CHAPTER 32 The Reproductive System 32-2 Learning Outcomes (cont.) 32.1 Summarize the organs of the...

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32The Reproductive

System

32-2


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.

32-3


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.

32-4


Introduction

• Male and female reproductive systems

– Function together to produce offspring

– Produce important hormones

32-5


The Male Reproductive System

• Testes– Produce sperm and

testosterone

– Divided into lobules

– Held in the scrotum

• Seminiferous tubules

– In the lobules of the testes

– Contain spermatogenic cells

• Interstitial cells produce testosterone

Male System

32-7


Sperm Cell FormationSpermatogenesis

Spermatogonium (46 chromosomes)

Primary spermatocytes (46 chromosomes)

Mitosis

Secondary spermatocyte

Secondary spermatocyte

Meiosis at puberty

Spermatid Spermatid Spermatid Spermatid

2nd meiotic division

32-8


Sperm Cell Formation (cont.)

• Head– Nucleus with 23

chromosomes– Covered by an

acrosome

• Midpiece - mitochondria

• Tail – Flagellum – Propels

the sperm

32-9


Internal Accessory Organs – Male

• Epididymis – where spermatids mature into sperm

• Vas deferens – carries sperm cells to urethra

• Seminal vesicles – secrete seminal fluid

– Sugar

– Prostaglandins

Male System

32-10


Internal Accessory Organs – Male (cont.)

• Prostate gland – Alkaline fluid that

protects sperm

– Contractions assist with expulsion of semen

• Cowper’s glands – fluid to lubricate end of penis

• Semen – Sperm cells– Fluids

Male System

32-11


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

32-12


Erection, Orgasm, and Ejaculation

• Erection – erectile tissue becomes engorged with blood

• Orgasm - emission occurs

• Ejaculation – semen is forced out of the urethra

32-13


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

32-14


Apply Your Knowledge

Matching:

___ Vasectomy

___ Mixture of sperm and fluids

___ Sperm cell formation

___ Secrete alkaline fluid/

prostaglandins

___ Produce testosterone

___ GnRH

___ Erectile tissue

G

E

F

A

C

B

D

ANSWER:A. Spermatogenesis

B. Testes

C.Penis

D.Vas deferens

E. Hypothalamus

F. Semen

G.Seminal vesicle

32-15


Common Diseases and Disorders of the Male 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

Impotence or erectile dysfunction (ED)

Disorder in which erection cannot be achieved or maintained; about 50% of males between 40 and 70 have some degree of ED

32-16


Common Diseases and Disorders of the Male Reproductive System (cont.)


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

32-17



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.

A. BPH

B. Epididymitis

C. Prostrate cancer

D. Testicular cancer

ANSWER:

A

B

C

D

32-18


The Female Reproductive System

• Ovaries– Produce ova, estrogen, and progesterone

– Medulla ~ nerves and lymphatic and blood vessels

– Cortex ~ ovarian follicles

Female System

32-20


Ovaries and Ovum Formation

OogenesisPrimordial follicles•Primary oocyte•Follicular cells

Primary oocyte stimulated to

continue meiosis

At puberty

Polar body

Secondary oocyte

Ovum, if fertilized

Released during ovulation

32-21


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

32-22


Internal Accessory Organs – Female (cont.)

• Uterus– Receives embryo

and sustains its development

– Divisions

– Wall ~ three layers

• Vagina– Extends from

uterus to outside body

– Rugae

– Wall ~ three layers

Internal Accessory Organs

32-24


External Accessory Organs - Female

• Mammary glands– Secretion of milk

– Structures

• Nipple

• Areola

• Alveolar glands

32-25


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

32-26


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

32-27


Female Reproductive Hormones

Hypothalamus secretes GnRH GnRH

Anterior pituitary releases FSH & LH

Stimulates

Ovaries to produce

estrogen and progesterone

Estrogen and progesterone are responsible for development of secondary sex characteristics

32-28


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

32-29


Follicular cellsbecome

corpus luteum,which secretesprogesterone

Anterior pituitaryreleases FSH

Uterine lining thickensOvarian folliclematures and secretes

estrogenThen 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

Reproductive Cycle (cont.)

32-30



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.

F

T

F

T

F

F

T

F

ANSWER:

first

lactiferous ducts

inner layer

Oogenesis

produce estrogen and progesterone

YIPPEE!

32-31


Common Diseases and Disorders of the Female Reproductive System (cont.)


Endometriosis Tissues of uterine lining grow outside of the uterus

Fibrocystic breast disease

Abnormal cystic tissue in the breast; size varies related to menstrual cycle

Fibroids Benign tumors in the uterine wall

Ovarian cancer More deadly than other types; detection difficult and often spreads before detection

32-32


Common Diseases and Disorders of the Female Reproductive System


Breast cancer Second leading cause of cancer deaths in women

Cervical cancer Generally 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 that limit normal activities

32-33


Diseases and Disorders of the Female Reproductive System (cont.)


Premenstrual syndrome (PMS)

Collection of symptoms occurring just before a menstrual period

Vaginitis/ vulvovaginitis

Inflammation of the vagina or inflammation of vagina and vulva; both associated with abnormal vaginal discharge

Uterine (endometrial) cancer

Most common in post-menopausal women; causes about 6% of cancer deaths

32-34



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

G

F

D

C

B

A

E

ANSWER:

32-35


Pregnancy

• 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

32-36


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

32-37


– Formation of • Placenta

• Amnion

• Umbilical cord

• Yolk sack

• Internal organs and external structures

The Prenatal Period (cont.)

• Embryonic period – Inner cell mass

organizes into the primary germ layer

• Ectoderm

• Mesoderm

• Endoderm

32-38


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

32-39


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

32-40


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

32-41


Hormonal Changes During Pregnancy (cont.)

• Relaxin – Inhibits uterine

contractions – Relaxes ligaments of

pelvis

• Lactogen – stimulates enlargements of mammary glands

• Aldosterone –increases sodium and water retention

• Parathyroid hormone (PTH) – blood calcium levels

32-42



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

32-43


The Birth Process

• Begins when progesterone levels fall

• Prostaglandins stimulate uterine contractions

• Uterine contractions stimulate release of oxytocin

• Oxytocin stimulates strong uterine contractions

32-44


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

32-45


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 breast-feeding continues

32-46



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!

32-47


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

32-48


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

32-49


Contraception (cont.)

Method Description

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

32-50



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?

32-51


Infertility

• Inability to conceive

• Primary

• Secondary

• Causes – 15% unknown– 35% male-related problems– 50% female-related problems

32-52


Infertility (cont.)

• Some male-related factors

– Impotence

– Retrograde ejaculation

– Low or absent sperm count

– Decreased testosterone

• Some female-related factors

– Pelvic inflammatory disease

– No ovulation or menstrual cycle

– Endometriosis

– Older than 40 years

32-53


Infertility (cont.)

• Tests – Semen analysis

– Monitoring of morning body temperature

– Blood hormone measurements

– Endometrial biopsy

– Urine analysis for LH

– Hysterosalpingogram

– Laparoscopy

32-54


Infertility (cont.)

• Treatments– Surgical repair of abnormalities

– Fertility drugs

– Hormone therapies

– Artificial insemination

– In vitro fertilization

– Use of surrogate

32-55



___ Retrograde ejaculation

___ Mumps infection

___ Inadequate diet

___ Scarring from STDs

___ Pelvic inflammatory

disease

___ Hormone imbalances

___ Use of some medications

___ 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

F

M

M

M

ANSWER:

Very good!

32-56


Sexually Transmitted Disease Infections Occurring in Both Sexes

STD Cause

AIDS HIV virus causes AIDS

Chlamydia Caused by bacterium Chlamydia trachomata.; most commonly reported; often no symptoms in female

Genital warts

Condyloma acuminat; caused by HPV; not everyone infected has symptoms

Gonorrhea Bacterial cause: Neisseria gonorrhoea

32-57


Sexually Transmitted Diseases (cont.)

STD Cause

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

32-58



Match:

___ Most commonly reported STD in the U.S.

___ Two types; both caused by a virus

___ Crabs

___ Increasing incidence in males

___ Common bacterial STD; can also grow in mouth

___ Caused by HPV virus

F

E

C

A

B

D

ANSWER: SUPER!

A. Gonorrhea

B. Genital warts

C. Syphilis

D. Chlamydia

E. Pubic lice

F. Herpes simplex

32-59


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.

32-60


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.

32-61


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.

32-62


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.

32-63


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).

32-64


The reproduction of mankind is a great marvel and mystery.

~Martin Luther

End of Chapter 27

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CHAPTER 32 The Reproductive System 32-2 Learning Outcomes (cont.) 32.1 Summarize the organs of the...

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