MCN REPRODUCTIVE SYSTEM 2nd year pptx.pdf

Maternal and Chilhealth nursing ppt for reproductive system.

1. REPRODUCTIVE
SYSTEM
Geraldine Sabate Ridad, RN, MAN

2. Individual Activity #3
•Draw/ Illustrate the Female and Male
Reproductive System labeled with its
corresponding parts and functions.
•Rubric
–able to draw at least 10 parts with correct
label, anatomy (3 points) and physiology (3
points). Right minus wrong. The rest bonus
points

6. Copyright © 2018 Wolters Kluwer · All Rights Reserved
INTRAUTERINE DEVELOPMENT
(5
th
week of IUL)

mesonephric (wolffian) paramesonephric (müllerian) ducts


(7-8
th
week of IUL) (10
th
week of IUL)
male reproductive organs female reproductive organs


(12
th
week of IUL) (12
th
week of IUL)
penile tissue elongates ,uterus, labia minora,
Urethra formed and labia majora formed

7. ❖GYNECOLOGY


❖ANDROLOGY

8. FUNCTIONS (MALE)
❖Production of Sperm Cells
❖Sustaining and transfer of the sperm
cells to the female
❖Production of male sex hormones

9. FUNCTIONS (FEMALE)
❖Production of female sex cells
❖Reception of sperm cells from the male
❖Nurturing the development of and
providing nourishment for the new
individual
❖Production of female sex hormones

10. Formation
of
Sex Cells

11. ❖ SEX CELLS-

❖MEIOSIS

13. MALE REPRODUCTIVE
SYSTEM

14. ❖Pathway of spermatozoa
•Epididymis
•Ductus deferens (Vas deferens)
•Ejaculatory duct
❖Accessory organs
•Seminal vesicles
•Prostate gland
•Bulbourethral glands
•Scrotal sac encloses testes
•Penis

15. MALE EXTERNAL STRUCTURES
• testes (which are encased in the scrotal sac)
•penis.

17. PENIS
❖male organ of COPULATION and functions in the
TRANSFER OF SPERM CELLS
❖Composed of 3 cylindrical masses of erectile tissue
1________________________________- filled with
blood during erection
2. _______________________________- prevent the
urethra from pinching closed, thereby maintaining the
urethra as a viable channel for ejaculation

*** contraction of _____________________________
at the penis base occurs (w/ sexual excitement), this traps
the blood

20. PENIS
❖________________________- sensitive ridge of
tissue

❖________________________- aka FORRESKIN-
retractable casing of skin; protects the nerve-sensitive
organs at birth

❖________________________- surgical removal of
prepuce, usually at the time of birth; for hygiene and
maintain normal circulation

24. PENIS
❖ ________________________- branch of pudendal
artery; provides the blood supply for penis

❖PENILE ERECTION- stimulated by
parasympathetic nerve stimulation
❖ _________________________ causes vasodilation

25. SCROTUM
❖Rugated skin-covered muscular pouch suspended
from the perineum
-contains the testes epididymis, and lower portion of
spermatic cord
❖to support the testes and help regulate the
temperature of sperm.
❖________________________________________
>>warm:
>>cold:

28. TESTES
❖Male GONADS, oval organs w/in the scrotum
❖Encased by a protective white fiber capsule
❖One testis is slightly larger than the other, suspended slightly
lower in the scrotum
❖Composed of lobules containing:
1.LEYDIG’S CELLS

2.SEMINIFEROUS TUBULE

31. TESTES
❖CRYPTORCHIDISM-
-may not produce viable sperm and have a four to seven
times increased rate of testicular cancer 

❖INGUINAL HERNIA

33. SPERMATOGENESIS

34. HYPOTHALAMUS releases
GnRH/F(gonadotropin releasing hormone/ factor)

influences the APG to release FSH and LH
***FSH- stimulates release of
ABP(androgen-binding protein)
***LH- stimulates release of TESTOSTERONE

ABP binds with TESTOSTERONE

SPERMATOGENESIS
❖ formation of sperm cells
❖ happens everyday

37. MALE INTERNAL STRUCTURES
•epididymis,
•vas deferens,
•seminal vesicles,
•ejaculatory ducts,
•prostate gland,
•urethra,
•bulbourethral glands

39. EPIDIDYMIS
❖Seminiferous tubule of each testis leads to a tightly coiled
tube (epididymis)
❖Approx. 12 ft.
❖Conducts SPERM from TESTIS to VAS DEFERENS
❖Where some sperm are STORED
❖Semen is produced by the cells lining the epididymis
❖EPIDIDYMITIS

40. ❖ sperm are immobile and incapable of
FERTILIZATION as they pass/ stored at the
epididymis level
❖___________ to travel the length of the epididymis
❖___________to reach MATURITY
❖ASPERMIA- absence of sperm
❖OLIGOSPERMIA- fewer than 20M sperm/ml

41. VAS DEFERENS
❖ aka DUCTUS DEFERENS
❖ carries SPERM fro epididymis to INGUINAL CANAL
into abdominal cavity and ends into the SEMINAL
VESICLES and EJACULATORY DUCTS
❖ sperm MATURES as they pass through the vas deferens
❖Not mobile due to the fairly ACIDIC medium of the
semen at this level
❖SPERMATIC CORD-
❖VARICOCELE

❖VASECTOMY

45. SEMINAL VESICLES
❖ 2 convoluted pouches
❖ empty into the urethra by way of EJACULATORY
DUCTS.
❖ secrete a VISCOUS portion of semen (high content of
basic sugar and protein; alkaline in PH)
>>

❖MOBILE SPERMS due to alkaline fluid
❖ sperms are MATURE and FERTILE
❖EJACULATORY DUCTS- join the SEMINAL VESICLE
with the URETHRA

46. PROSTATE GLAND
❖ secretes a thin ALKALINE FLUID which further
protects sperm from being immobilized by the naturally low
pH level of the urethra
❖ many develop HYPERTROPHY of the PROSTATE
>>Interferes w/ both fertility and urination
>> can be relieved by medical therapy/ surgery
❖URETHRA- continues to the outside through the shaft
and glans penis.

47. BULBOURETHRAL GLAND
❖ aka ____________________
❖ secrete an alkaline fluid that helps counteract the acid
secretion of the urethra
❖ ensures SAFE PASSAGE OF SPERMATOZOA

48. ❖ SPERMATOZOA- produced in the testes and reach
maturity in the external structures, surrounded by
SEMEN
❖Typical ejaculate = 2-5 ml fluid
>>Contains between 20 – 100 million spermatozoa per ml
❖SEMEN-

49. FEMALE REPRODUCTIVE
SYSTEM

50. FEMALE EXTERNAL STRUCTURES
•Vulva (from the Latin word for “covering”)

51. VULVA
❖ structures that form the female external genitalia
❖_________________________________-
>> pad of adipose tissue located over the symphysis pubis
covered by coarse, curly hairs.
❖______________________-2 pink HAIRLESS folds of
connective tissue just posterior to the mons pubis.
>>abundant with SEBACEOUS GLANDS
❖_________________-2 folds of adipose tissue covered by
PUBIC HAIR to serve as protection for the external
genitalia, distal urethra and vagina
>> trauma to the area can lead to EXTENSIVE EDEMA
FORMATION

53. ❖Other External Organs
❖____________- where opening of the bladder
(urethra) and the vagina both arise
❖____________- small rounded organ of ERECTILE
TISSSUE that is sensitive to touch and temperature
>>center of sexual arousal and orgasm in female
❖______________________- below clitoris, opening
into urethra

55. ❖____________________________________-
>> secretions help lubricate the external genetalia during
COITUS

❖____________________________________-
>> lubricate the external vulva during COITUS
>> alkaline pH of secretion helps to improve sperm in
the vagina

56. ❖____________________________________-
>> ridge of tissue; sometimes cut
(_________________) before birth to a child to enlarge
vaginal opening
❖____________________________________-
>> easily stretched for child birth to allow for
enlargement of vagina and passage of fetal head
❖_________________________________-
>> often torn during the 1
st
sexual intercourse; tough
but elastic semicircle of tissue
>>imperforate hymen?????? hematocolpometra

57. VULVAR BLOOD SUPPLY
❖ blood supply of the external genitalia is mainly from
the PUDENDAL ARTERY and a portion of the
inferior rectus artery
❖ Pudendal vein?????? extensive back pressure
??????development of varicosities in the labia majora and in
the legs.

58. THE VULVAR NERVE SUPPLY
❖ anterior portion- ilioinguinal and genitofemoral
nerves (L1 level).
❖posterior portion- pudendal nerve (S3 level).
❖extremely sensitive to touch, pressure, pain, and
temperature.

60. INTERNAL STRUCTURES

61. OVARIES
❖ grayish white with size and shape of almonds situated on
both sides of the uterus produces ESTROGEN and
PROGESTERONE
>> maturation and maintenance of SECONDARY SEX
CHARACTERISTICS
>>prevents OSTEOPOROSIS
>>keeps CHOLESTEROL LEVELS reduced

62. FALLOPIAN TUBES OR OVIDUCTS
❖ FUNCTIONS:
1.Convey ovum from ovaries to the uterus
2.Provide a place for fertilization of the ovum by sperm
❖PARTS:
❖1______________- most proximal division
❖2______________-cut or sealed in TUBAL
LIGATION
❖3_______________- longest; where FERTILIZATION
occurs
❖4_______________- most distal segment; its rim is
covered with fimbria that guides the ovum to the tube

64. UTERUS
❖ FUNCTIONS:
1.Receive fertilized ovum from fallopian tube
2.Provide place for implantation and nourishment during
fetal growth
3.Furnish protection to a growing fetus
4.At maturity of the fetus, expel it from a woman’s body

65. ❖PARTS:
1.________________________-
>> uppermost part; expands to contain growing fetus
2. _________________________-
>> most commonly cut during cesarean birth
3.__________________________-
>> lowest portion

67. ❖LAYERS:
1.________________________-
>> inner layer; shed as the menstrual flow
2. _________________________-
>> constricts the tubal junctions and prevents
regurgitation of menstrual flow
3.__________________________-
>> outer layer; add strength and support to the uterus

69. ❖Uterine Blood Supply
>> abdominal aorta??????two iliac arteries??????hypogastric
arteries and the uterine arteries
>>guarantee copious and adequate blood supply to
the growing fetus
>>the ovarian artery (a direct subdivision of the
aorta) joins the uterine artery and adds more blood to
the uterus.
>>The uterine veins (same twisting course as the
arteries)?????? empty into the internal iliac veins.

71. Copyright © 2018 Wolters Kluwer · All Rights Reserved
❖A pt decides to have a tubal ligation
(clamping of the fallopian tubes) after
the birth of her baby. The nurse notices
the first time she voids following
surgery that her urine looks blood
tinged. Would the nurse assume the
urine was contaminated by vaginal
secretions so its appearance is
innocent? Or would the nurse report this
as a potentially serious finding (her
surgery was on her reproductive, not
her urinary, system)?

72. ❖Uterine Nerve Supply
>> efferent nerves: T5 to T10 level (motor)
>>afferent nerves: T11 and T12  (sensory)

73. ❖Uterine Supports
>>  the uterus is suspended by ligaments??????free to
enlarge without discomfort during pregnancy
>>posterior ligament??????A fold of peritoneum behind
the uterus 
??????Douglas cul-de-sac:  a pouch between the rectum and
uterus
-the lowest point of the pelvis
-culdoscopy: culdoscope through the posterior
vaginal wall 
-laparoscopy: laparoscope through the abdominal
wall

75. ❖Uterine Supports
>>  broad ligaments: two folds of peritoneum that
cover the uterus in the front and back and extend to
the pelvic sides to help steady the uterus
>> round ligaments:  two fibrous, muscular cords
that pass from the body of the uterus through the
broad ligaments and down into the inguinal canal,
inserting into the fascia of the vulva.

76. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Anatomy and Physiology of the
Reproductive System: The Female #5
❖Uterine deviations
oBicornuate uterus
oAnteversion
oRetroversion
oAnteflexion
oRetroflexion

77. Copyright © 2018 Wolters Kluwer · All Rights Reserved

78. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Anatomy and Physiology of the
Reproductive System: The Female #6

79. VAGINA
❖ FUNCTIONS:
1.Act as organ of intercourse
2.Convey sperm to cervix
3.Serve as the birth canal
4.>>pH is ACIDIC due to GLYCOGEN
BREAKDOWN by DODERLEIN BACILLUS

80. VAGINA
❖When a woman lies on her back, as she does for a pelvic
examination, the course of the vagina is inward and
downward. 
❖posterior fornix: place for the pooling of semen after
coitus
❖bulbocavernosus muscle: circular muscle at the external
opening of the vagina; voluntary sphincter
❖vaginal artery, a branch of the internal iliac artery
❖nerve innervations originating at the S1–S3 levels. 

82. THE BREASTS
❖form early in intrauterine life.
❖Gynecomastia
❖in many women, breast tissue extends well into the axilla. 
❖supernumerary breast tissue or nipples are not uncommon and are
innocent findings.
❖acinar cells: produce milk 
❖Nipple: has approximately 20 small openings through which milk is
secreted.
-let-down reflex
-areola: darkly pigmented skin surrounding the nipples
- Montgomery tubercles: sebaceous glands
❖Ampulla: a reservoir for milk before breastfeeding
❖BLOOD SUPPLY: large thoracic branches of the axillary, internal
mammary, and intercostal arteries

84. MENSTRUAL CYCLE

85. episodic uterine bleeding in response to CYCLIC
HORMONAL CHANGES
Purpose: to bring an OVUM TO MATURITY and
renew a uterine tissue bed if fertilization occurs
_______________- first menstrual period (as early as
8/9 and as late as 17); dependent on critical amount
of fat that triggers HYPOTHALAMUS
(gonadostat)
- Or critical weight approx. 95 lb (43 kg)
Ave length:
OVULATION occurs:
PHASES:

88. ↓ESTROGEN

HYPOTHALAMUS releases GnRH/F

influences the APG to release FSH and LH

FSH- maturation of ovum (ovary)
LH- for ovulation
↑estrogen
↑progesterone

90. MENSTRUAL PHASE (day 1-5)
- LOW estrogen and progesterone
Menses, or a menstrual flow: mixture of blood
from the ruptured capillaries; mucin; fragments of
endometrial tissue; and the microscopic,
atrophied, and unfertilized ovum.
The iron loss in a typical menstrual flow is
approximately 11 mg.

▪DYSMENORRHEA

91. PROLIFERATIVE(day 6-14)

↓estrogen??????HYPOTHALAMUS??????GnRH??????APG??????FSH??????ov
aries (MATURATION of primordial follicle(filled
w/ fluid rich in ESTROGEN) to GRAAFIAN
FOLLICLE)?????? ↑estrogen?????? supress FSH??????
APG??????LH??????OVULATION (14 days before next
menstruation)

??????MITTELSCHMERZ

92. SECRETORY(day 15-21)

↑estrogen?????? LH??????CORPUS LUTEUM, yellow
(PROTEIN-rich fluid, LUTEIN)?????? ↑progesterone??????
suppress LH

??????UTERUS?????? twisted; dilated with glycogen and mucin;
velvety in color
>> to support a growing body

95. ISCHEMIC(day 22-28)
NO PREGNANCY!! --corpus luteum degenerates??????
↓progesterone and estrogen?????? MENSTRUATION

WITH PREGNANCY!!– corpus luteum maintain
function?????? ↑estrogen and progesterone??????NO
MENSTRUATION
______________- causes proliferation/ thickening of
endometrium-preparation for implantation
______________- increase endometrial vascularity

97. Characteristic Description
Beginning (menarche)
Average age at onset, 12.4 years; average range, 9–17
years
Interval between cyclesAverage, 28 days; cycles of 23–35 days not unusual
Duration of menstrual
flow
Average flow, 4–6 days; ranges of 2–9 days not abnormal
Amount of menstrual flow
Difficult to estimate; average 30–80 ml per menstrual
period; saturating a pad or tampon in less than 1 hr is
heavy bleeding
Color of menstrual flow
Dark red; a combination of blood, mucus, and
endometrial cells
Odor Similar to marigolds
CHARACTERISTICS OF NORMAL MENSTRUAL CYCLES

98. MATURATION of OOCYTES
??????in utero: 5-7 M
?????? 5 mos: formation stops
?????? birth: 2 M remain (some atrophy)
??????7 yrs: 500, 000
?????? 22 yrs: 300, 000
??????MENOPAUSE: 0

99. Anovulatory Cycles
??????immaturity of feedback mechanism
Amenorrhea
??????absence of menstruation
Oligomenorrhea
??????infrequent menstrual periods (more than 35
days without menstruating)

100. Menorrhagia
??????abnormally heavy or prolonged bleeding
Metrorrhagia
??????uterine bleeding at irregular intervals,
particularly between the expected menstrual periods
??????menstrual spotting between periods occurs as a
normal and harmless part of ovulation
Polymenorrhea
??????cycles with intervals of 21 days or fewer
??????Irregular menstruation of more than
approximately eight days

102. 9-12 yo?????? female
12-14 yo?????? male

ANDROGENIC hormones
✔Testosterone?????? muscle devt, physical growth, Inc sebaceous
gland secretion
✔Estrogen?????? breast devt, widening of pelvic diameter,
deposition of fat on expected areas
Prevent withdrawal of calcium from bones
Regulates cholesterol
Cholesterol component: Estrone, Estradiol, and Estriol
Inc HDL, dec LDL
✔Progesterone (pregnancy)
ORAL pills?????? anti-androgenic hormones?????? min testosterone

103. TANNER STAGING
MALESFEMALES
>weight increase>growth spurt
>testes growth>inc pelvic diameter
>hairs (face, axilla, pubic)>breast devt (thelarche)
> voice changes>pubic hair
> penile growth >Menarche
> Height inc >Axillary hair
> spermatogenesis>Vagina secretions
> Adrenarche

104. The Nursing Role in
Reproductive and Sexual
Health

105. HUMAN SEXUALITY
▪ Sex- refers to all the physical attributes that
distinguish women and men
-They include the reproductive systems and
the body attributes of each sex.
▪ Gender- refers to the cultural attributes
derived from sex differences.
-clothing styles
-personality differences
-tasks assigned

106. Where It All Begins:
Sex Characteristics
▪ Primary sex characteristics- are the
reproductive organs.
▪Secondary sex characteristics- are the
body attributes of each sex.
-Those physical characteristics that define the two
sexes but not directly related to reproduction.
▪Sexual dimorphism- refers to the extent to
which the secondary characteristics are evident
between women and men.

109. On Human Sex and Sexuality
▪No matter the culture, two persons must always
get together to reproduce offspring.
▪There are restrictions everywhere on mating.
▪Some sanctions may be preventive
(clitoridectomy), and others may be punitive
(honor killings by stoning)

110. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Menopause: Changes in Female
Reproductive Cycle
❖Signals the end of menstruation
❖Ends the fertile period in females
❖Stops the production of ova

111. SEXUAL INTERCOURSE
▪coitus, or copulation
▪the reproductive act in which the male penis enters the
female vagina.
▪If the reproductive act is complete, an average of 100
million sperm are ejaculated from the male body into
the female
▪In human beings, a pattern of physiological events
occurs during sexual arousal and intercourse. These
events take place in 4 stages or phases, identified by
Masters & Johnson: EXCITEMENT, PLATEAU,
ORGASM, AND RESOLUTION.

112. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Human Sexual Response Cycle
❖Excitement
❖Plateau
❖Orgasm
❖Resolution

113. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Common Features of Sexual Physiology
1.Sexual response cycle
2.Influence of menstrual cycle on sexual response
3.Influence of pregnancy on sexual response
4.Masturbation
5.Sexual harassment and violence
6.Individuals with unique needs or concerns

114. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Sexual harassment and violence
❖unwanted, repeated sexual advances, remarks,
or behavior toward another that is offensive to the
recipient or interferes with job or school
performance.
❖job superior demanding sexual favors from an
employee,
❖or it could be a man or woman sending sexist jokes
by e-mail to another person in the department.
❖In school, it can refer to bullying
❖quid pro quo (an equal exchange)
❖hostile work environment
❖Sexual harassment rules apply to same-gender
❖can lead to short- or long-term psychosocial
consequences for victims and their families such as
emotional distress

115. Copyright © 2018 Wolters Kluwer · All Rights Reserved
ASSESSMENT
❖Sexual health – difficult topic to bring up
❖Problems may not be evident on 1
st
meeting
until they feel more secure and trust you.
❖Begins w/ interviewing to determine:
oPt’s knowledge level of the Repro Process
oSTIs
oConcerns about his/ her reproductive fxning
oSafer sex practices

116. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Example Questions to Include in a Sexual
History

117. Copyright © 2018 Wolters Kluwer · All Rights Reserved
❖“Is it all right to call body parts by
nicknames, such as ‘peter’ for penis, when
we talk to children? Or should we use the
anatomic name?”

❖“Will it be important to give our child unisex
toys?”

118. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Examples of Nursing Diagnoses Related to
Reproductive and Sexual Health
❖Risk for infection related to high-risk sexual
behaviors
❖Altered sexuality patterns related to chronic illness
❖Unsatisfactory altered sexuality patterns in an
uncomplicated pregnancy related to knowledge
deficits

119. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Examples of Nursing Diagnoses and
Outcomes Related to Reproductive and
Sexual Health
Nursing Diagnosis Outcome
Risk for infection related to
high-risk sexual behaviors
Patient will identify at least two
actions that he or she can take to
reduce risk of sexually transmitted
disease.
Altered sexuality patterns related
to chronic illness
Patient will identify two strategies
that will assist in restoring previous
pattern of sexuality.
Unsatisfactory altered sexuality
patterns in an uncomplicated
pregnancy related to knowledge
deficits
Couple will be able to identify
factors that may contribute to the
altering of their usual pattern of
sexuality.

120. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Interventions Related to Promoting
Reproductive and Sexual Health
Nursing Diagnosis Possible Nursing and
Therapeutic Interventions
Risk for infection related to high-risk
sexual behaviors
•Teach patients strategies related
to reducing their specific at-risk
behavior.
•Work with patients to identify
which strategies would best work
for them.
Altered sexuality patterns related to
chronic illness
•Review with patients factors that
might impact on their pattern of
sexuality, such as fatigue and
self-image, and suggest strategies
to minimize these factors.
Unsatisfactory altered sexuality
patterns in an uncomplicated
pregnancy related to knowledge
deficits
•Explore with the couple what
factors might be contributing to
the change in sexuality pattern,
including cultural and religious
beliefs, and give appropriate
information related to knowledge
deficits.

121. Copyright © 2018 Wolters Kluwer · All Rights Reserved
Evaluating Outcomes Related to Promoting
Reproductive and Sexual Health
Nursing Diagnosis Possible Nursing and
Therapeutic Interventions
Risk for infection related to
high-risk sexual behaviors
•Patient will report that he or she
is taking precautions to prevent
contracting sexually transmitted
diseases.
Altered sexuality patterns related
to chronic illness
•Patient reports that a
satisfactory pattern of sexuality
has been achieved.
Unsatisfactory altered sexuality
patterns in an uncomplicated
pregnancy related to knowledge
deficits
•Couple reports that their anxiety
related to sexual relations during
the pregnancy has decreased.
•Couple reports achievement of a
mutually satisfying pattern of
sexuality.

122. The end!!! ☺