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The
Royal
Pentagon Review Specialist, Inc
. Maternity Nursing
Human Sexualitya.Concepts
1.A person’s sexuality encompasses the complex behaviors, attitudes andemotions and preferences that is related to sexual self and eroticism2.Sex is basic and dynamic aspect of life3.During reproductive years, the nurse performs as resource person on humansexuality
15 – 44 y.o. – age of reproductivity CBQb.Definitions related to sexualityGender Identity
– sense of feminity and masculinity – developed @age 3 or 2 -4 y.o.
Role Identity
 – attitudes, behaviours and attitudes that differentiate roles
Sex
– biologic male or female status. sometimes referred to as specific sexual behavior such as sexual intercourse
Sexuality
- behavior of being a girl or boy and is identity subject to a lifelong dynamicchange
II.Sexual Anatomy and Physiologya.Female Reproductive System
1.
External – Vulva/ Pudenda
a.
Mons pubis/ veneris
– mountain of venus, a pad of fatty tissues that liesover the symphysis pubis covered by skin and at puberty covered by pubichair that serves as a cushion or protection to the symphysis pubis
Stages of Pubic Hair Development (Tool Used: Tanner’s Scale/ Sexual Maturity Rating)
Stage 1 – Pre adolescence
•
no pubic hair, fine body hair Stage 2 – Occurs bet. 11 – 12 y.o
•
sparse, long, slightly pigmented and curly that develop alonglabiaStage 3 – Occurs bet. 12 – 13 y.o.
•
hairs become darker and curlier develops along pubissymphysisStage 4 – 13 – 14 y.o.
•
hair ssumes normal appearance of an adult but is not so thickand does not appear to the inner aspect of the upper thighStage 5 – Sexual Maturity
•
assumes the normal appearance of an adult, appears at theinner aspect of thigh
 b.
Labia Majora
– large lips latin, longitudinal fold from perenium to pubissymphysis
c.
Labia Minora
– aka Nymphae, soft and thin longitudinal fold created betweenlabia majora
•
Clitoris
– “key”, pea – shaped erectile tissue composed of sensitivenerve endings; sight of sexual arousal in females
•
Fourchet
– tapers posteriorly of the labia majora. Site for episotomy
1
 
- sensitive to manipulation, torn during pregnancy
d.
Vestibule
– almond shaped area that contains the hymen, vaginal orifice andbatholene’s gland
•
Urinary Meatus
 – small opening of urethra/ opening for urination
•
Skene’s Gland
– aka Paraurethral Gland, 2 small mucus secretingglands for lubrication
•
Hymen
– membranous tissue that covers the vaginal orifice
•
Vaginal Orifice
– external opening of the vagina
•
Bartholene’s Gland
– paravaginal gland, secretes alkalinesubstance, neutralizes acidity of the vagina
o
Doderleins Bacillus
– responsible for vaginal acidity
o
Parumculae Mystiformes
– healing of a hymen
e.
Perenium
– muscular structure in between lower vagina and anus2.Internal
a.
Vagina
– female organ for ovulation, passageway of menstruation, ¾ inches8 – 10 cm long containing rugae
o
Rugae – permits considerable stretching withouit tearingduring delivery CBQ
 b.
Uterus
– hollow muscular organ, varies in size, weight and shape, organ of menstruation
Size :
1 x 2 x 3
Shape :
pear shaped, pregnant - ovoid
Weight :
 
Uterine involution CBQNon pregnant: 50 – 60 gPreganant: 1000 g4
th
stage of Labor: 1000 g2
nd
week after of Delivery: 500 g3
rd
weeks after delivery: 300 g5 – 6 Weeks after delivery: 50 – 60 g
Three Parts of Uterus
•
Fundus
– upper cylindrical layer 
•
Corpus/ Body
– upper triangular layer 
•
Cervix
– lower cylindrical layer 
Isthmus
– lower uterine segment during pregnancyMuscular Composition: 3 main Muscles making possible expansion in all direction
a.
Endometrium
 
muscle layer for menses
o
Lines the non-pregnant uterus
o
Volumes the non pregnant uterus
o
Decidua
– slouching off of endometrium during menstruation
o
Endometriosis
Ectopic Endometrium
Common site is ovaries
Proliferation of abnormal growth of lining of outer part
Persistent dysmenorrhea, low back pain
Dx Exam: biopsy,laparoscopy
Tx: Lupron (luprolide)
inhibits FSH & LH
Tx: Danazol (Danacrine) DOC1.Inhibits ovulation
2
 
2.stop menstruation
b.Myometrium
o
Power of labor 
o
Smooth muscles is considered to be LIVING LIGATURE(muscles of delivery, capable of closing) of the body
o
Largest portion of the uterus
c.Peremetrium
o
Protects the entire uterus
c.
Ovaries
 
•
2 female sex gland
•
almond shape
•
Fxn: Ovulation,production of 2 hormones( estrogen and progesterone)
d.Fallopian Tube
•
2 – 3 inches long that serves as a passageway of the sperm from theuterus to the ampulla or the passageway of the mature ovum or fertilizedovum from the ampulla to the uterus
•
4 significant segments
o
Infundibulum
– most distal part, trumpet shape, has fimbrae
o
Ampulla
– outer 3
rd
or 2
nd
half, site of fertilization, common site for ectopic preg.
o
Isthmus
– site for sterilization, site for BTL
o
Interstitial
– most dangerous site for ectopic pregnancy
b.Male Reproductive System1.External
•
Penis
•
The male organ of copulation and urination
•
Contains of a body or shaft consisting of 3 cylindrical layers and erectiletissues
o
2 corpora cavernosa
o
1 corpus spongiosum
•
At the tip is the most sensitive area comparable to clitoris = glans penis
•
Scrotum
•
Pouch hanging below the pendulous penis, with medial septum devidinginto 2 sacs each containing testes
•
Requires 2 degrees celcius for continuous spermatogenesis
•
Cooling mechanism of testes
2.InternalThe Process of SpermatogenesisTestes
(900 coiled seminiferous tubules)
↓
epididymis
(site of maturation of sperm 6 m)
↓
Vas Deferens
(conduit pathway of sperm)
↓
Seminal Vesicle
(secreted:
fructose
form of glucose, nutritative value
3
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