Maternal and Child Health Nursing
Care of the Childbearing Family
Adele Pillitteri | 8th Edition
Biophysical Aspects of Human Reproduction
The Male Reproductive System erectile tissue in the penis shaft.
-Consists of both external and internal -The urethra passes through these layers of
divisions. tissue, allowing the penis to serve as both the
-Andrology is the study of the male outlet for the urinary and reproductive tracts in
reproductive organs. men.
Male Internal Structures
EPIDIDYMIS
-Tightly coiled tube (over 20 ft long)
-It is responsible for conducting sperm from the
tubule to the vas deferens.
-Some sperm are stored in the epididymis
VAS DEFERENS (Ductus Deferens)
-Reffered to as the spermatic cord
-Sperm complete maturation as they pass
through the vas deferens. They are still not
Male External Structures
mobile at this point, however, probably because
SCROTUM
of the fairly acidic medium of semen.
-Is a rugated, skin-covered, muscular pouch
suspended from the perineum.
SEMINAL VESICLES
-Function: to support the testes and help
-These glands secrete a viscous alkaline liquid
regulate the temperature of sperm.
with a high sugar, protein and prostaglandin
content.
TESTES
-Sperm become increasingly motile because
-Are two ovoid glands, 2 to 3 cm wide that rest
this added fluid sorrounds them with a more
in the scrotum.
favorable pH environment.
-Each testis is encased by a protective white
fibrous and is composed of number lobules.
PROSTATE GLAND
-Each lobule contains interstitial cells (Leydig
-Is a chesnut-sized gland
cells) that produce testosterone and a
-Purpose: to secrete a thin alkaline fluid
seminiferous tubule that produces spermatozoa.
BULBOURETHRAL GLANDS
PENIS
-Two bulbourethral, or Cowper’s, glands lie
-Is composed of three cylindrical masses of
beside the prostate gland and empty by short
ducts into the urethra. -the openings of the bladder and the uterus
-They supply one more source of alkaline fluid (vagina) both arise from this space.
to help ensure the safe passage of spermatozoa.
B. Clitoris
URETHRA -is a small (approximately 1-2 cm), rounded
-Is a hollow tube leading from the base of the organ of erectile issue at the forward junction of
bladder (8 inches or 18-20 cm long). the labia minora
-Covered by prepuce
The Female Reproductive System -Sensitive to touch and temperature
-Has both external and internal components. -Center for sexual arousal and orgasm
-The study of the female reproductive organs is
gynecology. C. Skene glands
-(paraurethral glands)
- secretions lubricate external genetalia during
coitus
D. Bartholin glands
-vulvovaginal glands
- secretions lubricate external genetalia during
coitus
E. Fourchette
-is the ridge of tissue formed by the posterior
Female External Structures joining of the labia minora and labia majora.
MONS VENERIS -this is the structure that sometimes tears
-is a pod of adipose tissue located over the (laceration) or is cut (episiotomy) during
symphisis pubis, the pubic bone joint. childbirth to enlarge the vaginal opening.
-covered by a triangle of course, curly hairs, the
purpose is to protect the junction of the pubic F. Hymen
bone from trauma. -Tough but elastic semicircle of tissue that
covers the opening of the vagina during
LABIA MINORA childhood
-posterior to the mons veneris spread two -Occasionally, a girl has an imperforate hymen,
hailess folds of connective tissue, the labia or a hymen so complete that it does not allow
minora: pink in color for the passage of menstrual blood from vagina
-the area is abundant with sebaceous glands, so (hematocolpomerra) or for sexual relations until
localized sabaceous cysts may occur here. it is surgical.
LABIA MAJORA Female Internal Structures
-are two folds of tissue
-compose of loose connective tissue covered by
epithelium and pubic hair
-serve as the protection for the external
genitalia
Other External Organs
[Link]
-is the flattened, smooth surface inside the labia
OVARIES
-size and shape of almonds (approximately 3 Three divisions:
cm long, 2 cm in diameter, 1.5 cm thick) Body or Corpus: expands to contain the
-they are grayish white and appear pitted, w/ growing fetus. Fundus is the portion be
minute indentations on the surface. palpated abdominally to determine the amount
Function: of uterine growth, to measure the force of
-to produce, mature or dicharge ova (egg cells) uterine contraction during labor
-To produce estrogen and progesterone and
initiate and regulate menstrual cycle Isthmus:
-are held suspended and in close contact with -enlarges greatly to aid in accomodating the
the ends of the fallopian tubes by three strong growing fetus during pregnancy.
ligaments that attached both to the uterus and -portion where the incision is made when a
pelvic wall. fetus is born by a Cesarean birth
Cervix:
FALLOPIAN TUBES-arise from each upper -lowest portion of the uterus
corner of the uterine body and extend outward Cervical canal: central cavity
and backward until each opens at its distal end, Internal OS: opening of the canal at the
next to an ovary. junction of the cervix and isthmus
Functions: External OS: at the level of ischial spine
-convey the ovum from the ovaries to the uterus -Important in estimating level of the fetus in the
-provide place for fertilization of the ovum by birth canal during childbirth.
sperm
The Uterine wall consists of 3 separate layers
Divided into four separate parts: of tissue
-Interstitial Portion: lies within the uterine wall Endometrium: important for menstrual function
Myometrium: offers extreme strength to the
-Isthmus: sealed in tubal ligation or tubal organ
sterilization procedure Perimetrium: add further strength and support
to the organ
-Ampulla: fertilization of an ovum usually
occurs VAGINA
-act as the organ of intercourse and to convey
-Infundibular Portion: funnel shaped, and sperm to the cervix
covered by fimbria (small hairs) that help to -during childbirth, it expands to serve as the
guide ovum to the fallopian tube. birth canal
UTERUS The Breasts
-is a hollow muscular, pear shaped organ
located in the lower pelvis, posterior to the
bladder and anterior to the rectum
Functions:
-receive the ovum from the fallopian tube;
-provide place for implantation and
nourishment;
-furnish protection to growing fetus and at
maturity of the fetus, expel it from a woman’s
body.
-the Mammary glands, or Breasts, remain in Physiology of menstruation
halted stage of development until a rise in
estrogen at puberty causes them to increase in
size.
Acinar Cells: produce milk
Ampulla: serves as the reservoir for milk before
breastfeeding
Areola: skin surrounding the nipple, darkly
pigmented, about 4 cm
Montgomery tubercle: the area appears rough
on the surface: contains sebaceous glands:
produce sebum, lubricates nipple and areaola
during breastfeeding
HYPOTHALAMUS
Menstruation -Release GnRH (luteinizing hormone- releasing
-is epsodic uterine bleeding in response to hormone[LHRH]): initiates menstrual cycles
cyclic hormonal changes -GnRH then stimulates the pituitary gland to
Purpose: send the gonadotrophic hormone to the ovaries
-to bring an ovum to maturity to produce estrogen
-to renew a uterine tissue bed that will be
necessary for the ovas growth should it be PITUITARY GLAND
fertilized
CHARACTERISTIC DESCRIPTION
Beginning/ First menstrual Average age at onset,
period (Menarche) 12.4 years: average
range, 9-14 years
Interval between cycles 28 days
(23-35 days) -Under the influence of the GnRH, the anterior
Duration of Menstrual Flow 4-6 days (2-9days) lobe of the pituitary gland produces 2
Amount of Menstrual Flow 30-80ml hormones:
Color of Menstrual Flow Dark red,
combination of 1. FSH (Follicle stimulating hormone)
blood, mucus and -Active in early in the cycle that is responsible
endometrial cells for the maturation of ovum.
Odor Similar to Marigolds
2. LH (Luteinizing Hormone)
-Most active at the middle of the cycle
-Responsible for the ovulation
-Release of the mature egg cells from the ovary
-Stimulates the growth of uterine lining during
the second half of menstrual cycle
OVARIES The Fourth Phase of the Menstrual Cycle
Menses
-is actualy the end of of an arbitrarily defined
menstrual cycle.
Menstrual Cycles Disorders
Oocytes: is activated by FSH to grow and PRE-MENSTRUAL SYNDROME (PMS)
mature. -refers to physical and emotional symptoms that
occur in one to two weeks before a woman’s
Graffian follicle: produce a clear fluid perIod.
(follicular fluid) that contains a high degree of COMMON SYMPTOMS INCLUDE:
estrogen and some progesterone. -Acne
-Tenderness of breasts
Ovulation: After an upsurge of LH from -Bloating
pituitary at about day 14, prostaglandins are -Feeling Tired
released and the graffian follicle ruptures; the -Irritabilty
ovum is set free from the surface of the ovary. -Mood Changes
Corpus Luteum: Yellow body AMENORRHEA
-LH continues to rise in amount and directs the - absence of menstruation
follicle cells left behind in the ovary to produce - one or more missed periods
lutein, bright yellow fluid high in progesterone.
DYSMENORRHEA
Corpus albicans: Corpus Luteum regresses -also known as menstrual painful periods or
replace with white fibrous tissue menstrual cramps.
- the pain is usually in the pelvis or lower
UTERUS abdomen that last less than three days.
The First Phase of the Menstrual Cycle
Proliferative OLIGOMENORRHEA
-immediately after a menstrual flow (during -menstruation occuring with intervals of more
first 5 or 4 days of a cycle) the endometrium, or than 35 days
lining of the uterus is very thin. -a condition in which you have infrequent
-the ovary begins to produce estrogen menstrual period
-the endometrium begins to proliferate -occurs in women of childbearing age
The Second Phase of the Menstrual Cycle POLYMENORRHEA
Secretory -menstruation occuring with intervals of lesss
-After Ovulation: endometrium become than 21 days (normal menstrual cycle is
corkscrew or twisted in appearance and dilated between 24 and 38 days long)
with quantities of glycogen and protein.
HYPOMENORRHEA
The Third Phase of the Menstrual Cycle -also known as short or scanty periods
Ischemic -is extremely light menstrual blood flow
-If fertilization does not occur the corpus
luteum in the ovary begins to regress after 8-10 HYPERMENORRHEA
days. -prolonged menstrual flow
-endometrium of the uterus begins to
degenerate; capillaries rupture with minute MENORRHAGIA
hemorrhages and endometrium sloughs off -regular menstrual cycles with excessive flow
(more than 80 ml of volum) or menstruation
lasting more than 7 days.
Sexual Health
- a multidisiplinary phenomenon that includes
feelings, attitudes, and actions.
The Sexual Response Cycle
-Human Sexual Response has four discrete \
stages: excitement, plateau, orgasm and
resolution
EXCITEMENT
-Occurs with physical and psychological
stimulation (sound, sight, emotion or thought)
causes para sympathetic nerve stimulation.
-Leads to arterial dilation and venous
constriction in the genital area
PLATEAU
-is reached just before orgasm
-In the woman, the clitoris is drawn forward
and retracts under the clitoral prepuce, the
lower part of te vagina becomes extremely
congested and there is increased breast nipple
elevation.
-In men, vasocongestion leads to distention of
the penis. Heart rate increases to 100 to 175
beats/min and respiratory rate for about 40
beats/min.
ORGASM
--vigorous contraction of muscles in the pelvic
area expels or dissimilates blood and fluid from
the area of congestion
-usually experienced as intense pleasure
affecting the whole body
-highly personal experience
RESOLUTION
-external and internal organs return to
unaroused state.
