1. Chapter 8 Goals Page 257 Students will be able to:
Name & locate female reproductive organs & learn their combining forms.
Explain how these organs & their hormones function in the normal processes of ovulation, menstruation, & pregnancy.
Identify abnormal conditions of the female reproductive system & of the newborn.
Describe important laboratory tests & clinical procedures used in gynecology & obstetrics, & recognize related abbreviations.
Apply you new knowledge to understanding medical terms in their proper contexts, such as medical reports & records.

2. Female Reproductive System
Chapter 8
Pages 257 – 310

3. Page 258
Introduction
Sexual reproduction = the union of the ovum (female gamete) & the sperm (male gamete)
Gamete = a sex cell (has half the number of chromosomes needed to create a new organism)
Fertilization = nuclei of the two gametes unite to form a single nucleus with half of the chromosomes/genetic code from each parent.
Gonads = special organs in males (testes) & females (ovaries) produce the sperm & the egg.

4. Introduction: Cont. Page 258
After an ovum leaves the ovary, it travels down one of two fallopian tubes leading to the uterus. If coitus has occurred & sperm cells travel into the fallopian tube, it penetrates the ovum. Fertilization
Zygote = fertilized ovum
Embryo = 2 – 8 weeks
Fetus = 8 – 38 or 40 weeks
Gestation = The period of development within the uterus.
Uterus = womb
coitus = copulation, sexual intercourse
gestation = pregnancy

5. Introduction: Cont. Page 258
Female are born with all the eggs, or ova, in the female ovary but begin to mature & are released from the ovary in a 21- to 28-day cycles when secondary sex characteristics develop.
Menarche = the occurrence of the first cycle
Menstruation = hormone changes resulting in the shedding of the uterine lining, & bleeding.
Menopause = when all eggs have been released, hormone production diminishes & menstruation ends.
secondary sex characteristics = body hair, breast development, structural changes in bones & fat

6. Introduction: Cont. Page 258
estrogen & progesterone = hormones of the ovaries
Pituitary gland = secretes other hormones that govern the reproductive functions of the ovaries, breasts, & uterus.
Gynecology = the study of the female reproductive system
Obstetrics = a specialty concerned with pregnancy & the delivery of the fetus
Neonatology = the study of the care & treatment of the newborn
Hormones = play important roles in the processes of menstruation & pregnancy, & in the development of secondary sex characteristics.
Obstetrics = Latin obstetrix means midwife
Pituitary gland = located at the base of the brain
Gynecology = organs, hormones, & diseases

7. Organs of the Female Reproductive System
Pages
Organs of the Female Reproductive System
Uterus, Ovaries & Associated Organs
Adnexa = fallopian tubes, ovaries, & supporting ligaments

8. Organs of the Female Reproductive System
Pages
Organs of the Female Reproductive System
Ovaries = a pair of small almond-shaped organs located in the pelvis. Held in place on either side of the uterus by a utero-ovarian ligament
Ovarian follicles = thousands of small sacs within each ovary (they each contains an ovum)
Ovulation = maturation of an ovum; it’s follicle ruptures through the surface & releases the ovum from the ovary.
Corpus luteum (meaning yellow body)= a ruptured follicle fills will yellow fat-like material. The corpus luteum secretes hormones (both estrogen & progesterone) that maintain the very first stages of pregnancy.

9. Organs of the Female Reproductive System
Pages
Organs of the Female Reproductive System
Fallopian tubes = lead from each ovary to the uterus. They are about 5 ½ inches long & lies near each ovary.
Fimbriae = finger-like ends of the fallopian tube. They catch the egg after its release from the ovary.
Cilia (small hairs) = line the fallopian tube & through their motion, sweep the ovum along. It usually takes the ovum about 2 to 3 days to pass through the fallopian tube.

10. Organs of the Female Reproductive System
Pages
Organs of the Female Reproductive System
Uterus = muscular walls & a mucus membrane lining filled with a rich supply of blood vessels. Situated between the urinary bladder & the rectum. The uterus (womb) normally is shape of a pear & is about 3 inches long in a non-pregnant woman
Fundus = the rounded upper portion of the uterus
Corpus = the larger, central section of the uterus
Endometrium = the inner layer, a specialized epithelial mucosa of the uterus
Myometrium = the middle, muscular layer of the uterine wall
Uterine seroua = the outer, membranous tissue layer

11. Organs of the Female Reproductive System
Pages
Organs of the Female Reproductive System
Cul-de-sac = midway between the uterus & the rectum (in the abdominal cavity)
Cervix = the narrow, lowermost portion of the uterus
Vagina = a muscular mucus-lined canal structure, extends from the uterus to the exterior of the body. (usually about 3 inches long)
Perineum = the region between the vaginal orifice & anus

12. Organs of the Female Reproductive System
Pages
Organs of the Female Reproductive System
Vulva = the collective external genitalia of the female
Bartholin glands = two small, rounded glands on either side of the vaginal orifice.
Clitoris = an organ sensitive, erectile tissue located anterior to the vaginal orifice & in front of the urethral meatus.
Labia majora = the outer lips of the vagina, surrounding the labia minora.
Labia minora = smaller, inner lips
Hymen = a thin membrane partially covering the entrance to the vagina (is broken apart during the first episode of intercourse)

13. Organs of the Female Reproductive System: Cont.
Page 261
Organs of the Female Reproductive System: Cont.
The Breast (Accessory Organ of Reproduction)
Breasts = located on the upper anterior region of the chest & are composed mostly of mammary glands but also contain fibrous & fatty tissue
Glandular tissue = contains milk glands or lobules that develop in response to hormones form the ovaries during puberty
Lactiferous ducts (milk carrying) & Sinuses (cavities) = that carry milk to the nipple, which has small openings for the ducts to release their milk

14. Organs of the Female Reproductive System: Cont.
Page 261
Organs of the Female Reproductive System: Cont.
Mammary papilla = breast nipple
Areola = the dark pigmented area around the mammary papilla
During pregnancy the hormones from the ovaries & the placenta stimulate glandular & other tissue in the breasts to their full development.
Parturition = giving birth
after birth hormones from the pituitary gland stimulate lactation
Lactation = the normal secretion of milk

15. Menstruation & Pregnancy
Pages 262 – 263
Menstruation & Pregnancy
Menstrual Cycle

16. Menstruation & Pregnancy
Pages 262 – 263
Menstruation & Pregnancy
Menstrual Cycle
Days 1 – 5 = menstrual period; discharge of bloody fluid containing disintegrated endometrial cells, glandular secretions, & blood cells.
Days 6 – 12; after bleeding ceases, the endometrium begins to repair itself. The maturing follicle in the ovary releases estrogen, which aids in the repair. The ovum grows in the follicle during this period.

17. Menstruation & Pregnancy
Pages 262 – 263
Menstruation & Pregnancy
Days 13 & 14 = ovulatory period; On about the 14th day of the cycle, the follicle ruptures & the egg leaves the ovary (ovulation), passing through the fallopian tube.
Days 15 – 28; the empty follicle fills with a yellow material & becomes the corpus luteum. The corpus luteum functions as an endocrine organ & secretes the hormone progesterone into the bloodstream. This hormone stimulates the building up of the lining of the uterus in anticipation of fertilization of the egg & pregnancy.

18. Menstruation & Pregnancy
Pages 262 – 263
Menstruation & Pregnancy
If fertilization does not occur, the corpus lupus luteum in the ovary stops producing progesterone & regresses. At this time, lowered levels of progesterone & estrogen probably are responsible for some women’s symptoms of depression, breast tenderness, & irritability before menstruation. The combination of these symptoms is know as premenstrual syndrome (PMS). After 2 days of decrease in hormones, the uterus endometrium breaks down, & the menstrual period begins days 1 to 5.

19. Menstruation & Pregnancy
Pages 262 – 263
Menstruation & Pregnancy
If fertilization does not occur, the corpus lupus luteum in the ovary stops producing progesterone & regresses. At this time, lowered levels of progesterone & estrogen probably are responsible for some women’s symptoms of depression, breast tenderness, & irritability before menstruation. The combination of these symptoms is know as premenstrual syndrome (PMS). After 2 days of decrease in hormones, the uterus endometrium breaks down, & the menstrual period begins days 1 to 5.
Days 1 – 5 = menstrual period; discharge of bloody fluid containing disintegrated endometrial cells, glandular secretions, & blood cells.
Days 6 – 12; after bleeding ceases, the endometrium begins to repair itself. The maturing follicle in the ovary releases estrogen, which aids in the repair. The ovum grows in the follicle during this period.
Days 13 & 14 = ovulatory period; On about the 14th day of the cycle, the follicle ruptures & the egg leaves the ovary (ovulation), passing through the fallopian tube.
Days 15 – 28; the empty follicle fills with a yellow material & becomes the corpus luteum. The corpus luteum functions as an endocrine organ & secretes the hormone progesterone into the bloodstream. This hormone stimulates the building up of the lining of the uterus in anticipation of fertilization of the egg & pregnancy.
If fertilization does not occur, the corpus lupus luteum in the ovary stops producing progesterone & regresses. At this time, lowered levels of progesterone & estrogen probably are responsible for some women’s symptoms of depression, breast tenderness, & irritability before menstruation. The combination of these symptoms is know as premenstrual syndrome (PMS). After 2 days of decrease in hormones, the uterus endometrium breaks down, & the menstrual period begins days 1 to 5.
Cycles vary in length, ranging form 21 to 42 days or longer. Ovulation typically occurs 14 days before the end of the cycle. A woman with a 42-day cycle ovulates on day 28, where as a woman with a 21 day cycle ovulates on day 7

20. Menstruation & Pregnancy
Pages 262 – 263
Menstruation & Pregnancy
Cycles vary in length, ranging form 21 to 42 days or longer. Ovulation typically occurs 14 days before the end of the cycle. A woman with a 42-day cycle ovulates on day 28, where as a woman with a 21 day cycle ovulates on day 7

21. Menstruation & Pregnancy: Cont.
Pages 263 – 264
Menstruation & Pregnancy: Cont.
Pregnancy

22. Menstruation & Pregnancy: Cont.
Pages 263 – 264
Menstruation & Pregnancy: Cont.
Pregnancy
Placenta = a vascular organ, forms after fertilization, attached to the uterine wall - connected to the embryo by the umbilical cord. The placenta is derived from maternal endometrium & from the chorion, the outermost membrane that surrounds the developing embryo.
The maternal blood & the fetal blood never mix during pregnancy, but important nutrients, oxygen, & wastes are exchanged

23. Menstruation & Pregnancy: Cont.
Pages 263 – 264
Menstruation & Pregnancy: Cont.
Amnion = the innermost of the embryonic membranes, holds the fetus suspended in an amniotic cavity surrounded by amniotic fluid
Human chorionic gonadotropin (hCG) the hormone used to test if women are pregnant.

24. Menstruation & Pregnancy: Cont.
Pages 263 – 264
Menstruation & Pregnancy: Cont.
The onset of true labor is marked by rhythmic contractions, dilation & thinning (effacement) of the cervix, & a discharge of bloody mucus from the cervix & vagina.
In a normal delivery position, the baby’s head appears first (cephalic presentation). After vaginal delivery of the baby, the umbilical cord is cut.
Afterbirth = The placenta is expelled.

25. Menstruation & Pregnancy: Cont.
Pages 265 – 266
Menstruation & Pregnancy: Cont.
Hormonal Interactions
Hormone
Production Sites
Target Organ
Effect
FSH
Pituitary gland
Ovary
Stimulates maturation of the ovum LH
Stimulates ovulation
Estrogen
Ovary Placenta (during pregnancy)
Uterus
Builds up the endometrial lining
During pregnancy the high levels of estrogen & progesterone from the ovary & placenta cause the pituitary gland stop producing FSH & LH. Therefore, while a woman is pregnant, additional eggs do not mature & ovulation cannot occur.
Oral contraceptives (birth control pills work the same way. IUD (intrauterine device) work the same way.
Hormone replacement therapy (HRT) given orally or as a transdermal patch or vaginal ring, relieves symptoms of menopause & delays the development of weak bones
Hot flashes, insomnia, & vaginal atrophy (lining of the vaginal dries & thins, predisposing the affected woman to irritation & discomfort during sexual intercourse)

26. Menstruation & Pregnancy: Cont.
Pages 265 – 266
Menstruation & Pregnancy: Cont.
Hormone
Production Sites
Target Organ
Effect
Progesterone
Ovary (corpus luteum) Placenta (during pregnancy)
Uterus
Sustains uterine lining & placenta during pregnancy
hCG
Placenta
Ovary (corpus luteum)
Sustains pregnancy

27. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal
Pages 274 – 276
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal
Gynecologic – Uterus
carcinoma of the cervix
malignant cells within the cervix (cervical cancer)
cervicitis
Inflammation of the cervix
carcinoma of the endometrium (endometrial cancer)
malignant tumor of the uterine lining (adenocarcinoma)
endometriosis
Endometrial tissue located outside the uterus
fibroide
Benign tumors in the uterus

28. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Pages 276 – 277
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Gynecologic – Ovaries
ovarian carcinoma (cancer)
malignant tumor of the ovary (adenocarcinoma)
ovarian cysts
collections of fluid within sacs (cysts) in the ovary

29. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Page 277
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Gynecologic – Fallopian Tubes
pelvic inflammatory disease (PID)
Inflammation & infection of organs in the pelvic region; salphingitis, oophoritis, endometritis, endocervicitis.

30. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Pages
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Gynecologic – Breast
carcinoma of the breast (breast cancer)
malignant tumor of the breast (arising from milk glands & ducts)
fibrocystic breast disease
Numerous small sacs of fluid surrounded by dense strands of fibrous tissue in the breast

31. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Pages
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Pregnancy
abruptio placentae
Premature separation of the normally implanted placenta
ectopic pregnancy
Implantation of the fertilized egg in any site other than the normal uterine location
multiple gestations
more than one fetus inside the uterus
placenta previa
Implantation of the placenta over the cervical opening or in the lower region of the uterus
preeclampsia
Abnormal condition associated with pregnancy, marked by high blood pressure, proteinuria, edema, & headache.

32. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Page 281
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Neonatal
Down syndrome
Chromosomal abnormality (trisomy 21) results in mental retardation, retarded growth, a flat face with a short nose, low-set ears, & slanted eyes.
erythroblastosis fetalis
Hemolytic disease in the newborn (HDN) caused by a blood group (Rh factor) incompatibility between the mother & the fetus
hyaline membrane disease
Acute lung disease commonly seen in the premature newborn (RDS)

33. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Page 282
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Neonatal
hydrocephalus
Accumulation of fluid in the spaces of the brain
meconium aspiration syndrome
Abnormal inhalation of meconium produced by a fetus or newborn
pyloric stenosis
Narrowing of the opening of the stomach to the duodenum

34. Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Page 281
Pathology: Gynecologic, Breast, Pregnancy, & Neonatal: Cont.
Neonatal – The Apgar Scoring system
SIGN
Score 1 2
Heart rate
Absent
Below 100
Over 100
Respiratory effort
Slow, irregular
Good, crying
Muscle tone
Limp
Some flexion of extremities
Active motion
Response to catheter in nostril
No Response
Grimace
Cough or sneeze
Color
Blue, pale
Body pink, extremities blue
Completely pink
The Apgar score is a system of scoring an infant’s physical condition at 1 & again 5 minutes after birth. Heart rate, respiration, color, muscle tone, & response to stimuli each are rated 0, 1, or 2. The maximum total score is 10. Infants with Apgar scores below 7 require immediate medical attention such as suctioning of the airways or oxygen to help breathing.

35. Clinical Tests & Procedures
Page 282
Clinical Tests & Procedures
Clinical Tests
Pap test (Pap smear)
Microscopic examination of stained cells removed from the vagina & cervix
Pregnancy test
Blood or urine test to detect the presence of hCG

36. Clinical Tests & Procedures: Cont.
Page 283
Clinical Tests & Procedures: Cont.
Procedures – X-Ray Studies
hysterosalpingography (HSG)
X-ray imaging of the uterus & fallopian tubes after injection of contrast material
mammography
X-ray imaging of the breast

37. Clinical Tests & Procedures: Cont.
Pages 283 – 284
Clinical Tests & Procedures: Cont.
Procedures – Ultrasound Examination & Magnetic Resonance Imaging (MRI)
breast ultrasound imaging & breast MRI
Technologies using sound waves & a magnetic field to create images of breast tissue
pelvic ultrasonography
Recording images of sound waves as they bounce off organs in the pelvic region

38. Clinical Tests & Procedures: Cont.
Pages 284 – 286
Clinical Tests & Procedures: Cont.
Gynecologic Procedures
aspiration
withdrawal of fluid from a cavity or sac with an instrument using suction
cauterization
Destruction of tissue by burning
colposcopy
visual examination of the vagina & cervix using a colposcope
conization
Removal of a cone-shaped section (cone biopsy) of the cervix
cryosurgery
Use of cold temperatures to destroy tissue

39. Clinical Tests & Procedures: Cont.
Pages 284 – 286
Clinical Tests & Procedures: Cont.
Gynecologic Procedures
culdocentsis
Needle aspiration of fluid from the cul-de-sac
dilation & curettage (D&C)
Widening the cervix & scraping off the endometrial lining of the uterus
exenteration
Removal of internal organs within a cavity
laparoscopy
Visual examination of the abdominal cavity using an endoscope (laparoscope)
tubal ligation
Blocking the fallopian tubes to prevent fertilization from occurring

40. Clinical Tests & Procedures: Cont.
Pages 286 – 287
Clinical Tests & Procedures: Cont.
Procedures – Procedures Related to Pregnancy
abortion (AB)
Termination of pregnancy before the embryo or fetus can exist on its own
amniocentesis
Needle puncture of the amniotic sac to withdraw amniotic fluid for analysis
cesarean section
Surgical incision of the abdominal wall & uterus to deliver a fetus
chronic villus sampling (CVS)
Sampling of placental tissues for prenatal diagnosis

41. Clinical Tests & Procedures: Cont.
Pages 286 – 287
Clinical Tests & Procedures: Cont.
Procedures – Procedures Related to Pregnancy
fetal monitoring
Continuous recording of the fetal heart rate & maternal uterine contractions to assess fetal status & progress of labor
In vitro fertilization (IVF)
Egg & sperm cells are combined outside the body in a laboratory dish (in vitro) to facilitate fertilization