REPRODUCTIVE NURSING SYSTEM

“REPRODUCTIVE SYSTEM ANATOMY & PHYSIOLOGY OF FETUS AND

BABY”

LECTURER:
Vetty Priscilla

1st group :

Rani Harlynd (1511314017)

Nofriyanti riska (1511314022)

NURSING FACULTY
ANDALAS UNIVERSITY
PADANG
2017/2018
 CHAPTER II

REPRODUCTIVE ANATOMY & PHYSIOLOGY

1. MALE REPRODUCTIVE SYSTEM

A. EXTERNAL MALE GENITALIA

1. Penis
The penis is the male organ of copulation (sexual intercourse) and is part
of the urinary system. The penis is made up of three columns of erectile
tissue covered by thick skin that is freely movable. Two of columns, the
cavernous bodies, contain blood spaces, which when empty cause the
penis to be limp (flaccid). The head of the penis is composed of an
enlarged portion of spongy tissue, which form a cap called the glans penis.
Covering the glans is the loosely fitting skin, called the prepuce, or
foreskin.
The penis has the following function :
1. It provides a passageway for urine to exit the body.
2. It deposits sperm in the female’s vagina to fertilize an ovum
 2. Scrotum
The scrotum is the wrinkled, pigmented pouch of skin, muscle and fascia
that lies beneath the penis and outside of the abdominal cavity. It is
divided into two sacs, with each sac containing ine testis (testicle), the
epididymis, and a portion of the spermatic cord.

B. INTERNAL MALE STRUCTURES

1. Testes
The testes are two oval-shaped glands approximately 5 cm long and 2.5
cm wide, located within the scrotal sac. They correspond to the ovaries of
the female. Each testis contains specialized tissue arranged in coiled tubes,
called seminiferous tubules, where the spermatozoa are produce. The two
principal functions of the testes are to manufacture sperm cells
(spermatogenesis) and to secrete male hormones (androgens).
 2. The Ductal System

The vas deferens is a cordlike duct that transports sperm from the
epididymis. One such duct travels from each testis up to the back of the
prostate and enters the urethra to form the ejaculatory ducts. Other
structures, such as blood vessels and nerves, also travel along with each
vas deferens and together form the spermatic cord. The urethra is the
terminal duct of the reproductive and urinary systems, serving as a
passageway for semen (fluid containing sperm) and urine. It passes
through the prostate gland and the penis and opens to the outside.

3. Accessory Glands

The accessory gland produce secretion for the following purposes :

 Nourish the sperm

 Protect the sperm from the acidic environment of the woman’s
vagina
 Enhance movement (motility) of the sperm
a. Seminal Vesicles

The seminal vesicles, which produce nutrient seminal fluid, and the prostate gland,
which produces alkaline prostatic fluid, are both connected to the ejaculatory duct
leading into the urethra. Their glandular lining produces a thick, milky secretion that
form much of the ejaculated semen. This secretion is thought to provide nourishment
and protection for the sperm

b. Prostate Gland
The prostate gland lies just under the bladder in the pelvis and surrounds the
middle portion of the urethra. Usually the size of a walnut, this gland enlarges
 with age. The prostate and the seminal vesicles above it produce fluid that
nourishes the sperm. This fluid provides most of the volume of semen, the
secretion in which the sperm is expelled during ejaculation. Other fluid that
makes up the semen comes from the vas deferens and from mucous glands in
the head of the penis.

c. Bulbourethral Gland (Cowper’s Gland)

The bulbourethral glands (Cowper’s glands) are two small structures about the
size of peas, located inferior to the prostate gland. They are composed of
several tubes whose epithelial linings secrete a mucus-like fluid. It is released
in response to sexual stimulation and lubricates the head of the penis in
preparation for sexual intercourse. Their existence is said to be constant, but
they gradually diminish in size with advancing age.

PHYSIOLOGY OF THE SEX ACT

Male Sexual Response

With sexual stimulation, the arteries leading to the penis dilate and increase blood
flow into erectile tissues. At the same time, the erectile tissue compresses the veins of
the penis, reducing blood flow away from the penis. Blood accumulates, causing the
penis to swell and elongate and producing an erection. As in women, the culmination
of sexual stimulation is an orgasm, a pleasurable feeling of physiologic and
psychological release.

Orgasm is accompanied by emission (movement of sperm from the testes and fluids
from the accessory glands) into the urethra, where it is mixed to form semen. As the
urethra fills with semen, the base of the erect penis contracts, which increases
pressure and forces the semen through the urethra to the outside (ejaculation). During
ejaculation, the ducts of the testes, epididymis, and vas deferens contract, causing
expulsion of sperm into the urethra, where the sperm mixes with the seminal and
prostatic fluids. These substances, together with mucus secreted by accessory glands,
form the semen, which is discharged from the urethra.

2.FEMALE REPRODUCTIVE SYSTEM

A. EXTERNAL FEMALE GENITALIA

1. Mons Pubis
The mons pubis is the elevated, rounded fleshy prominence over the symphysis pubis.
This fatty tissue and skin is covered with pubic hair after puberty. It protects the
symphysis pubis during sexual intercourse.

2. Labia
The labia majora (large lips), which are relatively large and fleshy, are comparable to
the scrotum in males. The labia majora contain sweat and sebaceous (oil-secreting)
glands; after puberty, they are covered with hair. Their function is to protect the
vaginal opening. The labia minora (small lips) are the delicate hairless inner folds of
skin; they can be very small or up to 2 inches wide. They lie just inside the labia
majora and surround the openings to the vagina and urethra. The labia minora grow
down from the anterior inner part of the labia majora on each side. They are highly
vascular and abundant in nerve supply. They lubricate the vulva, swell in response to
stimulation, and are highly sensitive.
3. Clitoris and Prepuce
The clitoris is a small, cylindrical mass of erectile tissue and nerves. It is located at
the anterior junction of the labia minora. There are folds above and below the clitoris.
The joining of the folds above the clitoris forms the prepuce, a hood-like covering
over the clitoris; the junction below the clitoris forms the frenulum.
A rich supply of blood vessels gives the clitoris a pink color. Like the penis, the
clitoris is very sensitive to touch, stimulation, and temperature and can become erect.
For its small size, it has a generous blood and nerve supply.

There are more free nerve endings of sensory reception located on the clitoris than on
any other part of the body, and it is, unsurprisingly, the most erotically sensitive part
of the genitalia for most females. Its function is sexual stimulation.

4. Vestibule
The vestibule is an oval area enclosed by the labia minora laterally. It is inside the
labia minora and outside of the hymen and is perforated by six openings. Opening
into the vestibule are the urethra from the urinary bladder, the vagina, and two sets of
glands. The opening to the vagina is called the introitus, and the half-moon–shaped
area behind the opening is called the fourchette. Through tiny ducts beside the
introitus, Bartholin’s glands, when stimulated, secrete mucus that supplies lubrication
for intercourse.
The vaginal opening is surrounded by the hymen (maidenhead). The hymen is a
tough, elastic, perforated, mucosa-covered tissue across the vaginal introitus. In a
virgin, the hymen may completely cover the opening, but it usually encircles the
opening like a tight ring. Because the degree of tightness varies among women, the
hymen may tear at the first attempt at intercourse, or it may be so soft and pliable that
no tearing occurs. In a woman who is not a virgin, the hymen usually appears as
small tags of tissue surrounding the vaginal opening, but the presence or absence of
the hymen can neither confirm nor rule out sexual experience.
5. Perineum
The perineum is the most posterior part of the external female reproductive organs.
This external region is located between the vulva and the anus. It is made up of skin,
muscle, and fascia. The perineum can become lacerated or incised during childbirth
and may need to be repaired with sutures. Incising the perineum area to provide more
space for the presenting part is called an episiotomy.

B.INTERNAL FEMALE REPRODUCTIVE ORGANS

1. Vagina

The vagina is a highly distensible musculo membranous canal situated in front of the
rectum and behind the bladder. It is a tubular, fibromuscular organ lined with mucous
membrane that lies in a series of transverse folds called rugae. The rugae allow for
extreme dilatation of the canal during labor and birth. The vagina is a canal that
connects the external genitals to the uterus. It receives the penis and the sperm
ejaculated during sexual intercourse, and it serves as an exit passageway for
menstrual blood and for the fetus during childbirth. In the adult, the vaginal cavity is
3 to 4 inches long.

2. Uterus

The uterus is a pear-shaped muscular organ at the top of the vagina. It lies behind the
bladder and in front of the rectum and is anchored in position by eight ligaments,
although it is not firmly attached or adherent to any part of the skeleton. The
following are the three function of the uterus :
 Menstruation : the uterus sloughs off the endometrium or lining of the uterus
 Pregnancy : the uterus support the fetus and allows the fetus to grow
 Labor and birth : the uterine muscles contract, and the cervix dilates during
labor to expel the fetus.

3. Cervix

The cervix, the lower part of the uterus, opens into the vagina and has a channel that
allows sperm to enter the uterus and menstrual discharge to exit. It is composed of
fibrous connective tissue.

4. Fallopian Tubes

The fallopian tubes are hollow, cylindrical structures that extend 2 to 3 inches from
the upper edges of the uterus toward the ovaries. Each tube is about 7 to 10 cm long
(4 inches) and approximately 0.7 cm in diameter.The end of each tube flares into a
funnel shape, providing a large opening for the egg to fall into when it is
releasedfrom the ovary. Cilia (beating, hair-like extensions on cells)line the fallopian
tube and the muscles in the tube’s wall.
The four functions of the fallopian tubes are to provide :
  A passageway in which sperm meet the ovum
 A side of fertilization, usually the outer third of the tube
 A safe, nourishing, environment for the ovum or zygote
 A means of transporting the ovum or zygotes to the corpus of the uterus

5. Ovaries

The ovaries are a set of paired glands resembling unshelled almonds set in the pelvic
cavity below and to either side of the umbilicus. They are usually pearl-colored and
oblong. They are homologous to the testes. Each ovary weighs from 2 to 5 grams and
is about 4 cm long, 2 cm wide, and 1 cm thick.
The ovaries have two main function :
 The development, maturation , and later expulsion of the ovum
 The secretion of hormones, chiefly estrogen and progesterone

Breast

The two mammary glands, or breasts, are accessory organs of the female
reproductive system that are specialized to secrete milk following pregnancy. They
overlie the pectoralis major muscles and extend from the second to the sixth ribs and
from the sternum to the axilla. Each breast has a nipple located near the tip, which is
surrounded by a circular area of pigmented skin called the areola.

Developing Baby

The womb is expanding, the baby is growing and taking all the nourishment from the
mother. What once started as a microscopic two-celled egg, will be formed into a
baby in just 12 weeks. The baby develops from conception to term, in a month-to-
month progress.
FETAL DEVELOPMENT
Embryonic Development at Specific Stages
First trimester

4 Weeks
• There are only the beginnings of facial features. All the major organs are starting to
form. Gill-like folds that develop into facial features, beginnings of the spinal cord,
skin is translucent, and rudimentary (basic; minimal) heart develops.

6 Weeks
• The length from crown to rump is about the size of a finger tip, ¾ ". The beginnings
of all the major organs will have formed.
• The embryo floats in a fluid filled bubble that will develop into the amniotic sac.
The sac is covered by a protective layer of cells, called chorion. The yolk sac supplies
the embryo with all its nutrients until the placenta is fully developed and takes over at
around the twelfth week. During the first 12 weeks, the embryo will develop features
and major organs of a human being. The embryo is susceptible to harmful
environmental influences. This is a vital time for the embryo to develop healthily;
taking supplements of folic acid, avoiding certain foods, and eliminating alcohol,
cigarettes, and any unnecessary drugs or medicines.

9 Weeks
• The length from crown to rump approximately 1 1/4". The facial features are
becoming more distinct, and the “tail” has disappeared. The muscles are also
developing. Eyes are formed but eyelids are still closed over them. Arms now bend at
the elbow and rudimentary hands and fingers develop. Knees will have formed and
developing feet with distinct toes.
• Heart- is now a four-chambered and fully formed organ; it beats about 180 times per
minute.
• Brain and nervous system- is four times the size it was at 6 weeks. Special glial cells
are being formed within the neural tube; they allow nerve cells to be joined so that
messages can be transmitted from the brain to the body.
• Digestive system- the mouth, intestine, and stomach are developing very rapidly,
but do not function yet.
• The fetal life-support system- the placental tissue that initially surrounds the fetus
and the amniotic sac is
becoming concentrated in one circular area on the womb wall to form the placenta.

12 Weeks
• At twelve weeks the fetus looks like a tiny human. It is about 2 1/2" long and
weighs 1/2 oz. Arms and legs are now beginning to move.
Skin is red and translucent. Fingers and toes are more defined, and nails are starting
to grow.
• Heart is complete and working, pumping blood to all parts of the body. Digestive
system has formed and is linked to the mouth and intestines. Sexual organs have
formed inside the body, but cannot yet establish the sex of the baby.
Second Trimester
20 Weeks
• By 20 weeks the fetus will be about 6 1/3" long and weighs 12 oz. Movements are
for more coordinated. The sexual organs are well developed and are usually visible
on ultra sound.
• The fetus is growing very quickly. At this stage, the mother should feel the
movements of the fetus. Movements are more noticeable as the fetus's leg bones
achieve their final relative proportions in a process called quickening.
Quickening is the process of muscles contracting that cause movement at the fetus's
synovial joints. The joint movement enhances the nutrition of the articular cartilage
and prevents the fusion of connective tissues within the joint. It also promotes bone
hardening.
• From now on, the fully developed placenta will provide all the fetus' needs until
birth; oxygen, nutrients and protective antibodies.

Third Trimester
29 Weeks
• By 29 weeks the baby is about 10" long and weighs about 2 lbs. 7 oz.
• The brain grows much larger, and fatty protective sheath covers the nerve fibers;
this important development allows brain impulses to travel faster, enhancing the
ability to learn. The lungs have developed most of their airways and air sacs. The
placenta is quite selective in what it allows to pass from the mother to the baby's
blood, stopping some harmful substances, such as certain drugs, from crossing over.
40 Weeks
• The baby is now ready to be born. When the head of the baby moves down from
high in the mother's abdomen and settles deeper into her pelvis in preparation for
birth, it is called engagement. This can happen any time between 36 weeks and labor.
• In the last four weeks of pregnancy the baby puts on a lot of weight and develops a
thick layer of fat. All organs are completely formed and functioning.
 REFERENCES

Leifer.2012. Maternity Nursing An Introductory Text. Canada : Elsevier Mosby

Lowdermilk. 2014. Maternity Nursing. USA : Elsevier Mosby
Woman’s Health Troughout The Lifespan.pdf