Chapter 20

REPRODUCTIVE SYSTEM

OBJECTIVE:
At the end to the topic, the students will be able to:
A. discuss the structures and functions of the reproductive system;
B. trace the pathway of sperm from the testis to the external environment;
C. name the exocrine and endocrine products of the ovary and testis;
D. explain homeostatic imbalance related to reproductive system.

Reproductive system or genital system - is the biological system made up of all

the anatomical organs involved in sexual reproduction. Many non-living substances
such as fluids, hormones, and pheromones are also important accessories to the
reproductive system.
Pheromones – bodily secretions such as urine, semen, or vaginal secretions, breast
milk and potentially saliva and breath, most is axillary sweat
Modulator – affect mood and emotion
Primer – affect over time endocrine or neuroendocrine systems related to
reproductive system
Releaser – elicit an often immediate, specific, behavioral response

Figure 20.1 The reproductive system

Figure 20.2. Female reproductive system

Female Reproductive System:
The function of the external female reproductive structures (the genitals) is twofold:
1. To enable sperm to enter the body and
2. to protect the internal genital organs from infectious organisms.
Main external structures of the female reproductive system include:
1. Labia majora - enclose and protect the other external reproductive organs.
Literally translated as "large lips," the labia majora are relatively large and
fleshy, comparable to the scrotum in males, labia majora contain sweat
(apocrine) and oil-secreting glands. After puberty, the labia majora are
covered with hair.
2. Labia minora: Literally translated as "small lips," the labia minora can be
very small or up to 2 inches wide. They lie just inside the labia majora, and
surround the openings to the vagina (the canal that joins the lower part of the
uterus to the outside of the body) and urethra (the tube that carries urine from
the bladder to the outside of the body).
3. Bartholin's glands: These glands are located beside the vaginal opening
and produce a fluid (mucus) secretion.
4. Clitoris: The two labia minora meet at the clitoris, a small, sensitive
protrusion that is comparable to the penis in males. The clitoris is covered
by a fold of skin, called the prepuce, which is similar to the foreskin at the
end of the penis. Like the penis, the clitoris is very sensitive to stimulation and
can become erect.
Internal reproductive organs in the female :
1. Vagina - a canal that joins the cervix (the lower part of uterus) to the outside
of the body; also known as the birth canal.
2. Uterus (womb) - a hollow, pear-shaped organ that is the home to
a developing fetus.
two parts of the uterus:
a. cervix - the lower part that opens into the vagina,
b. corpus - the main body of the uterus; can easily expand to hold
a developing baby.
A channel through the cervix allows sperm to enter and menstrual blood to
exit.
3. Ovaries - small, oval-shaped glands located on both side of the uterus;
produce eggs and hormones.
4. Fallopian tubes - are narrow tubes that are attached to the upper part of the
uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries
to the uterus. 
- Conception, the fertilization of an egg by a sperm, normally occurs in the
fallopian tubes. The fertilized egg then moves to the uterus, where it implants
into the lining of the uterine wall.

 What Happens During the Menstrual Cycle?

Females of reproductive age experience cycles of hormonal activity that repeat at
about one-month intervals. With every cycle, a woman's body prepares for a potential
pregnancy, whether or not that is the woman's intention.
menstruation - the periodic shedding of the uterine lining. (Menstru means
"monthly.'')
The average menstrual cycle takes about 28 days and occurs in phases:
1. follicular phase,
2. ovulatory phase (ovulation),
3. luteal phase.

Four major hormones (chemicals that stimulate or regulate the activity of cells or
organs) involved in the menstrual cycle:
 1. follicle-stimulating hormone,
2. luteinizing hormone, 
3. estrogen,
4. progesterone

Figure 20.3. Stages of follicular growth

Follicular Phase of the Menstrual Cycle - this phase starts on the first day of the
period.
Events that occur during the follicular phase of the menstrual cycle:
1. Two hormones, follicle stimulating hormone (FSH) and luteinizing hormone
(LH), are released from the brain and travel in the blood to the ovaries.
2. Follicle - the hormones that stimulate the growth of about 15 to 20 eggs in the
ovaries, each in its own "shell," These hormones (FSH and LH) also trigger
an increase in the production of the female hormone estrogen.
3. As estrogen levels rise, like a switch, it turns off the production of follicle-
stimulating hormone. This careful balance of hormones allows the body to
limit the number of follicles that mature.
4. As the follicular phase progresses, one follicle in one ovary becomes
dominant and continues to mature. This dominant follicle suppresses all of the
other follicles in the group. As a result, they stop growing and die. The
dominant follicle continues to produce estrogen.

Ovulatory Phase of the Menstrual Cycle - or ovulation, starts about 14 days after
the follicular phase started; the midpoint of the menstrual cycle, with the next
menstrual period starting about two weeks later.
Events that occur during this phase:
1. The rise in estrogen from the dominant follicle triggers a surge in the amount
of luteinizing hormone that is produced by the brain.
2. This causes the dominant follicle to release its egg from the ovary.
3. As the egg is released (a process called ovulation), it is captured by finger-
like projections on the end of the fallopian tubes (fimbriae). The fimbriae
sweep the egg into the tube.
4. Also during this phase, there is an increase in the amount and thickness of
mucus produced by the cervix (lower part of the uterus). If a woman were to
have intercourse during this time, the thick mucus captures the man's sperm,
nourishes it, and helps it to move towards the egg for fertilization.
Luteal Phase of the Menstrual Cycle - begins right after ovulation and involves the
following processes:
1. Once it releases its egg, the empty follicle develops into a new structure
called the corpus luteum.
2. The corpus luteum secretes the hormone progesterone. Progesterone
prepares the uterus for a fertilized egg to implant.
3. If intercourse has taken place and a man's sperm has fertilized the egg (a
process called conception), the fertilized egg (embryo) will travel through the
fallopian tube to implant in the uterus. The woman is now considered
pregnant.
4. If the egg is not fertilized, it passes through the uterus. Not needed to support
a pregnancy, the lining of the uterus breaks down and sheds, and the next
menstrual period begins.

How Many Eggs Does a Woman Have?

The vast majority of the eggs within the ovaries steadily die, until they are depleted
at menopause. At birth, there are approximately 1 million to 2 million eggs; by the
time of puberty, only about 300,000 remain. Of these, only about 500 will be
ovulated during a woman's reproductive lifetime. Any remaining eggs gradually die
out at menopause

Hypodermis
Figure 20.4. The mammary gland

mammary glands - The accessory reproductive glands of the female which produce
and secrete colostrum (briefly) and milk to nourish the growing infant; the glandular
milk-producing alveolar cells are surrounded by contractile myoepithelial cells, fibrous
connective tissue, and variable amounts of adipose tissue; they are highly
specialized sudoriferous = sweat glands; they are located on the ventral chest wall
superficial to the pectoralis muscles and the ducts drain to the nipple which is
surrounded by the pigmented areola; they are regulated hormonally by estrogens
and progesterone from the corpus luteum and placenta, and by prolactin (milk
production) from the anterior pituitary and oxytocin (milk letdown) from the posterior
pituitary; they also respond to autonomic NS impulses.
nipple - The small projection, covered by hairless skin,  near the center of the areola
of the mammary gland which contains dense fibrous connective tissue and some
erectile tissue surrounding the outlets of the lactiferous ducts through which neonates
obtain milk from the adult female.  [Note:  The A corresponding projection of the male
breast is a functionless vestigial structure.]

areola - The small darkly pigmented oval of slightly raised tissue which surrounds the
nipple of the breast; it has a peripheral border with occasional hair follicles, but is
otherwise hairless skin; size and degree of pigmentation are variable and, within an
individual, diameter can change with smooth muscle contractions associated with
sexual arousal.

lactiferous ducts - The 15-20 tubular drains for the lobes of the mammary glands
which converge to open at the tip of the nipple; their distal ends are expanded to form
lactiferous sinuses to store milk, which is produced gradually, until it can be released
during bouts of nursing which stimulates an autonomic reflex and is assisted by
oxytocin release for milk letdown.

alveoli - The clusters of milk producing glandular cells which comprise the various
lobes of the mammary glands; they are regulated hormonally by estrogens and
progesterone from the corpus luteum and placenta, and by prolactin from the anterior
pituitary; they develop at puberty to partial structural and functional maturity and
increase somewhat in size and complexity during each menstrual cycle, but do not
develop into fully functional glands until late in pregnancy.

lactiferous sinus - The short oval enlarged dilation of each lactifierous duct in the
breast tissue just beneath the nipple; in lactating females, this is a storage depot for
milk, which is produced gradually by the alveoli, and will be expressed from the
nipple by compression as the infant begins to nurse; the initial sensory feedback
provided by nursing stimulates an autonomic reflex, assisted by oxytocin, which then
triggers the letdown reflex.
lactation - The synthesis and secretion of milk by the female mammary glands; it is
regulated hormonally by estrogens and progesterone from the corpus luteum
and placenta, and by prolactin (milk production) from the anterior pituitary and
oxytocin (milk letdown) from the posterior pituitary; milk letdown also responds
to autonomic NS relex impulses.
milk ejection reflex - A neuroendocrine reflex in which afferent - sensory impulses
report pressure, i.e., mechanical stimulation, to the paraventricular and supraoptic
nuclei of the hypothalamus; neuroendocrine cells in these nuclei respond with
visceral efferent action potentials which are delivered to the posterior pituitary gland
= neurohypophysis where their axon terminals will release oxytocin into the
bloodstream; the oxytocin then travels to the mammary gland via the blood, binds to
oxytocin receptors on the myoepithelial cells, causing the myoepithelial cells to
contract, and resulting in increased intra-lumenal (intramammary) pressure and
ejection of milk from the alveolar lumen; elsewhere, in response to the same stimuli,
autonomic impulses are sent to the smooth muscle in the lactiferous ducts and
sinuses; their contractions move the milk toward the nipple.
milk letdown - The release of milk from the breast following tactile stimulation of the
nipple by the infant's suckling; it is regulated by an autonomic reflex, the milk ejection
reflex:  sensory impulses are routed to the hypothalamus which responds by causing
oxytocin release which then triggers contraction of the myoepithelial elements in the
breast as well as in the smooth muscle in the lactiferous ducts and sinuses; these
actions move the milk toward the nipple.
 Structure Function
mammary gland with
produce colostrum and then milk
alveoli
provides a "nozzle" the nursing infant can grip for
areola with nipple
suckling
lactiferous sinus stores milk between episodes of nursing
lactiferous ducts delivers milk from lactiferous sinuses to nipple surface
adipose tissue secondary sexual characteristic
suspensory ligament provides support for breast against the force of gravity

Figure 20.5. Male reproductive system

functions of male reproductive system :

1. To produce, maintain, and transport sperm (the male reproductive cells) and
protective fluid (semen)
2. To discharge sperm within the female reproductive tract during sex
3. To produce and secrete male sex hormones responsible for maintaining the
male reproductive system
Unlike the female reproductive system, most of the male reproductive system is
located outside of the body:
1.  penis,
2. scrotum,
3. testicles.

● Penis - used in sexual intercourse, has three parts:

a. Root - which attaches to the wall of the abdomen;
b. body, or shaft;
 c. glans,- cone-shaped part at the end of the penis, also called head of
the penis, is covered with a loose layer of skin called foreskin
(prepuce). This skin is sometimes removed in a circumcision. The
opening of the urethra, the tube that transports semen and urine,
is at the tip of the penis. The glans of the penis also contains a
number of sensitive nerve endings.
The body of the penis is cylindrical in shape and consists of three circular
shaped chambers. These chambers are made up of special, sponge-like
tissue. This tissue contains thousands of large spaces that fill
with blood when the man is sexually aroused. As the penis fills with blood,
it becomes rigid and erect, which allows for penetration during sexual
intercourse. The skin of the penis is loose and elastic to accommodate
changes in penis size during an erection.
Semen, which contains sperm (reproductive cells), is expelled (ejaculated)
through the end of the penis when the man reaches sexual climax (orgasm).
When the penis is erect, the flow of urine is blocked from the urethra,
allowing only semen to be ejaculated at orgasm.
● Scrotum - loose pouch-like sac of skin that hangs behind and below the
penis; contains the testicles (also called testes), as well as many nerves
and blood vessels. The scrotum acts as a "climate control system" for the
testes. For normal sperm development, the testes must be at a
temperature slightly cooler than body temperature. Special muscles in the
wall of the scrotum allow it to contract and relax, moving the testicles closer
to the body for warmth or farther away from the body to cool the
temperature.
● Testicles (testes) - oval organs about the size of large olives that lie in the
scrotum, secured at either end by a structure called the spermatic cord.
Most men have two testes. The testes are responsible for :
a. making testosterone, the primary male sex hormone
b. generating sperm. Within the testes are coiled masses of tubes
called seminiferous tubules. These tubes are responsible for
producing sperm cells.
The internal organs of the male reproductive system, also called accessory
organs:
1. Epididymis: The epididymis is a long, coiled tube that rests on the backside
of each testicle. It transports and stores sperm cells that are produced in the
testes. It also is the job of the epididymis to bring the sperm to maturity, since
the sperm that emerge from the testes are immature and incapable of
fertilization. During sexual arousal, contractions force the sperm into the vas
deferens.
2. Vas deferens: The vas deferens is a long, muscular tube that travels from
the epididymis into the pelvic cavity, to just behind the bladder. The vas
deferens transports mature sperm to the urethra, the tube that carries urine or
sperm to outside of the body, in preparation for ejaculation.
3. Ejaculatory ducts: These are formed by the fusion of the vas deferens and
the seminal vesicles (see below). The ejaculatory ducts empty into the
urethra.
4. Urethra: The urethra is the tube that carries urine from the bladder to outside
of the body. In males, it has the additional function of ejaculating semen when
the man reaches orgasm. When the penis is erect during sex, the flow of
urine is blocked from the urethra, allowing only semen to be ejaculated at
orgasm.
5. Seminal vesicles: The seminal vesicles are sac-like pouches that attach to
the vas deferens near the base of the bladder. The seminal vesicles produce
a sugar-rich fluid (fructose) that provides sperm with a source of energy to
 help them move. The fluid of the seminal vesicles makes up most of the
volume of a man's ejaculatory fluid, or ejaculate.
6. Prostate gland: The prostate gland is a walnut-sized structure that is located
below the urinary bladder in front of the rectum. The prostate gland
contributes additional fluid to the ejaculate. Prostate fluids also help to nourish
the sperm. The urethra, which carries the ejaculate to be expelled during
orgasm, runs through the center of the prostate gland.
7. Bulbourethral glands: Also called Cowper's glands, these are pea-sized
structures located on the sides of the urethra just below the prostate gland.
These glands produce a clear, slippery fluid that empties directly into the
urethra. This fluid serves to lubricate the urethra and to neutralize any acidity
that may be present due to residual drops of urine in the urethra.
 How Does the Male Reproductive System Function?
The entire male reproductive system is dependent on hormones, which are
chemicals that regulate the activity of many different types of cells or organs. The
primary hormones involved in the male reproductive system are:
a. follicle-stimulating hormone - necessary for sperm production
(spermatogenesis)
b. luteinizing hormone - also needed to make sperm
c. Testosterone - development of male characteristics, including muscle mass
and strength, fat distribution, bone mass, facial hair growth, voice change,
and sex drive.

How reproductive systems work

The male reproductive system consists of two major parts: the testes, where sperm
are produced, and the penis. The penis and urethra belong to both the urinary and
reproductive systems in males. The testes are carried in an external pouch known as
the scrotum, where they normally remain slightly cooler than body temperature to
facilitate sperm production. 
The external structures of the female reproductive system include the clitoris, labia
minora, labia majora and Bartholin's glands. The major internal organs of the female
reproductive system include the vagina and uterus — which act as the receptacle for
semen — and the ovaries, which produce the female's ova. The vagina is attached to
the uterus through is attached to the uterus through the cervix, while the fallopian
tubes connect the uterus to the ovaries. In response to hormonal changes, one
ovum, or egg — or more in the case of multiple births — is released and sent down
the fallopian tube during ovulation. If not fertilized, this egg is eliminated during
menstruation.

The female reproductive system. 

Fertilization occurs if a sperm enters the fallopian tube and burrows into the egg.
While the fertilization usually occurs in the oviducts, it can also happen in the uterus
itself. The egg then becomes implanted in the lining of the uterus, where it begins the
processes of embryogenesis (in which the embryo forms) and morphogenesis (in
which the fetus begins to take shape). When the fetus is mature enough to survive
outside of the womb, the cervix dilates, and contractions of the uterus propel it
through the birth canal. 
The purpose of the organs of the male reproductive system is to perform the
following functions: To produce, maintain, and transport sperm (the male
reproductive cells) and protective fluid (semen) To discharge sperm within the
female reproductive tract during sex.
 biologyexams4u
Figure 20.6. Spermatogenesis and oogenesis

Meiosis – a special type of cell division necessary for sexual reproduction in

eukaryotes. The cells produced by meiosis are gametes or spores. In many
organisms, including all animals and land plants (but not some other groups such as
fungi), gametes (sperm and egg cells).
- This process in cell division in sexually reproducing organisms that reduces the
number of chromosomes from diploid to haploid (half of the original number). Meiosis
involves 2 divisions. The two haploids cells (23 chromosomes, N each of the
chromosomes consisting of two sister chromatids) produced in meiosis I to the end
result is production of four haploid cells (23 chromosomes, N in humans) in meiosis
II. (leading to gametes in animals and spore in plant).

Spermatogenesis Oogenesis

The production of sperms from The production of eggs from oogonia is

spermatogonia is known as known as oogenesis
spermatogenesis

Occurs in testes Occurs inside the ovary

All stages are completed in testes The major part of oogenesis occurs
inside the ovary. The last few stages
occur in the oviduct.

It is a continuous process It is a discontinuous process. The early

stages take place in the fetus and the
rest in later stages of life.

Produces motile gametes Produces non-motile gametes

Equal cytokinesis occurs during the Unequal cytokinesis occurs during

spermatogenesis producing four sperms oogenesis ultimately producing one large
ovum and tiny polar bodies
Spermatogenesis is the process of the formation of haploid sperms from a diploid
stem cell known as spermatogonium. The process occurs inside the seminiferous
tubules in the testis. The entire process takes about 70 days.
Oogenesis - formation of the ovum. The process occurs in the ovaries of the female.
One oogonium produces a single ovum.

Spermatogenesis and oogenesis are the reproductive phases that include the
following – multiplication, growth, maturation and differentiation. The
spermatogonium and oogonium multiply by mitosis to form spermatocytes and
oocytes. The spermatocytes eventually lead to the formation of spermatids –  and it
contains only half of the genetic material present in the original primary spermatocyte
as a result of meiosis. Oocytes (germ cells) undergo mitosis and maturation to
form ootids that further differentiate to form ovum.

Homeostatic Imbalance:
1. Genital HPV (Human Papilloma Virus) - typically associated with females; most
common sexually transmitted infection. The majority of sexually active people in
the United States — male and female — will have HPV at some time in their lives,
but most will not experience any symptoms. In a small portion of women, it can
result in cervical cancer and genital warts; in men, it can cause penile and anal
cancer and genital warts, according to the NIH.
Both genders can develop sexually transmitted diseases, including genital
herpes, gonorrhea and syphilis, according to the National Institutes of Health
(NIH). HIV/AIDS, a disease of the immune system, is not exclusively transmitted
through sexual contact; sexual activity is one of the ways that the HIV virus is spread.
2. Severe menstrual cramping, or dysmenorrheal -for females; most common
disease of the reproductive system occurs with a woman's monthly menstrual period,
according to Dr. Sheryl Ross, OB/GYN and Women's Health Specialist at Providence
Saint John’s Health Center."Severe pain before or during your period can last
anywhere from one to seven days and disrupt your normal day-to-day routines at
school, work and socially," Diagnosis is made by the patient's medical history and a
pelvic exam. The best treatment includes medications that block the effects of
prostaglandins and include ibuprofen and naproxen. The birth control pill also
works well in treating dysmenorrhea by decreasing the blood flow, Ross noted.
3. Another common disorder of the female reproductive system is a vaginal yeast
infection, which is caused by a yeast fungus in the vagina. Most can be successfully
treated with over-the-counter medications, according to WebMD. 
4. Endometriosis is a condition where that normally lines the inside of your uterus —
the endometrium — ends up outside of uterus, most commonly in the ovaries, bowel
or the tissue lining your pelvis. The endometrial tissue becomes trapped, causing
pain.

Diseases of the male reproductive system

1. Prostate cancer - most common, but men can also suffer from testicular and
penile cancer, according to the American Cancer Society. Treatment for prostate
cancer depends on the age, severity of the disease and other health conditions of
the patient. The usual treatments for prostate cancer are surgery, radiation therapy,
watchful waiting, and hormonal treatment, according to the Cleveland Clinic. 
2. Erectile dysfunction - common condition that affects about one in 10 males on a
long-term basis, Cleveland Clinic noted; can be linked to vascular disease,
neurological disorders such as Multiple Sclerosis, trauma and psychological
episodes.
3. Prostatitis - swelling or inflammation of the prostate gland, and can cause painful
or difficult urination and ejaculation. Nearly half of all men experience symptoms of
prostatitis at some point during their lives.
4. Orchitis - inflammation of one or both of a man’s testicles, usually because of an
infection; Orchitis can result from the spread of bacteria through the blood from
somewhere else in the body; also can be a progression of epididymitis, an infection
of the tube that carries semen out of the testicles; called epididymo-orchitis.
Orchitis Symptoms - Most cases of orchitis are acute, which means you have
sudden, severe pain in one or both testicles that may spread to your groin (the area
where the upper thigh meets the lower belly). You also may have:
a. Testicles that appear tender, swollen, and red or purple
b. A heavy feeling in the swollen testicle
c. Blood in the semen
d. High fever
e. Nausea
f. Vomiting
g. Pain with urination
h. Pain from straining with a bowel movement
i. Pain with intercourse
j. Feeling ill
With epididymo-orchitis, the symptoms are similar and may start quickly (acute) or
slowly (chronic).
a. Orchitis causes an area of pain and swelling in the testicle for one to several
days.
b. Later, the infection spreads to involve the whole testicle.
c. may have discharge from the penis and pain or burning before or after pee
(urination).
Bacteria and viruses can cause orchitis –
a. Escherichia coli, Staphylococcus, and Streptococcus.
b. Bacteria that cause sexually transmitted diseases (STD), such
as gonorrhea, chlamydia, and syphilis, can cause orchitis in sexually active
men, ages 19 to 35. risk if having many sexual partners
c. The virus that causes mumps can cause orchitis Most common in young
boys (but rare in those younger than 10), orchitis begins 4 to 6 days after
mumps begins. A third of boys with mumps will get orchitis and then a
condition called testicular atrophy (shrinking of the testicles). That’s why it’s
important for all children, boys especially, to get the vaccine that protects
against mumps.
Orchitis Diagnosis - ultrasound; rectal exam(prostate ); urine test to look for
STD; Blood tests for HIV and syphilis

Defining and treating infertility

Infertility is defined as a couple's inability to conceive after one year of
unprotected intercourse. It can be caused by a condition in one partner or a
combination of circumstances.
1. In males, infertility - produce no sperm cells (azoospermia) or too few sperm
cells (oligospermia), or their sperm cells are abnormal or die before they can
reach the egg. Causes range from chromosomal defects to hormonal imbalance to
tumors. Lifestyle factors, such as drug and alcohol use, can also play role. In rare
cases, infertility in men is caused by an inherited condition, such as cystic fibrosis
2. In women, infertility - hinders the body's ability to ovulate, conceive, or carry
an infant to term.
Diagnosis In women - treated by obstetricians/gynecologists and for males,
urologists handle many disorders of their reproductive systems; infertility experts
that treat couples who are unable to conceive and endocrinologists who treat
hormonal disorders.
Figure 20.7 Female internal reproductive organs

Figure 20.8. Embryonic development

Figure 20.9. Stages of pre-natal development

 Figure 20.10. Stages of fetal development

Pls. watch you tubePREGNANCY AND EMBRYONIC DEVELOPMENTyoutube.com

REFERENCES:

https://www.livescience.com/26741-reproductive-system.html

https://www.webmd.com/sex-relationships/guide/your-guide-female-reproductive-
system

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.britannica.com
%2Fscience%2Fhuman-reproductive-
system&psig=AOvVaw2nbWjmo8RMCgHNhVC10zHT&ust=16226841163770
00&source=images&cd=vfe&ved=2ahUKEwiRg_7D5_fwAhXBzYsBHQ9vC-
IQr4kDegUIARD7AQ

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.biologyexams4u.com
%2F2013%2F06%2Fdifference-between-spermatogenesis-
and.html&psig=AOvVaw1sDPKcS-
nTmIaHvUNpxyUw&ust=1622684660132000&source=images&cd=vfe&ved=
0CAMQjB1qFwoTCJj79o3p9_ACFQAAAAAdAAAAABAD

https://www.apsubiology.org/anatomy/2020/2020_Exam_Reviews/Exam_5/CH27_
            Mammary_Glands.htm

https://www.google.com/url?sa=i&url=http%3A%2F%2Fwhat-when-how.com
%2Fnursing%2Fnormal-pregnancy-maternal-and-newborn-nursing-part-
2%2F&psig=AOvVaw0y43ZRy2de7bUy4jFV0L_j&ust=1623050359120000&s
ource=images&cd=vfe&ved=0CAMQjB1qFwoTCLClt6i7gvECFQAAAAAdAAA
AABAK