Reproductive system part 1
Chapter 1: Introduction
Opening remarks about the speaker's shirt related to reproductive justice in literature
Mention of sister's PhD dissertation on the topic
Course structure for the day:
Overview of assessments related to reproductive health
Reminder: Most nurses accompany providers during internal assessments, particularly in labor and delivery; internal assessments not primarily performed by nurses
Importance of familiarity with expected norms in assessments
Example: Awareness when a provider is not conducting an assessment correctly
Common nursing tasks like Foley catheter care and bathing will involve understanding the assessments
Legal considerations regarding pelvic exams:
In some states, pelvic exams under anesthesia were practiced without consent for medical students, allowing them hands-on experience
Legal changes in Maryland: As of 2019, consent is required in Maryland, but many states still allow this practice
Advocating for patient rights is crucial; patients should not have their bodies used for unconsented procedures
Content Warning: Discussion will include adult content and explicit images, similar to educational textbooks
Visual materials will be included throughout the course
Chapter 2: Glands Either Side
Breast Anatomy Overview:
Main components of breast tissue:
Glands: Produce milk during breastfeeding
Lobules: Store and produce milk
Fibrous Tissue: Provides support
Nipple Structure: Centrally located on the breast; connects to milk ducts which deliver milk
Areola: Pigmented area around the nipple; contains contraction muscles leading to nipple erection (e.g., in response to cold or arousal)
Vascular Supply: Blood flow through the internal mammary artery; Cooper's ligaments offer support
Lymph Node System:
Network of lymph drains into axillary nodes, can be an indicator of breast cancer if swollen or fixed
Breast Cancer Identification:
Awareness of normal breast tissue aids in recognizing lumps
Often, enlarged lymph nodes signal cancer; self-exams encouraged although difficult due to tissue complexity
Colostrum: Highly nutrient-rich milk produced in the first days post-delivery; triggers shift from colostrum to mature milk is delivery of placenta
Chapter 3: Things To Body
External Female Genitalia:
Features include: Mons pubis, prepuce (clitoral hood), labia majora/minora, clitoris, vestibule with six openings
Glands: Periurethral glands (lubricate urinary meatus) and Bartholin glands (produce mucus during sexual arousal)
Vagina: Connects external genitalia to cervix, urinary function sits centrally between uterus and vagina
Hymen: Tissue surrounding vaginal opening, may tear during adolescence (attributable to non-sexual activities)
Understand standard cleaning protocols (top to bottom, front to back) to prevent infection
Internal Organ Anatomy:
Uterus: Pear-shaped, mobile muscular organ; undergoes significant size changes; cervix offers entrance to uterus
Fallopian Tubes: Extend from uterus to ovaries, eggs float through gaps into tubes
Ovaries: Where estrogen/progesterone are secreted, eggs are stored; females are born with all the eggs they will have across their lifespan
Chapter 4: Types Of Things
Developmental Norms:
Changes in female breasts during infancy due to maternal hormone transfer;
Enlarged breast tissue and genitalia can occur in infants of any gender
Adolescence is a significant time for reproductive maturation
Concept of Tanner stages for assessing sexual maturation: age of onset varies, generally occurring between ages 8-14
Pregnancy Observations:
Breast development characterized by visibility of veins, darker areolas, and increased secretions due to hormonal changes
Cervical changes noted (Chadwick's sign) when it turns bluish during pregnancy
Mention of cervical shape changes post-delivery that remains permanently altered
Chapter 5: Say These Things
Menarche and Menopause defined:
Menarche: Onset of menstruation during early teenage years
Menopause: Cessation of menstruation, typically in late reproductive phase
Health History Essentials:
Common complaints from patients relevant to reproductive health:
Breast discomfort, changes in breast/ genitalia appearance, abnormal bleeding, infertility concerns, menstrual complaints
Questions include:
Age of menarche, onset of menopause, sexual activity history, contraceptive use
Detailed history regarding any previous surgeries or diagnoses related to breast or reproductive health
Health Risks:
Family health history focusing on types of cancers (breast, endometrial, cervical, ovarian), particularly breast cancer and its genetics
Chapter 6: Bilateral Breast Cancer
Breast Inspection Techniques:
Breast examination divided into quadrants: upper inner, upper outer, lower inner, lower outer
Attention given to the tail of Spence where most tumors arise
Positioning for examination:
Assess patients in various positions to observe for changes such as dimpling indicative of pathology
Notable Signs of Concern:
Unilateral changes more concerning than bilateral, as bilateral typically indicates a broader issue than a single localized occurrence
Presence of supernumerary nipples and their characteristics
Palpation Techniques:
Importance of thorough palpation using different methods (vertical strip, circular, wedge techniques)
Monthly self-exams encouraged for breast awareness and early detection
Starting mammograms around age 40, or earlier if risk factors present, is advisable
Chapter 7: Conclusion
Conclusive remarks on breast tissue changes:
Normal breast changes can occur over a lifetime, influenced by childbirth and breast feeding habits
Malignancy signs include changes in shape, skin texture, and functional capabilities of the breast
Importance of patient education on self-breast exams and understanding when to seek medical advice regarding breast or reproductive health issues
Emphasis on creating a safe space for discussions regarding reproductive health without judgment.