Transcript Textbook For Nursing Assistants

Textbook For Nursing
Assistants
Chapter 33 – The Reproductive
System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 1
Reproduction
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 2
Reproduction
Reproduction is the process by which a
living thing makes more living things like
itself
Because all living things eventually die,
the ability to reproduce is essential for the
survival of any species
Without the ability to reproduce, the
species would slowly die off and cease to
exist
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Slide 3
Why do We Look Like Our Parents?
Each of us receives our genes, the bundles of DNA that
determine how we develop and what we look like
physically, from our parents
Your mother gave you half of your genes and your father
gave you the other half, to make a full set
This is why you may look a lot like either one of your
parents, or like a blend of the two
Or why you may look very much like one of your siblings,
and not much like another one
It all depends on the combination of genes that you
received
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Slide 4
Why do We Look Like Our Parents?
Each species has a set number of genes,
or chromosomes (human beings have 46
chromosomes)
This means that to keep the number of
chromosomes the same from generation
to generation, the father contributes 23
chromosomes and the mother contributes
23 chromosomes
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Slide 5
Why do We Look Like Our Parents?
The special cells contributed by each
parent that contain half of the normal
number of chromosomes are called sex
cells, or gametes
The male sex cell is called a sperm cell
The female sex cell is called an egg, or
ovum (ova, plural)
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Slide 6
Conception
When the sperm joins the egg, forming a
cell that contains the complete number of
chromosomes, conception (fertilization)
occurs
During the 9 months leading up to the birth
of a baby, the single original cell that
formed at conception copies itself over
and over again, forming all of the baby’s
tissues and organs
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Slide 7
Function of the Reproductive System
One of the main functions of the reproductive
system in both males and females is to produce
and transport sex cells
The male reproductive system is designed to produce
sperm and deposit it inside the female’s body
The female reproductive system is designed to
produce eggs, receive sperm cells, contain and
nourish a developing baby, give birth, and provide
nourishment after the baby’s birth by producing breast
milk
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Assistants.
Slide 8
The Female Reproduction
System
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Slide 9
Structure of the Female Reproductive System
The internal organs are
The ovaries, fallopian tubes, uterus, and
vagina
The outer structures are
The labia, the clitoris, and the vaginal opening
The accessory organs are
The breasts (mammary glands)
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Slide 10
Structure of the Female Reproductive System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 11
Structure of the Female Reproductive System
The ovaries
The ovaries are two small, almond-shaped organs located deep
inside the abdomen on either side of the uterus
The ovaries store the ova, or eggs
When a baby girl is born, her ovaries contain all of the eggs that
she will ever have
The stored eggs are kept in a “holding pattern” until they are
needed
Once a girl passes through puberty and reaches reproductive
age, she begins to ovulate
Ovulation is the release of a ripe, mature egg from the ovaries
each month
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Slide 12
Structure of the Female Reproductive System
The fallopian tubes
The fallopian tubes, also called uterine tubes or
oviducts, are slender tubes about 4 to 5 inches long
that transport the egg from the ovary to the uterus
After leaving the ovary, the egg moves through the
fluid in the abdomen to the entrance of the nearest
fallopian tube
The open ends of the fallopian tubes nearest the
ovaries have small, fringe-like projections called
fimbriae
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Slide 13
Structure of the Female Reproductive System
The fallopian tubes
The fimbriae beat in a wave-like motion, helping to
move the egg into the tube
Once in the fallopian tube, the egg moves toward the
uterus, helped along by the peristaltic contractions of
the smooth muscle layer in the walls of the fallopian
tube and the tiny, hair-like cilia on the lining of the
fallopian tube
Like the cilia in the airways of the lungs, the cilia in
the fallopian tubes move gently back and forth,
creating a sweeping motion that helps to move the
egg along the length of the tube
Conception, if it occurs, occurs in the fallopian tubes
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Slide 14
Structure of the Female Reproductive System
The uterus
The uterus, sometimes referred to as the womb, is a hollow,
pear-shaped organ
The uterus has three sections:
 The fundus is the upper, rounded portion of the uterus
 The body is the mid-portion of the uterus
 The cervix is the lower, narrow portion of the uterus
Normally, the cervix is closed, except for a very tiny opening
 When a woman is about to give birth, the cervix dilates (opens),
becoming as large as 10 centimeters in diameter
 Dilation of the cervix creates an opening wide enough for the baby
to pass through into the vagina
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Slide 15
Structure of the Female Reproductive System
The uterus
The walls of the uterus are made of thick,
smooth muscle tissue
The muscular walls of the uterus expand to
accommodate a growing baby and then
contract during labor to push the baby out
The inner cavity of the uterus is shaped like a
capital “T” and is lined with tissue called
endometrium
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Slide 16
Structure of the Female Reproductive System
The vagina
The vagina is a muscular tube about three inches
long that connects the uterus to the outside of the
body
The vagina is the receiving organ for sperm
It also serves as the birth canal, through which a baby
passes during birth
The mucous membrane lining of the vagina helps to
lubricate the vagina during sexual intercourse and
protect the body from infection
It contains many folds, which allow the vagina to
expand enough to allow a baby to pass through
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Slide 17
Structure of the Female Reproductive System
The vulva
The vulva consists of the vaginal opening, the labia,
and the clitoris
The vaginal opening, also called the vaginal orifice, is
where the vagina opens to the outside of the body
The vaginal opening is located between the external
urinary opening (the urinary meatus or urethral orifice)
and the anus
The area between the vaginal opening and the anus
is often called the perineum
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Slide 18
Structure of the Female Reproductive System
The vulva
The labia, or “lips,” are folds of tissue that surround the vaginal
opening
 The many folds of the external female reproductive system can
create difficulties with hygiene, especially if a woman is injured, ill,
or otherwise unable to provide for her own cleanliness needs
The clitoris is located at the upper folds of the internal labia
 This tissue, which is very sensitive to touch, helps to initiate a
woman’s sexual arousal
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Slide 19
Structure of the Female Reproductive System
The breasts
(mammary glands)
In women, the breasts
are considered
accessory organs of
the reproductive
system because they
play a role in
nourishing the newborn
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Slide 20
Structure of the Female Reproductive System
The breasts (mammary glands)
Although the female breasts develop during
puberty, they do not become functional until
the end of pregnancy
The breasts are made up of lobes or sections
that contain glandular tissue and fat
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Slide 21
Structure of the Female Reproductive System
The breasts (mammary glands)
When it is stimulated by the hormone
prolactin (which is secreted by the pituitary
gland at the end of pregnancy), the glandular
tissue of the breasts produces milk, a process
known as lactation
In response to an infant’s suckling, the
glandular tissue contracts, sending the milk
through the ducts to the nipple
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Slide 22
Function of the Female Reproductive System
Each month during a
woman’s reproductive
years (from puberty to
menopause), her
body prepares itself to
become pregnant
If pregnancy does not
occur, the woman has
a menstrual period
and the cycle begins
again
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Slide 23
Function of the Female Reproductive System
A biofeedback mechanism limits the number of follicles
that mature each month
The cycle begins when the pituitary gland releases folliclestimulating hormone (FSH), a hormone that causes about 20
eggs in the ovaries to begin to grow and mature
Each egg grows within its own “shell,” called a follicle
FSH also stimulates the follicles to produce estrogen, another
hormone
As the estrogen level increases, it “turns off” FSH production
One egg-containing follicle continues to grow and mature, and
the others die off
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Slide 24
Function of the Female Reproductive System
When the egg has matured, luteinizing hormone
(LH), another hormone released by the pituitary
gland, causes the follicle to burst, releasing the
egg from the ovary (ovulation)
Following ovulation, the empty follicle becomes
known as the corpus luteum
The corpus luteum continues to produce
estrogen, and it also begins to produce
progesterone
Estrogen and progesterone cause the uterus to
begin to prepare itself to receive a fertilized egg
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Slide 25
Function of the Female Reproductive System
In response to estrogen and progesterone, the
lining of the uterus (the endometrium) thickens,
creating a soft, nourishing environment for a
fertilized egg, should one arrive
Estrogen and progesterone allow the fertilized
egg to attach itself to the endometrium through a
process called implantation
Once the fertilized egg implants, it begins to
divide, forming the cells and tissues that will
eventually become a new human being
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Slide 26
Function of the Female Reproductive System
If fertilization does not occur, the egg
passes into the uterus, where it usually
dissolves
The levels of hormones decrease, causing
the endometrial lining to break down and
pass through the vagina as the menstrual
period
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Slide 27
Function of the Female Reproductive System
This cycle of hormone secretion and egg
development occurs in a regular pattern
throughout a woman’s reproductive years
The cycle from the first day of one
menstrual period until the start of another
one averages from 22 to 45 days
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Slide 28
The Effects of Aging on the Female Reproductive System
Increased difficulty becoming pregnant
Many women in their late 30s and early 40s have
difficulty becoming pregnant
This is because each month, the number of healthy
eggs remaining in a woman’s ovaries decreases
Fertility treatments, such as the use of drugs to cause
more eggs to ripen each month or in-vitro fertilization
(IVF), are often very helpful for women in this age
group who wish to become pregnant
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Slide 29
The Effects of Aging on the Female Reproductive System
Decreased sex hormone production
As a woman ages, her body produces lower
amounts of sex hormones, especially
estrogen and progesterone
Eventually, this decreased hormone
production results in menopause, the
complete ending of a woman’s menstrual
cycles
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Slide 30
The Effects of Aging on the Female Reproductive System
Menopause
Occurs in most women sometime between
the ages of 45 and 55 years and is caused by
the loss of ovary function due to age
After the onset of menopause, the
reproductive organs do not function and
shrink to the size they were before puberty
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Slide 31
The Effects of Aging on the Female Reproductive System
Effects of Menopause
Can cause many bothersome symptoms, including
“hot flashes,” irritability, a loss of energy, and an
inability to sleep
Decreased production of estrogen and progesterone,
which are “feminizing” hormones, may also cause
some women to develop facial hair and a coarse
(“scratchy”) voice
Some women experience vaginal dryness and
irritation and may need to use a lubricant during
sexual intercourse
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Slide 32
The Effects of Aging on the Female Reproductive System
Hormone replacement therapy (HRT)
Oral estrogen and progesterone
Helps to minimize some of the more annoying “side effects” of
menopause (such as hot flashes); may also help keep bones
strong and prevent heart disease and some types of dementia
However, other research indicates that HRT may actually
increase a woman’s chances of developing certain types of
cancer
Each woman must work with her health care provider to
determine whether HRT is right for her, given her unique
situation and health history
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Slide 33
Disorders of the Female Reproductive System
Menstrual disorders
A woman may have problems with her
menstrual cycle, such as irregular periods,
excessive pain, or excessive bleeding
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Slide 34
Disorders of the Female Reproductive System
Amenorrhea is the absence of menstrual
flow
Primary amenorrhea occurs when a girl has
not begun to menstruate by the age of 16
years
Secondary amenorrhea is the absence of
menstrual flow in a woman who has had
previous menstrual periods
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Slide 35
Disorders of the Female Reproductive System
Dysmenorrhea is painful menstruation
Many women experience cramps in the lower
abdomen during menstrual periods, but for
some women the pain is severe enough to
interfere with daily activities
Extremely painful periods that prevent a
woman from doing what she normally does
should be brought to the attention of a health
care provider
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Slide 36
Disorders of the Female Reproductive System
Menorrhagia is excessive bleeding during a
menstrual period
Either in terms of the amount of blood lost or the
number of days that bleeding lasts
Hormonal disturbances, infections, and growths
inside the uterus can cause menorrhagia
Excessive bleeding for an extended period of time
can cause a woman to become anemic from the
chronic blood loss
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Slide 37
Disorders of the Female Reproductive System
Infertility is the inability to become pregnant or to
carry a pregnancy to full term
Although the cause of a couple’s infertility may be
related to the man’s inability to produce the amount of
sperm needed to fertilize the egg, in many cases, it is
related to a problem with the woman’s reproductive
system
Hormone imbalances, deformities of the reproductive
organs, or scar tissue can lead to infertility
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Slide 38
Disorders of the Female Reproductive System
Cysts and non-cancerous growths or tumors
Many organs in the female reproductive system can be affected
by cysts or other non-cancerous growths
Although these cysts and growths are not cancerous, they can
still cause problems
Cysts can form on the ovaries after ovulation or in the lubricating
glands located inside the vagina, creating a painful, infected
lump that may have to be surgically drained
Fibroids (myomas) sometimes form in the muscle wall
of the uterus
Fibroids can cause problems during pregnancy if they are large
enough to crowd a developing baby inside the uterus
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Slide 39
Disorders of the Female Reproductive System
Cancer
Common cancers affecting the female
reproductive system include
Cervical cancer
Endometrial cancer
Ovarian cancer
Breast cancer
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Slide 40
Disorders of the Female Reproductive System
Cervical cancer (cancer of the cervix, the lower
region of the uterus)
Is more common among women between the ages of
30 and 50 years and can be caused by a sexually
transmitted viral infection
Other factors that can increase a woman’s risk of
developing cervical cancer include having sexual
intercourse at an early age and having multiple sexual
partners
If diagnosed early enough, cervical cancer can be
effectively treated without putting a woman’s ability to
have children at risk
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Slide 41
Disorders of the Female Reproductive System
Endometrial cancer (cancer of the lining
of the uterus)
The most common type of cancer that affects
the female reproductive tract
Most commonly occurs after menopause
First sign may be postmenopausal bleeding
(uterine bleeding that occurs after a woman
has completed menopause)
Postmenopausal bleeding can also result from
hormone imbalances
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Slide 42
Disorders of the Female Reproductive System
Ovarian cancer (cancer of the ovary)
Most commonly occurs in women between
the ages of 40 and 65 years
A leading cause of cancer death for women
Associated with a high rate of death because
it grows quickly and spreads easily to other
organs
Early diagnosis and treatment can improve a
woman’s chances of survival
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Slide 43
Disorders of the Female Reproductive System
Breast cancer is the most commonly
occurring cancer in women
Breast cancer can develop in women with
relatives with breast cancer, especially a
mother or sister
But it can also develop in women who have
no family history of the disease
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Slide 44
Disorders of the Female Reproductive System
Women are encouraged to get
into the habit of examining their
breasts at the same time each
month
Monthly breast self-exams can
help a woman to become
familiar with the way her breast
tissue normally looks and feels
This knowledge may allow her
to recognize lumps or other
problems that need to be
reported to the nurse or doctor
for further evaluation
Early detection and new
treatment methods for breast
cancer allow many women to be
completely cured of this disease
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Slide 45
Common Diagnostic Procedures
When preparing a female patient or resident for a
procedure used to diagnose problems with the
reproductive system:
Be especially careful to help maintain a woman’s modesty and
privacy
Make sure that the privacy curtains and the door are closed, and
keep sensitive body parts (such as the breasts or vulva) covered
as much as possible
Be aware that your patient or resident may be fearful or anxious
about the test results
Be careful not to give advice or tell the person what you would
do if you were in her situation
Instead, listen, give competent and compassionate care, and
report your observations to the nurse
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Slide 46
Common Diagnostic Procedures
Pap test
A Pap test (named after the doctor who
invented the test, George Papanicolaou) is
routinely performed to detect changes in the
cervix that may indicate early cervical cancer
The doctor uses a swab to gather a sample of
cells from the cervix, and then the cells are
examined under a microscope to make sure
they are healthy
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Slide 47
Common Diagnostic Procedures
Biopsy
In biopsy, a tissue sample is obtained and
examined under a microscope for cancerous
cells
Biopsy may be used to detect endometrial,
cervical, or breast cancer
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Slide 48
Common Diagnostic Procedures
Dilation and curettage (D&C)
A D&C is a surgical procedure
The cervix is dilated (made wider) and tissue
is curetted (scraped) from the inside of the
cervix and the uterus
This tissue is then examined to determine the
cause of abnormal bleeding
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Slide 49
Common Diagnostic Procedures
Imaging studies
Radiographic imaging studies can allow a
doctor to see tumors or scar tissue that may
be blocking the fallopian tubes, a common
cause of infertility
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Slide 50
Common Diagnostic Procedures
Ultrasonography
During an ultrasound study, sound waves are
“bounced off” an organ and then translated into a
three-dimensional image
Ultrasound can reveal tumors or cysts on the ovaries
and in other structures of the female reproductive
tract
Ultrasound can also be used to check break cysts
In addition, ultrasound is used when a woman is
pregnant to check on the fetus and make sure that it
is developing properly
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Slide 51
Common Diagnostic Procedures
Mammography
A mammogram is an x-ray of breast tissue
Mammography can detect breast lumps at a
very early stage, before they become large
enough to be seen or felt
Many doctors recommend that women
receive routine mammograms, in addition to
performing monthly breast self-exams
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Slide 52
Common Surgical Procedures
Mastectomy
A mastectomy (surgical removal of a breast) may be
performed on a woman who has been diagnosed with
certain types of breast cancer
For some women with breast cancer, the cancer can
be treated by removing only the cancerous lump and
some of the surrounding tissue
But for many women, the entire breast must be
removed to treat the cancer effectively
This means that in addition to healing physically
from the procedure, the woman will need to heal
emotionally
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Slide 53
Common Surgical Procedures
Hysterectomy
A hysterectomy (surgical removal of the uterus) is a
very common procedure
It may be used to treat uterine cancer, excessive
bleeding, or other disorders of the female
reproductive tract
When a hysterectomy is performed through an
incision in the abdomen, it is called a total abdominal
hysterectomy (TAH)
When it is performed through the vagina by cutting
around the cervix, it is called a total vaginal
hysterectomy (TVH)
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Slide 54
The Male Reproductive System
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Slide 55
Structure of the Male Reproductive System
The organs and
structures of the male
reproductive system
include:
The testicles (testes)
The epididymis
The vas deferens
The penis
Accessory organs
include:
The seminal vesicles
The prostrate gland
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Slide 56
Structure of the Male Reproductive System
The testicles (testes)
The testicles are two walnut-like organs located in the
scrotum, a loose, bag-like sac of skin that is
suspended outside of the body, between the thighs
The testicles have two important functions:
They secrete testosterone, the hormone that is responsible
for the development of male secondary sex characteristics
and for the proper functioning of the male reproductive
system
They produce sperm cells
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Slide 57
Structure of the Male Reproductive System
The epididymis
After the sperm cells leave the testes, they
move into the epididymis, a series of coiled
tubes where the sperm cells mature and gain
the ability to “swim.”
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Slide 58
Structure of the Male Reproductive System
A sperm cell’s ability to
swim comes from its
flagellum, a whip-like “tail”
The whip-like motion of the
flagellum moves the sperm
cell forward, allowing it to
“swim” through the female
reproductive tract in search
of an egg to fertilize
The sperm cell is the only
human body cell that has a
flagellum
Sperm cells
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Slide 59
Structure of the Male Reproductive System
The vas deferens
From the epididymis, the sperm cells move into the
vas deferens, a passageway that transports the
sperm cells to the urethra
While in the vas deferens, the sperm cells are mixed
with the secretions from the seminal vesicles and the
prostate gland
These secretions, which nourish and protect the
sperm, form the fluid portion of semen
In the prostate gland, the vas deferens joins with the
urethra, which is the final passageway through which
the sperm leaves the man’s body
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Slide 60
Structure of the Male Reproductive System
The penis
The male urethra is contained in the penis
Semen (and urine) leave the man’s body by
way of the external urinary opening, which is
located at the tip of the glans penis, the
enlarged portion at the end of the penis
If a male has not been circumcised, a loose
fold of skin called the foreskin covers the
glans penis
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Slide 61
Function of the Male Reproductive System
The function of the male reproductive
system is to:
Produce and nourish male sex cells (sperm)
Deposit these cells inside the female’s body
so that fertilization can occur
Sperm cells are deposited in the female
reproductive tract through the process of
ejaculation
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Slide 62
The Effects of Aging on the Male Reproductive System
Decreased frequency and duration of erections
Beginning at around the age of 20 years, production
of testosterone and sperm begins to gradually decline
A man can remain fertile until late in life, even as late
as 80 years of age
But, due to decreased testosterone, effects of aging
on the cardiovascular system, medications: erections
occur less frequently and for a shorter period of time
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Slide 63
The Effects of Aging on the Male Reproductive System
Enlargement of the prostate gland
As a man ages, the prostate gland tends to
enlarge
Because the prostate gland surrounds the
urethra, this enlargement can make urination
difficult
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Slide 64
Disorders of the Male Reproductive System
Impotence (erectile dysfunction)
The inability to achieve or maintain an erection long
enough to engage in sexual activity
A patient or resident may experience erectile
dysfunction for several reasons
Lowered levels of male hormones
Circulatory problems that restrict blood flow to the penis
Medications
Emotional disturbances
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Slide 65
Disorders of the Male Reproductive System
Cancer
Testicular cancer usually affects young to
middle-aged adult men and can easily spread
to other parts of the body through the
lymphatic system before it is detected
Prostate cancer most commonly occurs in
men older than 50 years
Penile cancer
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Slide 66
Common Diagnostic Procedures
Bloodwork
A blood sample can be used to determine hormone
levels (for example, in a man with erectile
dysfunction) or for prostate-specific antigen (PSA), a
substance that is found in the blood of men with
prostate problems
Biopsy
A biopsy may be necessary to test tissue for the
presence of cancer in the prostate gland or the testes
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Slide 67
Sexually Transmitted Diseases
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Slide 68
Sexually Transmitted Diseases
A sexually transmitted disease (STD) is an
infection that is most often transmitted by sexual
contact
These infections, also known as venereal
diseases, can be caused by bacteria or viruses
The pathogens are transmitted through semen
and vaginal secretions
Some STDs, such as acquired
immunodeficiency syndrome (AIDS), involve the
entire body
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Slide 69
Types of Sexually Transmitted Diseases
Herpes simplex is a viral infection
There are two forms of herpes simplex
Herpes simplex type I causes the common “cold
sore” or “fever blister” on the lip
Herpes simplex type II, or genital herpes, causes
painful blisters to form around the vaginal opening
and perineum (in women) or the external urinary
opening (in men)
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 70
Types of Sexually Transmitted Diseases
Gonorrhea is a bacterial infection
In men, the bacterium that causes gonorrhea
infects the urethra
In women, the bacterium can travel to the
fallopian tubes and into the abdominal cavity,
resulting in a condition called pelvic
inflammatory disease (PID)
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 71
Types of Sexually Transmitted Diseases
Chlamydia, the most commonly occurring
STD, is caused by a type of bacteria
Like gonorrhea, chlamydia often is not
associated with any noticeable symptoms
Chlamydia can cause infertility in both men
and women and is treated with an antibiotic
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 72
Types of Sexually Transmitted Diseases
Genital (venereal) warts are caused by a virus
In men infected with the virus, small, wart-like growths
may occur inside the urethra
In women, the warts may be seen around the vaginal
opening, inside the vagina, or on the cervix
Infection with genital warts increases a woman’s risk
of developing cervical cancer
Treatment may involve removal of the growths with a
laser
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
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Slide 73
Types of Sexually Transmitted Diseases
Syphilis is a bacterial infection
The signs and symptoms of syphilis occur in
three stages
During the first stage, a painless lesion is seen on the
genitals
In the second stage this lesion heals, and 2 to 4
weeks later, the person develops a skin rash and a
fever
As many as 20 or more years later, the pathogen can
become active again, resulting in the third stage
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Slide 74
Types of Sexually Transmitted Diseases
AIDS is caused by human
immunodeficiency virus (HIV)
HIV can be transmitted in semen, vaginal
secretions, or blood
To date, there is no cure for AIDS, and most
people with AIDS die as a result of the
disease
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Slide 75
Prevention of Sexually Transmitted Diseases
The following methods are useful in the
prevention of STDs
When having sexual relations, use a barrier, such as
a condom
Some contraceptive creams, when used with a
condom, help to increase the condom’s effectiveness
against both pregnancy and STDs
If you or your partner have signs or symptoms of an
STD, do not have sexual relations until treatment has
been sought
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Assistants.
Slide 76
End of Presentation
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Assistants.
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