BACHELOR OF SCIENCE IN NURSING:

CARE OF MOTHER, CHILD AND

ADOLESCENT (Well Clients)
COURSE MODULE COURSE UNIT WEEK

1 2 2b
REPRODUCTIVE DEVELOPMNT
Anatomy of the Male and Female Reproductive System

 Read course and unit objectives

 Read study guide prior to class attendance
 Read required learning resources; refer to unit terminologies for jargons
 Proactively participate in classroom discussions
 Participate in weekly discussion board (Canvas) Answer and submit course unit tasks

At the end of this unit, the students are expected to:

Cognitive:
1. Describe anatomy and physiology pertinent to reproductive and sexual health.
2. Identify areas of care in relation to reproductive and sexual health that could benefit from additional
nursing research or application of evidence-based practice.
 3. Identify appropriate outcomes for reproductive and sexual health education.

Affective
1. Listen attentively during class discussions
2. Demonstrate tact and respect of other students opinions and ideas
3. Accept comments and reactions of classmates openly.

Psychomotor:
1. Integrate knowledge of reproductive health and sexuality with nursing process to achieve
quality maternal and child health nursing care.
2. Use critical thinking to analyze ways in which clients’ reproductive and sexual health can
be improved for healthier childbearing and adult health within a family-centered
framework.
3. Participate actively during class discussions
4. Follow Class rule and Apply Netiquettes

Adele Pilliteri, JoAnne Silbert-Flagg. (2018). Maternal and Child Health Nursing: Care of the
Childbearing and Childrearing Family. (8 th Ed.).

Ricci, Susan Scott Essentials of Maternity, Newborn, and Women's Health Nursing (4th Ed.)
https://www.khanacademy.org/science/health-andmedicine/human-anatomy-and-
physiology/reproductive- systemintroduction/v/welcome-to-the-reproductive-system

REPRODUCTIVE DEVELOPMENT
1. Intrauterine Development - The sex of an individual is determined at the moment of conception by the
chromosome information supplied by the particular ovum and sperm that joined to create the new life.
• A gonad is a body organ that produces the cells necessary for reproduction (the ovary in females,
the testis in males). At approximately week 5 of intrauterine life, primitive gonadal tissue is already
formed.
• In both sexes, two undifferentiated ducts, the mesonephric (wolffian) and paramesonephric
(müllerian) ducts, are present.
• By week 7 or 8, in chromosomal males, this early gonadal tissue differentiates into primitive testes
and begins formation of testosterone. Under the influence of testosterone, the mesonephric duct
begins to develop into the male reproductive organs, and the paramesonephric duct regresses. If
testosterone is not present by week 10, the gonadal tissue differentiates into ovaries, and the
paramesonephric duct develops into female reproductive organs
2. Pubertal Development - Puberty is the stage of life at which secondary sex changes begin. These
changes are stimulated when the hypothalamus synthesizes and releases gonadotropin-releasing
hormone (GnRH), which in turn triggers the anterior pituitary to begin the release of follicle-stimulating
hormone (FSH) and luteinizing hormone (LH). FSH and LH initiate the production of androgen and
estrogen, which in turn initiate secondary sex characteristics, the visible signs of maturity.
 3. Role of Androgen - Androgenic hormones are the hormones responsible for muscular development,
physical growth, and the increase in sebaceous gland secretions that causes typical acne in both boys
and girls. In males, androgenic hormones are produced by the adrenal cortex and the testes; in females,
by the adrenal cortex and the ovaries.
4. Role of Estrogen – When triggered at puberty by FSH, ovarian follicles in females begin to excrete a
high level of the hormone estrogen.This hormone is actually not one substance but three compounds
(estrone [E1], estradiol [E2], and estriol [E3]).
Secondary Sex Characteristics
Adolescent sexual development is categorized into stages (Tanner, 1990). There is wide variation in the
time required for adolescents to move through these developmental stages; however, the sequential order is
fairly constant. In girls, pubertal changes typically are manifest as:
1. Growth spurt
2. Increase in the transverse diameter of the pelvis
3. Breast development
4. Growth of pubic hair
5. Onset of menstruation
6. Growth of axillary hair
7. Vaginal secretions
Secondary sex characteristics of boys usually occur in the order of:
1. Increase in weight
2. Growth of testes
3. Growth of face, axillary, and pubic hair
4. Voice changes
5. Penile growth
6. Increase in height
7. Spermatogenesis (production of sperm)

Anatomy and Physiology of the Reproductive System

I. Male Reproductive System

A. Male External Structures
1. Scrotum - is a rugated, skin-covered, muscular pouch
suspended from the perineum. Its functions are to
support the testes and to help regulate the temperature
of sperm.
• In very cold weather, the scrotal muscle contracts to
bring the testes closer to the body;
• in very hot weather, or in the presence of fever, the
muscle relaxes, allowing the testes to fall away from
the body.
2. Testes - are two ovoid glands, 2 to 3 cm wide, that lie in the scrotum. Each
testis is encased by a protective white fibrous capsule and is composed of
several lobules, with each lobule containing interstitial cells (Leydig’s
cells) and a seminiferous tubule.
 Seminiferous tubules produce spermatozoa.
• Leydig’s cells are responsible for the production of testosterone.
 • Testes in a fetus first form in the pelvic cavity. They descend, late in intrauterine life (about the
34th to 38th week), into the scrotal sac. Because this descent occurs so late in pregnancy,
many male preterm infants are born with undescended testes.
• In most males, one testis is slightly larger than the other and is suspended slightly lower in the
scrotum than the other (usually the left one). Because of this, testes tend to slide past each
other more readily on sitting or muscular activity, and there is less possibility of trauma to
them.
• Spermatozoa do not survive at a temperature as high as that of the body, however, so the
location of the testes outside the body, where the temperature is approximately 1° F lower than
body temperature, provides protection for sperm survival (McCance & Huether, 2007).
3. Penis. The penis is composed of three cylindrical masses of erectile tissue in the penis shaft: two
termed the corpus cavernosa, and a third termed the corpus spongiosum. The urethra passes
through these layers of erectile tissue, making the penis serve as the outlet for both the urinary and
the reproductive tracts in men.
 At the distal end of the organ is a bulging, sensitive ridge of tissue, the glans. A retractable
casing of skin, the prepuce, protects the nerve-sensitive glans at birth.
B. Male Internal Sructures
1. Epididymis - the seminiferous tubule of each testis leads to a tightly coiled tube, the epididymis,
which is responsible for conducting sperm from the tubule to the vas deferens, the next step in the
passage to the outside.
• Because each epididymis is so tightly coiled, its length is extremely deceptive: it is actually over
20 ft long.
• Some sperm are stored in the epididymis, and a portion of
the alkaline fluid that will surround sperm at maturity
(semen, or seminal fluid that contains a basic sugar and
mucin, a form of protein) is produced by the cells lining
the epididymis.
• Sperm are immobile and incapable of fertilization as they
pass or are stored at the epididymis level.
• It takes at least 12 to 20 days for them to travel the length
of the epididymis and a total of 64 days for them to reach
maturity.
• This is one reason that aspermia (absence of sperm) and
oligospermia (20 million sperm/mL) are problems that do
not appear to respond immediately to therapy but rather after
only 2 months.
2. Vas Deferens (Ductus Deferens) - is an additional hollow tube surrounded by arteries and veins
and protected by a thick fibrous coating. It carries sperm from the epididymis through the inguinal
canal into the abdominal cavity, where it ends at the seminal vesicles and the ejaculatory ducts.
Sperm mature as they pass through the vas deferens.
• Vasectomy (severing of the vas deferens to prevent passage of sperm) is a popular means of
male birth control (Cook et al., 2009).
3. Seminal Vesicles - are two convoluted pouches that lie along the lower portion of the posterior
surface of the bladder and empty into the urethra by way of the ejaculatory ducts.
• These glands secrete a viscous alkaline liquid that has a high sugar, protein, and prostaglandin
content. Sperm become increasingly motile with this added fluid, because it surrounds them
with nutrients and a more favorable pH.
4. Ejaculatory Ducts - The two ejaculatory ducts pass through the prostate gland and join the seminal
vesicles to the urethra.
 5. Prostate Gland - is a chestnut-sized gland that lies just below the bladder. The urethra passes
through the center of it, like the hole in a doughnut.
• The prostate gland secretes a thin, alkaline fluid. When added to the secretion from the seminal
vesicles and the accompanying sperm from the epididymis, this alkaline fluid further protects
sperm from being immobilized by the naturally low pH level of the urethra.
6. Bulbourethral Glands - two bulbourethral or Cowper’s glands lie beside the prostate gland and
empty via short ducts into the urethra. Like the prostate gland and seminal vesicles, they secrete
an alkaline fluid that helps counteract the acid secretion of the urethra and ensure the safe
passage of spermatozoa.
7. Urethra - is a hollow tube leading from the base of the bladder, which, after passing through the
prostate gland, continues to the outside through the shaft and glans of the penis. It is
approximately 8 in (18 to 20 cm) long.

II. Female Reproductive System

A. Internal Structures
1. Mons Veneris - is a pad of adipose tissue located over the
symphysis pubis, the pubic bone joint. It is covered by a
triangle of coarse, curly hairs. The purpose of the mons
veneris is to protect the junction of the pubic bone from
trauma.
2. Labia Minora.- just posterior to the mons veneris spread
two hairless folds of connective tissue, the labia minora.
Before menarche, these folds are fairly small; by
childbearing age, they are firm and full; after menopause,
they atrophy and again become much smaller.
3. Labia Majora. The labia majora are two folds of adipose
tissue covered by loose connective tissue and epithelium
that are positioned lateral to the labia minora. Covered by
pubic hair, the labia majora serve as protection for the
external genitalia and the distal urethra and vagina.
4. Vestibule - is the flattened, smooth surface inside the labia. The openings to the bladder (the
urethra) and the uterus (the vagina) both arise from the vestibule
5. Clitoris - is a small (approximately 1 to 2 cm), rounded organ of erectile tissue at the forward
junction of the labia minora. It is covered by a fold of skin, the prepuce.The clitoris is sensitive to
touch and temperature and is the center of sexual arousal and orgasm in a woman.
6. Skene’s glands (paraurethral glands) are located just lateral to the urinary meatus, one on each
side. Their ducts open into the urethra.
7. Bartholin’s glands (vulvovaginal glands) are located just lateral to the vaginal opening on both
sides. Their ducts open into the distal vagina.
• Secretions from both of these glands help to lubricate the external genitalia during
coitus.
• The alkaline pH of their secretions helps to improve sperm survival in the vagina.
8. Fourchette is the ridge of tissue formed by the posterior joining of the two labia minora and the
labia majora. This is the structure that is sometimes cut (episiotomy) during childbirth to enlarge
the vaginal opening.
9. Hymen is a tough but elastic semicircle of tissue that covers the opening to the vagina in
childhood. It is often torn during the time of first sexual intercourse. However, because of the use
 of tampons and active sports participation, many girls who have not had sexual relations do not
have intact hymens at the time of their first pelvic examination.
B. Female Internal Structures
1. Ovaries. The ovaries are approximately 4 cm long by 2 cm in diameter and approximately 1.5
cm thick, or the size and shape of almonds. They are grayish white and appear pitted, or with
minute indentations on the surface.
• The function of the two ovaries (the female gonads) is to produce, mature, and discharge
ova (the egg cells). In the process, the ovaries produce estrogen and progesterone and
initiate and regulate menstrual cycles.
• Ovarian function, therefore, is necessary for maturation and maintenance of secondary sex
characteristics in females.
• At birth, each ovary contains approximately 2 million immature ova (oocytes), which were
formed during the first 5 months of intrauterine life.
• By age 7 years, only approximately 500,000 are present in each ovary; by 22 years, there
are approximately 300,000; and by menopause, none are left (all have either matured or
atrophied).
• Ovaries have three principal divisions:
1. Protective layer of surface epithelium
2. Cortex, where the immature (primordial) oocytes mature into ova and large amounts of
estrogen and progesterone are produced
3. Central medulla, which contains the nerves, blood vessels, lymphatic tissue, and some
smooth muscle tissue
2. Fallopian Tubes. The fallopian tubes arise from each upper corner of the uterine body and
extend outward and backward until each opens at its distal end, next to an ovary. Fallopian
tubes are approximately 10 cm long in a mature woman. Their function is to convey the ovum
from the ovaries to the uterus and to provide a place for fertilization of the ovum by sperm.

 The most proximal division, the interstitial portion, is that part of the tube that lies within
the uterine wall. This portion is only about 1 cm in length; the lumen of the tube is only 1 mm
in diameter at this point. The isthmus is the next distal portion. It is approximately 2 cm in
length and like the interstitial tube, is extremely narrow. This is the portion of the tube that is
cut or sealed in a tubal ligation, or tubal sterilization procedure. The ampulla is the third and
also the longest portion of the tube. It is approximately 5 cm in length. It is in this portion that
fertilization of an ovum usually occurs. The infundibular portion is the most distal segment
of the tube. It is approximately 2 cm long and is funnel shaped. The rim of the funnel is
covered by fimbria (small hairs) that help to guide
the ovum into the fallopian tube
3. Uterus. The uterus is a hollow, muscular, pear-shaped
organ located in the lower pelvis, posterior to the
bladder and anterior to the rectum. During childhood, it
is approximately the size of an olive. An adolescent is
closer to 17 years old before the uterus reaches its
adult size. With maturity, a uterus is approximately 5 to
7 cm long, 5 cm wide, and, in its widest upper part, 2.5
cm deep. In a nonpregnant state, it weighs
approximately 60 g.
 • The function of the uterus is to receive the ovum from the fallopian tube; provide a place for
implantation and nourishment; furnish protection to a growing fetus; and, at maturity of the
fetus, expel it from a woman’s body.
• Anatomically, the uterus consists of three divisions:
1. The body of the uterus is the uppermost part and forms the bulk of the organ. During
pregnancy, the body of the uterus is the portion of the structure that expands to contain the
growing fetus. The portion of the uterus between the points of attachment of the fallopian
tubes is termed the fundus.
2. The isthmus of the uterus is a short segment between the body and the cervix. In the
nonpregnant uterus, it is only 1 to 2 mm in length. It is the portion of the uterus that is most
commonly cut when a fetus is born by a cesarean birth.
3. The cervix is the lowest portion of the uterus. It represents approximately one third of the
total uterus size and is approximately 2 to 5 cm long. The opening of the canal at the
junction of the cervix and isthmus is the internal cervical os; the distal opening to the
vagina is the external cervical os. The level of the external os is at the level of the ischial
spines (an important relationship in estimating the level of the fetus in the birth canal).
 Layers of uterus
1. Perimetrium – a part of visceral peritoneum
2. Myometrium – bulk of uterus – three layers of muscle that contract under influence of
oxytocin during labor.
3. Endometrium – highly vascular mucosa
• Stratum functionalis – shed during menstruation
• Stratum basalis – deeper, permanent layer, gives rise to new stratum
functionalis
C. Breasts - the mammary glands, or breasts,
form from ectodermic tissue early in utero.
They then remain in a halted stage of
development until a rise in estrogen at
puberty produces a marked increase in their
size. The size increase occurs mainly
because of an increase of connective tissue
plus deposition of fat. The glandular tissue of
the breasts, necessary for successful
breastfeeding, remains undeveloped until a
first pregnancy begins
• Milk glands of the breasts are divided by connective tissue partitions into approximately 20
lobes. All of the glands in each lobe produce milk by acinar cells and deliver it to the nipple
via a lactiferous duct. The nipple has approximately 20 small openings through which milk is
secreted. An ampulla portion of the duct, located just posterior to the nipple, serves as a
reservoir for milk before breastfeeding.
• A nipple is composed of smooth muscle that is capable of erection on manual or sucking
stimulation. On stimulation, it transmits sensations to the posterior pituitary gland to release
oxytocin. Oxytocin acts to constrict milk gland cells and push milk forward into the ducts that
lead to the nipple. The skin surrounding the nipples is darkly pigmented out to approximately
4 cm and is termed the areola. The area appears rough on the surface because it contains
many sebaceous glands, called Montgomery’s tubercles.
 https://www.britannica.com/science/human-development

EBSCO HOST http://search.ebscohost.com Usersname: OLFU PW: #fatima2020

http://dbctle.erau.edu/initiatives/seven/ Iowa State Center for Excellence in Learning and Teaching.

Reproductive Development - is a part of prenatal development, and concerns the sex organs. It is a
part of the stages of sexual differentiation.

Secondary sex characteristics - any physical characteristic developing at puberty which distinguishes
between the sexes but is not directly involved in reproduction.

During puberty, a lot of changes occurs, physically and psychologically. During this times, effective coping
is necessary to adapt with those changes.
Try to recall your experiences during puberty. How were you able to understand those changes? What are
the problems or issues you’ve encountered during puberty? How were you able to cope with those
changes?

Be ready to share and discuss this with your classmates.

Textbook:
Pilliteri, Silbert-Flagg. (2018). Maternal and Child Health Nursing: Care of the Childbearing and
Childrearing Family. (8 th Ed.) Wolters Kluwer

Devakumar (2019). Oxford Textbook of Global Health of Women, Newborns, Children, and Adolescents.
PB Publishing.

Murray (2019). Foundations of Maternal-Newborn and Women’s Health Nursing, 7th edition. Elsevier.

Flagg (2018). Maternal and Child Health Nursing: Care of the Childbearing and Chilrearing Family.
Wolters Kluwer

Wolters Kluwer. Audrey Berman, Shirlee J. Snyder, Geralyn Frandsen. (n.d.). Fundamentals of Nursing
by Kozier and Erbs (10th ed.).
Pearson. Maternal and Child Health. (n.d.). https://apha.org/topics-and-issues/maternal-and-child-health
Maternal, newborn and adolescent health. (n.d.). https://www.who.int/maternal_child_adolescent/en/

Rosalinda Parado Salustiano. (2009). Dr. RPS Maternal & Newborn Care: A Comprehensive Review
Guide and Source Book for Teaching and Learning. C & E Publishing, Inc.