1. CHAPTER 21 REPRODUCTIVE SYSTEM
Conception Erectile
Fertility Genital
Gestation Intercourse
Lactation Mammography
Menses Menstrual
Ovulation
Ectopic
Fibroid
Sterility
Journal question: What tests are used to detect abnormalities of the fetus during pregnancy?

2. Chapter 21 Learning Objectives
Define at least 10 terms relating to the reproductive system.
Describe the function of the reproductive system.
Identify at least 10 reproductive system structures and the function of each.

3. Chapter 21 Learning Objectives
Identify at least three methods of assessment of the reproductive system.

4. Structure and Function
Male and female reproductive organs produce sex cells called gametes.
Combination of the female gamete (ova) and male gamete (sperm) is called fertilization.
Puberty is the age at which the reproductive organs mature sufficiently to allow reproduction.

5. Fertilization
After a sperm has penetrated an egg, the outer shell of the ovum makes it impossible for any other sperm to penetrate it.
FIGURE 21-1 Fertilization.

6. Male Organs of Reproduction
Testes
Produce sperm
Secrete testosterone, causing the appearance of secondary sexual characteristics such as facial and body hair, deepened voice, increased muscle mass, and thickening of the bones
Epididymis
Tube on the surface of each testis that stores the sperm while they mature
Penis
Excretes semen and urine
The average lifespan of the sperm is 2 to 3 days.

7. Male Reproductive System
FIGURE 21-2 Male reproductive system.

8. Female Organs of Reproduction
Ovaries
Glands that produce eggs and the hormones, estrogen, and progesterone
Fallopian tubes
Transport the mature ovum from the ovary to the uterus
After release from the ovary, the average lifespan of an egg is 12 to 24 hours, after which it disintegrates or is flushed out of the body with the menstrual flow. 

9. Female Organs of Reproduction
Uterus
A muscular structure in which the zygote is implanted after conception
Cervix
Neck of the uterus
Opens for delivery of a fetus
Vagina
Muscular tube that extends from the cervix to the exterior of the body
Inner layer of the uterus is called the endometrium, which is shed during each menstrual cycle.

10. Internal Structure of the Female Reproductive System
FIGURE 21-4 The internal structures of the female reproductive system.

11. Female Organs of Reproduction
Vulva
External structures of the female reproductive system
Labia majora
Mons pubis
Labia minora
Clitoris
Bartholin’s glands
Mammary glands

12. Menstrual Cycle Lasts approximately 28 days
Complex process of hormone secretion and tissue changes in the uterus
A mature ovum is released from an ovary on about the 14th day of each cycle.
If the released ovum is not fertilized, the endometrium is released from the body along with the ovum.
Sloughing of this bloody tissue, or menses, lasts 3 to 7 days.
The menstrual cycle continues until 45 to 50 years of age.

13. Menstrual Cycle Discuss the phases of the menstrual cycle.
FIGURE 21-6 The menstrual cycle.

14. Menstrual Cycle Menopause Cessation of the menstrual cycle
Hot flashes are symptoms of reduction in hormone production.
Levels of estrogen and pituitary gonadotropins are reduced.
A woman’s ability to conceive or reproduce ceases without these hormones.
Another term for menopause is climacteric-–cessation of the cycle.

15. Pregnancy
Pregnancy results from the union of the ovum and sperm, usually in the fallopian tube.
Growth of an offspring in the uterus lasts about 280 days (9 months).

16. Pregnancy
The fertilized egg is known as a zygote from the time of conception to 2 weeks.
It is then considered to be the morula, and it enters the uterus.
The largest cell in the female human body is the ovum or egg in the ovaries.

17. Pregnancy
As a blastocyst, it implants in the uterine wall and is considered to be an embryo through the eighth week.
From 8 weeks to birth, the unborn baby is called a fetus.
During the first 30 days of life, the baby is considered to be a neonate.

18. Pregnancy Changes in the female reproductive system during pregnancy
Increase in muscle mass of the uterus
Elongation of the vagina
Uterus increased to 16 times normal size
Increase in secretions, vascularity, and elasticity of the cervix and vagina

19. Pregnancy Amniotic sac Membrane surrounding the fetus in the uterus
Filled with fluid to cushion and protect the fetus
Placenta formed by a portion of the uterus
Placenta filters the blood of the mother and provides oxygen and nutrients to the fetus.

20. Pregnancy Premature baby
Born before the 37th week of pregnancy or weighing less than 5 pounds
No single cause but influences include
Social factors
Environmental factors
Economic status
Nutritional deficits
Cost of care for a premature neonate ranges from $12,000 to $150,000.

21. Labor and Delivery Three stages of labor
First stage: Muscle contractions of the uterus cause the amniotic sac to rupture and the cervix to open (dilate) to about 10 cm in diameter, allowing passage of the fetus.
Labor is muscle contractions signalling the onset of delivery of the fetus.

22. Labor and Delivery
Second stage: Delivery of the baby is called parturition.
Third stage: Delivery of the afterbirth, or placenta, takes place about 15 minutes later.
Uterus shrinks back to normal size, and the hormonal balance of the body is re-established during the first 6 to 8 weeks after delivery of the baby.

23. Growth and Development
Growth refers to the changes that can be measured by changes in height and weight and the changes in body proportions.
Development describes the stages of change in psychological and social functioning.
Changes in growth and development occur in spurts throughout the lifespan.

24. Growth and Development
Neonate (first 4 weeks of life)
At birth the neonate
Is 19 to 21 inches long
Weighs about 7 to 8 pounds
Has a head that is about one fourth of length of the body

25. Assessment Techniques
Many disorders of the reproductive system can be assessed by palpation.
Other disorders are assessed with blood tests, with tissue culture, or by visual examination.
Cystoscopy
Method is used to view some of the reproductive structures.
Most disorders of the male reproductive system are treated by a urologist.
Disorders of the female reproductive system are treated by a gynecologist.

26. Assessment Techniques
Prostate-specific antigen (PSA) test
Blood test that measures PSA to detect prostate cancer in men
Pap smear
Cells of the cervix are removed and studied.

27. Assessment Techniques
Mammography
X-ray technique used to visualize breast tissue
Amniocentesis
Procedure in which amniotic fluid is removed and tested to detect abnormalities of the fetus

28. Examination for Breast Cancer
FIGURE 21-7 Examination for breast cancer. (From Damjanov I: Pathology for the health professions, ed 3, St. Louis, 2006, Saunders.)

29. Assessment Techniques
Ultrasonography
Uses high-frequency sound waves to visualize structures deep in the body
Chorionic villus sampling (CVS)
Laparoscopy procedure to allow prenatal evaluation of the fetus

30. Disorders of the Reproductive System
Benign prostatic hypertrophy
Age-associated condition in men in which the prostate grows and may stiffen, causing blockage of the urethra
Cancer of the female reproductive system
Breast cancer
Endometrial cancer
Cervical cancer

31. Disorders of the Reproductive System
Cancers of male reproductive system
Prostate cancer
Testicular cancer
Chancroid
Contagious bacterial infection characterized by painful ulcers on the genital area

32. Disorders of the Reproductive System
Chlamydia
Caused by the bacteria Chlamydia trachomatis
Most common sexually transmitted disease
Cryptorchidism
Failure of the testes to descend into the scrotal sac before birth

33. Cryptorchidism
FIGURE 21-11 Cryptorchidism. (From Damjanov I: Pathology for the health professions, ed 3, St. Louis, 2006, Saunders.)

34. Disorders of the Reproductive System
Ectopic pregnancy
One that occurs in an abnormal location in the body
Endometriosis
Growth of endometrial tissue in an area other than the uterus
The embryo or fetus does not usually survive in ectopic pregnancies, and the situation can be life threatening to the woman if rupture results in internal bleeding.

35. Disorders of the Reproductive System
Erythroblastosis fetalis
Condition that may develop in an Rh-positive fetus of an Rh-negative mother who has developed antibodies against the Rh blood protein in a prior pregnancy
Fetal alcohol syndrome
Physical and mental birth defects that result from damage to the fetus by alcohol consumed by the mother
About 5,000 to 12,000 babies are born with fetal alcohol syndrome each year.

36. Disorders of the Reproductive System
Fibroid tumors
Benign growths found in the uterus
Genital warts
Caused by one type of human papillomavirus called condyloma acuminata
Fibroids are found in 50% of women older than 50 years.
Genital warts can often reappear after treatment removes the wart.

37. Disorders of the Reproductive System
Gonorrhea
Bacterial infection and one of the most prevalent sexually transmitted diseases
Herpes simplex virus
One of the most common sexually transmitted diseases resulting in blisters, which open into painful sores.
Gonorrhea can lead to sterility and arthritis if untreated.
Gonorrhea may result in blindness in babies born to infected mothers.
Herpes simplex virus is the most commonly sexually transmitted disease, affecting about 30 million people. It is also called genital herpes.

38. Disorders of the Reproductive System
Human papillomavirus (HPV)
Infection often does not cause visible symptoms but may appear as genital warts.
Klinefelter's syndrome
Defect appearing in males who carry an extra chromosome, resulting in a karyotype of XXY
More than 40 types of HPV has been identified.
HPV infection is the most important risk factor for the development of cervical cancer.

39. Disorders of the Reproductive System
Leukorrhea
Whitish vaginal discharge
Menstrual disorders
Dysmenorrhea: painful menstrual cramping
Menorrhagia: excessive bleeding
Amenorrhea: no bleeding
Orchitis
Inflammation of the testes
Orchitis usually results from sexually transmitted infections or mumps.

40. Disorders of the Reproductive System
Pelvic inflammatory disease (PID)
Associated with infection by gonorrhea or Chlamydia
Phimosis
Narrowing of the foreskin of the glans penis
Usually caused by infections

41. Disorders of the Reproductive System
Premenstrual syndrome (PMS)
Women experience irritability, depression, impaired concentration, headache, and edema.
Pubic lice
Yellow-gray parasites found in the pubic hair
Evidence indicates that serotonin (a brain chemical) may affect a severe and disabling form of PMS called premenstrual dysphoric disorder (PMDD).

42. Disorders of the Reproductive System
Syphilis
Caused by a spirochete bacteria
Three stages
First stage: painless sores, or chancres
Second stage: infection spreads and causes fever, swollen glands, and rash
Third stage: symptoms appear years later and affect nervous system tissue
Syphilis can be successfully treated with antibiotics.

43. Disorders of the Reproductive System
Trichomonas vaginalis
Parasitic protozoon causing a foul-smelling, yellowish green discharge, and redness of the vulva, urinary frequency, or painful urination
Vaginitis
Infection that may cause a scant, gray, foul-smelling discharge

44. Disorders of the Reproductive System
Yeast infection
Overgrowth of yeast in the vagina appearing as a cottage cheese–like discharge

45. Issues and Innovations
Alternatives in conception
Birth control
Assisted reproductive technology (ART)
In vitro fertilization (IVF)
Intracytoplasmic sperm injection (ICSI)
Gamete intrafallopian transfer (GIFT)
Surrogacy

46. Issues and Innovations
Factors increasing risk of infertility
Age
Smoking
Stress
Alcohol use
Athletic training
Weight
Sexually transmitted infections (STIs)
One of every 10 women is infertile.

47. Issues and Innovations
Redefining the sexes
Changes in family structure and sexual orientation
Gender roles

48. Summary
The function of the reproductive system is to produce offspring.
Reproductive structures of the man include the testes, prostate gland, penis, ejaculatory duct, and seminal vesicle.

49. Summary
Reproductive structures of the woman include the ovaries, fallopian tubes, vagina, uterus, and cervix.
Methods to assess the reproductive system include self-examination, mammography, cystoscopy, and chorionic villus sampling.

50. Summary
Growth and development of the neonate change rapidly after birth and occur in spurts throughout the lifespan.
Disorders of the reproductive system include sexually transmitted diseases, cancers, ectopic pregnancies, erythroblastosis fetalis, and fetal alcohol syndrome.

51. Review
Endometriosis, a disorder of the reproductive system, is: a. A condition that may develop in an Rh+ fetus of an Rh– mother who has developed antibodies against the Rh blood protein b. A growth of endometrial tissue in an area other than the uterus c. A bacterial infection that is one of the most prevalent sexually transmitted diseases d. Caused by one type of human papillomavirus e. Caused by a virus and results in blisters that open into painful sores

52. Review
Endometriosis, a disorder of the reproductive system, is: a. A condition that may develop in an Rh+ fetus of an Rh– mother who has developed antibodies against the Rh blood protein b. A growth of endometrial tissue in an area other than the uterus c. A bacterial infection that is one of the most prevalent sexually transmitted diseases d. Caused by one type of human papillomavirus e. Caused by a virus and results in blisters that open into painful sores

53. Review
What virus is the most important risk factor for the development of cervical cancer? a. Herpes simplex I b. Herpes zoster c. Enterovirus d. Human papillomavirus (HPV) e. All of the above

54. Review
What virus is the most important risk factor for the development of cervical cancer? a. Herpes simplex I b. Herpes zoster c. Enterovirus d. Human papillomavirus (HPV) e. All of the above

55. Review
Chlamydia, caused by the bacterium Chlamydia trachomatis, is: a. A painless swelling of the scrotum b. A contagious bacterial infection characterized by painful sores in the genital area c. The most common sexually transmitted disease d. Failure of the testes to descend into the scrotal sac before birth e. An age-associated condition in men in which the prostate grows and may stiffen

56. Review
Chlamydia, caused by the bacterium Chlamydia trachomatis, is: a. A painless swelling of the scrotum b. A contagious bacterial infection characterized by painful sores in the genital area c. The most common sexually transmitted disease d. Failure of the testes to descend into the scrotal sac before birth e. An age-associated condition in men in which the prostate grows and may stiffen

57. Review Orchitis, a disorder of the reproductive system, is:
a. An inflammation of the testes usually resulting from sexually transmitted infection or mumps
b. A whitish vaginal discharge
c. A narrowing of the foreskin of the glans penis
d. Caused by spirochete bacteria
e. Caused by one type of human papillomavirus

58. Review Orchitis, a disorder of the reproductive system, is:
a. An inflammation of the testes usually resulting from sexually transmitted infection or mumps
b. A whitish vaginal discharge
c. A narrowing of the foreskin of the glans penis
d. Caused by spirochete bacteria
e. Caused by one type of human papillomavirus