Types

ACCESSORY STRUCTURE
Gynecoid – typical
female pelvis
with rounded inlet
Android – normal male
pelvis with heart-
shaped inlet
Antropoid – “ape-like”
pelvis with oval inlet
Platypoid –  flat
External structure female-type pelvis
Nipple – raised, with transverse oval
pigmented area of inlet 
the breast
Areola –
pigmented area of
the skin
surrounding the
nipple
A. Pelvis-The bony ring located in lower portion of
Montgomery’s
the trunk consisting of three parts: Ilium, schium,
tubercles –
pubis, They held together by four (articulations): 
sebaceous glands
Symphysis pubis, two sacroliac , and sacrococcygeal, 
of the areola
fibrocartilage between these joint
provides movability
Ø The breast changes in size and nodularity
The major reproductive organs of the male
in response to ovarian cycle hormonal
can be grouped into three categories
changes.
The first category is sperm production and
Physical changes in breast size and activity
storage.
are at a minimum 5 to 7 days after
menstruation stop, the best time to detect The second category is the ejaculatory fluid
pathologic changes through breast self- producing glands which include the seminal
examination vesicles, prostate, and the vas deferens.

the final category are those used for

copulation, and deposition of the
spermatozoa (sperm) within the male,
these include the penis, urethra, vas
deferens, and Cowper's gland.

The external structures

. Penis: the male organ of copulation, elongated and
cylindrical consisting of a shaft and a glans
The penile shaft consist of three columns of erectile
tissue:
1.Corpora cavernosa: two lateral column located on
either side and in front of the urethra
2.Corpus spongiosum a posterior column which
contains the urethra. The tip is expanded to form the
glans penis. And a skin flap (prepuce /foreskin) that
covers the glans penis in circumcised males
 Glans penis: a cone- The internal
shaped expansion of structures
the corpus a.Testes
spongiosum that is
e highly senitive to Two small oval
sexual stimuli. male gonads and
contain hundreds of
Function: it carries tiny seminiferous
the urethra; tubules where
pathway for both sperm cells are
the urine and semen produced
Primary Function: suspended in the
deposit sperm in the scrotum
female vagina for Functions: secretion Testes: interstitial Cells of
fertilization of the of male sex Leydig are the cells
b. Scrotum: ovum hormones stimulated by the LH to
A sac or pouch-like structure from root of penis, (androgens) and site synthesize testosterone from
suspended from the perineal region that divides of spermatozoa cholesterol
into two compartments one for each testis. production in the
Testosterone homone
mature male
Primary Function: production is by the interstial
Endocrine function: cells of leydig.
The scrotum surrounds and protects the two
testes, internal structures also referred to as a.Hypothalamus:
testicles and the sperm by maintaining
b.APG:
temperature lower than the body.

Sperm production:
Testosrone is reponsible for the production of
• From the primitive germ cell, the primary
sex drive and potency
spermatogonia which are present at birth (dipliod –
Develops secondary sex characteristics: 44XY), the male spermatogonisa will develop into
mature spermatozoa a process called
larger, more muscular stature
spermatogenesis.
deepened voice

facial and body hair

broad shoulders

and development of an adam's apple.

• Together with FsH, stimulates sperm

production

exocrine function: the process of spermatogenesis
begins at the seminiferous tubules of the testes
which produce the male gamete (sperm) under
the influence of the FSH and testosterone.
Production of sperms by the seminiferous tubules
start at puberty and continuous throughout life
Together with FsH, stimulates sperm production
A continuous process that starts at puberty and is
completed within 72 hours
Types of sperm
Androsperm·Carries Y-sex chromosome
·Fast moving Smaller, weaker, short-lived·Dies in
acid
GynospermCarries X-sex chromosome Slower
·Bigger, stronger, long-lived Acid-resistant
Sex determination: The two chromosomes of the
23rd pair (XX or XY) are called the sex chromosomes.
·Y: smaller and carry only the genes for males
·X: larger sex chromosome in the sperm
Sex determination: The two chromosomes of the
23rd pair (XX or XY) are called the sex chromosomes.
·Y: smaller and carry only the genes for males
·X: larger sex chromosome in the sperm
PARTS OF INTERNAL MALE ORGAN
b.Epididymis
• Is a soft, cord-liked, coma-shaped body
which rests on the surface of the testes
where sperm mature and are stored
c.Vas deferens
Narrow tubes which carry sperm away from the
testes to the ejaculatory duct

• Carries several genes other than those for . Prostate gland

sexual trait and are called sex-linked.
• Female have 2 X chromosome(XX)
To produce female child each parent must
contribute an X chromosome
• Male have 1 X chromosome and 1 Y
chromosome (XY)
• To produce a male child, the mother
contribute an X chromosome and the father
must contribute the Y chromosome
• The prostate gland located below the
bladder (the structure that stores urine) and
lies between rectum and symphysis pubis
• Secretes a thin, lubricating milky fluid which
enters the urethra through the ducts and
helps in the pasage and viablility of
spermatozoa.
e. Urethra
• A thin tube which extends through the penis
and carries semen and urine outside of the
body, not simultaneously.

f. Cowper's glands

• Also called the bulbourethral glands are

found on each side of the urethra, just
below the prostate gland.

• Secrete small amount of lubricating fluid

• Life span

• Can survive in the female reproductive tract

up to 72 hours; believed to be healthy and
highly fertile for only about 24 hours

• ·Development take approxomately 70 days

and remains in the epididymis for 12 to 26
days for maturation

MENSTRUATION

• Is the periodic discharge of blood

and mucosal tissue from the inner lining of
the uterus through the vagina.

• Episodic uterine bleeding in response to

cyclic hormonal changes

• Brings an ovum to maturity and renews

uterine tissue bed

• Characteristics of the Menstrual cycle
Interval between cycles: average 28 days; cycles of
23 to 35 days not usual
Duration of Menstrual flow average flow: 2-7 days
ranges 1-9 days not normal
Amount of menstrual flow: Difficult to estimate;
average 30 to 80 ml. per menstrual period;
saturating a pad in less than an hour is considered
heavy bleeding.
The menstrual cycle can be divided into the
following parts:
Ovarian cycle
Uterine cycle
OVARIAN CYCLE
Phase 1 :The Follicular phase
• Days 1 through 13
It's called the follicular phase because
growth or maturation of the egg is taking
place inside the follicle, a small sac where
the egg matures.
• Ovulation occurs around day 14 of the cycle
Progesterone
inhibits secretion of
LHrelaxessmoothmuscles thereby decreases
contractions of uterus causes cervical
secretion of thick mucus maintain thickness
of endometriumallows pregnancy to be
maintained = Hormone of Pregnancy
repares breasts for lactation
Prolactin stimulates secretion of milk
• Oxytocin stimulates uterine contractions
during birth and compress uterine blood
vessels and control bleeding stimulates let-
down or milk-ejection reflex during
breastfeeding
Discomforts of Menstruation
• Breast tenderness and feeling of fullness
• Tendency towards fatigue
• Temperament and mood changes – because
of hormonal influence and decreased levels
of estrogen and progesterone
• Discomfort in pelvic area, lower back and
legs
• Retained fluids and weight gain
Abnormalities of Menstruation
• Amenorrhea – absence of menstrual flow
• Dysmenorrhea – painful menstruation
• Oligomenorrhea – scanty menstruation
• Polymenorrhea – too frequent menstruation
• Menorrhagia -excessive menstrual bleeding
• Metrorrhagia – bleeding between periods of
less than 2 weeks
• Hypomenorrhea – abnormally short
menstruation
 CARE OF THE FETUS
FETAL DEVELOPMENT
"Life is present from the moment of
conception."
ASSESSMENT OF THE FETAL GROWTH AND
DEVELOPMENT
PURPOSE
CARE OF THE FETUS
FETAL DEVELOPMENT
"Life is present from the moment of
conception."
ASSESSMENT OF THE FETAL GROWTH AND
DEVELOPMENT

 Predict the outcome of the pregnancy  Health history

 Manage the remaining weeks of the
pregnancy
 Physical Examination
 Plan possible complication at birth

 Plan for problems that may occur in the

newborn infant.
 Estimating Fetal health
 Decide whether to continue the pregnancy

 Find conditions that may affect future

pregnancies.  Fetal growth

 Assessing fetal well being

CARE OF THE FETUS

FETAL DEVELOPMENT

"Life is present from the moment of

conception."

• Assess the mother;

✔ pre pregnancy illness

( DM, HPN)

✔ Drugs

✔ Nutritional intake

✔ Personal habits (eg, cigarette smoking ect.) STAGES OF FETAL DEVELOPMENT

✔ Exposure to teratogens Pre embryonic – 1st 2 weeks, beginning

with fertilization
✔ Work activity
Embryonic – week 3 through 8
Assess mother the following;
Fetal – from 8 through birth
✔ Weight
- Full term: 38-42 weeks
✔ General appearance
- Preterm: < 38 weeks
✔ Bruises ( may indiacte intimate partner
violence) - Post-term: > 42 weeks
 THEFERTILIZATION
PROCESS Released from the
- Also referred to conception and impregnation. It Graffian Follicle
is considered as the beginning of pregnancy Will be surrounded by a
- The fusion of the sperm cell nucleus with the ring of
egg cell nucleus will produce a zygote (fertilized mucopolysaccharide
egg) fluid (Zona pellucida)
and a circle of cell
- occurs in the outer third of a fallopian tube, the (Corona Radiata)
ampullar portion • Per ejaculation, 2.5ml
semen containing 50- Moves from the ovary
- Each month inside your ovaries, a group of eggs to the fallopian tube
200M/ml spermatozoa is
starts to grow in small, fluid-filled sacs called through the cilia and
release (AVE 400M
follicles. Eventually one of the eggs erupts from peristaltic movement of
sperm/ejaculation)
the follicle (ovulation). It usually happens about fallopian tube
two weeks before your next period. • Moves through the cervix,
uterus, fallopian tube
- fertilization must occur fairly quickly because an
because of their flagella
ovum is capable of fertilization for only 24 hours
and uterine contractions
(48 hours at the most).
• Undergoes CAPACITATION
(changes in the plasma
membrane of the sperm
head to reveal sperm
binding receptors sites)
before penetrating into
corona radiata
The new cell created by fertilization is called a
ZYGOTE.

• Fertilization is the joining of two sex cells

(haploid) to create a new individual which is
a genetic combination of both parents
(diploid).

• Once the zygote is formed it begins to grow

in cell number through the process of
mitosis

• 1. Sperm to penetrates egg using enzymes

to break through eggs protective layer.

• 2. Once inside the egg, the nuclear

membrane of both the sperm and egg
rupture and the genetic material of the egg
and sperm are combined.

• 3. Once the zygote is formed it begins to

grow in cell number through the process of
MITOSIS. In a fertilized egg or zygote this
mitotic division is called cleavage
As the zygote
The blastocyst secretes an enzyme and breaks
moves through
through the uterus wall in a process known as
the fallopian
tube it IMPLANTATION
continues to
BLASTOCYST - It is this structure that attaches to
divide and
the uterine endometrium. The cells in the outer
grow into a
ring are trophoblast cells. They are the part of
ball of cells
the structure that will later form the placenta and
known as the
membranes. The inner cell mass, called the
morula made
embryoblast cells, is the portion of the structure
up of
thatAPPOSITION
will form the– embryo.
approximately
50 cells. the blastocyst sheds the last residues of the
corona and zona pellucida. The structure brushes
against the rich uterine endometrium
As the Morula ADHESION
moves into the
uterus from the 7 days or 5 days
fallopian tube it after fertilization, the trophoblast
becomes a burrows into the endometrium (upper part of
hollow structure uterus),
known as a
blastocyst INVASION

embedding the fertilized egg into the uterine

lining

Decidua - what
The cluster of
the
cells known as
endometrium is
the blastocyst
called after
divides into 3
implantation
layers in a
1. Decidua process of
basalis, the part GASTRULATION
of the
These layers will
endometrium
become all of
that lies di-
the organs and
rectly under the
tissues of the
embryo (or the
embryo.
portion where
the tro-
phoblast cells Ectoderm (Outer layer)
establish
Nervous system including brain, spinal
communication
cord and nerves
with maternal
blood vessels) Lining of the mouth, nostrils, and anus
2. Decidua Epidermis of skin, sweat glands, hair, nails
capsularis, the
portion of the

Mesoderm (Middle Layer
Bones and muscles
Blood and blood vessels
Reproductive and excretory systems
Inner layer (dermis) of skin
Endoderm (Inner Layer)
Lining of digestive tract
Lining of trachea, bronchi, and lungs
Liver, pancreas
Thyroid, parathyroid, thymus, urinary bladder
The outer layer of the blastocyst forms a membrane
that protects and nourishes the developing embryo.
AMNIOTIC FLUID - Formed by the secretion
of: 1. amniotic cells
2. lungs and skin of fetus
3. fetal urine
- 98% water, but also contains glucose,
protein, sodium, urea, creatinine, lanugo,
vernix caseosa
- slightly alkaline, replaced approximately
every 3 hours
- amniotic cells and the fetus urinating and
swallowing regulate the secretion and
reabsorption of the fluid
Functions of amniotic fluid:
o Shields against pressure; equalizes the
pressure around the fetus; cushions the fetus
from external compression
o Protects from temperature changes; .
provides constant temperature and fluid
for the fetus to swallow
. embryonic stem cells.
Contains fluid
(amniotic
fluid) that
protects fetus
by giving it a
stable
environment
and absorbing
shock
.
• Amniotic sac - formed by 2 fetal
membranes (chorion, amnion)
• Chorion - outer fetal membrane, formed
from the trophoblast
( maternal side of placenta)
• Amnion - originates in the blastocyst during
early stages of development, expands as
the fetus grows until it slightly adheres to
the chorion ( fetal side of placenta)
PLACENTA AND UMBILICAL CORD
PLACENTA- formed by the :
1. chorionic villi at the base of the implanted fertilized
ovum and the decidua basalis
2. endometrium at the side of implantation
Between days 6 and 14, implantation
(the adhering of the blastocyst
to the wall of the uterus) occurs.
The placenta also begins to form.
At this stage, there are no more
 By the 3rd week of • Fully functional by the 12th week
pregnancy the
placenta begins to 2 sides of placenta:
form in the uterus. 1. maternal side which is irregular and is
The placenta is the divided into subdivisions called cotyledons -
connection between DUNCAN
the mother and the
embryo which 2. fetal side covered by amnion, so it is
provides a supply of
smooth and shiny -SCHULTZ
oxygen and nutrients,
while keeping the
mother and embryo’s
blood supplies
separate.

.
Nutrients and oxygen are exchanged through
diffusion.The placenta is the embryo’s organ of
respiration, nourishment, and excretion.

Umbilical cord - a
structure that
connects the fetus
to the placenta.

- has 2 arteries
and 1 vein

- 2 arteries
carry deoxygenated
blood from the
fetus to the
placenta
 • During pregnancy, the fetal circulatory
system works differently than after birth:
• The fetus is connected by the umbilical cord
to the placenta. This is the organ that
develops and implants in the mother's
uterus during pregnancy.
• Through the blood vessels in the umbilical
cord, the fetus gets all needed nutrition
and oxygen. The fetus gets life support from
the mother through the placenta.
Waste products and carbon dioxide from the fetus
are sent back through the umbilical cord and
placenta to the mother's circulation to be removed
• In the fetal circulatory system, the umbilical
vein transports blood rich in O2 and
nutrients from the placenta to the fetal
body.
• Foramen Ovale
• Connects the left and right atria
• Bypassing fetal lungs
• Obliterated after birth to become
fossa ovalis
• Umbilical Vein
• Brings oxygenated blood coming
from the placenta to the heart and
liver
• Becomes ligamentum teres
• Umbilical arteries
• Carry unoxygenated blood from the
fetus to placenta
• Become umbilical ligaments after
birth
• Ductus venosus
▪ Carry oxygenated blood from
umbilical vein to IVC
▪ Bypassing fetal liver
▪ Becomes ligamentum venosum after
birth
• Ductus arteriosus
▪ Carry oxygenated blood from
pulmonary artery to aorta
▪ Bypassing fetal lungs
Umbilical arteries
▪ Carry unoxygenated blood from the
fetus to placenta
▪ Become umbilical ligaments after
birth
▪ Ductus venosus
▪ Carry oxygenated blood from
umbilical vein to IVC
▪ Bypassing fetal liver
▪
Blood from the placenta
is carried to the fetus by
the umbilical vein. About
half of this enters the
fetal ductus venosus and
is carried to the inferior
vena cava, while the
other half enters the
liver proper from the
inferior border of the
liver. The branch of the
umbilical vein that
supplies the right lobe of
the liver first joins with
the portal vein.
The blood then moves to the right atrium of
the heart. In the fetus, there is an opening
between the right and left atrium (the foramen
ovale), and most of the blood flows through
this hole directly into the left atrium from the
right atrium, thus bypassing pulmonary
circulation.
The continuation of this blood flow is into the left Some of the blood entering the right atrium does
ventricle, and from there it is pumped through not pass directly to the left atrium through the
the aorta into the body. Some of the blood foramen ovale, but enters the right ventricle and
moves from the aorta through the internal iliac is pumped into the pulmonary artery. In the
arteries to the umbilical arteries, and re-enters fetus, there is a special connection between the
the placenta, where carbon dioxide and other pulmonary artery and the aorta, called the
waste products from the fetus are taken up and ductus arteriosus, which directs most of this
enter the maternal circulation. blood away from the lungs
The continuation of this blood flow is into the left FROM HEAD TO TOE
ventricle, and from there it is pumped through
the aorta into the body. Some of the blood FROM PROXIMAL TO DISTAL
moves from the aorta through the internal iliac FROM GENERAL TO SPECIFIC
arteries to the umbilical arteries, and re-enters
the placenta, where carbon dioxide and other or described in general term of TRIMESTER
waste products from the fetus are taken up and
1st trimester - 12 weeks
enter the maternal circulation.
2nd trimester - 13 to 27
The continuation of this blood flow is into the left weeks
ventricle, and from there it is pumped through
the aorta into the body. Some of the blood 3rd trimester - 28 to 40
moves from the aorta through the internal iliac weeks
arteries to the umbilical arteries, and re-enters
the placenta, where carbon dioxide and other
waste products from the fetus are taken up and
enter the maternal circulation.

Week 5 - cranial nerves present, muscles have

innervation ( L 6-8mm)

Week 6 - fetal circulation established. Liver

produces red blood cells, CNS forms, primitive
kidney forms, lung buds present, cartilage forms,
primitive skeleton forms, muscles differentiate.

Week 7 - eyelids form, palate and tongue form

stomach formed, diaphragm formed, arms and
legs move (L 22-28mm)
 • All systems in
the fetus begin
forming by the
8th week.
Week 8 - • By the end of
resembles the 8th week of
human being, pregnancy the
eyes move to embryo is
face front, heart called a fetus
development and all of the
complete, major
hands and feet structures are
well formed; present.
bone cells begin
to replace
cartilage, all
body organs
have begun
forming (wt-2g,
L 3cm,).

Week 9 - fingers and toenails form; eyelids fuse shut
Week 10 - head growth slows, islets of langerhans
differentiated, bone marrow forms, rbc produced;
bladder sac forms, kidneys make urine
( wt-14g,L 5-6cm C – H )
Week 11 - tooth buds appear, liver secretes bile;
urinary system functions, insulin forms in
pancreas
Week 16 - meconium forms in bowels, scalp hair
appears, frequent fetal movement, skin thin and
pink ,sensitive to light, 200 ml of amniotic fluid
Week 20 - myelination of spinal cord begins,
peristalsis begins, lanugo covers body; vernix
caseosa covers body, brown fat deposit begins,
swallows and sucks amniotic fluid, heart beat
heard by fetoscope, hands can grasp, regular
schedule of sucking , kicking and sleeping (
wt 435 g L 19cm)
Week 24 - alveoli present in lungs/ begin
producing surfactant , eyes completely
formed, eyelashes and eyebrows
appear, many reflexes appear, (+)
chance of survival if born
Week 28 -subcutaneous fat deposits begin;
lanugo begins to disappears, nails
appear, eyelids open and close ; testes begin to
descend
Week 32 - more reflexes present, CNS direct
rhythmic breathing
movement/ partially
controls body temperature,
begins storing iron, calcium
phosphorus; ratio of lungs
surfactant lecithin and
sphingomyelin is 1.2:2
Week 36 - a few creases on soles of feet, skin less
wrinkled, fingernails reach fingertips,
sleep-wake cycle fairly definite, transfer of
maternal antibodies
Week 24 - alveoli present in lungs/ begin
producing surfactant , eyes completely
formed, eyelashes and eyebrows
appear, many reflexes appear, (+)
chance of survival if born
Week 28 -subcutaneous fat deposits begin;
lanugo begins to disappears, nails
appear, eyelids open and close ; testes begin to
descend
Week 32 - more reflexes present, CNS direct
rhythmic breathing
movement/ partially
controls body temperature,
begins storing iron, calcium
phosphorus; ratio of lungs
surfactant lecithin and
sphingomyelin is 1.2:2
Week 36 - a few creases on soles of feet, skin less
wrinkled, fingernails reach fingertips,
sleep-wake cycle fairly definite, transfer of
maternal antibodies
Week 38 - L/S ratio 2:1
Week 40 - lanugo only on shoulders and upper
back; creases cover sole, vernix mainly in folds
of skin, ear cartilage firm, less active, limited
space, ready to be born
Week 24 - alveoli present in lungs/ begin
producing surfactant , eyes completely
formed, eyelashes and eyebrows
appear, many reflexes appear, (+)
chance of survival if born
Week 28 -subcutaneous fat deposits begin;
lanugo begins to disappears, nails
appear, eyelids open and close ; testes begin to
descend
Week 32 - more reflexes present, CNS direct
rhythmic breathing
movement/ partially
controls body temperature,
begins storing iron, calcium
phosphorus; ratio of lungs
surfactant lecithin and
NOTE:
• The fetus often sinks into the birth canal
during the last 2 weeks, giving the
mother a feeling that the load she is
carrying is less. This event, termed
lightening, is a fetal announcement that
the third trimester of pregnancy has
ended and birth is at hand.