Beruflich Dokumente
Kultur Dokumente
CHILD
REPRODUCTIVE HEALTH
REVIEW OF THE ANATOMY AND
PHYSIOLOGY ON REPRODUCTION AND
CONCEPTION
SIDE VIEW OF THE MALE REPRODUCTIVE
ORGANS
MALE REPRODUCTIVE SYSTEM
A. EXTERNAL STRUCTURE
1. PENIS
FUNCTION:
• ORGAN FOR COPULATION
• PASSAGE FOR URINE AND SPERM
CORPORA CAVERNOSA – 2 LATERAL COLUMNS OF ERECTILE TISSUE
CORPUS SPONGIOSUM – COLUMN OF ERECTILE TISSUE ON THE UNDERSIDE OF THE
PENIS THAT INCREASE THE URETHRA
GLANS PENIS – CONE-SHAPED EXPANSION OF THE CORPUS SPONGIOSUM THAT IS
HIGHLY SENSITIVE TO SEXUAL STIMULUS
FRENULUM (PREPUCE OR FORESKIN) – SKIN FLAP THAT COVERS THE GLANS PENIS
IN UNCIRCUMCISED MEN
SMEGMA- CHEESY, NONFOUL WHITISH UNDER THE FORESKIN
2. SCROTUM- POUCH SHAPE; SUPPORTS THE TESTES , INTERNALLY, THE MEDIAL SEPTUM DIVIDES INTO 2 SACS
B INTERNAL STRUCTURE
1. TESTES- COVERED BY TUNICA VAGINALIS, 4 TO 5CM LONG
FXN: PRODUCTION OF TESTOSTERONE AND SITE FOR SPERMATOGENESIS (SPERM FORMATION) 400SPERMS/DAY
• SERTOLI CELLS- WITHIN THE SEMINIFEROUS TUBULES- RESP. FOR SUPPORTING & NURTURING
SPERMATOCYTES.
• SPERMATOZOA- MATURE CELLS
2. EPIDIDYMIS- TUBULAR SAC LOCATED NEXT TO EACH TESTIS (THAT IS A RESERVOIR FOR SPERM STORAGE
AND MATURATION
3.VAS DEFERENS – DUCT EXTENDING FROM THE EPIDIDYMIS TO THE EJACULATORY DUCT WHICH PROVIDES A
PASSAGEWAY FOR SPERMS
4. EJACULATORY DUCT- CANAL FORMED BY THE UNION OF THE VAS DEFERENS AND THE EXCRETORY DUCT
OF THE SEMINAL VESICLE, ENTERS THE URETHRA AT THE PROSTATE GLANDS
5. URETHRA – PASSAGEWAY FOR THE URINE AND SEMEN THAT EXTENDS FROM THE BLADDER TO THE
URETHRAL MEATUS
ACCESSORY GLANDS- PRODUCE SECRETIONS THAT FACILITATE TRANSPORTATION OF
SPERMATOZOA ALONG THE URETHRA DURING EJACULATION AND PROVIDE A TEMPORARY
SAFE FOR THE FRAGILE SPERMS
A) SEMINAL VESICLES – LOCATED BEHIND THE BLADDER AND INFRONT OF THE RECTUM,
DELIVER SECRETIONS TO THE URETHRA THROUGH THE EJACULATORY DUCTS
B) PROSTATE GLAND – SURROUNDS THE BASE OF THE URETHRA AND THE EJACULATORY
DUCT, SECRETES A CLEAR FLUID WITH A SLIGHTLY ACID PH RICH IN ACID PHOSPHATASE,
CITRIC ACID, ZINC AND PROTEOLYTIC ENZYMES
BULBOURETHRAL AND URETHRAL GLAND (COWPER GLANDS) – LIE AT THE BASE OF THE
PROSTATE AND ON EITHER SIDE OF THE MEMBRANOUS URETHRA
PRODUCE A CLEAR, ALKALINE MUCINOUS SUBSTANCE THAT LUBRICATES THE URETHRA
AND COATS ITS SURFACE:
THE ALKALINITY ASSISTS IN NEUTRALIZING ACIDIC FEMALE VAGINAL SECRETIONS,
WHICH WOULD DETRIMENTAL TO SPERM SURVIVAL
MALE REPRODUCTIVE SYSTEM PATHWAY OF
SPERM
• 1.SEMINIFEROUS TUBULES ( TESTES)
• 2.STRAIGHT TUBULES
• 3.BULBOURETHRAL GLAND
• 4.EFFERENT DUCTS
• 5.DUCTUS EPIDIDYMIS (STORAGE OF SPERM; 1 MONTH)
• 6.VAS DEFERENS ( STORAGE OF SPERM; FOR SEVERAL MONTHS)
• 7.PROSTATE GLAND
• 8.MEMBRANOUS URETHRA PASSAGEWAY FOR SPERM AND URINE
• 9.PENILE URETHRA
MALE BREAST
MAMMARY TISSUE REMAINS DORMANT THROUGHOUT LIFE, BUT THE
BREAST ARE A SITE OF SEXUAL EXCITATION AND AROUSAL
NEUROHORMONAL CONTROL OF THE MALE REPRODUCTIVE SYSTEM
A) AT PUBERTY THE HYPOTHALAMUS STIMULATE THE PITUITARY GLAND
TO PRODUCE FOLLICLE STIMULATING HORMONE(FSH )AND
LUTEINIZING HORMONE( LH)
FSH- STIMULATES GERM CELLS WITHIN THE TESTES TO MANUFACTURE
SPERM
LH – STIMULATES THE PRODUCTION OF TESTOSTERONE IN THE TESTES,
ALTHOUGH LH STIMULATES THE LEYDIG CELLS TO PRODUCE
TESTOSTERONE FROM CHOLESTEROL, TESTOSTERONE INHIBITS THE
SECRETION OF LH BY THE ANTERIOR PITUITARY
B) TESTOSTERONE – ONE OF SEVERAL ANDROGEN (THE MOST
POTENT) PRODUCED IN THE TESTES
RESPONSIBLE FOR THE DEVELOPMENT OF THE SECONDARY SEX
CHARACTERISTIC AT PUBERTY,
TESTOSTERONE PRODUCTION OCCURS IN THE INTERSTITIAL LEYDIG
CELL IN THE SEMINIFEROUS TUBULES, LEYDIG CELLS ARE
ABUNDANT IN THE NEWBORN AND PUBESCENT AGE AND
TESTOSTERONE IS ABUNDANT DURING THESE PERIOD
TESTOSTERONE PRODUCTION SLOWS AFTER 40 YRS. OF AGE; BY 80
YRS OF AGE PRODUCTION IS ONLY ABOUT ONE FIFTH PEAK LEVEL
C) SPERMATOGENESIS- OCCURS CONTINUALLY AFTER PUBERTY,
PROVIDING LARGE NO. OF SPERM FOR UNLIMITED EJACULATION DURING
THE MATURE LIFE SPAN
SPERMATOZOA ARE RELEASED FROM THE EPITHELIAL WALL OF THE
SEMINIFEROUS TUBULES, MEIOSIS OCCURS DURING THE PROCESS AND
THE NO. OF CHROMOSOMES IN EACH CELL IS REDUCED BY ONE HALF
(HAPLOID NO.)
SPERMATOGENESIS IS A HEAT-SENSITIVE PROCESS; THE 2 TO 3 F
DIFFERENCE BETWEEN SCROTAL AND ABDOMINAL TEMPERATURE
ALLOWS SPERMATOGENESIS TO PROCEED IN THE COOLER ENVIRONMENT
THE ENTIRE PERIOD OF SPERMATOGENESIS FROM GERMINAL CELL TO
MATURE SPERM TAKES ABOUT 75 DAYS
EXTERNAL FEMALE GENITAL STRUCTURES
EXTERNAL ORGANS
1. MONS PUBIS- FATTY TISSUE OVER THE SYMPHYSIS PUBIS
2. LABIA MAJORA- PIGMENTED SKIN EXTENDING FROM THE MONS PUBIS TO THE
PERINEUM
3. LABIA MINORA- SMALLER INNER FOLDS OF THE VULVA
4. CLITORIS- ERECTILE TISSUE LOCATED AT THE UPPER END OF THE LABIA MINORA;
PRIMARY SITE OF SEXUAL AROUSAL
5. URETHRAL MEATUS (URETHRAL ORIFICE) – SMALL OPENING OF THE URETHRA
LOCATED BETWEEN THE CLITORIS AND VAGINAL ORIFICE FOR THE PURPOSE OF
URINATION
6. SKENE OR PARA URETHRAL GLANDS- SMALL MUCUS SECRETING GLANDS THAT OPEN
INTO THE POSTERIOR WALL OF THE URINARY MEATUS AND LUBRICATES THE VAGINA
7. VESTIBULE – AN ALMOND SHAPED AREA BETWEEN THE LABIA MINORA CONTAINING
THE VAGINAL INTROITUS, HYMEN, AND BARTHOLIN GLANDS
8. VAGINAL INTROITUS -THE EXTERNAL OPENING OF THE VAGINA
9. HYMEN -MEMBRANOUS TISSUE IN THE VAGINAL INTROITUS
10. BARTHOLIN OR VULVOVAGINAL GLANDS- MUCUS SECRETING
GLANDS LOCATED IN EITHER SIDE OF THE VAGINAL ORIFICE
11. PERINEAL BODY- COMPOSED OF MUSCLE AND FASCIA THAT
SUPPORT PELVIC STRUCTURE
13. PERINEUM – THE AREA OF TISSUE BETWEEN THE ANUS AND
VAGINA;
EPISIOTOMY IS PERFORMED HERE
SIDE VIEW OF FEMALE REPRODUCTIVE
ORGANS
FUNCTIONS OF THE UTERUS
1. MENSTRUATION- THE SLOUGHING AWAY OF SPONGY LAYERS OF THE
ENDOMETRIUM WITH BLEEDING FROM TORN VESSELS
2. ENVIRONMENT FOR PREGNANCY- THE EMBRYO AND FETUS DEVELOP
IN THE UTERUS AFTER FERTILIZATION
3. LABOR , CONSISTING OF POWERFUL CONTRACTION OF THE
MUSCULAR UTERINE WALL THAT RESULT IN EXPULSION OF THE FETUS
UTERINE LIGAMENT-
BROAD AND ROUND LIGAMENTS THAT PROVIDE UPPER SUPPORT FOR
THE UTERUS; CARDINAL, PUBOCERVICAL AND UTEROSACRAL
LIGAMENTS THAT ARE SUSPENSORY AND PROVIDE MIDDLE SUPPORT;
PELVIC MUSCULAR FLOOR LIGAMENT THAT PROVIDE LOWER SUPPORT
FALLOPIAN TUBE – EXTEND FROM THE UPPER OUTER ANGLES OF THE
UTERUS AND END NEAR THE OVARY
TUBES SERVES AS THE PASSAGEWAY FOR THE OVUM TO TRAVEL FROM THE
OVARY TO THE UTERUS AND FOR THE SPERM TO TRAVEL FROM THE UTERUS
TO THE OVARY
OVARIES – FEMALE SEX GLANDS LOCATED ON EACH SIDE OF THE UTERUS
1. VASOCONGESTION
- OCCURS IN THE PELVIC ORGANS DURING SEXUAL EXCITEMENT BECAUSE THE
ARTERIES DILATE.
- LEADS TO ERECTION OF THE PENIS AND CLITORIS, VAGINAL LUBRICATION AND
ENGORGEMENT OF THE LABIA AND TESTICLES.
2. MYOTONIA( MUSCULAR TENSION)
- PRESENT THROUGHOUT THE BODY DURING SEXUAL AROUSAL AND ORGASM.
- EVIDENT IN VOLUNTARY AND INVOLUNTARY CONTRACTIONS.
HUMAN SEXUAL FUNCTION
FOUR PHASES:
1. EXCITEMENT – OCCURS AS A RESULT OF PHYSICAL OR MENTAL
EROTIC STIMULI SUCH AS KISSING, PETTING OR VIEWING EROTIC
IMAGE THAT LEADS TO SEXUAL AROUSAL
2. PLATEAU- AN INCREASED CIRCULATION AND HEART RATE INCREASE,
BOTH SEXES, INCREASED SEXUAL PLEASURE WITH INCREASED
STIMULATION AND FURTHER INCREASED MUSCLE TENSION
3. ORGASMIC- FEELING OF THE INEVITABILITY OF EJACULATION IN MEN
AND CONTRACTIONS OF THE LOWER THIRD OF THE VAGINA
4. RESOLUTION- ALL THE CHANGES IN THE BODY ARE REVERSED BACK
TO NORMAL
COMPARISON OF MALE AND FEMALE SEXUAL
RESPONSE
SEXUAL CONCERNS RELATED TO PREGNANCY
1. DURING PREGNANCY, THE WOMAN’S DESIRE FOR SEX MAY BE ALTERED DUE TO
FATIGUE, NAUSEA, AND OTHER DISCOMFORTS OF PREGNANCY
2. BREASTS MAYBE PAINFUL TO TOUCH, ESPECIALLY DURING THE FIRST TRIMESTER
3. SOME MEN FIND THE NORMAL INCREASE IN THE AMOUNT AND ODOR OF VAGINAL
DISCHARGE DURING PREGNANCY A “TURN OFF”, OTHERS DO NOT
4. OTHER SEXUAL CONCERNS DURING PREGNANCY INCLUDE DYSPAREUNIA AND
MALE ERECTILE DYSFUNCTION
5. FOR COUPLE WHO CANNOT HAVE OR WHO CHOOSE NOT TO HAVE INTERCOURSE
DURING PREGNANCY, KISSING, HUGGING AND ORAL OR MANUAL GENITAL
STIMULATION CAN BE SATISFYING EXPRESSIONS OF CLOSENESS AND INTIMACY
NURSING PROCESS
A. ASSESSMENT
1. BEFORE INTERACTING WITH ANY CLIENT REGARDING SEXUALITY AND
REPRODUCTION, THE NURSE MUST PERFORM A SELF-ASSESSMENT; PERSONAL
ATTITUDES AND VALUES WILL GREATLY INFLUENCE THE NURSING CARE
PROVIDER
2. A SEXUAL HISTORY INVOLVES GATHERING INFORMATION ABOUT THE CLIENT OR
COUPLE;
PAST AND CURRENT EXPERIENCES WITH SEXUAL ACTIVITY
SEXUAL KNOWLEDGE AND HOW IT WAS OBTAINED
ATTITUDES TOWARD SEXUALITY
CURRENT PROBLEMS, IF ANY
NUMBER OF SEXUAL PARTNERS IN THE LAST 6 MONTHS
KNOWLEDGE AND USE OF “SAFER” SEX PRACTICES
MENSTRUAL AND OBSTETRIC HISTORY
METHOD OF BIRTH CONTROL USED
SPECIFIC CONCERNS RELATED TO SEX AND SEXUALITY
B. NURSING DIAGNOSES
1. KNOWLEDGE DEFICIT
2. SEXUAL DYSFUNCTION
3. ALTERED SEXUAL FUNCTION
4. ANXIETY
C. PLANNING AND OUTCOME IDENTIFICATION
1. THE CLIENT AND HER PARTNER WILL BE KNOWLEDGEABLE ABOUT
REPRODUCTION AND SEXUALITY.
2. THE CLIENT AND HER PARTNER WILL RESUME A MUTUALLY SATISFYING
RELATIONSHIP
3. THE CLIENT AND HER PARTNER WILL EXPERIENCE REDUCED ANXIETY RELATED
TO THEIR SEXUAL RELATIONSHIP
D. IMPLEMENTATION
4. PROVIDE EDUCATION REGARDING REPRODUCTION AND SEXUALITY
PROVIDE THE CLIENT OR COUPLE WITH SPECIFIC INFORMATION ABOUT THE
REPRODUCTIVE SYSTEM’S STRUCTURE AND FUNCTION
SUGGEST WAYS TO ALLEVIATE REPRODUCTIVE SYSTEM DISCOMFORTS AND TO
PREVENT REPRODUCTIVE DISEASE
DISCUSS RISK AND POTENTIAL EFFECTS OF SEXUAL ACTIVITY
2. PROMOTE OPTIMAL SEXUAL FUNCTIONING