The Reproductive System PowerPoint® presentation to accompany:
Medical Assisting Third Edition
Booth, Whicker, Wyman, Pugh, Thompson
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Learning Outcomes 31.1 List the organs of the male reproductive system and give the locations, structures, and functions of each. 31.2 Describe how sperm cells are formed. 31.3 Describe the substances found in semen. 31.4 Describes the process of erection and ejaculation.
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Learning Outcomes 31.1 List the organs of the male reproductive system and give the locations, structures, and functions of each. 31.2 Describe how sperm cells are formed. 31.3 Describe the substances found in semen. 31.4 Describes the process of erection and ejaculation.
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Learning Outcomes (cont.) 31.5 List the actions of testosterone. 31.6 Describe the causes, signs and symptoms, and treatment of various disorders of the male reproductive system. 31.7 List the organs of the female reproductive system and give the locations, structures, and functions of each. 31.8 Explain how ova develop.
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Learning Outcomes (cont.) 31.9 List the actions of estrogen and progesterone. 31.10 Explain how and when ovulation occurs. 31.11 Describe what happens to an ovum after ovulation occurs. 31.12 List the purpose and events of the menstrual cycle. 31.13 Define menopause and explain what causes it.
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Learning Outcomes (cont.) 31.14 Describe the causes, signs and symptoms, and treatments of various disorders of the female reproductive system. 31.15 Explain how and where fertilization occurs. 31.16 Describe the process of implantation. 31.17 Explain the difference between an embryo and a fetus.
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Learning Outcomes (cont.) 31.18 Describe the changes that occur in a woman during pregnancy. 31.19 List several birth control methods and explain why they are effective. 31.20 List the causes of and treatments for infertility. 31.21 Describe the causes, signs and symptoms, and treatments of the most common sexually transmitted diseases.
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Introduction
Male and female reproductive systems
Function together to produce offspring
Female reproductive system nurtures developing offspring
Produce important hormones
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Male Reproductive System
Testes
Scrotum – sac that holds the testes
Seminiferous tubules
Primary organs
Develop in the abdominal pelvic cavity of fetus
Descend into scrotal sac shortly before or after birth
Produce the male sex cells (sperm)
Produce the male hormone testosterone
On top of testes
Filled with spermatogenic cells that produce sperm cells
Interstitial cells produce testosterone Male System
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Male Reproductive System (cont.) Spermatogenesis
Spermatogenesis
Spermatogonia (46 chromosomes) Mitosis – makes primary spermatocytes Undergo meiosis
two secondary spermatocytes
Divides – two spermatids = 4 spermatids Develop flagella to become mature sperm cells with 23 chromosomes
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Male Reproductive System (cont.)
Sperm cells
Head
Nucleus with 23 chromosomes Acrosome – enzymefilled sac
Helps sperm penetrate ovum
Midpiece
Mitochrondria that generate cell’s energy
Tail
Flagellum that propels sperm forward
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Male Reproductive System: Internal Accessory Organs
Epididymis
Sits on top of each testis
Receives spermatids from seminiferous tubules
Seminal vesicle
Secrete
Spermatids become sperm cells
Vas deferens
Tube connected to epididymis Carries sperm cells to urethra
Fluid rich in sugar used to make energy Prostaglandins – stimulate muscular contractions in female to propel sperm forward
Seminal fluid
Released into vas deferens just before ejaculation 60% of semen volume Male System
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Internal Accessory Organs
Male Reproductive System: Internal Accessory Organs (cont.)
Prostate gland
Surrounds urethra
Produces and secretes a milky, alkaline fluid into urethra just before ejaculation
Fluid protects sperm in the acidic environment of the vagina 40% of semen
Bulbourethral (Cowper’s) glands
Produce a mucus-like fluid
Secreted just before ejaculation Lubricates end of penis
Semen
Alkaline mixture
Nutrients Prostoglandins
1.5 to 5.0 ml per ejaculate Sperm count of 40 to 250 million / ml
Male System
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Male Reproductive System: Internal Accessory Organs (cont.)
Scrotum
Holds testes away from body Temperature 1° below body temperature Lined with serous membrane that secrets fluid
Penis
Shaft
Glans penis
Cone-shaped structure on end of penis
Prepuce
Testes move freely
Erectile tissues surround urethra
Skin covering glans penis in uncircumcised males
Functions
Deliver sperm Urination Male System
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Male Reproductive System: Erection, Orgasm, and Ejaculation
Erection
Orgasm
Parasympathetic nervous system stimulates erectile tissue Become engorged with blood
Sperm cells propelled out of testes into urethra Secretions from accessory organs also released into urethra
Ejaculation
Semen is forced out of urethra Sympathetic nerves then stimulate erectile tissue to release blood Penis returns to flaccid state
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Male Reproductive System: Hormones
Hypothalamus
Gonadotropin-releasing hormone (GnRH)
Stimulates anterior pituitary to release
Follicle-stimulating hormone (FSH) – initiates spermatogenesis Luteinizing hormone (LH) – stimulates interstitial cells in the testes to produce testosterone
Testosterone
Secondary sex characteristics Maturation of male reproductive organs Regulated by negative feedback
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Apply Your Knowledge Matching:
ANSWER:
D Vasectomy ___
A. Spermatogenesis
___ F Mixture of sperm and fluids
B. Testes
___ A Sperm cell formation
C. Penis
___ G Secrete alkaline fluid / prostaglandins
D. Vas deferens
___ B Produce testosterone
E. Hypothalamus
E GnRH ___
F. Semen
___ C Erectile tissue
G. Seminal vesicle
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Diseases and Disorders of the Male Reproductive System Disease/Disorder Description Benign prostatic Nonmalignant enlargement of the prostate hypertrophy (BPH) gland; common in older men Epididymitis
Inflammation of an epididymis; usually starts as an urinary tract infection
Impotence or Disorder in which erection cannot be erectile dysfunction achieved or maintained; about 50% of males (ED) between 40 and 70 have some degree of ED
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Diseases and Disorders of the Male Reproductive System Disease/Disorder Description Prostate cancer
Most common form of cancer in men over 40; risks of developing it increase 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; more aggressive malignancy
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Apply Your Knowledge Your patient has an elevated PSA. What is a PSA and what does it indicate? ANSWER: The PSA is a prostate-specific antigen in the blood. Elevations of the PSA may indicate prostate cancer.
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Female Reproductive System: Ovaries and Ovum Formation
Ovaries (2)
Primary sex organs produce
Sex cells called ova
Hormones estrogen and progesterone
Located in the pelvic cavity
Medulla
Cortex
Inner area; contains nerves, lymphatic vessels, and blood vessels Outer area; contains ovarian follicles
Covered by epithelial and dense connective tissues
Female System
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Female Reproductive System: Ovaries and Ovum Formation (cont.)
Primordial follicles develop before birth and contain
Oogenesis is the process of ovum formation
A primary oocyte or immature ovum (born with maximum number)
At puberty, primary oocytes are stimulated to continue meiosis
Follicular cells
Becomes 1 polar body (a nonfunctional cell) and A secondary oocyte
Secondary oocyte released during ovulation
If fertilized, the oocyte divides to form a mature, fertilized ovum
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Female Reproductive System: Internal Accessory Organs
Fallopian tube – tube – oviduct oviduct
Infundibulum and 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
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Female Reproductive System: Internal Accessory Organs (cont.)
Uterus
Hollow, muscular organ Receives embryo and sustains its development Divisions
Fundus – domed Fundus – domed upper portion Body – Body – main main portion Cervix – Cervix – narrow, narrow, lower section extending into vagina (cervical (cervical orifice) orifice)
Wall of uterus
Endometrium
Innermost lining Vascular Tubular glands – glands – mucus mucus
Myometrium
Internal Accessory Organs
Middle, thick, muscular layer
Perimetrium
Thin layer covering the myometrium Secretes serous fluid to coat and protect uterus
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Female Reproductive System: Internal Accessory Organs (cont.)
Vagina
Tubular, muscular organ
Extends from uterus to outside body (vaginal ( vaginal introitus) introitus)
Muscular folds – folds – rugae rugae – – enable enable expansion
Receive erect penis
Passage for delivery of offspring and uterine secretions
Wall
Innermost mucosal layer
Middle muscular layer
Outer fibrous layer
Internal Accessory Organs
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Internal Female Organs
Back
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Female Reproductive System: External Accessory Organs
Mammary glands
Secretion of milk Structures
Nipple
Oxytocin induces lactiferous ducts to deliver milk through openings
Areola – pigmented area around nipple Alveolar glands – within mammary glands
Make milk when stimulated by prolactin
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Female Reproductive System: External Genitalia
Collectively known as the vulva
Labia majora
Rounded folds of adipose tissue and skin Protect other external reproductive organs
Labia minora
Fold of skin between labia majora Very vascular Merge to form hood over clitoris Vestibule – space enclosed by labia minora
Bartholin’s glands secrete mucus during sexual arousal
External Genitalia
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Female Reproductive System: External Genitalia (cont.)
Clitoris
Anterior to urethral meatus
Contains female erectile tissue
Rich in sensory nerves
Perineum
Between vagina and anus Area for episiotomy, if needed, during birth process External Genitalia
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Female Reproductive System: Erection, Lubrication, and Orgasm
Nervous stimulation
Clitoris becomes erect
Bartholin’s glands activates – lubrication
Vagina elongates
Orgasm
Sufficient stimulation of clitoris Walls of uterus and fallopian tubes contract to propel sperm up tubes
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Female Reproductive System: Hormones Hypothalamus secretes GnRH
Ovaries to produce estrogen and progesterone
GnRH
Anterior pituitary releases FSH & LH
Estrogen and progesterone
Responsible for development of secondary sex characteristics
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Female Reproductive System: Reproductive Cycle
Menstrual cycle
Regular changes in uterine lining, resulting in monthly bleeding
Menarche – first menstrual period Menopause – termination of cycle due to normal aging of ovaries
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Female Reproductive System: Reproductive Cycle (cont.) Anterior pituitary releases FSH Then releases LH
Ovarian follicle matures and secretes estrogen Triggers ovulation
Uterine lining thickens Lining more vascular and glandular
Without fertilization Corpus luteum degenerates
Estrogen and progesterone levels fall
Follicular cells become corpus luteum which secretes progesterone
Uterine lining breaks down – menses starts
Cycle begins again with release of FSH
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YIPPEE!
Apply Your Knowledge True or False:
ANSWER:
___ F The ovaries only produce estrogen.
They also produce progesterone.
___ F Ovulation is the process of ovum formation.
Oogenesis
T The fallopian tube is also called the oviduct. ___ F The endometrium is the outer layer of the uterine wall. ___ T Alveolar glands produce milk. ___
inner layer
lactiferous ducts
F ___Oxytocin induces the alveolar glands to deliver milk through the nipples.
___ F Menarche is the termination of the menstrual cycle.
the first menstrual cycle
T Menopause occurs due to normal aging of the ovaries. ___
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Diseases and Disorders of the Female Reproductive System Disease/Disorder Description Breast cancer
Second leading cause of cancer deaths in women; classified as stage 0 to 4
Cervical cancer
Slow to develop; Pap smear detects abnormal cervical cells
Cervicitis
Inflammation of the cervix usually due to an infection
Dysmenorrhea
Condition with severe menstrual cramps limiting normal activities
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Diseases and Disorders of the Female Reproductive System (cont.) Disease/Disorder Description Endometriosis
Tissues of uterine lining growing outside of the uterus
Fibrocystic breast disease
Abnormal cystic tissue in the breast; size varies related to menstrual cycle; common in 60% of women between 30 and 50
Fibroids
Benign tumors in the uterine wall; affect 25% of women in their 30s and 40s
Ovarian cancer
Considered more deadly than other types; detection difficult and often spreads before detection
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Diseases and Disorders of the Female Reproductive System (cont.) Disease/Disorder Description Premenstrual syndrome (PMS)
Collection of symptoms occurring just before a menstrual period
Vaginitis / vulvovaginitis
Inflammation of the vagina / inflammation of vagina and vulva; both associated with abnormal vaginal discharge
Uterine Most common in post-menopausal women; (endometrial) cancer causes about 6% of cancer deaths in women
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Apply Your Knowledge Matching:
ANSWER:
E Inflammation of the cervix ___
A. Dysmenorrhea
___ G Cancer common in post-menopausal women
B. Cervical cancer
___ B Develops slowly; detected by Pap smear
C. Fibroids
___ F Uterine tissue grows outside uterus
D. Breast cancer
D Second leading cause of cancer death in women E. Cervicitis ___ A Severe menstrual cramps ___
F. Endometriosis
___ C Benign tumors in the uterine wall
G. Uterine cancer
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Pregnancy: Fertilization
Pregnancy – condition of having a developing offspring in the uterus
Fertilization – process in which a sperm cell unites with an ovum; results in pregnancy
Only one sperm cell penetrates the follicular cells and the zona pellucida that surround the ovum’s cell membrane
After fertilization, ovum releases enzymes that cause the zona pellucida to become impenetrable to other sperm
Zygote forms from union of ovum and sperm
Contains 46 chromosomes
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Pregnancy: The Prenatal Period
Time before birth
Zygote – undergoes rapid mitosis
First week after fertilization Cleavage – rapid cell division Morula – ball of cells resulting from cleavage
Travels down fallopian tube to uterus Becomes blastocyst which implants in endometrial wall
Blastocyst
Some cells (inner cell mass) become embryo Others, along with cells from uterus, form placenta
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Pregnancy: The Prenatal Period (cont.)
Embryonic period
Week 2 through 8 Inner cell mass organizes into three primary germ layers
Ectoderm Mesoderm Endoderm
Formation of
Placenta
Amnion
Umbilical cord
Yolk sack
Most internal organs and external structures of embryo
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Pregnancy: The Prenatal Period (cont.)
Fetal period
Week 8 through birth
Rapid growth
5th month – skeletal muscles active
6th month – gains weight
Last 3 months – fetal brain cells rapidly divide
GI and respiratory systems last to develop
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Pregnancy: Fetal Circulation
Placenta and umbilical blood vessels carry out the exchange of nutrients, oxygen, and waste products Unique differences from normal circulation
Foramen ovale – hole between right and left atria enables most of fetal blood to bypass lungs Ductus arteriosus – connection between pulmonary trunk and aorta Ductus venosus – vessel that bypasses liver
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Pregnancy: Hormonal Changes
Embryonic cells secrete human chorionic gonadotropin (HCG)
Maintains the corpus luteum
Estrogen and progesterone
Secreted by corpus luteum and placenta Functions
Stimulate uterine lining to thicken, development of mammary glands, enlargement of female reproductive organs Inhibit release of FSH and LH from anterior pituitary gland (preventing ovulation) and uterine contractions
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Pregnancy: Hormonal Changes (cont.)
Relaxin
From corpus luteum Inhibits uterine contractions and relaxes ligaments of pelvis
Lactogen
From placenta Stimulates enlargements of mammary glands
Aldosterone
From adrenal gland Increases sodium and water retention
Parathyroid hormone (PTH)
Helps maintain high calcium levels in the blood
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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 Endoderm – epithelial
tissue and some epithelial tissue
tissue only
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The Birth Process
Begins when progesterone levels fall
Prostaglandins secreted by uterus stimulate uterine contractions
Uterine contractions stimulate posterior pituitary gland to release oxytocin
Oxytocin stimulates strong uterine contractions
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The Birth Process (cont.)
Three stages
Dilation
Expulsion or parturition
Cervix thins and softens (effacement) Lasts 8 – 24 hours
Actual birth May take 30 minutes or less
Placental stage – 10 to 15 minutes after the birth, the placenta separates from uterine wall and is expelled
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The Birth Process (cont.)
The postnatal period
Six-week period following birth
Neonatal period – first four weeks
Neonate is adjusting to life outside uterus
Milk production and secretion
Prolactin – production of milk
Oxytocin – ejection of milk from mammary gland ducts
Production continues as long as breast-feeding continues
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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
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Contraception Method
Description
Coitus interruptus
Penis is withdrawn from vagina before ejaculation; not a reliable method
Rhythm method
Requires abstinence around time of ovulation; not a reliable method
Mechanical barriers
Prevent sperm from entering female reproductive tract
Chemical barriers
Destroy sperm in the female reproductive tract; primarily spermicides; often used with mechanical barriers
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Contraception (cont.) Method
Description
Oral contraceptives
Birth control pills; prevent ovulation by preventing LH surge
Injectable contraceptives
Prevent ovulation and alter lining of uterus to prevent implantation of blastocyst
Insertable contraceptives
Ring inserted vaginally and removed at the beginning of the 4th week to allow menstruation
Contraceptive implants
Small rods of progesterone implanted beneath skin; prevent ovulation
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Contraception (cont.) Method
Description
Transdermal contraceptives
Contraceptives in the form of a patch; applied weekly for 3 weeks; not used the 4 th 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 fulgurated to prevent sperm from reaching oocyte Vasectomy – vas deferens is fulgurated to prevent ejaculation of sperm
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Apply Your Knowledge 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 using the rhythm method of birth control very carefully.” What patient teaching would you do to assist her to understand? ANSWER: The rhythm method is not as effective as other birth control, because it is sometimes difficult to tell when ovulation occurs.
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Infertility
Inability to conceive a child
Primary – no prior pregnancy, unable to achieve pregnancy in 12 months
Secondary – at least one prior pregnancy, unable to achieve pregnancy after one year
Causes
15% unknown
35% male-related problems
50% female-related problems
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Infertility (cont.)
Male-related
Impotence
Retrograde ejaculation
Low or absent sperm count
Medications / drugs
Decreased testosterone
Scarring from STDs
Prior mumps infection
Inflammation of epididymis or testes
Female-related
Scarring from STDs Pelvic inflammatory disease Inadequate diet No ovulation or menstrual cycle Endometriosis Abnormal shape of uterus or cervix Hormonal imbalances Cysts in ovaries Older than 40 years
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Infertility (cont.)
Tests
Semen analysis Monitoring of morning body temperature Blood hormone measurements Endometrial biopsy Urine analysis for LH Hysterosalpingogram laparoscopy
Treatments
Surgical repair of abnormalities Fertility drugs Hormone therapies Artificial insemination In vitro fertilization Use of surrogate
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Apply Your Knowledge Indicate whether each cause of infertility is male-related (M), female-related (F), or both (B). ANSWER: ___ F Pelvic inflammatory M Retrograde ejaculation ___ disease M Mumps infection ___
___ F Hormone imbalances
___ F Inadequate diet
M Use of some medications ___
B Scarring from STDs ___
___ F Being over 40 years old
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Sexually Transmitted Diseases STD
Cause
AIDS
HIV virus causes AIDS; described in Chapter 21
Chlamydia
Caused by bacterium; most commonly reported; often no symptoms in female
Genital warts
Caused by HPV; not everyone infected has symptoms
Gonorrhea
Bacterial cause
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Sexually Transmitted Diseases (cont.) STD
Cause
Herpes simplex
Caused by viruses; type I causes cold sores; type II commonly known as genital herpes; may be passed from mother to child during childbirth
Pubic lice
Parasitic infestation; commonly called crabs
Syphilis
Caused by bacteria; decreasing in women but increasing in males who have sex with other males
Trichomoniasis
Caused by protozoan parasite; also called trichomonas infection or “trich”
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Apply Your Knowledge Match:
ANSWER:
D Most commonly reported STD in the U.S. ___
A. Gonorrhea
F Two types; both caused by a virus ___
B. Genital warts
E Crabs ___
C. Syphilis
C Increasing incidence in males ___
D. Chlamydia
A Common bacterial STD; can also grow in mouth E. Pubic lice ___ B Caused by HPV virus ___
F. Herpes simplex
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In Summary
Ability to reproduce is a basic characteristic of life
Female and male systems work together to produce offspring
Medical assistant must have knowledge of reproductive systems to
Assist with exams and procedures
Provide patient education