1. Reproductive System PTA 120-Pathology Week 10

2. Objectives Describe the anatomy, physiology, and functions of the reproductive system. Demonstrate knowledge of reproductive disorder etiologies and pathologies including: o Breast Cancer o Pelvic floor incompetence and weakness

3. Objectives Discuss anatomic structures and physiologic processes related to the reproductive systems. Discuss physical effects of aging on the body. Define reproductive pathological conditions including signs and symptoms of each:

4. Objectives Discuss how reproductive pathologies can adversely affect function requiring the modification of treatment intervention to protect the patient from worsening the condition and optimize treatment outcomes. Discuss the modifications and precaution that may be required for the treatment of patients with urinary and reproductive disorders.

5. Textbooks Pathology for the Physical Therapist Assistant, Ch 11 Physical Therapy Clinical Handbook for PTAs

6. Female Reproductive System Essentials of Human Anatomy & Physiology 9th ed. Marieb

7. Support for the Uterus

8. Male Reproductive System Essentials of Human Anatomy & Physiology 9th ed. Marieb

9. Functions of the Reproductive System Female reproductive system o Produces female hormones to maintain the reproductive cycle o Produce egg cells and transport to site of fertilization o Provide safe and favorable environment for growth of embryo http://www.cchs.net/health/health- info/docs.asp Male reproductive system o Produce and secrete male sex hormones o Produce, maintain and transport reproductive cells and protective fluid

10. Physical Effects of Aging on the Reproductive System Physiologic ChangeFunctional Effect Ovaries cease releasing eggsMenstrual periods stop Decreased production of estrogen and testosterone hormones by ovaries, and by pituitary gland Vagina walls thin and become less elastic and rigid Decreased vaginal secretions and genital tissue Cessation of menstrual period, reproductive capacity lost Prostate tissue replaced with scar like tissue and enlarges Slowed urination and ejaculation http:..www.nlm.nih.gov/medlineplus

11. Breast Cancer Description o Malignant tumors in the breast o Can occur in men, but less common o Tends to metastasize through lymphatic system o ACS recommends all women perform breast self-examination each month o Inflammatory breast cancer Risk factors o Increasing age, female sex, Caucasian race o History of breast cancer in the family o Hormones, nullparity o History of hypertension, obesity, excessive alcohol consumption, diabetes o Radiation exposure to the thorax

12. Breast Cancer Signs and Symptoms o Small, painless lump Freely moveable that becomes fixed o Breast asymmetry, palpable nodules in the axilla, skin thickening and dimples, retraction of or discharge from the nipples o Paget’s disease of the breast Scaly, crusty patch on the nipple, areola and surrounding skin; red, swollen and tender breasts Treatment o Early detection through breast self-exams and mammography o Surgery o Radiation, chemotherapy, hormone therapy

13. Pelvic floor weakness Description o Pelvic floor muscles become weak and stretched and are no longer able to support the sphincters of the urethra and anus -> decreased bladder or bowel control o Common in women Etiology o Genetics o Pregnancy and vaginal delivery, multiple deliveries at increased risk o Obesity, constant heavy lifting and straining o Surgeries, episiotomy o Nerve damage

14. Pelvic floor weakness Signs and Symptoms o Urinary incontinence o Fecal incontinence if anal sphincter musculature is damaged o Stress incontinence due to increased intraabdominal pressure onto pelvic floor Sneezing, coughing, laughing Exercising, lifting heavy weights

15. Physical Therapy Pelvic floor strengthening – Kegel exercises, vaginal weighted inserts Biofeedback Electrical stimulation Patient may have urine leakage during physical activities

16. Other reproductive disorders Endometriosis, Premenstrual Syndrome o Modalities to decrease pain Uterine and ovarian Cancer o Mobility and strengthening after surgery Uterine Prolapse o Pelvic floor strengthening