PHYSIOLOGY FOR NURSING

LECTURE -7-
MALE REPRODUCTIVE
SYSTEM
FEMALE REPRODUCTIVE
SYSTEM
 INTRODUCTION
¢ Sexual reproduction produces new individuals:
— Gametes (sperm & ova) formed by testes and
ovaries.
— Fertilization produces one cell (a zygote) with
one set of chromosomes from each parent.
— Creates genetic variation.
¢ Gonads produce gametes & secrete sex hormones.

¢ Reproductive systems:

— Gonads, ducts, glands & supporting structures.

 REPRODUCTIVE AND HORMONAL
FUNCTIONS
OF THE MALE GENITAL SYSTEM
The reproductive functions of the male can
be divided into subdivisions:
(1) Spermatogenesis, which means the
formation of sperm.
(2) Performance of the male sexual act.
(3) Regulation of male reproductive
functions by the various hormones.
REPRODUCTIVE ORGANS
§ Primary sex organs = Testis
§ Secondary sex organs:

a) Pathway of spermatozoa:
— Epididymis.
— Ductus deferens (Vas deferens).
— Ejaculatory duct.

b) Accessory organs:
— Seminal vesicles.
— Prostate gland.
— Bulbourethral glands.
— Scrotal sac encloses testes.
— Penis.
FUNCTIONS OF THE TESTIS:
1- Gametogenic function :
the process of formation of the sperm
(spermatogenesis) by germ cells.
2- Hormonal function :
secretion of male sex hormones
(testicular androgens called
testosterone) by Leydig cells.
Longitudinal section of the Testis showing
multiple coiled seminiferous tubules.

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SEMINIFEROUS TUBULES: CONTAIN SERTOLI
CELLS , SPERMATOGONIA AND MATURE
SPERM.

7
¢ Sertolicells -- extend from basement membrane to lumen .
¢ Functions :
— Form blood-testis barrier.
— Support developing sperm cells (nutrition of the sperm) .
— Produce fluid & control release of sperm into lumen.
— Secrete inhibin which slows sperm production.
— Secrete androgen binding proteins.

BLOOD TESTIS BARRIER (8)

 Spermatogenesis

Definition: It is the process of formation of the

sperm by germ cells within the seminiferous
tubules of the testis.
q Occurs during active sexual life as the result of
stimulation by anterior pituitary gonadotropic
hormones.
q Begins at an average age of 13 years ( time
puberty in male).
q Continues throughout most of the remainder of
life but decreases markedly in old age.
The spermatogonia (primitive germ cells):
q Undergo mitotic division.
q Continually proliferate and differentiate to form
spermatid.
q Spermatids mature to sperms in sertoli cells.

q The duration of spermatogenesis is 65-70 days in human.

Steps of spermatogenesis:
Spermatogenesis is divided into 3 phases:
¢ 1-mitosis

¢ 2- meiosis

¢ 3- sperminogenesis = cell differentiation.

 FACTORS AFFECTING
SPERMATOGENESIS:

1. Hormonal Factors that affect spermatogenesis:

¢ Testosterone: High intratubular levels are essential for
normal spermatogenesis.

Ø Testosterone produced by Leydig cells, is concentrated in

the tubular fluid because of the presence of high levels of
androgen binding protein secreted by Sertoli cells.

¢ FSH: follicle stimulating hormone is necessary for

meiosis steps of spermatogenesis
¢ LH (luteinizing hormone):

Ø Stimulates spermatogenesis indirectly by enhancing

Leydig cell secretion of testosterone hormone.

¢ Prolactin, its role is not obvious in male however,

patients with oligospermia usually suffer from
hyperprolactinemia .

¢ Oestrogen depresses spermatogenesis by inhibiting

FSH release.

¢ Growth Hormone, and thyroxine are needed for

spermatogenesis for controlling metabolic functions of
the testes.
2.Temperature: Spermatogenesis requires a temperature
considerably lower than that of core body temperature. The
testes are outside the body, so normally maintained at
temperature of about 32°C.

3. Diet factors:

Ø Starvation or protein deficiency depresses spermatogenesis.

Ø Vitamin E, Folic acid and B12 are needed in

spermatogenesis for nucleic acid synthesis. Vit C is also
required for spermatogenesis.

4. Irradiation, bacterial toxins, chemical toxins and O2

lack: induced massive testicular germ cells damage.
 SEMEN:
¢ Mixture of sperms and seminal fluid.
¢ 60% from seminal vesicles, 30% from prostate.

¢ Slightly alkaline, milky appearance and sticky.

¢ Contains nutrients, clotting proteins & an
antibiotic to protect the sperms.
¢ Typical ejaculate is 2.5 to 5 ml in volume.
¢ Normal sperm count is 50 to 150 millions/ml.

— Only one can fertilize the ova.

— If less than 20 millions/ml ,this means sterile.
Functions of testosterone hormone:
1-Testosterones with FSH are responsible for
maintenance of spermatogenesis.
2-Testosterones is responsible for the primary and
secondary sexual characteristics that develop in
the male during adolescence.
v Development of internal and external genitalia.
v Deepening of the voice.
v Broad shoulder.
v Muscle enlargement.
v Growth of facial, axillary, and pubic hair.
v Beginnings of the sex drive.
3- General Anabolic Effects:
Ø Increases the synthesis and decrease breakdown
of protein leading to increase rate of growth.
Ø Cause fusion of epiphyses to the long bone, thus
eventually stop growth.
Ø Cause moderate sodium, potassium, water,
calcium, sulfate and phosphate retention.
Ø Increases the basal metabolic rate (BMR) is also
by probably as a result of the androgen anabolic
effect on proteins.
 HORMONAL CONTROL OF MALE PHYSIOLOGY
Hypothalamus
• Hypothalamus secretes
gonadotropin releasing
GnRh
hormone (GnRH).
• Anterior pituitary secretes
Anterior Pituitary
FSH and LH.
Follicle
Stimulating
Luteinizing • FSH causes Sertoli cells to
Hormone
Hormone secrete ABP and inhibin.
• LH causes interstitial cells to
Interstitial Cells
Sertoli Cells secrete testosterone.
Testosterone
• ABP and testosterone
Androgen Binding
Protein (ABP) +inhibin
stimulate spermatogenesis.
• Control is negative feedback
Spermatogenesis by ­testosterone and inhibin.
Hormonal control of testicular functions
Female reproductive
system
 Introduction
** The reproductive functions of the female begin
at puberty and ends at menopause.

** In men the tonic secretion of LH, FSH

and testosterone regulate the continuous production
of sperm.
** In women release only a single ovum at a time
from a limited pool of ova present at birth.
Female reproductive organs:
1- The primary sex organs : The ovaries.
Functions start at puberty and stop at
menopause (45-55y).
(a) Gametogenic function: Formation and
discharge mature ovum. 1 ≥ ovum /month.
(b) Hormonal function: Secretion of
estrogens, progesterone and inhibin .
2- Secondary sex organs: the vagina,
uterus, and fallopian tubes.
 Gametogenic function of the ovary
(oogenesis)
¢ The proliferation of the primitive germ cells in
the ovaries (the oogonia) occurs only during
embryonic life i.e. no new ova are formed after
birth.
¢ Ovarian functions start at puberty and stop at
menopause . Menopause occurs around the age
of 45-55y.
¢ Every month, only one ovum (sometimes more)
is discharge from the ovaries.
 FEMALE REPRODUCTIVE CYCLE
¢ Controlled by monthly hormonal cycle from the
hypothalamus, anterior pituitary and ovary.
¢ Monthly cycle of changes in ovary and uterus.
¢ Ovarian cycle:

— Is the changes in ovary during and after

maturation of the follicles and oocytes.
¢ Uterine cycle (menstrual cycle):

— Is the preparation of the uterus to receive

fertilized ovum.
— If implantation does not occur, the functional
layer of endometrium is shed during
menstruation.
HORMONAL REGULATION OF REPRODUCTIVE CYCLE

¢ Gonadotropin Releasing Hormone (GnRH),

secreted by the hypothalamus, controls the
female reproductive cycle.

— Stimulates anterior pituitary to secrete Follicle

Stimulating Hormone (FSH) & Luteinizing
Hormone (LH).

¢ FSH & LH target the ovaries and drive the

ovarian cycle.
¢ Estrogens and progesterone from the ovaries
drive the uterine cycle.
 PHASES OF OVARIAN CYCLE:
1-Follicular Phase: 2- Ovulation:
Starts with the first day of
It occurs usually on the 14th day
menstruation and ends with
(in female who has a regular 28
ovulation ( day 1- day 14).
days menstrual cycle).
¢ Follicle growth by FSH.
¢ Rupture of the graafian
¢ Follicles grow into Graafian
(mature) follicle. follicle [By LH].
¢ Granulosa cells of follicle secrete ¢ Release of oöcyte from ovary.

estrogens and inhibin. ¢ Ovulated oöcyte picked up by

¢ Increasing levels of estrogens fimbriae of fallopian tube.
and inhibin inhibit FSH
¢ Transported to the uterus.
(Negative feedback
Mechanism). ¢ It is fixed (if fertilized).

¢ Increasing estrogens also ¢ Or lost out during menses (if

stimulates secretion of LH. not fertilized).
(Positive feedback
mechanism).
PHASES OF OVARIAN CYCLE:
3-Luteal phase
(postovulatory phase):
from the 15th to the 28th days
of the cycle
— Development of corpus
luteum from ovulated or
ruptured follicle by LH.
— Corpus luteum secretes
mostly progesterone &
some estrogens.
— Progesterone prepares
endometrium for possible
pregnancy.
Ovarian Cycle

Follicular Phase Ovulation Luteal Phase

 PHASES OF UTERINE CYCLE:
1-Proliferative phase:
From the 5th day until the From the ovulation to the 28th
ovulation (14th day ). day.
— The growing follicle
secrets high estrogen
levels.
— Estrogen stimulates :
o Growth of the functional
layer of endometrium to 4-
10 mm thickness.
2-Secretory phase:
— The corpus luteum secretes
estrogen and progesterone.
— Progesterone stimulates:
¢ Increased thickening of the
functional layer of
endometrium to 12-18 mm.
¢ Increased blood supply
into the endometrium.
¢ Growth of endometrial
glands and secretion of
uterine milk.
¢ Progesterone prepares
endometrium for possible
pregnancy.
 PHASES OF UTERINE CYCLE:
3-Menstruation phase (menses):

From 1- 5 days of the cycle and it

coincides with the first 5 days of
the follicular phase.
— Decline in progesterone
levels causes functional layer
of endometrium to
degenerate resulting in
vaginal bleeding called
menstruation.
— Mark the beginning of the
next cycle.
¢Uterine Cycle
SUMMARY OF OVARIAN AND MENSTRUAL CYCLES
NEGATIVE FEEDBACK CONTROL
OF FEMALE CYCLE:
If no pregnancy: If pregnancy occur

— Increasing levels of ¢ Corpus luteum continues to

progesterone cause develop and secrete
negative feedback that (progesterone and estrogen) for
inhibits LH secretion. the first 2-4 months of
— After about two weeks pregnancy until placenta
corpus luteum atrophies to developed.
corpus albicans (white
body).
— Progesterone and estrogen
levels decline.
— Functional layer of
endometrium sheded into
first five days of next cycle.
 NEGATIVE FEEDBACK CONTROL
OF FEMALE CYCLE:
Starting the next cycle:

¢ With the decline in progesterone,

estrogens and inhibin secretion:-

¢ Inhibition of GnRH, FSH

and LH stops.

¢ Renewed secretion of these

hormones starts a new cycle
of growth and preparation
in ovaries and uterus.
Functions of estrogens:
1- On secondary sex organs:
At puberty stimulate the rapid growth of secondary sex organs.
2- On the ovary:
Essential for ovulation.
3- On the uterus:
(a) It causes proliferate the endometrial glands and blood vessels.
(b) Together with progesterone it induces the endometrial changes in the
secretory phase of the uterine cycle.
4- On secondary sex characters:
Responsible for the feminine contour of females
5- Metabolic effects:
(a) Protein metabolism: It has a protein anabolic effect.
(b)Fat metabolism: It lower the plasma cholesterol level and inhibit
atherosclerosis in premenopausal women..
(c) Sodium and water retention.
(d) Skeleton: It increases the osteoblastic activity and rapid closure of
epiphysis.
Functions of progesterone:
1- On the ovary: Large doses of progesterone inhibit
ovulation due to its inhibition of LH secretion.
2- On the uterus:
(a) It is responsible for the secretory changes in the
endometrium.
(b) It is essential for the formation of the placenta
and embedding of the fertilized ovum.
3- Thermogenic effect: It rises body temperature 0.5
°C at the time of ovulation.
4- On the GIT: It inhibits the intestinal motility, so it
may be responsible for the constipation during
pregnancy.
 Stages of Pregnancy and Development

• Fertilization
• Embryonic
development
• Fetal
development

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

 Mechanisms of Fertilization
• The oocyte is viable for 12 to 24 hours after ovulation.
• Sperm are viable for 12 to 48 hours after ejaculation.
• Sperm cells must reach the uterine tube, the site for
fertilization to be possible.
• Fertilization occurs when the genetic material of a
sperm and an oocyte combine to form zygote.
• Membrane receptors on an oocyte pulls in the head
of the first sperm cell to make contact.
• The oocyte then undergoes its second meiotic
division.
• The membrane of the oocyte does not permit a second
sperm head to enter.

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

 The Zygote

• Results from the fusion of DNA of sperm and

oocyte.
• Begins rapid mitotic cell divisions.
• Occurs in the uterine tube.
• Moves toward the uterus.
• Develops into embryo (implantation).

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

 Functions of the Placenta
• Forms a barrier between mother and embryo
(blood is not mixed).
• Delivers nutrients and oxygen.
• Removes waste from embryonic blood.
• Becomes an endocrine organ and takes over
for the corpus luteum:
• Estrogen
• Progesterone
• Other hormones that maintain pregnancy

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

 PHYSIOLOGICAL EFFECTS OF PREGNANCY ON THE MOTHER
— 1. Gastrointestinal system:
q Morning sickness is common due to elevated progesterone..
q Heartburn is common because of organ crowding by the fetus..
q Constipation is caused by decrease motility of the digestive tract.
— 2. Urinary System:
q Kidneys have additional burden and more urine is produced .
q Frequent micturation due to pressure on the bladder.
— 3. Respiratory System:
q Respiratory rate increase.
— 4. Cardiovascular system:
q Blood volume increases by 25 to 40 %.
q Blood pressure and pulse increase.
q Varicose veins are common.
 PHYSIOLOGY OF THE BREAST

Hormones needed for milk production and

secretion:
Estrogens develop the ducts system in the breasts.
Progestrone develop the alveoli.
Prolactin stimulate milk synthesis in the alveoli.
Oxytocin stimulate milk ejection from the alveoli.

Milk ejection reflex (release from mammary glands):

Suckling stimulates the hypothalamus to produce oxytocin.
Oxytocin secreted from the posterior pituitary.
Oxytocin causes smooth muscles around alveoli to contract and squeeze milk into lactiferous ducts,
lactiferous sinuses and into the nipple.
Operated by positive feedback.