Part II: Reproductive System
Outlines
 Revision of anatomy & physiology of reproductive system (male& female).
 Menstrual Cycle.
Learning Objectives
At the end of this chapter, the student should be able to:
1.
Explain two major functions of the reproductive system.
2.
Label an anatomic drawing of the female and male reproductive systems,
including external genitalia and internal anatomy.
3.
Discuss major functions of each reproductive structure, gland, and organ.
4.
Trace the path of sperm through the male reproductive system, from the site
of formation to ejaculation from the body.
5.
Describe the process of semen production.
6.
Compare hormonal regulation of male reproductive function with that of the
female.
7.
Illustrate the inter-relationships of the ovarian and uterine cycles and the
overall menstrual cycle.
8.
١
Describe and compare the male and female sexual response cycles.
University of Mosul / College of Nursing
Maternity & Neonatal nursing
Reproductive Systems
• External and internal parts.
• Main purpose – produce offspring.
• Secondary functions.
– Allow for sexual intimacy and fulfillment.
– Provide a conduit for urinary elimination.
• Most structures paired.
• Male and female systems complementary.
Male Reproductive System
• Testes produce gametes (sperm).
• Contains one half of genetic material needed to produce human baby.
• Urinary tract and reproductive system closely connected.
Male External Genitalia
• Penis
– Composed of a bulbous head, called the glans penisor glans, and a shaft.
– Serves a dual role as the male organ of reproduction and as the external organ
of urinary elimination.
• Scrotum
٢
University of Mosul / College of Nursing
Maternity & Neonatal nursing
– An external sac that houses the testes in two internal compartments.
– Protects the testes from trauma and regulates the temperature within the
testes.
Male Internal Reproductive Organs:
• Testes
– Two oval organs, one within each scrotal sac.
– Produce male sex hormones (androgens) and form mature spermatozoa.
• Ductal system (vas deferens)
– The muscular tube in which sperm begin their journey out of a man’s body.
– Involved in the formation of nutrient plasma.
٣
University of Mosul / College of Nursing
Maternity & Neonatal nursing
• Accessory glands and semen
– Seminal vesicles.
• Paired glands that empty an alkaline, fructose-rich fluid into the ejaculatory
ducts during ejaculation.
– Prostate.
– Cowper’s glands.
– Semen.
٤
University of Mosul / College of Nursing
Maternity & Neonatal nursing
Female Reproductive System:
• Composition
– The external genitalia (vulva) and internal reproductive organs.
• Functions
– Allow for sexual intimacy and fulfillment.
– Produce children through the processes of conception, pregnancy, and
childbirth.
External Genitalia of the Female Reproductive System:
٥
University of Mosul / College of Nursing
Maternity & Neonatal nursing
• Mons pubis
– Located atop symphysis pubis.
• Labia majora
– Paired fatty tissue folds.
– Extends from mons pubis to true perineum.
• Labia minora
– Paired erectile tissue folds.
• Clitoris
– Hooded body composed of erectile tissue.
– Prepuce is the hooded structure over the clitoris.
• Vestibule
– Area between the labia minora.
– Location of urethral meatus.
• Perineum
– Band of fibrous, muscular tissue.
Internal Reproductive Organs
• Vagina (birth canal)
٦
University of Mosul / College of Nursing
Maternity & Neonatal nursing
– A muscular tube that leads from the vulva to the uterus.
– Fornices.
• Uterus (womb)
– A hollow, pear-shaped, muscular structure.
– Functions.
1. Prepare for pregnancy each month.
2. Protect and nourish the growing child.
– Four sections
1. Cervix
• Connects the vagina and uterus.
• Outer os.
2. Uterine isthmus
• Connects the cervix to the main body of the uterus.
• Thinnest portion of the uterus, and does not participate in the muscular
contractions of labor.
• Most likely to rupture during childbirth.
3. Corpus
• Main body of the uterus.
٧
University of Mosul / College of Nursing
Maternity & Neonatal nursing
4. Fundus
• Topmost section of the uterus.
– Walls of the corpus and fundus have three layers.
1. Perimetrium
2. Myometrium
3. Endometrium.
Paired fallopian tubes
– Tiny, muscular corridors 8-14 cm long.
– 3 sections:
1. Isthmus.
2. Ampulla.
3. Infundibulum.
• Ovaries
– Two sex glands homologous to the male testes; located on either side of the
uterus.
– Functions
1. Produce the female hormones estrogen and progesterone.
2. Store ova and help them mature.
٨
University of Mosul / College of Nursing
Maternity & Neonatal nursing
3. Regulate the menstrual cycle in response to anterior pituitary hormones.
Regulation of Reproductive Function;
• Puberty
– The time of life in which an individual becomes capable of sexual
reproduction.
– Occurs between 10 and 14 years of age.
– Development of secondary sex characteristics.
– Menarche.
• Menstrual cycle
– Recurring changes that take place in a woman’s reproductive tract associated
with menstruation and the events that surround menstruation.
• Menstruation
1. The casting away of blood, tissue, and debris from the uterus as the inner
lining sheds.
2. Flow lasts 4 to 6 days.
3. Can contribute to low iron stores and anemia.
– Encompasses the events that transpire in a woman’s reproductive organs
between the beginnings of two menstrual periods.
– Ovarian cycle and the uterine cycle.
٩
University of Mosul / College of Nursing
Maternity & Neonatal nursing
• Ovarian cycle
1. Follicular phase
– Ovarian cycle and the uterine cycle
• Ovarian cycle
1. Follicular phase
2. Controlled by FSH
3. Encompasses days 1-14 of a 28-day cycle
4. Ovulation
• Luteal phase
• Controlled by luteinizing hormone
• Includes days 15-28
– Uterine cycle
•
Refers to the changes that occur in the inner lining of the uterus
•
Four phases
1. Menstrual phase
- Day 1 of the menstrual cycle: onset of menstruation.
- Uterine lining is shed.
- Follicle begins to develop.
١٠
University of Mosul / College of Nursing
Maternity & Neonatal nursing
- Ends when the menstrual period stops on approximately day 5 of the cycle.
2. Proliferative phase
- Uterine lining becomes thicker.
- Ends with ovulation on day 14.
3. Secretory phase
- Corpus luteum begins to produce progesterone
- Prepares for pregnancy
4. Ischemic phase
- Days 27 and 28, estrogen and progesterone levels fall
- Uterine lining becomes ischemic and begins to slough
Cervical mucus changes
• Menstrual phase – cervix does not produce mucus
• Proliferative phase – a tacky, crumbly type of mucus that is yellow or white
• Ovulation - distensible, stretchable quality called spinnbarkheit
• After ovulation – mucus becomes scanty, thick, and opaque
١١
University of Mosul / College of Nursing
Maternity & Neonatal nursing
Menopause
– Reproductive capability ends.
– Ovaries cease to function.
١٢
University of Mosul / College of Nursing
Maternity & Neonatal nursing
– Hormone levels fall.
– Climacteric.
– Usually between 47 and 55 years of age.
Sexual Response Cycle:
• Two physiological responses.
– Vasocongestion.
• Occurs in the pelvic organs during sexual excitement.
• Leads to erection of the penis and clitoris, vaginal lubrication, and
engorgement of the labia and testicles.
– Myotonia
• Present throughout the body.
• Produces muscular contractions during orgasm.
• Four phases
– Excitement phase.
– Plateau phase.
– Orgasm phase.
– Resolution phase.
Excitement Phase of the Sexual Response:
١٣
University of Mosul / College of Nursing
Maternity & Neonatal nursing
• Female
– Clitoris becomes engorged and enlarged.
– Labia majora separate; labia minora increase in size.
– Uterus increases in size and begins to elevate.
• Male
– Penis becomes erect.
– Scrotal sac thickens.
– Testicular elevation occurs.
Plateau Phase of the Sexual Response:
• Female
– The outer third of the vagina becomes engorged, the clitoris retracts behind its
hood, and the labia minora deepen in color.
– The uterus is fully elevated in the pelvic cavity.
• Male
– The head of the penis in the male becomes further engorged, and the testes
remain engorged and elevated.
Orgasm Phase of the Sexual Response:
• Female
١٤
University of Mosul / College of Nursing
Maternity & Neonatal nursing
– The clitoris remains retracted behind the hood, and the outer third of the
vagina, rectal sphincter, and uterus undergo rhythmic contractions.
• Male
– Experiences contractions of the urethra, base of the penis, and rectal muscles,
as well as emission and expulsion of semen.
Resolution Phase of the Sexual Response:
• Female
– The clitoris descends, and the labia and internal organs return to their
prearoused positions and colors.
– Male
– Erection is lost.
– Testes descend.
– Scrotum thins.
١٥
University of Mosul / College of Nursing
Maternity & Neonatal nursing