FEMALE FEMALE REPRODUCTIVE REPRODUCTIVE

SYSTEMSYSTEM

HST IHST I

Spring 2009Spring 2009

EXTERNAL GROSS EXTERNAL GROSS ANATOMYANATOMY

VestibuleVestibule – located inside the labia – located inside the labia minora; holds the urethra and the minora; holds the urethra and the vaginavagina

Labia MajoraLabia Majora – large folds of fatty tissue – large folds of fatty tissue covered with hair on their outer surfacecovered with hair on their outer surface

Labia MinoraLabia Minora – hairless folds that are – hairless folds that are located within the labia majoralocated within the labia majora

Mons PubisMons Pubis – triangular fat pad covering – triangular fat pad covering symphysis pubissymphysis pubis

VaginaVagina – muscular tube that connects – muscular tube that connects the cervix of the uterus to the outside of the cervix of the uterus to the outside of the bodythe body

External Gross External Gross Anatomy ContinuedAnatomy Continued UrethraUrethra – passage of urine – passage of urine ClitorisClitoris – sexual stimulation – sexual stimulation Bartholins glandsBartholins glands – lubrication – lubrication HymenHymen – thin skin across the – thin skin across the

vaginavagina AnusAnus – Defecation – Defecation PerineumPerineum – skin between – skin between

vagina and anusvagina and anus

INTERNAL GROSS INTERNAL GROSS ANATOMYANATOMY OvariesOvaries

1) produces eggs (ovum) 1) produces eggs (ovum)

2) almond shaped2) almond shaped

3) contain thousands of 3) contain thousands of folliclesfollicles

4) produce estrogen4) produce estrogen

Internal Gross Internal Gross Anatomy ContinuedAnatomy Continued UterusUterus: hollow, muscular, : hollow, muscular,

pear-shapedpear-shaped

1) Perimetrium – outer layer1) Perimetrium – outer layer

2) Myometrium – muscle layer2) Myometrium – muscle layer

3) Endometrium – inner lining3) Endometrium – inner lining

Uterus has 3 sections:Uterus has 3 sections:

FundusFundus – top – top sectionsection

CorpusCorpus – – middle sectionmiddle section

CervixCervix – – narrow, narrow, bottom bottom sectionsection

BREASTSBREASTS

NippleNipple - where milk is expelled - where milk is expelled during lactationduring lactation

AreolaAreola –colored circular area –colored circular area around the nipplearound the nipple

Mammary glandsMammary glands – produce milk – produce milk ColostrumColostrum – like skim milk – no fat – like skim milk – no fat

content. Present before milk content. Present before milk comes incomes in

Breast-self examBreast-self exam – monthly at the – monthly at the end of menstruationend of menstruation

LactationLactation

Main function Main function of the of the mammary mammary glandsglands

Starts after Starts after childbirthchildbirth

Recommended Recommended for the first 6 for the first 6 months of lifemonths of life

Lactation ContinuedLactation Continued

Benefits for infantsBenefits for infants:: Greater immune healthGreater immune health Superior nutritionSuperior nutrition Fewer diarrheal, urinary tract, Fewer diarrheal, urinary tract,

and middle ear infectionsand middle ear infections Higher intelligence levelHigher intelligence level Less tendency to develop Less tendency to develop

allergiesallergies

Lactation ContinuedLactation Continued

Benefits for mothersBenefits for mothers:: Weight lossWeight loss BondingBonding Hormone release – oxytocin Hormone release – oxytocin

(stimulates uterine (stimulates uterine contractions) and prolactin contractions) and prolactin (helps mother to relax)(helps mother to relax)

PUBERTYPUBERTY

Hypothalmus secretes gonatropic Hypothalmus secretes gonatropic releasing hormone (GnRH) that releasing hormone (GnRH) that stimulates the pituitary gland – stimulates the pituitary gland – begins the hormone production in begins the hormone production in ovary – estrogen ovary – estrogen

Produces secondary sex Produces secondary sex characteristicscharacteristics

Pituitary gland releases Follicle Pituitary gland releases Follicle Stimulating Hormone (FSH) Starts the Stimulating Hormone (FSH) Starts the production of eggs in the female production of eggs in the female

OVULATIONOVULATION

Occurs when a Occurs when a mature ovum is mature ovum is released from a released from a follicle and follicle and travels from the travels from the ovaries through ovaries through the fallopian the fallopian tubes to the tubes to the uterus.uterus.

FERTILIZATIONFERTILIZATION

The union The union of the ovum of the ovum and the and the sperm cell sperm cell to create to create new lifenew life

Usually Usually takes place takes place within the within the fallopian fallopian tubestubes

Steps of FertilizationSteps of Fertilization

MENSTRUATIONMENSTRUATION

28-30 day cycle28-30 day cycle Occurs if fertilization does not Occurs if fertilization does not

take placetake place Involves the shedding of the Involves the shedding of the

endometrium through endometrium through menstrual blood flowmenstrual blood flow

Typically last about 3-7 daysTypically last about 3-7 days

Diseases and Diseases and Abnormal ConditionsAbnormal Conditions

Premenstrual syndromePremenstrual syndrome Cervical and uterine cancerCervical and uterine cancer EndometriosisEndometriosis Ovarian cancerOvarian cancer Pelvic inflammatory diseasePelvic inflammatory disease Breast tumorsBreast tumors

Premenstrual Premenstrual Syndrome (PMS)Syndrome (PMS) Group of symptoms that appear Group of symptoms that appear

3-14 days before menstruation3-14 days before menstruation Etiology is unknownEtiology is unknown Symptoms vary, may include Symptoms vary, may include

nervousness, irritability, nervousness, irritability, depression, headache, edema, depression, headache, edema, back ache, constipation, back ache, constipation, abdominal bloating, and breast abdominal bloating, and breast enlargement and tendernessenlargement and tenderness

Cervical and Uterine Cervical and Uterine cancercancerCervical cancer:Cervical cancer: Can be detected early with pap Can be detected early with pap

smearsmear Symptoms include abnormal Symptoms include abnormal

discharge and vaginal bleedingdischarge and vaginal bleedingUterine cancer:Uterine cancer: Symptoms include enlarged Symptoms include enlarged

uterus, watery discharge, and uterus, watery discharge, and abnormal bleedingabnormal bleeding

TreatmentTreatment

Hysterectomy – removal of Hysterectomy – removal of uterus and cervixuterus and cervix

Panhysterectomy – surgical Panhysterectomy – surgical removal of the uterus, removal of the uterus, ovaries, and fallopian tubesovaries, and fallopian tubes

ChemotherapyChemotherapy RadiationRadiation

EndometreosisEndometreosis

Abnormal growth of endometrial Abnormal growth of endometrial tissue outside the uterustissue outside the uterus

Usually becomes embedded in the Usually becomes embedded in the ovaries or fallopian tubesovaries or fallopian tubes

Can lead to sterility if scar tissue Can lead to sterility if scar tissue formsforms

Symptoms include pelvic pain, Symptoms include pelvic pain, abnormal bleeding, and abnormal bleeding, and dysmenorrhea (painful menstruation)dysmenorrhea (painful menstruation)

TreatmentTreatment

Vary with age and degree of Vary with age and degree of abnormal tissue growthabnormal tissue growth

Hormonal therapyHormonal therapy Pain medicationsPain medications Surgical removal of affected Surgical removal of affected

organsorgans

Ovarian CancerOvarian Cancer

Between age 40-65Between age 40-65 Initial symptoms are vague, Initial symptoms are vague,

and include abdominal and include abdominal discomfort and mild GI discomfort and mild GI disturbances such as disturbances such as constipation and/or diarrheaconstipation and/or diarrhea

With progression, pain, With progression, pain, abdominal distention, and abdominal distention, and urinary frequency occururinary frequency occur

TreatmentTreatment

Surgical removal of ALL of the Surgical removal of ALL of the reproductive organs, and reproductive organs, and affected lymph nodesaffected lymph nodes

ChemotherapyChemotherapy RadiationRadiation

Pelvic Inflammatory Pelvic Inflammatory Disease (PID)Disease (PID) Inflammation of the cervix Inflammation of the cervix

(cervicitis), the endometrium (cervicitis), the endometrium (endometritis), fallopian tubes (endometritis), fallopian tubes (salpingitis), and sometimes (salpingitis), and sometimes the ovaries (oophoritis)the ovaries (oophoritis)

Usually caused by pathogenic Usually caused by pathogenic organism such as bacteria, organism such as bacteria, viruses, or fungi.viruses, or fungi.

SymptomsSymptoms

Pain in the Pain in the lower lower abdomenabdomen

FeverFever Purulent Purulent

(pus) vaginal (pus) vaginal dischargedischarge

Breast TumorsBreast Tumors

Can be benign or malignantCan be benign or malignant Symptoms include a lump or Symptoms include a lump or

mass in breast tissuemass in breast tissue Change in breast size or Change in breast size or

shape (flattening or bulging shape (flattening or bulging of tissue)of tissue)

Discharge from the nippleDischarge from the nipple

TreatmentTreatment

Lumpectomy – removal of Lumpectomy – removal of tumor tumor

Simple mastectomy – surgical Simple mastectomy – surgical removal of the breastremoval of the breast

Radical mastectomy – surgical Radical mastectomy – surgical removal of the breast, removal of the breast, underlying muscles, and underlying muscles, and axillary lymph nodesaxillary lymph nodes

Breast – Self Breast – Self Examination (BSE)Examination (BSE)

InspectionInspection: :

The breast The breast should be should be examined in examined in front of a front of a mirror to mirror to observe for observe for changes in changes in appearanceappearance

BSE ContinuedBSE Continued

Inspection Inspection ContinuedContinued: : Raise your Raise your hands over hands over your head and your head and observe for the observe for the same changes.same changes.

BSE ContinuedBSE Continued

PalpationPalpation::While laying down, While laying down,

using circular using circular motions, palpate motions, palpate the breast from the breast from top to bottom, top to bottom, side to side, side to side, from the from the collarbone to the collarbone to the top of the top of the abdomen, then abdomen, then from the armpit from the armpit to cleavageto cleavage

BSE ContinuedBSE Continued

PalpationPalpation::

Assess breast Assess breast while standing while standing or sitting; this or sitting; this is typically is typically accomplished accomplished during a during a showershower

Mammogram & Mammogram & UltrasoundsUltrasounds Can detect tumors or masses Can detect tumors or masses

up to two years before the up to two years before the tumor mass can be felt.tumor mass can be felt.

Women age 40-49 should Women age 40-49 should have a mammogram every 2 have a mammogram every 2 years and those after 50 years and those after 50 should have one yearlyshould have one yearly

Sexually Transmitted Sexually Transmitted DiseasesDiseases

Acquired Immune Deficiency Acquired Immune Deficiency SyndromeSyndrome

ChlamydiaChlamydia GonorrheaGonorrhea

Acquired Immune Acquired Immune Deficiency Syndrome Deficiency Syndrome (AIDS)(AIDS) Caused by human Caused by human

immunodeficiency virus (HIV)immunodeficiency virus (HIV) Virus attacks the immune Virus attacks the immune

system weakening it until the system weakening it until the body is unable to fight off body is unable to fight off infections and diseasesinfections and diseases

Spread through blood or body Spread through blood or body fluids of an infected personfluids of an infected person

AIDS ContinuedAIDS Continued

When the HIV virus causes a When the HIV virus causes a CD4 or T-cells (special WBC’s) CD4 or T-cells (special WBC’s) to fall below 200 cells per to fall below 200 cells per cubic millimeter, and/or cubic millimeter, and/or opportunistic diseases opportunistic diseases appear, AIDS is diagnosed.appear, AIDS is diagnosed.

Most Common Most Common Opportunistic DiseasesOpportunistic Diseases Pneumocystis carinii – type of Pneumocystis carinii – type of

pneumoniapneumonia Candidiasis – yeast infectionCandidiasis – yeast infection Kaposi’s sarcoma – form of Kaposi’s sarcoma – form of

skin cancerskin cancer

TreatmentTreatment

Currently there is no cure for HIV Currently there is no cure for HIV or AIDSor AIDS

Therapy with a combination of Therapy with a combination of drugs, commonly called a drug drugs, commonly called a drug cocktail, is used to slow the cocktail, is used to slow the progression of the disease.progression of the disease.

Prevention is the best method of Prevention is the best method of treatment when dealing with treatment when dealing with HIV/AIDSHIV/AIDS

ChlamydiaChlamydia

One of the most frequent STD’sOne of the most frequent STD’s Caused by strains of the Caused by strains of the

chlamydial organism (specialized chlamydial organism (specialized bacterium that lives as an bacterium that lives as an intracellular parasiteintracellular parasite

Females are frequently Females are frequently asymptomatic, although some asymptomatic, although some may have vaginal discharge.may have vaginal discharge.

Frequently causes PID and Frequently causes PID and sterility if not treatedsterility if not treated

GonorrheaGonorrhea

Caused by gonococcus Caused by gonococcus bacterium neisseria bacterium neisseria gonorrhoeaegonorrhoeae

Females are frequently Females are frequently asymptomatic but may asymptomatic but may experience dysuria, pain in the experience dysuria, pain in the lower abdomen, and yellow-lower abdomen, and yellow-greenish vaginal dischargegreenish vaginal discharge

TreatmentTreatment

Both Chlamydia and Gonorrhea Both Chlamydia and Gonorrhea are treated with large doses are treated with large doses of antibiotics including of antibiotics including tetracycline, erythromycin, tetracycline, erythromycin, doxycycline, and azithromycindoxycycline, and azithromycin

QuestionsQuestions