethical considerations surrounding sexual behavior, including consent, respect, and the moral implications of sexual choices - **GENDER IDENTITY AND ROLES:** Gender identity is a person's internal sense of being male, female, a blend of both, or neither, and can be the same or different from their sex assigned at birth. - **Component of sexual aspect** - **SEXUAL ORIENTATION** This refers to the pattern of emotional, romantic, or sexual attraction one feels towards others. - **SEXUAL IDENTITY** Sexual identity is how individuals perceive themselves and what they call themselves based on their sexual feelings and attractions. - **SEXUAL BEHAVIOR** This includes the actions through which individuals express their sexuality, such as kissing, sexual intercourse, masturbation, and other forms of sexual activity - **SEXUAL DESIRE (LIBIDO)** Sexual desire, or libido, refers to an individual's level of sexual interest or drive - **SEXUAL AROUSAL** Sexual arousal is the physiological and emotional response to sexual stimuli, leading to the readiness for sexual activity - **SEXUAL HEALTH** Sexual health is the state of physical, emotional, mental, and social well-being in relation to sexuality - **SEXUAL INTIMACY**: This involves the emotional and physical closeness between partners in asexual relationship - **SEXUAL VALUES ANDBELIEFS**: These are the personal, cultural, or religious principles that guide an individual's attitudes and behaviors regarding sexuality. - **GENDER IDENTITY**: Gender identity is a deeply-felt sense of being male, female, a blend of both, neither, or something else, and can influence one's sexuality. - **SEXUAL RIGHTS** Sexual rights involve the rights of individuals to have control over their sexual and reproductive health - **Sexual orientation** - **Heterosexuality** -- opposite gender - **Homosexuality** -- own sex - **Bisexuality** -- both - **Transsexuality** -- should be opposite gender - **Sexual expression** - **CELIBACY** -- abstinence from sexual activity - **TRANSVESTISM** -- individual who dresses - **VOYEURISM** -- sexual arousal by looking at another's body - **SADOMASOCHISM** -- involves inflicting pain(**sadism**) or receiving pain (**masochism**) - **MASTURBATION** -- self-stimulation for erotic pleasure - **EXHIBITIONISM** -- revealing one's genitals in public - **PEDOPHILES** -- interested in sexual encounters with children. - **Sexual dysfunction** - **Desire disorder** - **Hypoactive Sexual Desire Disorder (HSDD)**- A lack or absence of sexual fantasies and desire for sexual activity - **Sexual Aversion Disorder**- An extreme aversion to and avoidance of sexual contact - **Arousal disorder** - **Erectile Dysfunction (ED)** - **Female Sexual Arousal Disorder** - **Orgasm disorder** - DELAYED EJACULATION - PREMATURE EJACULATION - FEMALE ORGASMIC DISORDER (ANORGASMIA) - **Pain disorder** - **DYSPAREUNIA** - **VAGINISMUS** - **Sexual dysfunction due to medical condition or medications** - **DIABETES-RELATED SEXUAL DYSFUNCTION** - **MEDICATION-INDUCED SEXUAL DYSFUNCTION** - **Psychological sexual disorder** - **SEXUAL ANXIETY AND PERFORMANCEANXIETY** - **BODY IMAGE ISSUES** - **TRAUMA-RELATED SEXUAL DYSFUNCTION** - **Human sexual response** - **Excitement** - **Plateau** - **Orgasm** - **Resolution** **FRAMEWORK FOR MATERNALAND CHILD HEALTH NURSING** - Maternal-child nursing is defined as, **"The nursing specialty that deals with the care of women throughout their pregnancy and child birth and the care of their newborn children"** - **Standard** **1**: Every woman and newborn receive routine, evidence-based care and management of complications during labor, childbirth and the early postnatal period, according to WHO guidelines. - **Standard** **2**: The health information system enables use of data to ensure early, appropriate action - **Standard 3**: Every woman and newborn with condition(s) that cannot be dealt with effectively with the available resources is appropriately referred. - **Standard 4:** Communication with women and their families is effective and responds to their needs and preferences - **Standard 5**: Women and newborns receive care with respect and preservation of their dignity - **Standard 6**: Every woman and her family are provided with emotional support that is sensitive to their needs and strengthens the woman's capability - **Standard 7**: For every woman and newborn, competent, motivated staff are consistently available to provide routine care and manage complications - **Standard 8:** The health facility has an appropriate physical environment, with adequate water, sanitation and energy supplies, medicines, supplies and equipment for routine maternal and newborn care and management of complications. - **Phases of Health Care** - Health promotion - Health maintenance - Health restoration - Health rehabilitation - **Types of family structures include** - 1\. Nuclear family (traditional family) - 2\. Cohabitation family - 3\. Extended or multigenerational family - 4\. Single-parent family - 5\. Blended family - 6\. Communal family - 7\. Gay or lesbian family - 8\. Foster family