MALE REPRODUCTIVE SYSTEM • Tail- movement (flagellum)

External
- Glans Penis- synonymous to the female clitoris
- Corpus Spongiosum Penis- body
- Scrotum- for protection of the testes
• Cold temperature – loose testes for the
scrotum to net get affected by the temperature
of the body.
• Hot temperature – the scrotum is closer to
4. Semen- fluid containing sperms with other
the body for it not to get affected by the
substances
environment’s temperature.
5. Testes- production of sperm cell
Internal - Tunica Albuginea- Erection; maintains tempe-
rature
1. Penis - Seminiferous tubules- Site for spermatogenesis
2. Urethra - Lobules- sperm storage; contains seminiferous
3. Sperm Cell tubules
4. Semen - Rete Testis- Transport sperm
5. Testes - Mediastinum Testis- Depression or deeper
6. Epididymis portion; transportation
7. Vas deferens (2) 6. Epididymis
8. Seminal Vesicle (2) - Testicles produce sperm and goes to epididymis
9. Cowper’s Gland - Storage of sperm until maturity
10. Prostate Gland - It takes around 20 days to travel from testicle to
11. Ejaculatory Duct epididymis
7. Vas Deferens- passage way of sperm
- Vasectomy- permanent contraceptive method
- Takes 30-40 ejaculations to make
sure there is no sperm cells
8. Seminal Vesicle
- plays a major role in secreting vicious fluid
- Components: CHO (Carbohydrates), CHON
(Pro-tein), Fructose
- 30% of fluid came from seminal vesicle
9. Cowper’s Gland- products of alkaline fluid
- Alkaline fluid neutralizes acidic environment of
1. Penis- hanging erectile organ for copulation the urethra to protect the sperm
2. Urethra- passageway for semen and sperm cell - 10% of fluid came from bulbourethral gland
3. Sperm- 64 days maturity (dead after 64 days) - Also known as bulbourethral gland
• Acrosome 10. Prostate Gland- 60% fluid in semen, for
- Part of the head of sperm cell. transport
- Releases enzyme Hyaluronidase to melt the 11. Ejaculatory Duct- delivers sperm into the
hard layer in ovum urethra adding secretion and additives from
- Beheading to release and enzyme called prostate
prostaglandin- responsible for contraction
*Gland- releases enzyme
- Acrosome Reaction- when the head of sperm
got in touch to oocyte that releases enzymes *3 Accessory Gland- Seminal Vesicle, Cowper’sGland,
responsible for melting down the outer layer of Prostate Gland
ovum
• Mid piece- contains mitochondria (ATP) *After coitus, pee to avoid infection
• Nucleus- Contains DNA (genetic make-up of a *1 ejaculation= 3-5cc of sperm; 1cc contains 120-150M
person) sperm cells
 FEMALE REPRODUCTIVE SYSTEM

Fourchette

Episiotomy
- Widens the vaginal opening and facilitate
1. Clitoris- Highly sensitive area delivery of the baby
2. Urethral Opening- passageway of urine - Procedure in NSD
3. Hymen- remnant tissues inside the opening of the - Without Episiotomy, delivery can cause
vagina; Carunculae mystefoumis (remnants of laceration therefore it avoids perineal laceration
hymen) - Fourchette- site for episiotomy and
4. Mons Pubis/ Veneris- acts as a cushion; made up Episiorraphy
of adipose tissue - Episiorraphy- repair of episiotomy
5. Labia Majora- Major lip; outer lips (with pubic - Lateral Episiotomy- lateral cut
hair) - Medio-lateral Episiotomy- most convenient
6. Labia Minora- Minor lip; inner lips of the labia way to use to avoid laceration in rectum/anus
7. Anus
8. Bartholin’s Gland- release of a substance *Oxytocin- utilize uterine contraction
responsible for lubrication
*Breast feeding helps to utilize uterine contraction
9. Vagina
10. Cervix • Breast Self-Examination (BSE)
11. External OS/ Opening
12. Internal OS/ Opening - Outer to Inner palpation (from tail of Spence to
breast
- When reached the nipple area, pinch, to check
for secretion
16. Female Breast
- Lobule & Lobe- milk producing organ
- Ducts- canal as a passageway of milk
- Areola
- Nipple

13. Wall of Uterus

- Endometrium- inside
- Myometrium- middle
- Perimetrium- outside
14. Fallopian Tube
- Isthmus- narrowest
- Ampulla- where the sperm meets (fertilization)
- Infundibulum- push the released egg
- Fimbriae- works like a suction of eggs
15. Fundus- Top of uterus
• Mastitis
- Inflammation of fatty tissues of the breast
- Can be a caused of bacterial clog, trapped milk,
or the mother do not breastfeed her baby.
- Nursing Considerations: Breast pumping, Warm
compress, wear comfortable bra, Breastfeed
- Contraindications: Pulmonary Problem or Infec-
tion, Chemotherapy, AIDS, Active lesions
17. Pelvis
• Gynecoid
- Most common pelvis in woman
- Ciruclar pelvic inlet
- SUBPUBIC ANGLE: 80-50°; 9-10cm
- Much wider, much shorter
• Android
- Most common pelvis of man
- SUBPUBIC ANGLE: 50-60°; 6cm- 7cm
- Longer
• Ischial Spines- projects if the baby is floating
or engaged
• Prominent Projecting- projects if the baby is
facing front or back
MENSTRUATION
- “Menarche” 1st menstruation
• Phases of Menstruation
1. Menstruation/ Bleeding
- 1-5 days bleeding
2. Pre-Ovulatory Phase/ Follicular/ Ovarian Phase
- 6-13 days
- Ovum (egg) inside the follicle is developing
- 13 days ready for release
- Ovulation- 14th day
3. Post-Ovulatory Phase/ Luteal Phase/ Secretory
Phase
- 15-28 days
- It last for 14 days
- Egg has been secreted by ovary during ovulation
• Hormones
Brain- organ responsible for controlling all organs and
glands
Hypothalamus
- Controls pituitary gland (anterior & posterior).
- 6th day, hypothalamus will secrete to anterior
pituitary gland
- It excretes Gonadotrophin Releasing Hormone
(GnRH) all around pituitary gland
- GnRH surround/ affect anterior pituitary and
releases Follicle Stimulating Hormone (FSH)
Follicle Stimulating Hormone (FSH)
- Travels to the blood stream to reach the ovary
- FSH targets immature cells or primordial follicle
- 200,000 primordial follicles every ovary
- FSH stimulates 15-20 follicles.
- Granulosa Cells- secretes estrogen; release of
egg
- Day 11, 12, 13 Phase
Estrogen
- Steroid sex hormone
- Development of secondary characteristics
(during puberty – breast tissue, vulva, vagina,
and uterus)
- Stimulates blood vessels and the development
of endometrium
- Cervical Mucus: water consistency, stretchy,
thin
- Maintain the endometrium thin to help sperm
penetrate the egg cell
While follicles matures, it sends signal to hypothalamus positive and gives the feeling of nausea,
to release GnRH to stimulates Anterior Pituitary Gland laziness, and etc.
to release 2nd hormone called LUTEINIZING HORMONE
(LH) CONTRACEPTIVE METHODS

Luteinizing Hormone (LH) - Against conception

- Travels to blood stream Considerations:

- Increase level of LH triggers ovulation (increase - Personal values
in temperature) → the trigger results in - Ability to use method correctly
“expulsion” - How methods affects sexual enjoyment
- Ovary will release mature egg→ fimbriae suck - Financial factors
the egg→ egg will travel to ampulla→ wait - Status of couple’s relationship
there for 5-6 days - Prior exercises
- Future plans
-1- 7th day (bleeding)- most safe - Contraindications
-8- 9th day- safe
-10- 19th day- super unsafe Types:
-20- 28th day- unsafe • Abstinence
Granulosa cell will become CORPUS LUTEUM→ Corpus - No sexual contact
Luteum secretes PROGESTERONE - Advantage: no STD
PROGESTERONE - CONS: Difficult to comply

- Steroid sex hormone • Fertility Awareness/ Natural

- Acts on the tissue that was previously affects by
the estrogen
- When fertilization happens, placenta will
secrete progesterone to maintain/ hold
pregnancy
20- 24th day
- Endometrium will thicken to hold the zygote
and maintains pregnancy
- If no fertilization happen, it will thicken to
prepare for next menstruation
- If no fertilization CORPUS LUTEUM will be
CORPUS ALBICANS (whitish; eventually withers
and shred off)
- If (+) fertilization, zygote- fertilized egg (1-2
weeks) → embryo→ releases HcG (Human
Chorionic Gonadotrophin) that makes PT
1. Calendar/ Rhythm Method
- Periodic abstinence from intercourse during
fertile period
- 28 days
- Sudden drop in body temperature (14 th day-
Ovulation)
- Sudden increase in body temperature (15 days)
Menstrual Beads
- Red Bead: 1st day of menstrual period (1-7 days;
SAFE)
- White: Day when you are likely to get pregnant
(8- 20 days; UNSAFE)
- Brown: day when you are not likely to get
pregnant (SAFE)
- Dark Brown: 28th day cycle
 - Signals disrupt hormone production. Disruption
of hormones suppresses ovulation.
Questions to ask:
a. Have your menses returned? If yes, Begin other
method of contraception
b. If no, are you supplementing regularly or
allowing long periods without breastfeeding →
If yes, maintain breastfeeding for infant health
c. If no, is your baby more than 6 months old?
d. If no, no additional contraception necessary
5. Coitus Interruptus

2. Basal Body Temperature - Withdrawal method

- Oldest method, not safe
- Increasing of temperature during ovulation (14 th
day) • Artificial
- 15th- 16th day, ↓ decrease temperature
1. Oral Contraceptive Pills
- Not efficient method
- (+) cervical mucus method - Helpful to those who have PCOS
- It contains Estrogen and Progesterone
3. Cervical Mucus/ Billing method
- 99% effective
- Fertile Consistency: Watery, thin, clear, - Suppresses FSH and LH= no ovulation
stretchable, and slippery. (caused by estrogen)
Symptoms:
- Spinnbarkeit Test: Stretching the cervical mucus
- Ferning Test: Checking crystallization of sodium - Nausea
chloride using microscope - Headache
- Breast tenderness
- Possible contraindication
- Weight gain
- Spotting
- Hypoglycemia
Contraindication:
- No breastfeeding
- Mothers that has history of Cardio Vascular
Disease (CVD) or Stroke
- ↑ High Estrogen promotes blood clots that
results in CVD/ stroke
- Liver problems
2. Intrauterine Device (IUD)
- T-shaped
- Mirena- last 5-7 years
- Copper T380- last up to 8 years
4. Lactation Amenorrhea Method (LAM) - No spermicidal agent that kills sperm cell
- Prevent implantation= results in ectopic
- Absence of menstruation after birth pregnancy and heavy menstruation
- Post Natal (1- 6 months) effective - Not recommended for woman who has pelvic
- Baby stimulation triggers signals to mother’s disease, cancer, etc.
brain (baby’s sucking stimulates nipple)
3. Spermicidal Agent
 - Spermicidal Foam TAHBSO- Total Abdominal Hysterectomy Bilateral
- Spermicidal Film Salphingo-Oophorectomy
- Spermicidal Jelly
1. Tubal Ligation
4. Diaphragm
- Bilateral Tubal Ligation (BTL)- both side
- Can be used up to 2-3 years - Unilateral Tubal Ligation (UTL)- one side
- Put 2 hours before intercourse
- Stay at least 6 hours remove before 24 hours 2. Vasectomy
after sex - Cutting of vas deferens
- Change after giving birth - Upper portion of scrotum- NSV Opening (Cut,
5. Cervical Cap Cautery, Tie)
- Block the passageway of sperm cell
- Apply spermicidal agent - Sperm cell is viable for 6 months after surgery
- Fits snugly over the cervix, preventing sperm - It would take 30-40 ejaculation to make sure
from entering uterus. that there is no viable sperm cells.
6. Male Condom
- A thin, fitted tube worn over the penis during
sex
7. Estrogen- Progesterone Patch
- Upper outer arm
- Buttock Abdomen
- Upper torso
- Stick the patch into the skin for 1 week. It needs
to be consistent for 3 weeks= 1 month
CONS:
- HPN and Blood Clot
- ↑Estrogen→ Increase Blood flow → Increase
contractility of Blood Vessels= Hypertension ELECTIVE TERMINATION OF PREGNANCY

8. Emergency Post- Coital Contraceptives
- After sexual intercourse
- Should be taken in 72 hours after unprotected
coitus
- Should be done before the age of viability or 20
weeks of gestation
- Medical abortion: endangered the mother’s life
Medication given to terminate pregnancy:

9. Subcutaneous Implants • Mifepristone

- Norplant system - Given before the age of viability

- Can last up to 5 years - Stop the production of progesterone in placenta
- Thickens cervical mucus
Per Orem (PO)
- CONS: Scarring at injections site
- Take 1 dose of Mifepristone (200mg) with water
10. Intramuscular Injection
• Cytotec/ Misoprostol
- Depo-Provera
- Given every 12 weeks (150mg IM) - This drug’s purpose is not for abortion. This is a
- Last for 1-3 months GastroIntestinal (GI) drug for GI ulcer
- Contraindicated to pregnancy - Side effect causes miscarriage or abortion
- Promotes excessive bleeding
• Surgical Method of Contraception
Per Orem (PO)
 - Place 4 pills under tongue hold for 30 minutes - Instillation abortion is performed by injecting a
without drinking. chemical solution consisting of either saline,
- After 30 minutes, rinse your mouth with water urea, or prostaglandin through the abdomen
or drink something and into the amniotic sac.
- If you vomit during the 30 minutes when - Hypertonic Saline Solution→ amniotic sac/fluid
Misoprostol pills are under your tongue, it is → fetal dehydration
likely they will note work. It is necessary to
Hysterotomy
immediately repeat the step.
- If you are 9-11 weeks pregnant or had little or - Opening of the Uterus to remove the dead fetus
no bleeding after 3 hours, repeat the previous HUMAN SEXUAL RESPONSE
step.
- Wait 24 hours to 40 hours. While waiting you 1. Excitement
can do normal activities. 2. Plateu
- You should begin bleeding within 3 hours after 3. Orgasm
using the 4 pill. The bleeding should be similar 4. Resolution
to or heavier than your normal menstruation, it
means abortion is taking place
Excitement
Dilation & Curettage (D&C)
- Parasympathetic Nerve Simulation
- Ripening of the cervix (dilatation of the cervix) - ↑ RR, ↑PR, ↑BP
→ use of curette with vaginal speculum - Uterus pulls up and away from vagina
- In this procedure, patient is awake. - Cervix pulls up from vagina
- Uterus must be hard/ constricted - Clitoris increases in diameter
- Sedative/ Pain relievers: Nubain and Midazolam - Vagina begins to lubricate within 10-20 seconds
* Blighted Ovum- occurs when an early embryo never of stimulation
develops or stops developing, is resorbed (breakdown) - Labia increases in size
and leaves an empty gestational sac. Plateu
Dilation & Evacuation - Clitoris retracted
- Should be done 20 weeks and above gestation - Labia Minora increases in size, color- bright red
- Administer cytotec because of ↑vascularity
- In this procedure, the body parts are grasped at - Secretion of Batholin’s Gland (lubrication)
random with a long toothed clamp - Orgasmic Platform: Vaginal entrance contracts
producing grasping effect
- ↑Vascularity= lubricated
- Expansion of vaginal barrel
- Uterus fully elevated
Orgasm
- Seminal pool location
- Shortest period of the human response
- Uterus contracts similar to labor
- Rectus sphincter contacts in rhythm with uterus
- Strong vaginal contractions of orgasmic
platform
Resolution
- Uterus drops back to normal position
Saline Induction - Cervix drops into seminal pool
- Orgasmic platform resolves
 - Beginning; happens in testes
2. Ovulation (Ovarian factor)
- Hormones can affect ovulation
3. Mucus and Sperm interaction (Cervical Factor)
- Sticky and Dry period
4. Endometrial integrity and cavity size and shape
(Uterine factor)
- Should not have cyst
5. Oviduct patency and anatomic relationship to
the ovary (Tubal factor)
- Oviduct- Fallopian tube
6. Insemination (Coital factor)
a. Ejecting sperm
b. Assisted reproductive technique
(GIFT&ZIFT)

PHYSIOLOGY OF CONCEPTION
- Conception= Pregnancy Male Infertility Factors
- Ovum + Spermatozoa= Gametes
1. Inadequate sperm count
Basic Requirements for Successful Completion of - 3-5cc per ejaculation (1tsp)= 120- 150M sperm
Reproductive Process cells
2. Obstruction or impaired sperm motility
1. Release of ova (single cell) from the ovaries
(ovulation) on a regular cyclic basis.
2. Production of an ejaculate containing an ample
amount/ number of spermatozoa (motile,
healthy, complete sperms)
3. Deposition of spermatozoa in the female
reproductive tract, usually on or near the
cervical OS (Cervical Opening)
a. PH level of vagina- 3.8
b. Vagina is naturally acidic in environment to
prevent pathogenic agents
c. Semen is alkaline
d. Vagina’s acidity became alkalinic during
intercourse 3. Normal morphology
e. Vagina is self-cleaning - Should be on normal shape
4. Migration of the spermatozoa through the
female reproductive tract to the fallopian tubes
5. Patency of fallopian tube
6. Normal intrauterine environment for cervix to
fallopian tube lumen to enable active
movement of spermatozoa
7. Condition appropriate for fusion of gametes
within the fallopian tube
Factors Involved Fertility
1. Spermatogenesis (Male factor)
- Production of sperms
 4. Ejaculation Problem
- Premature ejaculation
5. Obstruction in seminiferous tubules, duct, or
vessels, preventing movement of spermatozoa
a. Orhitis- inflamed testes
b. Epididymitis- inflamed epididymis
Female Infertility Factors
1. Ovarian Factor
- Common problem is PCOS (Polycystic Ovary
Syndrome)
- Cyst- abnormal cell growth
- Cannot do In Vitro Fertilization if (+) PCOS/ cyst
2. Tubal Transport Problems
- Pelvic Inflammatory Disease (PID): Inflamed
uterus, ovary, fallopian tube
3. Uterine Problems
- Endometriosis- build-up of dead tissues
- Dead tissues are going up instead of going down
- Dead tissues obstruct the flow of oxygen that
causes pain
- Regular menstruation can be irregular on as it
can alter the menstrual period pattern.
4. Cervical Problems
- Cervicitis- inflammation in cervix caused by
infection
5. Unexplained infertility
ASSISTED REPRODUCTIVE TECHNIQUES
• Artificial Insemination
1. Stimulation- the ovaries are stimulated by the
hormones
2. Control- ultrasound control the size and number
of follicles
3. Release of an egg from the follicle- Intake of
hormone stimulated the release of an egg
4. Preparation of the semen sample- On the day of
the insemination, the husband must pass a
sperm sample, and the exerts will select in the
laboratory only the highest quality
5. Insemination- On the day of ovulation, selected
sperm cells are injected into the woman’s
uterus using a small catheter
• GIFT and ZIFT
a. GIFT- Gamete Intra-Fallopian Transfer
b. ZIFT- Zygote Intra-Fallopian Transfer
GIFT- eggs are removed from a woman’s ovary,
mixed with the man’s sperm. Placed in the fallopian
tube where fertilization occurs.
ZIFT and In Vitro Fertilization- the egg is stimulated
and collected using IVF method. The egg is mixed
with sperm in a dish and wait for it to fertilize. It is
then placed in the uterus if IVF or the tube if ZIFT
• In-Vitro Fertilization (IVF)
- Embryo is being planted to the uterus of the
mother since it already undergoes the changes
 - If planted in fallopian tube, it might cause EMBRYONIC LAYER
ectopic pregnancy
1. Endoderm
- Embryo release HcG that makes PT result
2. Mesoderm
positive
3. Ectoderm
- 3- 5 days from fertilization to embryo
- 3-8 weeks: development of embryo
- Fertilization: 2 cells, 4 cells, 8 cells, 16 cells
- 8-12 weeks: maturation of placenta
(blastomeres)
- Maternal blood pool: supply of O2 blood and
- Morula stage- embryo consists of 16 cells or
nutrients
blastomeres
1. Ovarian hyper-stimulation • ENDODERM BECOMES…
2. Egg retrieval - Digestive
3. Sperm preparation - Liver
4. Co-incubation - Pancreas
5. Embryo transfer - Lungs (inner layers)
6. Pregnancy
• ECTODERM
• Surrogate Embryo Transfer
- Hair
- Tradition- transfer in relative - Nails
- Gestation- transfer in stranger - Skin
- Nervous System

GENETIC ASSESSMENT and COUNSELING

• MESODERM: for blood vessels and heart
- 23 pairs of chromosomes
 Autosomes- no. of chromosomes/ 22 pairs - Circulatory system
of autosome - Lungs/ epithelial
 1 pair- sex chromosomes (XX and XY) - Skeletal
 22 autosomes + 1 pair of sex - Muscular system
chromosomes= 23 • Folic Acid: Spina bifida
 X & Y= allele
• Allantois: Circulatory System → Urinary System
AUTOSOMAL DISORDERS
- Dominant and recessive
- Autosomal dominant can carry a disorder; 4
kids (carrier, carrier, not carrier, carrier
- Autosomal recessive: 4 kids (c, nc, c, nc) at least
50%
X-LINKED DISORDER
- XX or XY
- Alteration in X chromosomes
- Dominant: all individuals with the genes are
affected
 XY: female children of affected men are all
affected (1st- any other gen.)
 XX: either male or female, all male child are
the carrier never the XX
RECESSIVE
- XX: carrier, in female children, expression of the
disease is blank; male disease will be
manifested
 Stop na sa 1st gen.