Medical assisting Administrative and clinical procedures (5e) Chapter 32 The reproductive system

After studying this chapter you will be able to: Summarize the organs of the male reproductive system including the locations, structures, and functions of each; describe the causes, signs and symptoms, and treatment of various disorders of the male reproductive system; summarize the organs of the female reproductive system including the locations, structures, and functions of each;...

The Reproductive

System

Learning Outcomes (cont.)

32.1 Summarize the organs of the male reproductive

system including the locations, structures, and functions of each.

32.2 Describe the causes, signs and symptoms, and

treatment of various disorders of the male reproductive system.

32.3 Summarize the organs of the female reproductive

system including the locations, structures, and functions of each.

32.4 Describe the causes, signs and symptoms, and

treatment of various disorders of the female reproductive system.

Learning Outcomes (cont.)

32.5 Explain the process of pregnancy, including

fertilization, the prenatal period, and fetal circulation

32.6 Describe the birth process, including the postnatal

period.

32.7 Compare several birth control methods and their

effectiveness

32.8 Explain the causes of and treatments for infertility.

32.9 Describe the causes, signs and symptoms, and

treatments of the most common sexually transmitted

infections.

• Male and female reproductive systems

– Function together to produce offspring

– Produce important hormones

The Male Reproductive System

• Testes

– Produce sperm and

testosterone

– Divided into lobules

– Held in the scrotum

• Interstitial cells produce testosterone

Male System

Sperm Cell Formation

Spermatogenesis

Spermatogonium (46 chromosomes)

Primary spermatocytes (46 chromosomes)

Mitosis

Secondary spermatocyte

Secondary spermatocyte

Meiosis at puberty

Spermatid Spermatid Spermatid Spermatid

2 nd meiotic division

Sperm Cell Formation (cont.)

• Head

– Nucleus with 23

chromosomes– Covered by an

acrosome

• Midpiece - mitochondria

• Tail

– Flagellum – Propels

the sperm

Internal Accessory Organs – Male

fluid

– Sugar – Prostaglandins

Male System

Internal Accessory Organs – Male (cont.)

– fluid to lubricate end of penis

• Semen

– Sperm cells– Fluids

Male System

External Organs – Male

• Scrotum

– Pouch that holds

the testes away from the body

– Lined with serous

membrane that secrets fluid

• Penis

– Shaft– Glans penis – Prepuce

– Functions

• Deliver sperm

• Urination

Male System

Erection, Orgasm, and Ejaculation

• Erection – erectile tissue becomes

engorged with blood

• Orgasm - emission occurs

• Ejaculation – semen is forced out of the

urethra

Male Reproductive Hormones

• Gonadotropin-releasing hormone (GnRH)

• Follicle-stimulating hormone (FSH)

• Luteinizing hormone (LH)

• Testosterone

– Secondary sex characteristics

– Maturation of male reproductive organs

– Regulated by negative feedback

Apply Your Knowledge

Matching:

_ Vasectomy

_ Mixture of sperm and fluids

_ Sperm cell formation

_ Secrete alkaline fluid/

Reproductive System

Disease/Disorder Description

Benign prostatic

hypertrophy (BPH) Nonmalignant enlargement of the prostate gland

Epididymitis Inflammation of an epididymis;

usually starts as an urinary tract infection

Common Diseases and Disorders of the Male

Reproductive System (cont.)

Disease/Disorder Description

Prostate cancer Most common form of cancer in

men over 40; risk increases with age

Prostatitis Inflammation of the prostate

gland; may be acute or chronic

Testicular cancer Malignant growth in one or both

testicles; more common in males 15–30 years; aggressive malignancy

Apply Your Knowledge

Match:

More common in men over 40 years

old.

Common in older men; symptoms

include difficulties with urination.

More common in males 15-30 years

old; aggressive.

Often starts as urinary tract infection;

symptoms include swelling of the

scrotum and painful ejaculation.

The Female Reproductive System

• Ovaries

– Produce ova, estrogen, and progesterone

– Medulla ~ nerves and lymphatic and blood

vessels– Cortex ~ ovarian follicles

Female System

Ovaries and Ovum Formation

At puberty

Polar body Secondar

y oocyte

Ovum, if fertilized

Released during ovulation

Internal Accessory Organs – Female

• Fallopian tube – oviduct

– Infundibulum and fimbriae

• Fringed, expanded end of fallopian tube near ovary

• Function to “catch” an ovum

– Muscular tube

• Lined with mucous membrane and cilia

• Propels ovum toward uterus

Internal Accessory Organs

Internal Accessory Organs – Female (cont.)

– Rugae – Wall ~ three layers

Internal Accessory Organs

External Accessory Organs - Female

External Genitalia – Female

• Vulva

– Labia majora

• Adipose tissue and skin

• Form the mons pubis

– Labia minora

• Vascular folds of skin

• Form hood over clitoris

• Vestibule

• Bartholin’s glands

• Clitoris

– Contains female erectile tissue – Rich in sensory nerves

• Perineum – between vagina and anus

Female System

Erection, Lubrication, and Orgasm

• Nervous stimulation

– Clitoris becomes erect

– Bartholin’s glands activate

– Vagina elongates

• Orgasm

– Sufficient stimulation of clitoris

– Walls of uterus and fallopian tubes contract to

propel sperm

Female Reproductive Hormones

progesterone  Estrogen and progesterone are

responsible for development of secondary sex characteristics

Reproductive Cycle

• Menstrual cycle

– Regular changes in uterine lining

– Shedding of lining and bleeding

• Menarche – first menstrual period

• Menopause – termination of cycle due to normal aging of ovaries

releases FSH Ovarian follicle Uterine lining thickens

matures and secretes

estrogen

Then releases LH

Triggers ovulation

Lining more vascular and glandular

Without fertilization

 Corpus luteum degenerates

 Estrogen and progesterone levels fall

 Uterine lining breaks down – menses starts

 Cycle begins again with release of FSH

Apply Your Knowledge

True or False:

_ The ovaries only produce estrogen.

_ Ovulation is the process of ovum formation.

_ The fallopian tube is also called the oviduct.

_ The endometrium is the outer layer of the uterine wall.

_ Alveolar glands produce milk.

_Oxytocin induces the alveolar glands to deliver milk through the

nipples.

_ Menarche is the termination of the menstrual cycle.

_ Menopause occurs due to normal aging of the ovaries.

inner layer

Oogenesis produce estrogen and progesterone

YIPPEE!

Female Reproductive System (cont.)

Disease/Disorder Description

Endometriosis Tissues of uterine lining grow

outside of the uterusFibrocystic breast

disease Abnormal cystic tissue in the breast; size varies related to

menstrual cycle

Fibroids Benign tumors in the uterine

wallOvarian cancer More deadly than other types;

detection difficult and often spreads before detection

Common Diseases and Disorders of the

Female Reproductive System

Disease/Disorder Description

Breast cancer Second leading cause of cancer

deaths in womenCervical cancer Generally slow to develop; Pap

smear detects abnormal cervical cells

Cervicitis Inflammation of the cervix

usually due to an infectionDysmenorrhea Condition with severe

menstrual cramps that limit normal activities

Reproductive System (cont.)

vulvovaginitis Inflammation of the vagina or inflammation of vagina and

vulva; both associated with abnormal vaginal discharge

post-Apply Your Knowledge

Matching:

_ Inflammation of the cervix A Dysmenorrhea

_ Cancer common in post-menopausal women B Cervical cancer

_ Develops slowly; detected by Pap smear C Fibroids

_ Uterine tissue grows outside uterus D Breast cancer

_ Second leading cause of cancer death in women E Cervicitis

_ Severe menstrual cramps F Endometriosis

_ Benign tumors in the uterine wall G Uterine cancer

• Condition of having a developing offspring

in the uterus

• Fertilization

– Sperm penetrates cell membrane

– Zona pellucida becomes impenetrable

– Zygote

• Union of ovum and sperm nuclei

• 46 chromosomes

The Prenatal Period

• Zygote – undergoes rapid mitosis

• Morula – ball of cells

• Blastocyst

– Implants in the endometrial wall

– Inner cell mass becomes the embryo

– Others plus cells from uterus form the

placenta

– Inner cell mass

organizes into the

primary germ layer

• Ectoderm

• Mesoderm

• Endoderm

The Prenatal Period (cont.)

• Fetal period – fetus

– Rapid growth

– 5th month

• Skeletal muscles active

• Growth rate slows

– 6th month – gains

weight

– Last 3 months – fetal brain cells rapidly divide

– GI and respiratory systems last to

develop

Fetal Circulation

• Placenta and umbilical blood vessels –

exchange nutrients, oxygen, and waste products

• Unique differences

– Foramen ovale ~ bypass lungs

– Ductus arteriosus ~ between pulmonary trunk and

aorta – Ductus venosus ~ bypasses liver

Hormonal Changes During Pregnancy

• Human chorionic gonadotropin (HCG)

– Secreted by embryonic cells

– Maintains the corpus luteum

• Estrogen and progesterone

– Secreted by corpus luteum and placenta

– Stimulate uterine lining to thicken

– Inhibit release of FSH and LH from anterior pituitary

gland

Hormonal Changes During Pregnancy (cont.)

• Relaxin

– Inhibits uterine

contractions – Relaxes ligaments of

• Parathyroid hormone (PTH) – blood

calcium levels

Apply Your Knowledge

What are the primary germ layers and what tissue

develops from them?

ANSWER: The primary germ layers are the:

 Ectoderm – nervous tissue and some epithelial tissue

 Mesoderm – connective tissue and some epithelial tissue

 Endoderm – epithelial tissue only

The Birth Process

• Begins when progesterone levels fall

• Prostaglandins stimulate uterine contractions

• Uterine contractions stimulate release of

oxytocin

• Oxytocin stimulates strong

uterine contractions

The Birth Process (cont.)

• Dilation

– Effacement

– Lasts 8 – 24 hours

• Expulsion or parturition

– Actual birth stage

– May take 30 minutes or less

• Placental stage

– Blood vessels constrict

– Placenta separates from uterine wall and is expelled

The Postnatal Period

• Six-week period

– Neonatal period –

first four weeks

– Neonate adjusts to

life outside uterus

• Milk production and secretion

– Prolactin – Oxytocin

– Production continues

as long as feeding continues

breast-Apply Your Knowledge

What are the three stages of the birth process and

what occurs during each?

ANSWER: The three stages are:

 Dilation – the cervix thins, softens (effacement), and dilates to approximately 10 cm

 Expulsion – also called parturition; the actual birth stage

 Placental stage – placenta separates from uterine wall and is

expelled

Impressive!

barriers Destroy sperm in the female reproductive tract; primarily spermicides; often used

with mechanical barriers

implants Small rods of progesterone implanted beneath skin; prevent ovulation

Contraception (cont.)

Transdermal

contraceptives Contraceptives in the form of a patch; applied weekly for 3 weeks; not used

the 4th week to allow menstruation

Intrauterine

device (IUD) Small, solid devices placed into uterus by MD; prevents implantation of

blastocyst

Surgical

methods Tubal ligation – fallopian tube is cut and tied

Vasectomy – vas deferens is cut and tied

Apply Your Knowledge

ANSWER: The rhythm method is not as effective as other

birth control, because it is sometimes difficult to tell when

ovulation occurs.

Your patient has just been told that she is pregnant, but

she does not understand why she could get pregnant She

states, “ I have been very careful in using the rhythm

method of birth control.” What patient teaching would you

do to assist her to understand?

• Some female-related factors

– Pelvic inflammatory disease

– No ovulation or menstrual cycle – Endometriosis – Older than 40 years

Infertility (cont.)

• Tests

– Semen analysis

– Monitoring of morning body temperature

– Blood hormone measurements

– Endometrial biopsy

– Urine analysis for LH

– Hysterosalpingogram

– Laparoscopy

Apply Your Knowledge

_ Being over 40 years old

Indicate whether each cause of infertility is male-related

(M), female-related (F), or both (B).

B

F

F F

Sexually Transmitted Disease Infections

Occurring in Both Sexes

AIDS HIV virus causes AIDS

Chlamydia Caused by bacterium Chlamydia

trachomata.; most commonly reported; often no symptoms in female

Genital

warts Condyloma acuminat;not everyone infected has symptomscaused by HPV;

Gonorrhea Bacterial cause: Neisseria gonorrhoea

Sexually Transmitted Diseases (cont.)

Herpes

simplex Viral cause: type II commonly known as genital herpes

Pubic lice Parasitic infestation; commonly

called crabs; Pediculosis pubis

Syphilis Bacterial cause: Treponema

pallidum; decreasing in women but

increasing in homosexual males

Trichomoniasis Protozoan: Trichomonas vaginalis

Apply Your Knowledge

_ Common bacterial STD; can

also grow in mouth

In Summary

32.1 The organs of the male reproductive system

include the testes, responsible for sperm and hormone production; the accessory organs

of vas deferens, seminal vesicles, prostate, and bulbourethral glands; scrotum; and

penis

32.2 The diseases of the male reproductive

system vary widely between simple inflammation and cancers

In Summary (cont.)

32.3 The organs of the female reproductive

system include the ovaries, fallopian tubes,

uterus, and vagina

The external accessory organs include the mons pubis, labia majora and minora,

clitoris, urethral meatus, vaginal orifice,

Bartholin’s glands, perineum, and mammary

glands

32.4 The diseases of the female reproductive

system vary widely between simple inflammation and cancers

In Summary (cont.)

32.5 Fertilization occurs with the union of a sperm

cell and an ovum, usually within the fallopian tubes

The fertilized ovum, now a blastocyst, implants in the endometrial wall of the uterus

The embryonic period occurs from week 2 through week 8 of the pregnancy; the fetal period is from week 9 through delivery

In Summary (cont.)

32.6 The birth process ends pregnancy and

occurs in three stages: Dilation (effacement),

expulsion (parturition), and placental stage

(afterbirth)

32.7 Some of the contraceptive methods include

coitus interruptus; barrier methods; chemical barriers; oral contraceptives; injectable,

implantable, and insertable contraceptives; and

intrauterine devices

In Summary (cont.)

32.8 The causes of infertility are varied, with about

15% of infertility from unknown causes

There are a number of infertility tests and treatments; the treatment plan depends on the reason for the infertility

32.9 There are many sexually transmitted

infections, all passed between sexual partners (both heterosexual and same-sex partners)