Reproductive Health I

mons pubis

protect pelvic bones

labia majora

protect underlying tissues

labia minora

lubricate vulvar skin, bactericidal secretions

clitoris

erectile tissue

skene’s glands

secretions that lubricate vaginal opening, present around urethra

hymen

thin tissue that surrounds vaginal opening

perineal body

stretches during delivery, area between vagina and anus

vagina

• muscular membranous tube that connects external genitals to uterus

• birth canal

fundus of the uterus

rounded upper portion of uterus, muscular

cervix

bottom of uterus, internal and external os

anterior fornix/posterior fornix

posterior fornix allows for semen pooling

broad ligament

provide uterus stability in pelvis

round ligament

help keep uterus in place, pulls it down and forward

cardinal ligament

• suspend uterus in true pelvis - prevent uterus prolapse

• chief ligament

isthmus

• connects fallopian tube with uterus

• area for surgical sterilization (tubal ligation)

ampulla

usual fertilization site for egg

fimbriae

• fingerlike projections

• bring egg into fallopian tube

ovaries

• hold eggs

• control hormones: primary source for estrogen + progesterone

  • during pregnancy, placenta is primary source of progesterone, helps maintain pregnancy

false pelvis

support weight of enlarged pregnant uterus + direct fetus to true pelvis

true pelvis

• must be adequate sixe and if not = CPD

• pelvic inlet, cavity, and outlet

pelvic inlet

b/t false + true pelvis, diameter helps determine if babies head can pass

pelvic cavity

curved canal, baby must adjust

pelvic outlet

can baby pass through pubic arch

ischial spines

narrowest part of the bony pelvis + plays role in fetal station

breasts provide…

milk (alveoli) and antibodies

estrogens

breasts, hip widening, increased uterus size, increased desire

progesterones

• stable uterus for implantation after fertilization

• cervix secretes thick protective mucus, helps wiht lactation

FSH (follicle stimulating hormone)

helps egg follicle to mature

LH (leutinizing hormone)

causes decreased estrogen production but allows progesterone production to continue

ovarian cycle two phases

follicular, luteal

follicular phase

• day 1-14

• immature follicle matures as result of FSH

• oocyte grows in follicle

• ovum discharged into fimbria of fallopian tube (ovulation)

luteal phase

• day 15-28

• ovum leaves follicle

• ovum remains in ampulla if fertilized

• reaches uterus in 72-96 hrs after release

what happens when the ovum reaches the uterus?

implants into endometrium and secretes hCG (human chorionic gonadotropin)

what happens if no fertilization occurs?

corpus luteum degenerates

how long is ovum fertile?

12-24 hrs

menstrual phase

shedding of some endometrial cells

proliferative phase

• endometrial cells enlarge + thicken due to increased estrogen (peaks just before ovulation)

• cervical mucus: more elastic, thin, clear (better for sperm)

secretory phase

• progesterone causes marked swelling of epithelium

• vascularity of uterus increases to provide nourishing bed for implantation

ischemic phase

• begins if implantation doesn’t occur

• estrogen + progesterone levels decrease

• corpus luteum degenerates (bleeding occurs - menstrual phase begins)

follicular phase involves which uterine phases?

menstrual, proliferative

luteal phase involves which uterine phase?

secretory

scrotum

sac-like pouch that contains testes to protect sperm by keeping temp lower than body temp

testes

sperm production + testosterone secretion

epididymis

duct behind each testis that is sperm reservoir

vas deferens + ejaculatory ducts

connect epididymis + prostate to allow sperm passage through ejaculatory ducts

seminal vessels

• secrete alkaline viscous clear fluid with the sperm during ejaculation 

• helps with sperm motility + metabolism

prostate glands

• secrete milky fluid that protects sperm from acidic vaginal environment + urethra

• helps with hormone production + regulates urine flow

mitosis

• for growth + tissue repair

• process by which our body cells divide + replace themselves

• exact copies of original cell

meiosis

• process leading to development of eggs + sperm

• cells only contain half the genetic material of chromosomes so when fertilization occurs the normal cell number is restored

monochorionic diamnotic

• 1 placenta, 1 chorion, 2 amnion

  • with 1 placenta, 1 baby can take more nutrients

• identical: 1 egg + 1 sperm

• division within 5 days of fertilization

monochorionic monoamniotic

• 1 placentae, 1 chorion, 1 amnion

  • worry about chord tangling with 1 amnion

• identical: 1 egg + 1 sperm

• division 8-12 days after fertilization

dichorionic diamniotic

• fused placentae, 2 chorions, 2 amnions

  • rare

• identical: 1 egg + 1 sperm

• division within 3 days of fertilization

dichorionic diamniotic II

• separate placentae, 2 chorions, 2 amnions

• fraternal: 2 eggs + 2 sperm

gametogenesis

• meiosis occurs during gametogenesis in which gametes (sperm + ovum) are produced

• oogenesis + spermatogenesis

oogenesis

produces female gamete (ocum) in female, all ova present at birth

spermatogenesis

produces male gamete (sperm), takes place starting at puberty

how long does sperm live

• 48-72 hrs

• but only fertile for 24 hrs

process of fertilization

• takes palce in ampulla of fallopian tube

• only single sperm enters ovum, leading to fertilixation

• chromosomes pair up, creating ziploid zygote

• XX or XY

chorionic villus

has fetal material, attaches to endometrium

chorion vs amnion

c - outer membrane

a - inner membrane

yolk sac

nutrition till 12 wks until placenta comes

amniotic fluid functions

• cushions fetus + umbilical cord

• helps control temp

• allows fetus to change positions

• analyze for fetal health + maturity (especially lungs)

• promotes growth + development (esp. lungs)

amniotic fluid fetal lung maturity

• tests for amt of lecithin + sphingomyelin

  • phospholipids which act as surfactants to keep alveoli open

• L/S ration > or equal 2: 1 = mature lungs

what is amniotic fluid made of

• made of albumin, vernix, fetal urine, uric acid, lecithin, sphingomyelin

• fetus swallows it + fluid flows out of lungs

polyhydramnios

• more fluid than anticipated

• >2000mL

• causes: twins, diabetes (increased fetal urine), GI problem (baby), maternal diabetes/high BG

oligohydramnios

• <400mL

• perfusion issue, baby kidney/bladder obstruction issue, leaking fluid, high BP

umbilical cord

• body stalk connecting placenta with fetus

• surrounded by special connective tissue called Wharton’s jelly

• no sensory or motor innervation

• twisted, spiral shape due to fetal movement

• 2 arteries, 1 vein

1 vein carries ____ from placenta to baby

oxygenated blood

2 arteries carry ________ and ___ from baby to placenta

deoxygenated blood, waste

placental functions

• 20 wks

• immunologic properties - protect against antibody production since homograft (don’t reject baby)

• excretion

• fetal respiration (gas exchange)

• production of fetal nutrients

• production of hormones (hCG)

embryonic development wk 4

• heart begins to beat

• arm + leg buds present

• somites develop - beginning vertebrae

• primary lung buds present

• eyes + ears begin to form

embryonic development wk 6

• body is straighter

• trachea developed

• nares present

• liver produces blood cells (functioning)

• heart begins circulating blood

• digits develop

• tail begins to recede

fetal development wk 12

• face well developed

• eyelids closed

• tooth buds appear

• genitals well differentiated

• urine produced

• spontaneous movement occurs

• fetal heart tones can be heard with doppler

fetal development wk 20

• subq brown fat appears

• vernix begins to form

• lanugo over entire body

• nipples + nails are present

• fetal movement felt by mother

• fetal heartbeat by fetoscope

fetal development wk 24

• viability

• eyes structurally complete

• vernix caseosa covers skin

• alveoli beginning to form

• both grasp + startle reflexes present

• fingerprints + footprints present

• considered viable at this stage

fetal development wk 28

• brain develops rapidly

• nervous system begins to regulate

• eyelids open

• testes begin to descend

• lungs can provide gas exchange

fetal development wk 36

• increase in subq fat

• lanugo begins to disappear

fetal development wk 38

• full term (37 and 0/7)

• skin smooth + polished

• vernix in creases + folds only

• head bigger than chest