Reproduction

REPRODUCTION HEALTH ASSESSMENT

CHAPTER 18 – BREASTS, ETC.

  • Puberty

    • Tanner Stages: Puberty is categorized into stages that describe physical development.

    • Thelarche: The onset of breast development indicating the start of puberty in females.

    • Menarche: The first occurrence of menstruation.

  • Pregnancy Changes

    • Nipples: Changes include darkening and enlargement.

    • Ductwork: Development of ductal systems for lactation.

    • Colostrum: The first milk produced during pregnancy, rich in antibodies.

  • Aging

    • Atrophy: Gradual decline in tissue mass and hormonal activity leading to reduced breast tissue.

    • More Fibrous: Increased proportion of fibrous tissue compared to glandular tissue in breasts.

  • Male Breast Health

    • Gynecomastia: Development of breast tissue in males, can occur in adolescents and older males due to hormonal changes.

  • Breast Cancer

    • BRCA1 & BRCA2: Tumor suppressor genes that, when mutated, increase the risk of breast and ovarian cancer.

    • Screening vs Diagnostic Mammograms:

    • Screening mammograms are for early detection in asymptomatic women.

    • Diagnostic mammograms are for women with symptoms or who have been previously diagnosed.

  • Lifestyle Factors Influencing Cancer Risk

    • Increased Risk: Alcohol consumption, smoking, and obesity (chronic adipose tissue inflammation).

    • Decreased Risk: Regular physical activity, consumption of fruits and vegetables, and calcium-rich foods.

    • Postmenopausal Hormone Replacement Therapy (HRT): Can both increase and decrease risk depending on individual health factors.

  • Breast Self-Examination (BSE)

    • Recommended to perform right after menstrual cycle (days 4-7) for consistent results.

    • Methodology:

    • While Showering or Lying Supine: Use three middle fingers in a circular motion applying varying levels of pressure; follow an up-and-down pattern.

    • Seated Examination: Raise arm slightly, examine underarm area.

    • Visual Inspection: Note any changes with hands on hips and shoulders hunched, looking for surface irregularities.

CHAPTER 25 – MALE GENITOURINARY

  • Infants

    • Testes typically descend before birth; circumcision practices discussed.

  • Puberty

    • Tanner’s Stages: A way to describe stages of development in males.

    • Physical vs Psychological Maturity: Earlier physical maturity does not equate to psychological or emotional maturity, impacting behavioral negotiation.

  • Aging and Male Health

    • No end to fertility, however, benign prostatic hyperplasia (BPH) is common with age which can lead to urinary tract infections (UTIs).

  • Chronic Kidney Disease

    • Commonly linked with diabetes mellitus (DM) and hypertension (HTN).

  • Bladder Cancer

    • Mainly caused by exposure to chemicals and smoking, which can settle in the bladder.

  • Sexually Transmitted Infections (STIs)

    • Approximately 20 million new cases annually in the US.

    • Half of new cases are in individuals aged 15-24 years.

    • Increasing incidence rates: Chlamydia, gonorrhea, syphilis, and also HSV, HPV (with a vaccine available), HIV, Hepatitis B.

    • Many STIs are often asymptomatic.

  • Testicular Self-Examination (TSE)

    • T = Timing: Recommended once a month.

    • S = Shower: Warm water helps relax the scrotal sac for easier examination.

    • E = Examine: Check for changes and report any immediately.

    • Cure Rate: Almost 100% if detected early and treated before metastasis.

    • Normal Testicle Characteristics: Egg-shaped, movable, rubbery with a smooth surface; the epididymis resting on top/behind and spermatic cord described as a thick strand of string.

    • Abnormal Indicators: Firm, painless lump; areas that feel hard; overall swollen testicle.

CHAPTER 26 – ANUS, RECTUM, PROSTATE

  • First Stool: The first stool passed by a newborn is called meconium.

  • Prostate Cancer

    • Risk Factors: Family history, BRCA1/BRCA2 mutations, Lynch Syndrome, smoking, and obesity.

    • PSA Screening Recommendations: Start at age 50 for average risk, 40 for high-risk individuals.

  • Colorectal Cancer

    • Associated with colon polyps, which are precursors to cancer in bowel lining.

    • Additional Risk Factors: Older age, genetics (Lynch Syndrome), history of chronic inflammatory bowel disease (IBD like Crohn’s or ulcerative colitis), Type 2 Diabetes Mellitus (T2DM).

    • Lifestyle factors: Smoking, poor diet, heavy alcohol consumption, obesity, and physical inactivity are contributing factors.

    • Screening Tests:

    • Fecal immunochemical test and colonoscopy are primary methods for detection.

CHAPTER 27 – FEMALE GENITOURINARY

  • Developmental Changes

    • Explains Tanner’s stages as they apply to female development.

    • Changes in the uterus shape during pregnancy.

    • Cervical and vaginal secretions become more acidic to combat bacteria; however, an acidic environment may promote yeast infections.

  • Aging in Females

    • Menopause leads to an increased risk of vaginitis due to a more basic vaginal environment, dryness, and reduced elasticity.

  • Cervical Cancer

    • Human Papillomavirus (HPV) is the primary causative agent, responsible for 90% of cases.

  • Female Genital Mutilation/Cutting

    • 200 million girls and women are affected globally with extensive and severe medical complications resulting from these practices.