The Reproductive System Make gametes – egg & sperm Deliver sperm Place for gametes to meet - fertilization Place for the embryo/fetus to grow Way to get out – delivery Way to feed the newborn

(urogenital diaphragm) Pelvic diaphragm (urogenital diaphragm) Levator ani coccygeus piriformis

Episiotomy Perineum

Gynecomastia: abnormally large breasts in male, hormonal imbalances

Fig. 26.23(TE Art) Glandular tissue – glands & ducts Superficial fascia Suspensory ligaments Areola Nipple Pectoralis major muscle Deep fascia Lactiferous duct Glandular tissue – glands & ducts Connective tissue – ligaments Adipose tissue

Axillary tail Retromammary space

Breast Cancer Breast cancer is the #1 (maybe #2 now) cause of death of women between the ages of 35-54 1.5% of breast cancer incidence and mortality occur in men (1300 cases, 400 deaths per year) Women in the US have a 1 in 8 lifetime risk of developing breast cancer Age 20: 1 in 2,187 Age 30: 1 in 258 Age 40: 1 in 67 (start having yearly mammograms) Age 50: 1 in 38

Uterine tube ovary peritoneum uterus Cervix of uterus vagina bladder & urethra Labia minora Labia majora clitoris Recto-uterine pouch Vesico-uterine pouch

infundibulum isthmus Uterine tube ampulla ovary fimbriae Broad ligament cervix vagina

Ovarian ligament medulla cortex Suspensory ligament Fimbriae of uterine tube Tunica albuginea Birth: 2 million primary oocytes Puberty: 400,000

ampulla isthmus infundibulum Fimbriae Tubal ligation

fundus Body endometrium Myometrium perimetrium cervix Cervical canal (smooth mm) perimetrium cervix Cervical canal Cervical glands

Endometrium Stratum functionalis Stratum basalis myometrium

Uterine ligaments Suspensory ligament Broad ligament Round ligament Cardinal ligament Uterosacral ligament Rectouterine pouch Vesicouterine pouch Ectopic pregnancy

mesosalpinx mesovarium mesosalpinx mesovarium Broad ligament

TDF No TDF glans glans CC & CS Labia minora scrotum Labia majora

Mons pubis clitoris Labia majora Urethra orifice Vestibule Labia minora Vaginal orifice glans clitoris crus Paraurethral gland Vestibular bulb Greater vestibular gland

Pelvic diaphragm Testes, scrotum, penis Ductus (vas) deferens Urethra (prostatic, membranous, spongy) Parietal peritoneum Bladder, rectum Prostate gland

Tunica vaginalis (parietal & visceral layers) Spermatic cord ductus deferens blood vessels Pampiniform plexus nerves Ductus deferens epididymis Rete testes Efferent ductule Semitubes – spermatogenesis – ahead one slide – then back Tunica vaginalis (parietal & visceral layers) Seminiferous tubules (spermatogenesis) Tunica albuginea Pathway of sperm

Interstitial (Leydig) cell hypothalamus Pituitary gland FSH & LH Test. Interstitial (Leydig) cell Secrete testosterone Sustentacular (Sertoli) cell: bind testosterone Blood – testes barrier

Layers of scrotum 3 ways to keep sperm at right temperature Superficial Inguinal ring External spermatic fascia (internal spermatic fascia) Cremaster muscle Pampiniform plexus Tunica vaginalis Testes Covered with TA Median septum of scrotum Dartos muscle 3 ways to keep sperm at right temperature

Removed skin and fat (scrotum) Inguinal canal

Spermatic cord covered with spermatic fascia (external, cremaster mm, internal) Testes covered with tunica albuginea (tunica vaginalis removed)

cryptorchidism

Sperm Facts It takes 74 days for sperm to mature Young men make 300,000 sperm/minute or 400 million/day Avg. sperm count 50-120 million sperm/mL Lower than 20-25 million/mL = infertility Sperm count has dropped over last 60 years avg. 113 million/mL in 1940 avg. 66 million/mL today semen volume has decreased as well

Testicular cancer cancer of the testes most common in males age 15-35 abnormal mass in testes good survival rate if found early – orchiotomy Lance Armstrong 1996 – diagnosed with testicular cancer metastasized to lungs & brain 1997 – clean bill of health 1999 – won 1st Tour de France

vasectomy

60% of semen fructose, fibrinogen & PG’s Seminal vesicle Prostate gland 30% of semen base, clotting enzymes & fibrinolysin Bulbourethral gland base & lubricant Dorsal view

Internal urethral sphincter Prostatic utricle Ejc. ducts Spongy urethra Bulbourethral glands Ejaculatory ducts Prostatic urethra Membranous urethra Pelvic diaphragm External urethral sphincter

Dorsal vein Dorsal artery & nerve Corpus spongiosum C.C C.S Corpus cavernosum prepuce glans Urethral orifice circumcision

Parasympathetic NS: vasodilation Sympathetic NS: peristalsis, sphincter closure & muscle contraction (200 inches/sec)

Parasympathetic nerves Nitric oxide cGMP Dilate vessels + - Viagra Alcohol Drugs Antidepressants Appetite suppressors Vascular problems Diabetes Stress