The Reproductive Systems Lecture Outline

The Reproductive Systems Lecture Outline
Chapter 28 The Reproductive Systems Lecture Outline

INTRODUCTION Sexual reproduction is a process in which organisms produce offspring by means of germ cells called gametes. The organs of reproduction are grouped as gonads (produce gametes and secrete hormones), ducts (transport, receive, and store gametes), and accessory sex glands (produce materials that support gametes). Gynecology is the specialized branch of medicine concerned with the diagnosis and treatment of diseases of the female reproductive system. Urology is the study of the urinary system but also includes diagnosis and treatment of diseases and disorders of the male reproductive system. Principles of Human Anatomy and Physiology, 11e

Chapter 28 The Reproductive Systems
Sexual reproduction produces new individuals germ cells called gametes (sperm & 2nd oocyte) fertilization produces one cell with one set of chromosomes from each parent Gonads produce gametes & secrete sex hormones Reproductive systems gonads, ducts, glands & supporting structures Gynecology is study of female reproductive system Urology is study of urinary system & male reproductive system Principles of Human Anatomy and Physiology, 11e

MALE REPRODUCTIVE SYSTEM
The male structures of reproduction include the testes, a system of ducts (ductus epididymis, ductus deferens, ejaculatory duct, urethra), accessory sex glands (seminal vesicles, prostate gland, bulbourethral glands), and several supporting structures, including the penis (Figure 28.1). Principles of Human Anatomy and Physiology, 11e

Male Reproductive System
Gonads, ducts, sex glands & supporting structures Semen contains sperm plus glandular secretions Principles of Human Anatomy and Physiology, 11e

Scrotum The scrotum is a cutaneous outpouching of the abdomen that supports the testes; internally, a vertical septum divides it into two sacs, each containing a single testis (Figures 28.2). Skin contains dartos muscle causes wrinkling Temperature regulation of testes sperm survival requires 3 degrees lower temperature than core body temperature cremaster muscle in spermatic cord elevates testes on exposure to cold & during arousal warmth reverses the process Principles of Human Anatomy and Physiology, 11e

Scrotal Sacs, Dartos & Cremaster Mm
Principles of Human Anatomy and Physiology, 11e

Testes The testes, or testicles, are paired oval-shaped glands (gonads) in the scrotum (Figure 28.3). The testes contain seminiferous tubules (in which sperm cells are made) (figure 28.5). Embedded among the spermatogenic cells in the tubules are large Sertoli cells or sustentacular cells (Figure 28.4). The tight junctions of these cells form the blood-testis barrier that prevents an immune response against the surface antigens on the spermatogenic cells. Principles of Human Anatomy and Physiology, 11e

Testes Paired oval glands measuring 2 in. by 1in.
Surrounded by dense white capsule called tunica albuginea septa form compartments called lobules Each is filled with 2 or 3 seminiferous tubules where sperm are formed Principles of Human Anatomy and Physiology, 11e

Tunica Vaginalis Tunica vaginalis
Piece of peritoneum that descended with testes into scrotal sac. Facilitates movement of testes within scrotum Principles of Human Anatomy and Physiology, 11e

Descent of Testes Develop near kidney on posterior abdominal wall
Descends into scrotum by passing through inguinal canal during 7th month of fetal development Failure of the testes to descend is called cryptorchidism; it may involve one or both testes. Principles of Human Anatomy and Physiology, 11e

Cryptorchidism Testes do not descend into the scrotum
3% of full-term & 30% of premature infants Untreated bilateral cryptorchidism results in sterility & a greater risk of testicular cancer Descend spontaneously 80% of time during the first year of life surgical treatment necessary before 18 months Principles of Human Anatomy and Physiology, 11e

Testes - cells The sustentacular cells
nourish spermatocytes, spermatids, and spermatozoa mediate the effects of testosterone and follicle stimulating hormone on spermatogenesis phagocytose excess spermatids cytoplasm as development proceeds control movements of spermatogenic cells and the release of spermatozoa into the lumen of the seminiferous tubule secrete fluid for sperm transport and the hormone inhibin. The Leydig cells or interstitial endocrinocytes found in the spaces between adjacent seminiferous tubules secrete testosterone (Figure 28.4). Principles of Human Anatomy and Physiology, 11e

Spermatogenesis - Introduction
Spermatogenesis is the process by which the seminiferous tubules of the testes produce haploid sperm. (Review the discussion of reproductive cell division in Chapter 3. Take special note of Figures 3.33 and 3.34) It begins in the diploid spermatogia (stem cells). They undergo mitosis to reserve future stem cells and to develop cells (2n primary spermatocytes) for sperm production. Principles of Human Anatomy and Physiology, 11e

Spermatogenesis is formation of sperm cells from spermatogonia.

Spermatogenesis - Introduction
The diploid primary spermatocytes undergo meiosis I forming haploid secondary spermatocytes. Meiosis II  haploid spermatids. The spermatids are connected by cytoplasmic bridges. The final stage of spermatogenesis is spermiogenesis which is the maturation of the spermatids into sperm. The release of a sperm from its connection to a Sertoli cell is known as spermiation. Principles of Human Anatomy and Physiology, 11e

Review Review of Meiosis

Chromosomes in Somatic Cells & Gametes
Somatic cells (diploid cells) 23 pairs of chromosomes for a total of 46 each pair is homologous since contain similar genes in same order one member of each pair is from each parent 22 autosomes & 1 pair of sex chromosomes sex chromosomes are either X or Y females have two X chromosomes males have an X and a smaller Y chromosome Gametes (haploid cells) single set of chromosomes for a total of 23 produced by special type of division: meiosis Principles of Human Anatomy and Physiology, 11e

Meiosis I -- Prophase I tetrad
Chromosomes become visible, mitotic spindle appears, nuclear membrane & nucleoli disappear Events not seen in prophase of Metaphase or Meiosis II synapsis all copies of homologous chromosomes pair off forming a tetrad crossing-over portions of chromatids are exchanged between any members of the tetrad parts of maternal chromosomes may be exchanged with paternal ones genetic recombination produces gametes unlike either parent Principles of Human Anatomy and Physiology, 11e

Exchange of Genetic Material
Chromosomes are exchanged between chromatids on homologous chromosomes Principles of Human Anatomy and Physiology, 11e

Meiosis I -- Metaphase I, Anaphase I & Telophase I
In metaphase I, homologous pairs of chromosomes line up along metaphase plate with attached microtubules In anaphase I, each set of homologous chromatids held together by a centromere are pulled to opposite ends of the dividing cell Telophase I and cytokinesis are similar to mitotic division Result is 2 cells with haploid number of chromosomes Principles of Human Anatomy and Physiology, 11e

Meiosis II Consists of 4 phases : prophase II, metaphase II, anaphase II and telophase II Similar steps in this cellular process as in mitosis centromeres split sister chromatids separate and move toward opposite poles of the cell Each of the daughter cells produced by meiosis I divides during meiosis II and the net result is 4 genetically unique haploid cells or gametes. Principles of Human Anatomy and Physiology, 11e

Spermatagonium Principles of Human Anatomy and Physiology, 11e

Location of Stages of Sperm Formation
Seminiferous tubules contain all stages of sperm development: spermatogonia, primary spermatocyte, secondary spermatocyte, spermatid, spermatozoa supporting cells called sertoli cells Leydig cells in between tubules secrete testosterone Principles of Human Anatomy and Physiology, 11e

Supporting Cells of Sperm Formation
Sertoli cells -- extend from basement membrane to lumen form blood-testis barrier support developing sperm cells produce fluid & control release of sperm into lumen secrete inhibin which slows sperm production by inhibiting FSH Principles of Human Anatomy and Physiology, 11e

Spermatogenesis Spermatogonium (stem cells) give rise to 2 daughter cells by mitosis One daughter cell kept in reserve -- other becomes primary spermatocyte Primary spermatocyte goes through meiosis I DNA replication tetrad formation crossing over Principles of Human Anatomy and Physiology, 11e

Spermatogenesis Secondary spermatocytes are formed
23 chromosomes of which each is 2 chromatids joined by centromere goes through meiosis II 4 spermatids are formed each is haploid & unique all 4 remain in contact with cytoplasmic bridge accounts for synchronized release of sperm that are 50% X chromosome & 50% Y chromosome Principles of Human Anatomy and Physiology, 11e

Spermiogenesis & Spermiation
Spermiogenesis = maturation of spermatids into sperm cells Spermiation = release of a sperm cell from a sertoli (sustentacular) cell Principles of Human Anatomy and Physiology, 11e

Sperm Morphology (Figure 28.8)
Adapted for reaching & penetrating a secondary oocyte Head contains DNA & acrosome (hyaluronidase and proteinase enzymes) Midpiece contains mitochondria to form ATP Tail is flagellum used for locomotion They are produced at the rate of about 300 million per day and, once ejaculated, have a life expectancy of 48 hours within the female reproductive tract. Principles of Human Anatomy and Physiology, 11e

Hormonal Control of the Testes
GnRH (gonadotropin releasing hormone) stimulates anterior pituitary secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). LH assists spermatogenesis and stimulates production of testosterone. FHS initiates spermatogenesis Figure 28.7 summarizes the hormonal relationships of the hypothalamus, pituitary gland, and testes. Principles of Human Anatomy and Physiology, 11e

Hormonal Control of Spermatogenesis
Puberty hypothalamus increases its stimulation of anterior pituitary with releasing hormones (GnRH) anterior pituitary increases secretion LH & FSH LH stimulates Leydig cells to secrete testosterone an enzyme in prostate & seminal vesicles converts testosterone into dihydrotestosterone (DHT is more potent.) FSH stimulates spermatogenesis with testosterone, stimulates sertoli cells to secrete androgen-binding protein (keeps hormones levels high) testosterone stimulates final steps spermatogenesis Principles of Human Anatomy and Physiology, 11e

Hormonal Control of Spermatogenesis
Testosterone controls the growth, development, functioning, and maintenance of sex organs stimulates bone growth, protein anabolism, and sperm maturation stimulates development of male secondary sex characteristics. Negative feedback systems regulate testosterone production (Figure 28.8). Inhibin is produced by sustentacular (Sertoli) cells. Inhibition of FSH by inhibin helps to regulate the rate of spermatogenesis. Principles of Human Anatomy and Physiology, 11e

Hormonal Effects of Testosterone
Testosterone & DHT bind to receptors in cell nucleus & change genetic activity Prenatal effects  male genitalia At puberty, final development of 2nd sexual characteristics and adult reproductive system sexual behavior & libido male metabolism (bone & muscle mass heavier) deepening of the voice Principles of Human Anatomy and Physiology, 11e

Control of Testosterone Production
Negative feedback system controls blood levels of testosterone Receptors in hypothalamus detect increase in blood level Secretion of GnRH slowed Anterior pituitary (FSH & LH hormones) slowed Leydig cells of testes slowed Blood level returns normal Principles of Human Anatomy and Physiology, 11e

Effect of Inhibin Hormone
Sperm production is sufficient sertoli cells release inhibin inhibits FSH secretion by the anterior pituitary decreases sperm production Sperm production is proceeding too slowly less inhibin is released by the sertoli cells more FSH will be secreted sperm production will be increased Principles of Human Anatomy and Physiology, 11e

Reproductive System Ducts in Testes
The duct system of the testes includes the seminiferous tubules, straight tubules, rete testis, efferent ducts, and ductus epididymis. Principles of Human Anatomy and Physiology, 11e

Pathway of Sperm Flow through the Ducts of the Testis
Seminiferous tubules Straight tubules Rete testis Efferent ducts Ductus epididymis Ductus (vas) deferens Principles of Human Anatomy and Physiology, 11e

Epididymis The epididymis is a comma-shaped organ that lies along the posterior border of the testis (Figures 28.3a). Sperm are transported out of the testes through the efferent ducts in the epididymis which empty into a single tube called the ductus epididymis. The ductus epididymis is lined by stereocilia and is the site of sperm maturation and storage; sperm may remain in storage here for at least a month, after which they are either expelled or degenerated and reabsorbed. Principles of Human Anatomy and Physiology, 11e

Epididymis 1.5in long along posterior border of each testis
Head, body and tail region Multiple efferent ducts become a single ductus epididymis in the head region 20 foot tube if uncoiled Tail region continues as ductus deferens Principles of Human Anatomy and Physiology, 11e

Histology of the Epididymis
Ductus epididymis lined with pseudostratified ciliated columnar epithelium layer of smooth muscle Site of sperm maturation motility increases over 2 week period Storage for 1-2 months Propels sperm onward Principles of Human Anatomy and Physiology, 11e

Anatomy The ductus (vas) deferens, or seminal duct, stores sperm and propels them toward the urethra during ejaculation (Figures 28.3a). The spermatic cord is a supporting structure of the male reproductive system, consisting ductus deferens testicular artery autonomic nerves veins and lymphatic vessels cremaster muscle (Figure 28.2). Principles of Human Anatomy and Physiology, 11e

Spermatic Cord All structures passing to and from the testes
testicular artery pampiniform plexus of veins autonomic nerves lymphatic vessels ductus (vas) deferens cremaster muscle Principles of Human Anatomy and Physiology, 11e

Anatomy The ejaculatory ducts are formed by the union of the ducts from the seminal vesicles and ducti deferens; their function is to eject spermatozoa into the prostatic urethra (Figure 28.9). The male urethra is the shared terminal duct of the reproductive and urinary systems which serves as a passageway for semen and urine. The male urethra is subdivided into three portions: prostatic, membranous, and spongy (cavernous) (Figures 28.1 and 26.22). Principles of Human Anatomy and Physiology, 11e

Ejaculatory Ducts Posterior View
Formed from duct of seminal vesicle & ampulla of vas deferens About 1 inch long Adds fluid to prostatic urethra just before ejaculation Principles of Human Anatomy and Physiology, 11e

Ductus (Vas) Deferens Pathway of 18 inch muscular tube
ascends along posterior border of epididymis passes up through spermatic cord and inguinal ligament reaches posterior surface of urinary bladder empties into prostatic urethra with seminal vesicle Lined with pseudostratified columnar epithelium & covered with heavy coating of muscle convey sperm along through peristaltic contractions stored sperm remain viable for several months Principles of Human Anatomy and Physiology, 11e

Urethra 8 inch long passageway for urine & semen
Prostatic urethra (1 inch long) Membranous urethra (passes through UG diaphragm ) Penile (spongy) urethra (through corpus spongiosum) Principles of Human Anatomy and Physiology, 11e

Vasectomy Male sterilization Vas deferens cut & tied off
Sperm production continues Sperm degenerate 100% effective 40% reversible Principles of Human Anatomy and Physiology, 11e

Inguinal Canal & Inguinal Hernias
The inguinal canal is 2 inch long tunnel through (i.e., weak spot in) the 3 muscles of the anterior abdominal wall originates at deep inguinal ring and ends at superficial ring Hernia: a rupture or separation of a portion of the abdominal wall resulting in the protrusion of a part of an organ (most commonly the small or large intestine). Indirect hernia -- loop of intestine protruding through deep ring Direct hernia -- loop of intestine pushes through posterior wall of inguinal canal Principles of Human Anatomy and Physiology, 11e

Accessory Sex Glands The seminal vesicles secrete an alkaline, viscous fluid that contains fructose, prostaglandins, and clotting proteins (Figure 28.9). The alkaline nature of the fluid helps to neutralize acid in the male urethra and female reproductive tract. The fructose is for ATP production by sperm. Prostaglandins contribute to sperm motility and viability. Semenogelin is the main protein that causes coagulation of semen after ejaculation. Principles of Human Anatomy and Physiology, 11e

Accessory Sex Glands Principles of Human Anatomy and Physiology, 11e

Seminal Vesicles Posterior View
Pair of pouchlike organs found posterior to the base of bladder Alkaline, viscous fluid neutralizes vaginal acid & male urethra fructose prostaglandins coagulation proteins Posterior View Principles of Human Anatomy and Physiology, 11e

The prostate gland (Figure 28.9)
Is a donut shaped gland about the size of a golf ball which is inferior to the urinary bladder and surrounds the prostatic urethra. It secretes a milky, slightly acidic fluid that contains: citric acid, which can be used by sperm for ATP production acid phosphatase several proteolytic enzymes, including: prostate-specific antigen (PSA), pepsinogen, lysozyme, amylase, and hyaluronidase which liquefy coagulated semen. Prostatitis is a common group of disorders which may be characterized by symptoms such as difficult urination, urinary frequency, and pain; or which may be asymptomatic. Principles of Human Anatomy and Physiology, 11e

Prostate Gland Single organ size of chestnut inferior to bladder
pH 6.5 fluid citric acid enzymes for seminal liquefaction Many duct openings Enlarges with age Posterior View Principles of Human Anatomy and Physiology, 11e

Bulbourethral or Cowper’s Glands
The bulbourethral (Cowper’s) glands mucus for lubrication and an alkaline substance that neutralizes acid (Figure 28.9). Principles of Human Anatomy and Physiology, 11e

Bulbourethral or Cowper’s Glands
Paired, pea-sized gland within the urogenital diaphragm alkaline mucous connects to spongy urethra Posterior View Principles of Human Anatomy and Physiology, 11e

Secretions - Summary Semen (seminal fluid) is a mixture
spermatozoa and accessory sex gland secretions that provides the fluid in which spermatozoa are transported, provides nutrients, and neutralizes the acidity of the male urethra and female vagina antibiotic, seminal plasmin, and prostatic enzymes that coagulate and then liquefy semen to aid in its movement through the uterine cervix. Once ejaculated, liquid semen coagulates within 5 minutes due to the presence of clotting proteins from the seminal vesicles. After about minutes, semen re-liquifies because PSA and other proteolytic enzymes produced by the prostate gland break down the clot. Principles of Human Anatomy and Physiology, 11e

Semen Statistics Mixture of sperm & seminal fluid
slightly alkaline, milky appearance, sticky Typical ejaculate is 2.5 to 5 ml in volume Normal sperm count is 50 to 150 million/ml Coagulates within 5 minutes Reliquifies in 15 minutes Semen fertility analysis----bad news if sperm show lack of forward motility, low count or abnormal shapes. Principles of Human Anatomy and Physiology, 11e

Penis The penis contains the urethra and is a passageway for the ejaculation of semen Body composed of three erectile tissue masses filled with blood sinuses lined by endothelial cells surrounded by smooth muscle and elastic connective tissue. paired corpora cavernosa penis unpaired corpus spongiosum penis Four anatomical parts root = bulb + crura body glans penis Principles of Human Anatomy and Physiology, 11e

Anatomy of the Penis (Figure 28.10)
Passageway for semen & urine Body composed of three erectile tissue masses filled with blood sinuses Composed of bulb, crura, body & glans penis Principles of Human Anatomy and Physiology, 11e

Cross-Section of Penis
Corpora cavernosa upper paired, erectile tissue masses begins as crura of the penis attached to the ischial & pubic rami and covered by ischiocavernosus muscle Corpus spongiosum lower erectile tissue mass surrounds urethra begins as bulb of penis covered by bulbospongiosus muscle ends as glans penis All surrounded by the tunica albuginea Principles of Human Anatomy and Physiology, 11e

Glans Penis Enlarged distal end of corpus spongiosum
The distal end of the unpaired corpus spongiosum is the glans penis. External urethral orifice is spiral small slit The prepuce, or foreskin, covers the uncircumcised glans penis. Principles of Human Anatomy and Physiology, 11e

Circumcision Removal of prepuce 3 - 4 days after birth
Possibly lowers UTIs, cancer & sexually transmitted disease Principles of Human Anatomy and Physiology, 11e

Root of Penis & Muscles of Ejaculation
Bulb of penis or base of corpus spongiosum enclosed by bulbospongiosus muscle Crura of penis or ends of corpora cavernosa enclosed by ischiocavernosus muscle Principles of Human Anatomy and Physiology, 11e

Erection & Ejaculation
parasympathetic reflex causes erection sexual stimulation  dilation of arteries supplying the penis nitric oxide mediates local vasodilation veins become compress, and blood is trapped Ejaculation sympathetic reflex muscle contractions close sphincter at base of bladder peristaltic contractions in the ductus deferens, seminal vesicles, ejaculatory ducts and prostate propel semen into the penile portion of the spongy urethra ischiocavernous & bulbospongiosus promote emission Principles of Human Anatomy and Physiology, 11e

FEMALE REPRODUCTION SYSTEM
The female organs of reproduction include the ovaries (gonads), uterine (Fallopian) tubes, uterus, vagina, vulva, and mammary glands (Figure 28.11). Principles of Human Anatomy and Physiology, 11e

Female Reproductive System
Ovaries produce 2nd oocytes & hormones Uterine tubes transport fertilized ova Uterus where fetal development occurs Vagina & external genitalia constitute the vulva Mammary glands produce milk Principles of Human Anatomy and Physiology, 11e

Ovaries The ovaries are paired glands
Ovaries and testes are developmentally homologous. The ovaries are located in the upper pelvic cavity, on either side of the uterus. They are maintained in position by a series of ligaments (Figure 28.11b and 28.12). The histology of the ovary is illustrated in Figure Principles of Human Anatomy and Physiology, 11e

Reproductive Ligaments
Broad ligament suspends uterus from side wall of pelvis Mesovarium attaches ovaries to broad ligament Ovarian ligament anchors ovary to uterus Suspensory ligament covers blood vessels to ovaries Round ligament attaches ovaries to inguinal canal Principles of Human Anatomy and Physiology, 11e

Ovaries: Overview The germinal epithelium covers the surface of the ovary but does not give rise to ova. It is followed by the tunica albuginea, ovarian cortex (contains ovarian follicles), and ovarian medulla (containing blood vessels, lymphatics, and nerves). Ovarian follicles lie in the cortex and consist of oocytes in various stages of development. A mature (Graafian) follicle expels a secondary oocyte by a process called ovulation. A corpus luteum contains the remnants of an ovulated follicle and produces progesterone, estrogens, relaxin, and inhibin until it degenerates into a corpus albicans. Principles of Human Anatomy and Physiology, 11e

The Ovary: Anatomy Pair of organs, size of unshelled almonds found in upper pelvic region Regional histology tunica albuginea is capsule of dense connective tissue cortex is region just deep to tunica, containing follicles medulla is deeper region composed of connective tissue, blood vessels & lymphatics germinal epithelium is simple epithelial covering over the ovary Principles of Human Anatomy and Physiology, 11e

Oogenesis and Follicular Development
Oogenesis occurs in the ovaries. It results in the formation of a single haploid secondary oocyte. The oogenesis sequence includes reduction division (meiosis I), equatorial division (meiosis II), and maturation (Figure 28.15). While oogenesis is occurring, the follicle cells surrounding the oocyte are also undergoing developmental changes (Figures and 28.14). The sequence of follicular cell changes is: primordial, primary, secondary, and mature (Graffian) follicles, and corpus luteum and corpus albicans. Table 28.1 summarizes the events of oogenesis and follicular development. Principles of Human Anatomy and Physiology, 11e

Follicular Stages primordial primary secondary graafian ovulation
Corpus luteum is an ovulation wound fills in with hormone-secreting cells Corpus albicans is a white scar left after corpus luteum degenerates (when it is not needed.) An ovarian cyst is a fluid filled sac in or on an ovary. Most require no treatment, but the larger ones may require surgery. Principles of Human Anatomy and Physiology, 11e

Histology of a Graafian Follicle
Zona pellucida clear area between oocyte & granulosa cells Corona radiata granulosa cells attached to zona pellucida--still attached to oocyte at ovulation Antrum formed by granulosa cells secreting fluid By this time, the oocyte has reached the metaphase of meiosis II stage and stopped developing -- the first polar body has been discarded Principles of Human Anatomy and Physiology, 11e

Early Life History of Oogonia
Germ cells from yolk sac migrate to ovary & become oogonia In the female fetus, oogonia divide to produce millions by mitosis but most degenerate (atresia) Some develop into primary oocytes & stop in prophase stage of meiosis I 200,000 to 2 million are present at birth 40,000 remain at puberty, but only 400 mature during a woman’s life Each month, hormones cause meiosis I to resume in several follicles so that meiosis II is reached by ovulation Penetration by the sperm causes the final stages of meiosis to occur. Principles of Human Anatomy and Physiology, 11e

Review of Oogenesis Principles of Human Anatomy and Physiology, 11e

Follicular Development

Uterine or Fallopian Tubes
Narrow, 4-inch tube extends from ovary to uterus infundibulum is open, funnel-shaped portion near the ovary fimbriae are moving finger-like processes ampulla is central region of tube isthmus is narrowest portion joins uterus Principles of Human Anatomy and Physiology, 11e

Uterine Tube Histology: three layers
the internal mucosa, the middle muscularis, and the outer serosa (Figure a-c). Ciliated cells and peristaltic contractions help move a secondary oocyte toward the uterus. Principles of Human Anatomy and Physiology, 11e

Histology & Function of Uterine Tube
The uterine (Fallopian) tubes transport ova from the ovaries to the uterus and are the normal sites of fertilization (Figure 28.16). Histology = 3 Layers mucosa = ciliated columnar epithelium with secretory cells provide nutrients muscularis = circular & longitudinal smooth muscle peristalsis helps move ovum down to the uterus serosa = outer serous membrane Function -- events occurring in the uterine tube fimbriae sweep oocyte into tube cilia & peristalsis move it along sperm reaches oocyte in ampulla, fertilization occurs within 24 hours after ovulation zygote reaches uterus about 7 days after ovulation Principles of Human Anatomy and Physiology, 11e

Lining of the Uterine Tubes

Uterus The uterus (womb) is an organ the size and shape of an inverted pear that functions in the transport of spermatozoa, menstruation, implantation of a fertilized ovum, development of a fetus during pregnancy, and labor (Figure 28.18). Anatomical subdivisions fundus body isthmus cervix Principles of Human Anatomy and Physiology, 11e

Anatomy of the Uterus 3 inches long by 2 in. wide and 1 in. thick
subdivided fundus body isthmus cervix interior contains uterine cavity accessed by cervical canal (internal & external os) Principles of Human Anatomy and Physiology, 11e

Uterus – Clinical Application
The uterus normally projects anterior and superior to the urinary bladder in a position called anteflexion (Figure 28.11). The uterus is normally held in position by a series of ligaments (Figure 28.12). Uterine prolapse is a downward displacement of the uterus. It has many causes and may be characterized as first degree (mild), second degree (marked), or third degree (complete). Treatment depends on the degree of prolapse. Principles of Human Anatomy and Physiology, 11e

Position of Uterus Anteflexion -- normally projects anteriorly and superiorly over the urinary bladder Retroflexion -- posterior tilting of the uterus Principles of Human Anatomy and Physiology, 11e

Histology Histology (Figure 28.18) outer perimetrium middle myometrium
The myometrium consists of three muscle layers. inner endometrium, divided into stratum functionalis (shed during menstruation) stratum basalis (gives rise to a new stratum functionalis after each menstruation) Principles of Human Anatomy and Physiology, 11e

Histology of the Uterus
Endometrium simple columnar epithelium stroma of connective tissue and endometrial glands stratum functionalis shed during menstruation stratum basalis replaces stratum functionalis each month Myometrium 3 layers of smooth muscle Perimetrium visceral peritoneum Principles of Human Anatomy and Physiology, 11e

Blood Supply Blood is supplied to the uterus by the uterine arteries and their numerous branches and is drained by the uterine veins (Figure 28.19). Principles of Human Anatomy and Physiology, 11e

Blood Supply to the Uterus
Uterine arteries branch as arcuate arteries and radial arteries that supply the myometrium Straight & spiral branches penetrate to the endometrium spiral arteries supply the stratum functionalis their constriction due to hormonal changes starts menstrual cycle Principles of Human Anatomy and Physiology, 11e

Hysterectomy Surgical removal of the uterus Indications for surgery
endometriosis, ovarian cysts, excessive bleeding, cancer of cervix, uterus or ovaries Complete hysterectomy removes cervix Radical hysterectomy removes uterus, tubes, ovaries, part of vagina, pelvic lymph nodes and supporting ligaments Hysterectomy is the most common gynecological operation Principles of Human Anatomy and Physiology, 11e

Secretions and Functions
Secretory cells of the mucosa of the cervix produce a cervical mucus (a mixture of water, glycoprotein, serum-type proteins, lipids, enzymes, and inorganic salts) when thin, is more receptive to sperm when thick, forms a cervical plug that physically impedes sperm penetration mucus supplements the energy needs of the sperm. Both the cervix and the mucus serve as a sperm reservoir, protect sperm from the hostile environment of the vagina, and protect sperm from phagocytes. The cervix and the mucus also play a role in capacitation. Principles of Human Anatomy and Physiology, 11e

Vagina (Figures 28.11, 28.16) The vagina functions as a passageway for spermatozoa and the menstrual flow, the receptacle of the penis during sexual intercourse, and the lower portion of the birth canal 4 inch long fibromuscular organ ending at cervix mucosal layer stratified squamous epithelium & areolar connective tissue large stores of glycogen breakdown to produce acidic pH muscularis layer is smooth muscle allows considerable stretch adventitia is loose connective tissue that binds it to other organs lies between urinary bladder and rectum Principles of Human Anatomy and Physiology, 11e

Vagina - Anatomy The vaginal orifice is often partially covered by a thin fold of vascularized mucous membrane called the hymen. If the orifice is completely covered, this imperforate hymen must be surgically opened to permit menstrual flow (Figure 28.20). A small amount of vaginal discharge is normal and varies during the menstrual cycle. Abnormal discharge is heavier and thicker than usual, abnormal in color and odor, and accompanied by stinging, itching, or burning. It may be caused by infection or chemical irritation. Abnormal bleeding is any bleeding other than normal menstrual discharge. It has numerous causes. Principles of Human Anatomy and Physiology, 11e

Vagina - Histology The mucosa of the vagina is continuous with that of the uterus and lies in a series of transverse folds called rugae. Mucosa dendritic cells are APCs (antigen-presenting cells) that participate in the transmission of viruses, such as HIV, to a female during intercourse with an infected male. The mucosa contains large stores of glycogen which decompose into organic acids which set up a hostile acid environment for sperm. Alkaline components of semen neutralize the acidity and increase sperm viability. Principles of Human Anatomy and Physiology, 11e

Vulva The term vulva, or pudendum, refers to the external genitalia of the female (Figure 28.20). It consists of the mons pubs, labia majora, labia minora, clitoris, vestibule, vaginal and urethral orifices, hymen, bulb of the vestibule, and the paraurethral (Skene’s), greater vestibular (Bartholin’s), and lesser vestibular glands (Figure 28.21). Table 28.2 summarizes the homologous structures of the male and female reproductive systems. Principles of Human Anatomy and Physiology, 11e

Vulva (pudendum) Mons pubis -- fatty pad over the pubic symphysis
Labia majora & minora -- folds of skin encircling vestibule where find urethral and vaginal openings Clitoris -- small mass of erectile tissue Bulb of vestibule -- masses of erectile tissue just deep to the labia on either side of the vaginal orifice Principles of Human Anatomy and Physiology, 11e

Perineum The perineum is the diamond-shaped area between the thighs and buttocks of both males and females that contains the external genitals and anus (Figure 28.21). During childbirth the emerging fetus may cause excessive stretching and tearing of the perineum. A physician may make a surgical incision (episiotomy) in this region to prevent excessive, jagged tears. Principles of Human Anatomy and Physiology, 11e

Perineum Diamond-shaped area between the thighs in both sexes
bounded by pubic symphysis and coccyx urogenital triangle contains external genitals anal triangle contains anus Principles of Human Anatomy and Physiology, 11e

Mammary Glands The mammary glands are modified sudoriferous (sweat) glands that lie over the pectoralis major and serratus anterior muscles (Figure 28.22). Milk-secreting cells, referred to as alveoli, are clustered in small compartments (lobules) within the breasts. The essential functions of the mammary glands are synthesis of milk, secretion and ejection of milk, which constitute lactation. Principles of Human Anatomy and Physiology, 11e

Mammary Glands Modified sweat glands that produce milk (lactation)
amount of adipose determines size of breast milk-secreting glands open by lactiferous ducts at the nipple areola is pigmented area around nipple suspensory ligaments suspend breast from deep fascia of pectoral muscles (aging & Cooper’s droop) Principles of Human Anatomy and Physiology, 11e

Fibrocystic Disease of the Breasts
Fibrocystic disease is the most common cause of a breast lump one or more cysts (fluid-filled sacs) thickening of alveoli (clusters of milk-secreting cells) develop Cause hormonal imbalance excess of estrogen or deficiency of progesterone in the postovulatory phase result is lumpy, swollen & tender breast a week before menstruation begins Principles of Human Anatomy and Physiology, 11e

Female Reproductive Cycle - Introduction
The general term female reproductive cycle encompasses the ovarian and uterine cycles, the hormonal changes that regulate them, and cyclical changes in the breasts and the cervix Controlled by monthly hormone cycle of anterior pituitary, hypothalamus & ovary Ovarian cycle changes in ovary during & after maturation of oocyte The uterine (menstrual) cycle involves changes in the endometrium preparation of uterus to receive fertilized ovum if implantation does not occur, the stratum functionalis is shed during menstruation Principles of Human Anatomy and Physiology, 11e

Hormonal Regulation of Reproductive Cycle
GnRH secreted by the hypothalamus controls the female reproductive cycle stimulates the release of FSH and LH by the anterior pituitary gland (Figure 28.23). FSH initiates growth of follicles that secrete estrogen estrogen maintains reproductive organs LH stimulates ovulation & promotes formation of the corpus luteum which secretes estrogens, progesterone, relaxin & inhibin progesterone prepares uterus for implantation and the mammary glands for milk secretion relaxin facilitates implantation in the relaxed uterus inhibin inhibits the secretion of FSH At least six different estrogens have been isolated from the plasma of human females, with three in significant quantities: beta-estradiol, estrone, and estriol. Principles of Human Anatomy and Physiology, 11e

Overview of Hormonal Regulation

Overview of Female Reproductive Cycle

Estrogens have several important functions:
Promotion of the development and maintenance of female reproductive structures, secondary sex characteristics, and the breasts. Increase protein anabolism and build strong bones. Lower blood cholesterol. Moderate levels of estrogens in the blood inhibit the release of GnRH by the hypothalamus and secretion of LH and FSH by the anterior pituitary gland. Progesterone works with estrogens to prepare the endometrium for implantation and the mammary glands for milk synthesis. Principles of Human Anatomy and Physiology, 11e

Other Hormones A small quantity of relaxin is produced monthly to relax the uterus by inhibiting contractions (making it easier for a fertilized ovum to implant in the uterus). During pregnancy, relaxin relaxes the pubic symphysis and helps dilate the uterine cervix to facilitate delivery. Inhibin inhibits secretion of FHS and GnRH and, to a lesser extent, LH. It might be important in decreasing secretion of FHS and LH toward the end of the uterine cycle. Principles of Human Anatomy and Physiology, 11e

Hormonal Changes Principles of Human Anatomy and Physiology, 11e

Phases of the Female Reproductive Cycle
The female reproductive cycle may be divided into four phases (Figure 28.24). The menstrual cycle (menstruation) lasts for approximately the first 5 days of the cycle. During this phase, small secondary follicles in each ovary begin to develop. the stratum functionalis layer of the endometrium is shed, discharging blood, tissue fluid, mucus, and epithelial cells. Principles of Human Anatomy and Physiology, 11e

Menstrual Phase - 5 days First day is considered beginning of the 28 day cycle In ovary 20 follicles that began to develop 6 days before are now beginning to secrete estrogen fluid is filling the antrum from granulosa cells In uterus declining levels of progesterone caused spiral arteries to constrict -- glandular tissue dies stratum functionalis layer is sloughed off along with 50 to 150 ml of blood (average.) Principles of Human Anatomy and Physiology, 11e

Preovulatory Phase - days 6-13
In the uterus (proliferative phase) the time between menstruation and ovulation. This phase is more variable in length that the other phases. endometrial repair occurs Principles of Human Anatomy and Physiology, 11e

Preovulatory Phase - days 6-13
In the ovary (follicular phase) primary follicle develop into secondary follicle (occasionally more than one) The dominant follicle continues to increase its estrogen production under the influence of an increasing level of LH (Figure 28.24). develops into a vesicular ovarian (Graafian) follicle, or mature follicle. by day 14, graafian follicle has enlarged & bulges at surface of the ovary (Figure 28.13). follicular secretion of estrogen & inhibin has slowed the secretion of FSH increasing estrogen levels trigger the secretion of LH In the uterus (proliferative phase) increasing estrogen levels have repaired & thickened the stratum functionalis to 4-10 mm in thickness Principles of Human Anatomy and Physiology, 11e

Ovulation Ovulation is the rupture of the vesicular ovarian (Graafian) follicle with release of the secondary oocyte into the pelvic cavity, usually occurring on day 14 in a 28-day cycle. high levels of estrogen during the last part of the preovulatory phase exert positive feedback on both LH and GnRH to cause ovulation (Figure 28.25). GnRH promotes release of FSH and more LH by the anterior pituitary gland. The LH surge brings about the ovulation. Principles of Human Anatomy and Physiology, 11e

Ovulation Rupture of follicle & release of 2nd oocyte on day 14 Cause
increasing levels of estrogen stimulate release of GnRH which stimulates anterior pituitary to release more LH Corpus hemorrhagicum results Principles of Human Anatomy and Physiology, 11e

Signs of Ovulation Increase in basal body temperature
Changes in cervical mucus Cervix softens Mittelschmerz---pain Principles of Human Anatomy and Physiology, 11e

Ovulation Following ovulation, the vesicular ovarian follicle collapses (and blood within it forms a clot) to become the corpus hemorrhagicum (Figure 28.13). The clot is eventually absorbed by the remaining follicle cells. In time, the follicular cells enlarge, change character, and form the corpus luteum, or yellow body, under the influence of LH. Stimulated by LH, the corpus luteum secretes estrogens and progesterone. Principles of Human Anatomy and Physiology, 11e

Phases - Postovulatory - days 15-28
Time between ovulation and onset of the next menstrual period. (Figure 28.26): most constant timeline = lasts 14 days In the ovary (luteal phase) both estrogen and progesterone are secreted in large quantities by the corpus luteum. if fertilization does not occur, then the corpus albicans is formed as hormone levels drop, secretion of GnRH, FSH & LH rise if fertilization does occur, then the developing embryo secretes human chorionic gonadotropin (hCG) which maintains health of corpus luteum & its hormone secretions Principles of Human Anatomy and Physiology, 11e

Phases - Postovulatory - days 15-28
Time between ovulation and onset of the next menstrual period. (Figure 28.26): most constant timeline = lasts 14 days In the uterus (secretory phase) hormones from corpus luteum promote thickening of endometrium to mm formation of more endometrial glands & vascularization if no fertilization occurs, menstrual phase will begin Principles of Human Anatomy and Physiology, 11e

Negative Feedback on GnRH

Fertilization If fertilization and implantation do occur, the corpus luteum is maintained The placenta will take over its hormone-producing function. During this time, the corpus luteum, maintained by human chorionic gonadotropin (hCG) from the developing placenta, secretes estrogens and progesterone to support pregnancy and breast development for lactation. Once the placenta begins its secretion, the role of the corpus luteum becomes minor. With reference to the uterus, this phase is also called the secretory phase because of the secretory activity of the endometrial glands as the endometrium thickens in anticipation of implantation. Principles of Human Anatomy and Physiology, 11e

Menstrual Abnormalities
Amenorrhea = absence of menstruation hormone imbalance, extreme weight loss or low body fat as with rigorous athletic training Dysmenorrhea = pain associated with menstruation severe enough to prevent normal functioning uterine tumors, ovarian cysts, endometriosis or intrauterine device Abnormal uterine bleeding = excessive amount or duration or intermenstrual fibroid tumors or hormonal imbalance Principles of Human Anatomy and Physiology, 11e

Review Figure summarizes the hormonal interactions during the ovarian and uterine cycles. Women athletes who train intensively may develop three conditions which disrupt their reproductive cycle. This is known as female athlete triad and consists of amenorrhea, disordered eating, and premature osteoporosis. Principles of Human Anatomy and Physiology, 11e

BIRTH CONTROL METHODS Several methods of birth control are available, each with advantages and disadvantages. Only total abstinence is 100% reliable is. Methods of birth control discussed in the text include surgical sterilization (vasectomy, tubal ligation), hormonal methods (oral contraception, the Norplant implant, Depo-Provera injection, the vaginal ring), intrauterine devices (IUDs), spermacides, barrier methods (condom, vaginal pouch, diaphragm, cervical cap), periodic abstinence (rhythm method, sympto-thermal method), coitus interruptus (withdrawal), and induced abortion (including the drug RU 486, or mifepristone). A summary of methods of birth control and their failure rates is presented in Table 28.3. Principles of Human Anatomy and Physiology, 11e

Surgical Sterilization
Male (vasectomy) removal of a portion of the vas deferens incision in posterior scrotal sac out patient & local anesthesia sperm can no longer reach the exterior degenerate and removed by phagocytosis sexual desire not effected since testosterone levels unchanged Female (tubal ligation) uterine tubes are tied closed and cut sperm can not reach oocyte Principles of Human Anatomy and Physiology, 11e

Hormonal Birth Control
Oral contraceptive --- “the pill” progesterone & estrogen combination pill negative feedback on the anterior pituitary & hypothalamus to prevent secretion of FSH & LH no follicular development or ovulation no possible pregnancy other benefits of the pill regulate menstrual cycle & reduce endometriosis Risks increased for smokers increased chances of blood clot formation Not recommended for people with liver disease, hypertension, heart disease, migraines Principles of Human Anatomy and Physiology, 11e

Other Hormonal Methods
Norplant surgically implanted capsules releasing progestin & inhibiting ovulation for 5 years Depo-provera intramuscular injection of progesterone every 3 months that changes uterine lining & ovum maturation Vaginal ring worn internally releasing progestin or combination of progestin & estrogen Principles of Human Anatomy and Physiology, 11e

Intrauterine Devices Small object made of plastic, copper or steel left in cavity of uterus changes uterine lining so is unfavorable for embryo implantation approved for 10 year usage May cause excessive bleeding or discomfort Principles of Human Anatomy and Physiology, 11e

Spermatocides Chemical substances in foam, cream, jelly, douche or suppository that kill sperm upon contact Available without prescription Normally used in conjunction with a barrier device May inactivate HIV virus & decrease incidence of gonorrhea Principles of Human Anatomy and Physiology, 11e

Mechanical Barriers Male & female condoms (vaginal pouch)
covers penis or lines vagina Diaphragm = dome-shaped cap over cervix prevents entry of sperm into uterus does not protect against AIDS or STD may cause recurrent UTIs All of the above may offer some protection against sexually transmitted disease Principles of Human Anatomy and Physiology, 11e

Physiological Methods of Birth Control
Rhythm method (periodic abstinence) abstaining from intercourse when secondary oocyte is likely to be viable (3 to 7 days of cycle) 3 days before ovulation, ovulation & 3 days after few women absolutely regular cycles will not know it was an irregular cycle until too late Sympto-thermal method observe body for signs of ovulation & abstain form intercourse accordingly increased basal body temperature & mucus changes problem is sperm is viable for 48 hours Coitus interruptus (withdrawal before ejaculation) Principles of Human Anatomy and Physiology, 11e

Induced Abortion Miscarriage is a spontaneous loss of the fetus
Induced abortions vacuum aspiration (suction) infusion of saline solution to kill embryo surgical evacuation (scraping) `RU 486 is called a nonsurgical abortion antiprogestin drug that causes uterine lining to collapse & embryo is lost (menstruation occurs) can be taken up to 5 weeks after conception Principles of Human Anatomy and Physiology, 11e

DEVELOPMENT OF THE REPRODUCTIVE SYSTEMS
The gonads develop from intermediate mesoderm(Figure 28.29). Indeterminate gonads appear during the fifth week of development Also, both mesonephric (Wolffian) ducts and paramesonephric (Mullerian ducts) are present and empty into the urogenital sinus. Principles of Human Anatomy and Physiology, 11e

If a SRY gene on the Y chromosome is expressed, the Sertoli cells begin to secrete Mullerian-inhibiting substance (MIS) which causes apoptosis of cells of the maramesonephric (Mullerian) ducts. The primitive gonadal tissue begins to secrete testosterone which cause the mesonephric duct to develop into the epididymis, ductur deferens, ejaculatory duct, and seminal vesicle. The testes connect to the mesonephric duct through a series of tubules that eventually become the seminiferous tublule. Principles of Human Anatomy and Physiology, 11e

In the female, SRY is absent. The gonads develop into ovaries, The paramesonephric ducts fuse to form the uterus and vaginal and the unfused portions become the fallopian tubes. The external genitalia develop from the genital tubercle (Figure 28.28). In male embryos, some testosterone is converted to dihydrotestosterone (DHT). This causes the genital tubercle to develop into the urethra, prostate, and external genitals. In the absence of DHT the genital tubercle develops into the clitoris, labia minora, labia majora, and vestible. Principles of Human Anatomy and Physiology, 11e

Early Developmental Anatomy
Male Duct Development Female Duct Development In 6 week old embryo, paramesonephric & mesonephric ducts are found near the gonadal bulge Principles of Human Anatomy and Physiology, 11e

Early Anatomy -- Male Pattern
Depends upon SRY gene on Y chromosome sertoli cells secrete Mullerian inhibiting substance leydig cells secrete testosterone causing mesonephric duct to develop into male tubes seminiferous tubules, epididymis & vas deferens & seminal vesicles prostate & cowper’s glands are outgrowths of urethra testosterone secretion stops at birth when hCG from the placenta stops stimulating leydig cells Principles of Human Anatomy and Physiology, 11e

Early Anatomy -- Female Pattern
Females have 2 X chromosomes so SRY gene is absent Gonads develop into ovaries no mullerian-inhibiting substance is produced so female pattern of duct development occurs paramesonephric duct develops into vagina, uterus & uterine tubes mesonephric ducts degenerate Female pattern depends on the absence of testosterone Early Anatomy -- Female Pattern Principles of Human Anatomy and Physiology, 11e

Development of External Genitalia
External genitals similar at 8 weeks (genital tubercle) DHT causes external male structures to develop before birth Labioscrotal swelling scrotum or labia majora Urethral folds spongy penile urethra or labia minora Glans area glans penis or clitoris Absence of DHT results in development of female Principles of Human Anatomy and Physiology, 11e

Deficiency of 5 Alpha-Reductase
Rare genetic defect producing a deficiency of 5 alpha-reductase enzyme that converts testosterone into dihydrotestosterone (DHT) At birth, baby looks externally female due to lack of DHT during development At puberty, testosterone levels rise masculine characteristics appear breasts fail to develop an internal exam reveals testes & other structures Principles of Human Anatomy and Physiology, 11e

AGING AND THE REPRODUCTIVE SYSTEMS
Puberty refers to the period of time when secondary sexual characteristics begin to develop and the potential for sexual reproduction is reached. In males, declining reproduction function is more subtle, with males often retaining reproductive capacity into their 80s or 90s. In males, decreasing levels of testosterone decrease muscle strength, sexual desire, and viable sperm. Prostate disorders are increasingly common with age, particularly benign hypertrophy. Principles of Human Anatomy and Physiology, 11e

AGING AND THE REPRODUCTIVE SYSTEMS
In females, the reproductive cycle normally occurs once each month from menarche, the first menses, to menopause, the last menses. Between the ages of 40 and 50 the ovaries become less responsive to the stimulation of gonadotropic hormones from the anterior pituitary. As a result, estrogen and progesterone production decline, and follicles do not undergo normal development. In addition to the symptoms of menopause, such as hot flashes, copious sweating, headache, vaginal dryness, depression, weight gain, and emotional fluctuations, with age females also experience increased incidence of osteoporosis, uterine cancer, and breast cancer. Principles of Human Anatomy and Physiology, 11e

Aging Male Reproductive System
Decline in reproductive function is more subtle (capacity may remain into 90’s) Decline in testosterone at 55 reduced muscle synthesis fewer viable sperm reduced sexual desire Enlargement of prostate (benign hyperplasia) 1/3 of males over 60 frequent urination, decreased force of stream, bed-wetting & sensation of incomplete emptying Principles of Human Anatomy and Physiology, 11e

DISORDERS: HOMEOSTATIC IMBALANCES

Reproductive System Disorders in Males
Prostate Disorders In acute prostatitis, the prostate gland becomes swollen and tender. In chronic prostatitis, one of the most common chronic infections in men of the middle and later years, the gland feels enlarged, soft, and very tender with an irregular surface outline. Principles of Human Anatomy and Physiology, 11e

Testicular Cancer Most common cancer in age group 20-35
one of the most curable Begins as problem with spermatogenic cells within the seminiferous tubules Sign is mass within the testis Regular self-examination is important Principles of Human Anatomy and Physiology, 11e

Prostate Cancer Leading male cancer death
treatment is surgery, radiation, hormonal and chemotherapy Blood test for prostate-specific antigen (PSA) enzyme of epithelial cells amount increases with enlargement (indication of infection, benign enlargement or cancer) Treatment for prostate cancer may involve surgery, radiation, hormonal therapy, or chemotherapy. Over 40 yearly rectal exam of prostate gland Acute or chronic prostatitis is an infection of prostate causing swelling, tenderness & blockage of urine flow treat with antibiotics Principles of Human Anatomy and Physiology, 11e

Reproductive System Disorders in Males
Premature ejaculation is ejaculation that occurs too early. It is usually caused by anxiety or other psychological causes, or an unusually sensitive foreskin or glans penis. Principles of Human Anatomy and Physiology, 11e

Erectile Dysfunction (Impotence)
Consistent inability of adult male to hold an erection long enough for sexual intercourse Causes psychological or emotional factors physical factors diabetes mellitus, vascular disturbances, neurological disturbances, testosterone deficiency, drugs (alcohol, nicotine, antidepressants, tranquilizers,etc) Viagra causes vasodilation of penile arteries and brings on an erection Principles of Human Anatomy and Physiology, 11e

Reproductive System Disorders in Females
Premenstrual syndrome (PMS) refers to severe physical and emotional distress that occurs during the postovulatory (luteal) phase of the female reproductive cycle. Endometriosis is characterized by the growth of endometrial tissue outside the uterus. The tissue enters the pelvic cavity via the open uterine tubes and may be found in any of several sites - on ovaries, rectouterine pouch, surface of the uterus, sigmoid colon, pelvic and abdominal lymph nodes, cervix, abdominal wall, kidneys, and/or urinary bladder. Symptoms include premenstrual pain or unusual menstrual pain. Principles of Human Anatomy and Physiology, 11e

Endometriosis Growth of endometrial tissue outside of the uterus
tissue discharged from open-end of uterine tubes during menstruation can cover ovaries, outer surface of uterus, colon, kidneys and bladder Problem is tissue responds to hormonal changes by proliferating then breaking down & bleeding causes pain, scarring & infertility Principles of Human Anatomy and Physiology, 11e

Breast cancer is the second-leading cause of death from cancer in United States women. It is seldom seen before age 30, but its occurrence rises rapidly after menopause. Two genes increase susceptibility to breast cancer: BRCA1 (breast cancer 1) and BRCA2. Mutation of BRCA1 also confers high risk for ovarian cancer. Early detection - especially by breast self-examination and mammography - is still the most promising method to increase the survival rate for breast cancer. Principles of Human Anatomy and Physiology, 11e

Breast cancer is the second-leading cause of death from cancer in United States women. The factors that increase the risk of breast cancer development include family history of breast cancer, especially in a mother or sister; never having a child or having a first child after age 35; previous cancer in one breast; exposure to ionizing radiation, such as x-rays; excessive alcohol intake; and cigarette smoking. Treatment for breast cancer may involve hormone therapy, chemotherapy, radiation therapy, lumpectomy (removal of just the tumor and immediate surrounding tissue), a modified or radical mastectomy (removal of part or all of the affected breast, along with underlying pectoral muscles and the axillary lymph nodes in the latter case), or a combination of these. Radiation treatment and chemotherapy may follow the surgery. Principles of Human Anatomy and Physiology, 11e

Breast Cancer - Summary
Second-leading cause of cancer death in the U.S. 1 in 8 women affected rarely before 30, but more common after menopause 5% of cases are younger women (genetic mutation) Detection by self-examination & mammography ultrasound determines if lump is benign, fluid-filled cyst or solid & possibly malignant Risk factors family history, no children, radiation, alcohol & smoking Treatment lumpectomy, radical mastectomy, radiation therapy or chemotherapy Principles of Human Anatomy and Physiology, 11e

Ovarian cancer is the sixth most common form of cancer in females. Most common cause of gynecological deaths excluding breast cancer It is difficult to detect before it metastasizes beyond the ovaries. Risk factors include age (usually over age 50); race (white are at greatest risk); family history of ovarian cancer; never having children or first pregnancy after age 30; high-fat, low-fiber, vitamin A-deficient diet; and prolonged exposure to asbestos or talc. Early ovarian cancer has no symptoms or only mild ones associated with other common problems. Later-stage signs and symptoms include an enlarged abdomen, abdominal and/or pelvic pain, persistent gastrointestinal disturbances, urinary complications, menstrual irregularities, and heavy menstrual bleeding. Principles of Human Anatomy and Physiology, 11e

Cervical cancer starts with cervical dysplasia (change in shape, growth & number of cells) and can be diagnosed in its earliest stages with a Pap smear. There is some evidence linking cervical cancer to the virus that produces genital warts (papilloma virus). Other risk factors are increased incidence associated with an increased number of sexual partners, young age at first intercourse, and cigarette smoking. Principles of Human Anatomy and Physiology, 11e

Yeast Infection Vulvovaginal candidiasis is the most common form of vaginitis and is caused by the yeast like fungus Candida albicans. Candida albicans grows on mucous membranes Causes vulvovaginal candidiasis or vaginitis inflammation of the vagina severe itching and pain yellow cheesy discharge with odor The disorder, experienced at least once by about 75% of females, is usually a result of proliferation of the fungus following antibiotic therapy for another condition Principles of Human Anatomy and Physiology, 11e

Sexually Transmitted Disease
On the increase in the United States Chlamydia -- bacteria; asymptomatic, leads to sterility from scar tissue formation Gonorrhea -- bacteria, discharge common, blindness if newborn is infected during delivery Syphilis -- bacteria, painless sores (chancre), 2nd stage all organs involved, 3rd stage organ degeneration is apparent (neurosyphilis) Genital Herpes -- virus, incurable, painful blisters AIDS & hepatitis B --viruses (chapters 22 & 24) Principles of Human Anatomy and Physiology, 11e

Sexually transmitted diseases (STDs)
Chlaymdia is a STD caused by the bacterium Chlamydia trachomatis. At present chlamydia is the most prevalent and one of the most damaging of the STDs. In most cases, the initial infection is asymptomatic and difficult to recognize clinically. In males, urethritis is the principal result. In females, urethritis may spread through the reproductive tract and develop into inflammation of the uterine tubes, which increases the risk of ectopic pregnancy and sterility. Principles of Human Anatomy and Physiology, 11e

Sexually transmitted diseases (STDs)
Gonorrhea (“clap”) is an infectious STD that affects primarily the mucous membrane of the urogenital tract, the rectum, and occasionally the eyes. The disease is caused by the bacterium Neisseria gonorrhoreae. Males usually suffer inflammation of the urethra with pus and painful urination. In females, infection may occur in the urethra, vagina, and cervix, and their may be a discharge of pus. However, infected females often harbor the disease without any symptoms until it has progressed to a more advanced stage. If the uterine tubes become involved, pelvic inflammation may follow, often causing sterility and occasionally causing peritonitis. If the bacteria are transmitted to the eyes of a newborn in the birth canal, blindness can result. Administration of a 1% silver nitrate solution or penicillin or erythromycin in the neonate’s eyes prevents infection. Principles of Human Anatomy and Physiology, 11e

Sexually transmitted diseases
Syphilis is an STD caused by the bacterium Treponema pallidum. It is acquired through sexual contact, exchange of blood, or transmitted through the placenta to a fetus. The disease progresses through several stages: primary, secondary, latent, and tertiary. During the primary stage, the chief symptom is a painless open sore, called a chanker. A skin rash, fever, and aches in the joints usher in the secondary stage: a systemic infection. The tertiary stage occurs when signs of organ degeneration appear. Principles of Human Anatomy and Physiology, 11e

Sexually transmitted diseases
Genital herpes is an incurable STD caused by the type II herpes simplex virus (HSV-2). HSV-2 causes genital infections such as painful blisters on the prepuce, glans penis, and penile shaft in males and on the vulva or sometimes high up in the vagina in females. The blisters disappear and reappear in most patients, but the virus itself remains in the body. Principles of Human Anatomy and Physiology, 11e

end Principles of Human Anatomy and Physiology, 11e

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