URINARY SYSTEM

1
REPRODUCTIVE SYSTEMS
MALE AND FEMALE
2
SEXUAL REPRODUCTION

• THOUGH THERE ARE SUPERFICIAL DIFFERENCES, HUMANS
  AND MOST OTHER EUCARYOTES ACCOMPLISH SEXUAL
  REPRODUCTION IN MUCH THE SAME WAY
• SEXUAL REPRODUCTION IN MICROBIAL EUCARYOTES IS
  OFTEN DIFFERENT IN SIGNIFICANT DETAILS
• PROCARYOTIC AND VIRAL SEXUAL REPRODUCTION ARE
  VASTLY DIFFERENT FROM THAT OF EUCARYOTES
• WE WILL CONCENTRATE ON MAMMALIAN REPRODUCTION,
  IGNORING MICROBES

3
SEXUAL REPRODUCTION

• THE COMBINING OF GENETIC MATERIAL FROM TWO
  INDIVIDUALS TO PRODUCE UNIQUE OFFSPRING
• THESE TWO PARENTS ARE TYPICALLY DENOTED MALE AND
  FEMALE
• HUMANS ARE EITHER MALE OR FEMALE
• MANY SPECIES POSSESS INDIVIDUALS THAT ARE BOTH
  MALE AND FEMALE
• E.G., MOST PLANTS, MANY INVERTEBRATES

4
SEXUAL REPRODUCTION

• TO SEXUALLY REPRODUCE, THE PARENTS MUST PRODUCE
  GAMETES
• GAMETES ARE PRODUCED BY MEIOSIS
• EACH GAMETE POSSESSES HALF THE NORMAL CHROMOSOMAL
  COMPLEMENT
• SPERM ARE MALE GAMETES
• EGGS (OVA) ARE FEMALE GAMETES
• GAMETES FUSE TO PRODUCE A ZYGOTE
• FERTILIZATION ? ZYGOTE ??? OFFSPRING

5
SEXUAL REPRODUCTION

• GAMETES
• EGGS
• LADEN WITH NUTRIENTS REQUIRED BY THE DEVELOPING
  EMBRYO
• ESSENTIALLY IMMOBILE
• SPERM
• HIGHLY MOBILE
• POSSESS ESSENTIALLY NO NUTRIENTS

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7
SEXUAL REPRODUCTION

• SEX DETERMINATION
• AN INDIVIDUAL ABLE TO PRODUCE SPERM IS MALE
• AN INDIVIDUAL ABLE TO PRODUCE EGGS IS FEMALE

8
SEXUAL REPRODUCTION

• SEX DETERMINATION IN MAMMALS
• AN INDIVIDUAL POSSESSING A Y CHROMOSOME IS MALE
• MALES ARE GENETICALLY XY
• AN INDIVIDUAL LACKING A Y CHROMOSOME IS FEMALE
• FEMALES ARE GENETICALLY XX

9
REPRODUCTIVE SYSTEMS

• THE GONADS ARE THE PRIMARY SEX ORGANS OF BOTH
  GENDERS
• TESTES, OVARIES
• GONADS PRODUCE GAMETES
• GONADS HAVE OTHER FUNCTIONS AS WELL
• SECONDARY SEX ORGANS ARE ALSO REQUIRED FOR
  REPRODUCTION
• E.G., PENIS, PROSTATE, UTERUS, VAGINA
• STORAGE SURVIVAL OF GAMETES, UNITING GAMETES,
  HOUSING DEVELOPING FETUS

10
REPRODUCTIVE SYSTEMS

• SECONDARY SEX CHARACTERISTICS
• BEGIN TO DEVELOP AT PUBERTY
• DISTINGUISH BETWEEN SEXES
• INVOLVED IN MATE ATTRACTION
• E.G., FACIAL HAIR, LOW-PITCHED VOICE, BREAST
  GROWTH, ETC.

11
CHROMOSOMES

• NORMAL HUMAN CELLS POSSESS 23 PAIRS OF
  CHROMOSOMES
• 23 IS MICHAEL JORDANS NUMBER
• DIPLOID (2N)
• GAMETES ARE HAPLOID (N)
• 22 PAIRS ARE AUTOSOMES
• 1 PAIR ARE SEX CHROMOSOMES
• XX IN FEMALE, XY IN MALE

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13
SEX CHROMOSOMES

• X CHROMOSOME
• LARGE
• CONTAINS THOUSANDS OF GENES
• ESSENTIAL FOR LIFE
• ONLY ONE COPY IS REQUIRED
• FEMALES HAVE AN EXTRA COPY
• ONE COPY IS INACTIVATED IN EACH OF A FEMALES
  CELLS
• HALF MATERNAL, HALF PATERNAL

14
SEX CHROMOSOMES

• Y CHROMOSOME
• VERY SMALL
• CONTAINS VERY FEW GENES
• NONESSENTIAL
• ABSENCE ? FEMALE DEVELOPMENT
• DEFAULT FOR MAMMALS
• PRESENCE ? MALE DEVELOPMENT
• SRY GENE
• SEX-DETERMINING REGION OF THE Y

15
SEX CHROMOSOMES

• Y CHROMOSOME SRY GENE
• ENCODES PROTEIN
• TESTIS-DETERMINING FACTOR (TDF)
• INTERACTS WITH OTHER GENES
• THESE GENES ? MALE DEVELOPMENT
• TESTES FORMED AT 8 9 WEEKS
• TESTOSTERONE PRODUCED
• PRODUCTION THROUGH FIRST TRIMESTER
• MULLERIAN-INHIBITING FACTOR PRODUCED
• AIDS IN DEVELOPMENT OF MALE SYSTEM

16
SEX DETERMINATION

• FEMALES ARE GENETICALLY XX
• EGGS POSSESS A SINGLE X CHROMOSOME
• MALES ARE GENETICALLY XY
• SPERM POSSESS EITHER AN X OR A Y CHROMOSOME, NOT
  BOTH
• THE SEX OF AN OFFSPRING IS DETERMINED BY THE
  SPERM
• HENRY VIII SHOULD HAVE BEEN NICER TO HIS WIVES

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18
MALE REPRODUCTIVE SYSTEM
19
TESTES

• PRIMARY MALE SEX ORGANS
• OVAL, 4 CM LONG, 2.5 CM DIAMETER
• DIVIDED INTO 250 300 LOBULES
• 1 3 SEMINIFEROUS TUBULES IN EACH
• UP TO 70 CM LONG
• SITE OF SPERM PRODUCTION
• INTERSTITIAL CELLS
• BETWEEN SEMINIFEROUS TUBULES
• SITE OF TESTOSTERONE PRODUCTION

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21
TESTES

• SEMINIFEROUS TUBULES
• GERM CELLS
• SUSTENTACULAR CELLS

22
TESTES

• SEMINIFEROUS TUBULES
• SEVERAL LAYERS OF GERM CELLS
• DIVIDE BY MEIOSIS
• ULTIMATELY FORM SPERM CELLS

23
TESTES

• SEMINIFEROUS TUBULES
• SUSTENTACULAR CELLS
• FEWER IN NUMBER THAN GERM CELLS
• PROTECT GERM CELLS
• PROMOTE GERM CELL DEVELOPMENT
• PRVIDE NUTRIENTS, GROWTH FACTORS
• REMOVE WASTE
• SECRETE THE HORMONE INHIBIN
• REGULATE RATE OF SPERM PRODUCTION

24
TESTES

• SEMINIFEROUS TUBULES
• SUSTENTACULAR CELLS
• FORM BOUNDARY OF TUBULE
• TIGHT JUNCTIONS BETWEEN THESE CELLS FORMS THE
  BLOOD-TESTIS BARRIER (BTB)
• PREVENTS LARGE MOLECULES FROM BLOOD ECF FROM
  ENCOUNTERING GERM CELLS
• ESP. ANTIBODIES (PREVENT ATTACK)
• GERM CELLS ARE GENETICALLY DIFFERENT

25
TESTES

• SEMINIFEROUS TUBULES
• EMPTY INTO RETE TESTIS
• MOVED BY FLUID FLOWING FROM SUSTENTACULAR CELLS
• POSSIBLY MOVED BY CILIA ALSO
• SPERM DO NOT SWIM IN MALE REPRODUCTIVE SYSTEM
• NETWORK OF TUBULES
• POSTERIOR SIDE OF TESTIS
• SITE OF PARTIAL MATURATION

26
TESTES

• TESTICULAR ARTERIES
• BLOOD SUPPLIED TO TESTIS
• ARISE FROM ABDOMINAL AORTA
• LONG, SLENDER ARTERIES
• PASS THROUGH INGUINAL CANAL INTO SCROTUM
• LOW BLOOD PRESSURE (NO PULSE)
• POOR OXYGEN SUPPLY
• SPERM DEVELOP LARGE MITOCHONDRIA
• PRECONDITIONED FOR SURVIVAL IN HYPOXIC FEMALE
  REPRODUCTIVE TRACT?

27
TESTES

• TESTICULAR VEINS
• BLOOD DRAINED FROM TESTIS
• RIGHT ? INFERIOR VENA CAVE
• LEFT ? LEFT RENAL VEIN
• LYMPHATIC VESSELS ALSO DRAIN
• TESTES ? INGUINAL LYMPH NODES

28
SCROTUM

• POUCH CONTAINING TESTES
• DIVIDED INTO TWO COMPARTMENTS
• MEDIAN SEPTUM
• EXTERNALLY SEEN AS PERINEAL RAPHE
• PROTECTION VS. INFECTIONS
• LEFT TESTIS SUSPENDED LOWER
• PROTECTION VS. COMPRESSION
• SEBACEOUS GLANDS
• SPARSE HAIR
• RICH SENSORY INNERVATION
• DARKER PIGMENT

29
SCROTUM

• SPERMATIC CORD
• PASSES UP BACK OF SCROTUM
• ? THROUGH INGUINAL RING
• ? INTO INGUINAL CANAL
• CONTAINS
• VAS DEFERENS (DUCTUS DEFERENS)
• TESTICULAR ARTERIES VEINS
• LYMPHATIC VESSELS
• NERVES

30
SCROTUM

• TEMPERATURE REGULATION
• SCROTUM 2o COOLER (35o VS 37oC)
• REQUIRED FOR SPERM PRODUCTION
• MAINTAINED BY THREE MECHANISMS
• CREMASTER MUSCLE
• DARTOS MUSCLE
• PAMPINIFORM PLEXUS

31
SCROTUM

• TEMPERATURE REGULATION
• CREMASTER MUSCLE
• COLD ? CONTRACTS DRAWS TESTES CLOSER TO BODY TO
  KEEP WARM
• WARM ? RELAXES SUSPENDS TESTES FURTHER FROM
  BODY
• DARTOS MUSCLE
• COLD ? SCROTUM BEOMES TAUT
• HELD AGAINST WARM BODY
• REDUCES SURFACE AREA OF SCROTUM

32
SCROTUM

• TEMPERATURE REGULATION
• PAMPINIFORM PLEXUS
• NETWORK OF VEINS SURROUNDING TESTICULAR ARTERY
• HEAT TRANSFERRED FROM ARTERY TO VEINS
• COUNTERCURRENT HEAT EXCHANGER
• BLOOD REACHING TESTES IS 2o COOLER THAN BODY
  TEMP

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SPERMATIC DUCTS

• PATH OF SPERM
• SEMINIFEROUS TUBULES
• ? RETE TESTIS
• ? EFFERENT DUCTULES
• ? (DUCT OF THE ) EPIDIDYMIS
• ?DUCTUS (VAS) DEFERENS
• ? EJACULATORY DUCT
• ?URETHRA

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SPERMATIC DUCTS

• EFFERENT DUCTULES
• 12 SMALL DUCTULES
• CARRY SPERM FROM RETE TESTIS TO EPIDIDYMIS
• CILIATED CELLS HELP MOVE SPERM

38
SPERMATIC DUCTS

• EPIDIDYMIS
• SPERM MATURATION STORAGE
• 7.5 CENTIMETERS LONG
• SINGLE COILED DUCT 6 METERS LONG
• REABSORBS 90 OF FLUID SECRETED BY TESTES
• THREE REGIONS
• HEAD ? BODY
• IMMATURE SPERM ? MATURE SPERM
• 20 DAY JOURNEY
• TAIL
• SPERM STORAGE
• FERTILE FOR 40 60 DAYS
• REABSORBED IF NOT EJACULATED

39
SPERMATIC DUCTS

• DUCTUS (VAS) DEFERENS
• 45 CM LONG, 2.5 MM DIAMETER
• TRAVELS THROUGH INGUINAL CANAL TO PELVIC CAVITY
• WIDENS INTO A TERMINAL AMPULLA
• UNITES WITH DUCT OF SEMINAL VESICLE

40
SPERMATIC DUCTS

• DUCTUS (VAS) DEFERENS
• INNERVATED MUSCULAR TUBE
• DURING ORGASM, PERISTALTIC CONTRACTION DRIVE
  SPERM FROM EPIDIDYMIS ? EJACULATORY DUCT
• SNIP, SNIP ? VASECTOMY

41
SPERMATIC DUCTS

• EJACULATORY DUCT
• FORMED BY CONVERGENCE OF VAS DEFERENS AND DUCT OF
  SEMINAL VESICLE
• SHORT DUCT
• 2 CENTIMETERS LONG
• PASSES THROUGH PROSTATE
• EMPTIES INTO URETHRA

42
URETHRA

• 20 CENTIMETERS LONG
• THREE REGIONS
• PROSTATIC URETHRA
• MEMBRANOUS URETHRA
• PENILE URETHRA
• SHARED BY MALE URINARY AND REPRODUCTIVE SYSTEMS
• CANNOT PASS URINE AND SEMEN SIMULTANEOUSLY

43
ACCESSORY GLANDS

• SEMINAL VESICLES
• PROSTATE
• BULBOURETHRAL GLANDS

44
SEMINAL VESICLES

• PAIRED GLANDS
• POSTERIOR TO URINARY BLADDER
• 5 CENTIMETERS LONG
• SIZE OF LITTLE FINGER
• CONNECTIVE TISSUE SMOOTH MUSCLE
• EMPTIES INTO AMPULLA OF VAS DEFERENS
• SECRETIONS CONSTITUTE 60 OF SEMEN

45
PROSTATE

• UNPAIRED
• SURROUNDS EJACULATORY DUCT PORTION OF URETHRA
• 2 4 CENTIMETER DIAMETER
• NOT ROUND
• CONTAINS 30 50 SEPARATE GLANDS
• EMPTIES THROUGH 20 PORES INTO URETHRA
• SECRETIONS CONSTITUTE 30 OF SEMEN
• PROSTATE CANCER VERY COMMON CANCER IN MEN

46
PROSTATE

• BENIGN PROSTATE HYPERPLASIA
• BEGINS TO GROW SLOWLY AT AGE 45
• OVER 90 OF MEN AT AGE 70 DISPLAY PROSTATE
  ENLARGEMENT
• COMPRESSES URETHRA
• OBSTRUCTS URINE FLOW

47
PROSTATE

• PROSTATE CANCER
• SECOND MOST COMMON CANCER IN MEN
• (LUNG IS MOST COMMON)
• AFFECTS 9 OF MEN OVER AGE 50
• TUMORS FORM NEAR PERIPHERY OF GLAND
• DO NOT OBSTRUCT URINE FLOW
• GENERALLY UNNOTICED
• OFTEN METASTASIZES TO NEARBY LYMPH NODES, LUNGS,
  OTHER ORGANS
• 80 SURVIVAL IF DETECTED EARLY
• 10 50 SURVIVAL AFTER METASTASIS

48
PROSTATE

• PROSTATE CANCER
• DETECTED BY
• DIGITAL RECTAL EXAM (DRE)
• PROSTATE SPECIFIC ANTIGEN (PSA)
• ACID PHOSPHATASE (PROSTATE ENZYME)

49
BULBOURETHRAL GLANDS

• PAIRED GLANDS
• 1 CENTIMETER DIAMETER
• SHORT DUCTS EMPTY INTO URETHRA
• FLUID PRODUCED UPON AROUSAL
• NEUTRALIZES ACIDITY IN URETHRA
• ACIDITY IS FROM RESIDUAL URINE
• ACIDITY IS HARMFUL TO SPERM
• LUBRICATES HEAD OF PENIS IN PREPARATION FOR
  INTERCOURSE

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PENIS

• COPULATORY ORGAN
• DEPOSITS SEMEN INTO VAGINA
• INTERNAL ROOT
• EXTERNALLY VISIBLE SHAFT GLANS
• SKIN LOOSELY ATTACHED TO SHAFT
• ALLOWS EXPANSION DURING ERECTION
• CONTINUS OVER GLANS (PREPUCE / FORESKIN)
• OFTEN REMOVED BY CIRCUMCISION
• CONTAINS THREE BODIES OF ERECTILE TISSUES

52
PENIS

• ERECTILE TISSUES
• PRODUCE ERECTION
• FILL WITH BLOOD DURING AROUSAL
• CORPUS SPONGIOSUM
• VENTRAL SIDE OF PENIS
• ENCLOSES PENILE URETHRA
• EXPANDS DISTALLY TO FILL GLANS
• CORPUS CAVERNOSA
• PAIRED
• DORSAL SIDE OF PENIS
• SEPARATED BY MEDIAL SEPTUM

53
PENIS

• ERECTILE TISSUES
• (CORPUS SPONGIOSUM CORPUS CAVERNOSA)
• POSSESS NUMEROUS LACUNAE
• TINY BLOOD SINUSES
• TRABECULAE BETWEEN LACUNAE
• TRABECULAE CONTAIN SMOOTH MUSCLE
• TONUS OF TRABECULAR MUSCLE COLLAPSES LACUNAE IN
  FLACCID PENIS

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PENIS

• ROOT
• TURNS 90o DORSALLY AT BODY SURFACE
• CORPUS SPONGIOSUM TERMINATES INTERNALLY AS A
  DLATED BULB
• ENSHEATHED IN MUSCLE
• CORPORA CAVERNOSA DIVERGE
• EACH ARM CRUS
• ATTACH PENIS TO PUBIC ARCH
• EACH ENSHEATHED IN MUSCLE

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PUBERTY

• PERIOD OF TIME BETWEEN AWAKENING OF
  REPRODUCTIVE SYSTEM AND ATTAINING THE ABILITY TO
  SEXUALLY REPRODUCE
• AWAKENING CAUSED BY SURGE IN PITUITARY
  GONADOTROPINS (HORMONES)
• AGE 8 10 IN MOST GIRLS
• AGE 10 12 IN MOST BOYS
• END OF PUBERTY MARKED BY FIRST MENSTRUAL PERIOD
  OR FIRST EJACULATION OF VIABLE SPERM
• AROUND AGE 12 IN MOST GIRLS
• AROUND AGE 13 IN MOST BOYS

57
PUBERTY

• ENDOCRINE CONTROL
• TESTOSTERONE PRODUCTION HIGH DURING FIRST
  TRIMESTER
• TESTOSTERONE PRODUCTION CEASES
• TESTOSTERONE PRODUCTION RESUMES DURING PUBERTY

58
HORMONES

• IMPORTANT HORMONES ABBREVIATIONS
• FOLLICLE-STIMULATING HORMONE
• FSH
• GONADOTROPIN-RELEASING HORMONE
• GnRH
• LUTEINIZING HORMONE
• LH

59
PUBERTY

• ENDOCRINE CONTROL
• HYPOTHALAMUS SECRETES GnRH
• OCCURS AS HYPOTHALAMUS MATURES
• TARGET CELLS IN PITUITARY
• PITUITARY SECRETES FSH LH
• GONADOTROPINS
• TARGET CELLS IN TESTES
• FSH ? SUSTENTACULAR CELLS
• LH ? INTERSTITIAL CELLS

60
PUBERTY

• ENDOCRINE CONTROL
• RESPONSE OF TESTES
• ENLARGE (FIRST SIGN OF PUBERTY)
• LH ? INTERSTITIAL CELLS SECRETE TESTOSTERONE
  (ANDROGEN)
• FSH ? SUSTENTACULAR CELLS SECRETE
  ANDROGEN-BINDING PROTEIN (ABP)

61
PUBERTY

• ENDOCRINE CONTROL
• EFFECTS OF TESTOSTERONE ABP
• SPERMATOGENESIS STIMULATED
• GnRH SECRETION INHIBITED
• REDUCED SENSITIVITY OF PITUITARY TO GnRH
• FSH LH PRODUCTION REDUCED
• REDUCED SENSITIVITY OVERCOME DURING PUBERTY
• FSH LH SECRETION INCREASES
• SECONDARY SEX CHARACTERISTICS DEVELOPED
• REPRODUCTIVE DUCTS ACCESSORY GLANDS ENLARGE
• GROWTH HORMONE SECRETION STIMULATED
• ERYTHROPOIESIS STIMULATED
• LIBIDO (SEX DRIVE) STIMULATED

62
PUBERTY

• ENDOCRINE CONTROL
• SUSTENTACULAR CELLS SECRETE THE HORMONE INHIBIN
• SUPPRESSES FSH SECRETION
• DOES NOT INHIBIT LH SECRETION
• SPERM PRODUCTION INHIBITED
• A DROP IN SPERM COUNT STOPS INHIBIN SECRETION
• FSH SECRETION RISES
• SPERM PRODUCTION INCREASES

63
AGING SEXUAL FUNCTION

• TESTOSTERONE PRODUCTION PEAKS AT AGE 20, THEN
  DECLINES STEADILY
• DROPS TO 20 OF THIS LEVEL AT AGE 80
• CORRESPONDING DECLINE IN ACTIVITY OF INTERSTITIAL
  AND SUSTENTACULAR CELLS
• CORRESPONDING DECLINE IN FEEDBACK INHIBITION OF
  PITUITARY
• FSH LH LEVELS INCREASE AFTER 50
• PRODUCE MALE CLIMACTERIC
• TYPICALLY LITTLE OR NO EFFECT

64
AGING SEXUAL FUNCTION

• ERECTILE DYSFUNCTION
• FREQUENT INABILITY TO SUSTAIN ERECTION ADEQUATE
  FOR INTERCOURSE
• AFFECTS 20 OF MEN IN SIXTIES
• AFFECTS 50 OF MEN IN EIGHTIES
• OVER 90 STILL ABLE TO EJACULATE

65
SPERMATOGENESIS

• MEIOSIS SPERMIOGENESIS
• MEIOSIS
• GERM CELLS ? SPERMATIDS
• DIPLOID (2N) ? HAPLOID (N)
• TWO DIVISIONS (MEIOSIS I II)
• SPERMIOGENESIS
• SPERMATIDS ? SPERMATOZOA
• PROCESS TAKES 74 DAYS
• 300,000 SPERM PER MINUTE
• 400 MILLION SPERM PER DAY

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SPERMATOGENESIS

• PRIMORDIAL GERM CELLS
• FORM IN YOLK SAC
• COLONIZE GONADS
• WEEK 5 6 OF DEVELOMENT
• ? SPERMATOGONIA
• PERIPHERY OF SEMINIFEROUS TUBULE
• OUTSIDE OF BLOOD-TESTIS BARRIER (BTB)
• MULTIPLY BY MITOSIS
• FORM TYPE A TYPE B SPERMATOGONIA

68
SPERMATOGENESIS

• TYPE A TYPE B SPERMATOGONIA
• TYPE A
• REMAIN OUTSIDE OF BTB
• CONTINUE MITOSIS UNTIL DEATH
• TYPE B
• MIGRATE CLOSER TO TUBULE LUMEN
• ? PRIMARY SPERMATOCYTES
• MUST PASS THROUGH BTB

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SPERMATOGENESIS

• PASSAGE THROUGH BTB
• TIGHT JUNCTION BETWEEN TWO SUSTENTACULAR CELLS
  DISMANTLED
• NEW TIGHT JUNCTION FORMED BEHIND SPERMATOCYTE
• SPERMATOCYTE MOVES TOWARD LUMEN
• SEPARATED FROM ANTIBODIES
• SPERMATOCYTE UNDERGOES MEIOSIS

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SPERMATOGENESIS

• PASSAGE THROUGH BTB
• MEIOSIS I
• ? 2 SECONDARY SPERMATOCYTES
• MEIOSIS II
• ? 4 SPERMATIDS
• EQUAL IN SIZE
• CYTOKINESIS INCOMPLETE
• CELLS REMAIN CONNECTED VIA CYTOPLASMIC BRIDGES
• TIGHT GAP JUNCTIONS LINK TO SUSTENTACULAR
  CELLS
• SPERMIOGENESIS

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SPERMATOGENESIS

• SPERMIOGENESIS
• SPERMATIDS ? SPERMATOZOA
• GRADUAL TRANSFORMATION
• NO CELL DIVISION
• SPROUTS FLAGELLUM
• DISCARDS BULK OF CTOPLASM
• RELEASED INTO TUBULE
• SUSTENTACULAR SECRETIONS WASH DOWN TUBULE

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SPERMATOZOON

• BASIC ANATOMY
• HEAD
• 4 5 mM LONG, 3 mM WIDE
• TAIL
• 50 - 60 mM LONG

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SPERMATOZOON

• SPERM HEAD
• NUCLEUS
• FILLS MOST OF HEAD
• CONTAINS CHROMOSOMES (HAPLOID)
• ACROSOME
• TIP OF SPERMATOZOON
• LYSOSOME
• CONTAINS ENZYMES REQUIRED FOR FERTILIZATION
• BASAL BODY
• POWERS FLAGELLUM

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SPERMATOZOON

• SPERM TAIL
• MIDPIECE
• THICKEST PART
• NUMEROUS MITOCHONDRIA
• SPIRAL AROUND FLAGELLUM
• PRODUCE ATP
• PRINCIPAL PIECE
• LONGEST PORTION OF TAIL
• ENDPIECE
• NARROW END OF SPERM

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SEMEN

• FLUID EXPELLED DURING ORGASM
• TYPICAL EJACULATION 2 5 ML
• 60 SEMINAL VESICLE FLUID
• 30 PROSTATIC FLUID
• 10 SPERM SPERMATIC DUCT SECRETIONS
• TRACE OF BULBOURETHRAL FLUID

79
COMPONENTS OF SEMEN

• SPERMATOZOA
• 50 120 MILLION PER MILLILITER
• FRUCTOSE
• PROVIDES ENERGY FOR SPERM MOTILITY
• SPERMINE
• BASE, NEUTRALIZES VAGINAL ACIDITY
• FIBRINOGEN
• SEMEN CLOT, ADHERE TO VAGINA CERVIX
• CLOTTING ENZYMES
• FIBRINOGEN ? FIBRIN
• FIBRINOLYSIN
• DISSOLVES FIBRIN 15 30 MIN AFTER EJACULATION
• PROSTAGLANDINS
• STIMULATES PERISTALTIC CONTRACTIONS OF UTERUS
• DRAWS SPERM INTO UTERUS
• DECREASES VISCOSITY OF CERVICAL MUCUS

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MALE SEXUAL RESPONSE

• FOUR PHASES
• EXCITEMENT
• PLATEAU
• ORGASM
• RESOLUTION

81
MALE SEXUAL RESPONSE

• EXCITEMENT PHASE
• INITIATED BY EROTIC STIMULI
• SIGHT, SOUND, AROMA, TOUCH, ETC.
• VASOCONGESTION
• SWELLING OF GENITALS WITH BLOOD
• MYOTONIA
• MUSCLE TENSION
• INCREASED HEART RATE
• INCREASED BLOOD PRESSURE
• INCREASED RESPIRATORY RATE
• BULBOURETHRAL GLANDS SECRETE FLUID

82
MALE SEXUAL RESPONSE

• EXCITEMENT PHASE
• ERECTION
• NERVE FIBERS SECRETE NITRIC OXIDE (NO)
• RELAXATION OF DEEP ARTERIES, LACUNAE
• OUTFLOW OF BLOOD BLOCKED
• ERECTILE TISSUES FILL WITH BLOOD EXPAND (MAINLY
  CORPORA CAVERNOSA)
• PENIS ENLARGED RIGID
• ELEVATED ANGLE ALLOWS PENETRATION

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MALE SEXUAL RESPONSE

• PLATEAU PHASE
• SUSTAINED AT HIGH LEVEL
• RESPIRATORY RATE
• HEART RATE
• BLOOD PRESSURE
• INCREASED VASOCONGESTION
• INCREASED MYOTONIA

84
MALE SEXUAL RESPONSE

• ORGASM PHASE
• FURTHER INCREASE IN
• HEART RATE
• BLOOD PRESSURE
• RESPIRATORY RATE
• SHORT INTENSE REACTION
• 3 15 SECONDS
• EJACULATION
• INTENSE FEELING OF RELEASE

85
MALE SEXUAL RESPONSE

• ORGASM PHASE EJACULATION
• DISCHARGE OF SEMEN INTO VAGINA
• TWO PHASES
• EMISSION
• EXPULSION

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MALE SEXUAL RESPONSE

• ORGASM PHASE EJACULATION
• EMISSION
• NERVOUS SYSTEM STIMULATED PERISTALSIS IN SMOOTH
  MUSCLE OF VAS DEFERENS
• SPERM PROPELLED INTO AMPULLA
• AMPULLA CONTRACTS, SPERM PROPELLED INTO PROSTATIC
  URETHRA
• SMOOTH MUSCLE IN PROSTATE FORCES PROSTATIC FLUID
  INTO URETHRA
• SECRETIONS OF SEMINAL VESICLES ADDED

87
MALE SEXUAL RESPONSE

• ORGASM PHASE EJACULATION
• EXPULSION
• FURTHER SECRETION OF PROSTATE AND SEMINAL
  VESICLES
• INTERNAL URINARY SPHINCTER CONSTRICTED
• BULBOSPONGIOSUS CONTRACTS
• SURROUNDS ROOT OF CORPUS SPONGIOSUM
• 5 6 STRONG, SPASMODIC CONTRACTIONS
• URETHRA COMPRESSED, SEMEN EXPELLED

88
MALE SEXUAL RESPONSE

• RESOLUTION PHASE
• REDUCED BLOOD FLOW TO PENIS
• DETUMNESCENCE
• LOSS OF ERECTION
• CARDIOVASCULAR AND RESPIRATORY FUNCTIONS RETURN
  TO NORMAL
• DIFFICULT TO REATTAIN ERECTION
• 10 MINUTES TO A FEW HOURS

89
FEMALE REPRODUCTIVE SYSTEM
90
OVARIES

• PRIMARY FEMALE SEX ORGANS
• 3 CM x 1.5 CM x 1 CM
• OUTER CORTEX
• SITE OF GERM CELLS DEVELOPMENT
• INNER MEDULLA
• MAJOR ARTERIES VEINS
• LACKS DUCTS
• EGGS DEVELOP IN FOLLICLES

91
(No Transcript)
92
SECONDARY SEX ORGANS

• INTERNAL GENITALIA
• UTERINE TUBES
• UTERUS
• VAGINA

93
UTERINE TUBES

• FALLOPIAN TUBES / OVIDUCTS
• 10 CENTIMETERS LONG
• OVARY ? UTERUS
• INFUNDIBULUM
• PROJECTIONS FIMBRIAE
• AMPULLA
• ISTHMUS

94
UTERINE TUBES

• SMOOTH MUSCLE
• FOLDED MUCOSA
• CILIATED CELLS
• SECRETORY CELLS
• BEATING CILIA AND MUSCULAR CONTRACTIONS CONVEY
  EGG FROM OVARY TO UTERUS

95
UTERUS

• 7 CM x 4 CM x 2.5 CM
• THICK MUSCULAR CHAMBER
• OPENS INTO VAGINA
• TILTS FORWARD OVER BLADDER
• PEAR-SHAPED
• FUNCTIONS
• HARBOR EMBRYO
• PROVIDE NUTRITION FOR EMBRYO
• EXPEL FETUS AT END OF DEVELOPMENT

96
UTERUS

• CERVIX
• INFERIOR END OF UTERUS
• CERVICAL CANAL
• INTERNAL OS (SUPERIOR END)
• EXTERNAL OS (INFERIOR END)
• CERVICAL GLANDS
• SECRETE MUCUS
• BODY DEFENSE
• MUCUS THINS NEAR TIME OF OVULATION
• EASIER PASSAGE FOR SPERM

97
UTERUS

• CERVICAL CANCER
• COMMON ON WOMEN AGES 30 50
• BEGINS IN EPITHELIAL CELLS
• GROWS SLOWLY
• REMAINS LOCAL FOR SEVERAL YEARS
• EASILY REMOVED
• EARLY DETECTION BY PAP SMEAR
• SCRAPE
• MICROSCOPIC EXAMINATION
• INVASIVE MUCH MORE DANGEROUS

98
UTERUS

• UTERINE WALL
• PERIMETRIUM
• OUTERMOST
• MYOMETRIUM
• BULK OF WALL (1.25 CM THICK)
• SMOOTH MUSCLE PRODUCES LABOR CONTRACTIONS
• ENDOMETRIUM
• SITE OF ATTCHMENT OF EMBRYO
• FORMS PLACENTA
• MUCOSA
• STRATUM FUNCTIONALIS
• SHED WITH EACH MENSTRUAL PERIOD
• STRATUM BASALIS
• NOT SHED, REGENERATES A NEW FUNCTIONALIS

99
UTERUS

• BLOOD SUPPLY
• UTERINE ARTERY
• ? ARCUATE ARTERIES
• ??SPIRAL ARTERIES
• WIND THROUGH ENDOMETRIUM
• SPASM TO INITIATE MENSTRUATION

100
(No Transcript)
101
(No Transcript)
102
VAGINA

• FUNCTIONS
• RECEIPT OF PENIS, SEMEN
• DISCHARGE OF MENSTRUAL FLUID
• BIRTH OF BABY
• 8 10 CM LONG
• THIN, DISTENSIBLE WALL
• TILTS POSTERIORLY

103
VAGINA

• NO GLANDS
• LUBRICATED BY TRANSUDATION
• SEROUS FLUID THROUGH WALLS
• MUCUS FROM CERVICAL GLANDS
• FRICTION RIDGES (VAGINAL RUGAE)
• STIMULATE PENIS, INDUCE EJACULATION
• EPITHELIAL CELLS RICH IN GLYCOGEN
• FERMENTED BY BACTERIA
• ? LACTIC ACID
• pH 3.5 4.0
• INHIBITS GROWTH OF PATHOGENS

104
SECONDARY SEX ORGANS

• EXTERNAL GENITALIA
• VULVA / PUDENDUM (COLLECTIVELY)
• MONS PUBIS
• LABIA MAJORA
• LABIA MINORA
• CLITORIS
• VAGINAL ORIFICE
• URETHRAL ORIFICE
• ACCESSORY GLANDS
• ERECTILE TISSUE

105
SECONDARY SEX ORGANS

• EXTERNAL GENITALIA
• VULVA / PUDENDUM (COLLECTIVELY)
• MONS PUBIS
• MOUND OF ADIPOSE TISSUE OVER PUBIC SYMPHISIS
• LABIA MAJORA
• THICK FOLDS OF SKIN ADIPOSE TISSUE
• INFERIOR TO MONS PUBIS
• PUBIC HAIR ON LATERAL SURFACES
• LABIA MINORA
• MEDIAL TO LABIA MAJORA
• HAIRLESS
• FORM PREPUCE OVER CLITORIS

106
SECONDARY SEX ORGANS

• EXTERNAL GENITALIA
• LABIA MINORA
• MEDIAL TO LABIA MAJORA
• HAIRLESS
• FORM PREPUCE OVER CLITORIS
• CLITORIS
• HOMOLOGOUS TO PENIS
• CONTAINS ERECTILE TISSUE
• NO URINARY FUNCTION
• PRIMARY CENTER OF EROTIC STIMULATION
• GLANS PROTRUDES SLIGHTLY FROM PREPUCE

107
SECONDARY SEX ORGANS

• EXTERNAL GENITALIA
• VESTIBULAR BULBS
• DEEP TO THE LABIA MAJORA
• ERECTILE TISSUE CONGESTED WITH BLOOD DURING
  EXCITEMENT
• CAUSE VAGINA TO TIGHTEN AROUND PENIS
• GREATER VESTIBULAR GLAND
• PAIRED, HOMOLOGOUS TO BULBOURETHRAL GLANDS
• DUCTS OPENING INTO LOWER VAGINA
• KEEP VULVA MOIST
• PROVIDE LUBRICANT DURING SEXUAL EXCITEMENT
• LESSER VESTIBULAR GLANDS
• LUBRICATE VAGINA
• PARAURETHRAL GLANDS
• PAIRED, HOMOLOGOUS TO PROSTATE
• MUCOUS GLANDS

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(No Transcript)
109
BREASTS

• DEVELOP AT PUBERTY
• SECONDARY SEXUAL CHARACTERISTIC
• MOUND OF TISSUE OVERLYING PECTORALIS MAJOR
• PRINCIPAL REGIONS
• CONICAL/PENDULOUS BODY
• NIPPLE AT APEX
• AXILLARY TAIL
• EXTENSION TOWARD ARMPIT
• IMPORTANT IN BREAST CANCER METASTASIS

110
BREASTS

• NIPPLE
• SURROUNDED BY AREOLA
• BLOOD VESSELS NERVES NEAR SURFACE
• MORE SENSTIVE , REDDISH IN COLOR
• SMOOTH MUSCLE FIBERS
• CONTRACT IN RESPONSE TO COLD, TOUCH, SEXUAL
  AROUSAL
• WRINKLES SKIN, ERECTS NIPLE
• OFTEN MELANIZED DURING PREGNANCY
• NIPPLE AREOLA
• MORE VISIBLE TO INFANT
• AREOLAR GLANDS
• SMALL BUMPS ON SURFACE
• INTERMEDIATE BETWEEN SWEAT GLANDS AND MAMMARY
  GLANDS
• SECRETIONS PROTECT FROM CHAPPING SURING NURSING
• SECRETIONS FROM SEBACEOUS GLANDS ALSO PROTECT

111
BREASTS

• MAINLY ADIPOSE COLLAGENOUS TISSUE
• SIZE DETERMINED BY AMOUNT OF ADIPOSE TISSUE
• NO EFFECT ON MILK PORDUCTION
• MAMMARY GLAND
• DEVELOPS DURING PREGNANCY
• 15 20 LOBES, RADIAL AROUND NIPPLE
• EACH LOBE DRAINED BY LACTIFEROUS DUCT
• DUCT ? LACTIFEROUS SINUS ? NIPPLE

112
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113
BREAST CANCER

• OCCURS IN ONE OF EVERY EIGHT OR NINE AMERICAN
  WOMEN
• A LEADING CAUSE OF MORTALITY
• TUMORS BEGIN WITHIN CELLS OF MAMMARY DUCTS
• MAY METASTASIZE INTO OTHER ORGANS
• SOME BREAST CANCER GENES FOUND
• BRCA1, BRCA2
• MOST BREAST CANCER NOT HEREDITARY
• SOME TUMORS STIMULATED BY ESTROGEN

114
BREAST CANCER

• DETECTION
• BREAST SELF-EXAMINATION
• MAMMOGRAMS (X-RAYS)
• TREATMENT
• LUMPECTOMY
• MASTECTOMY
• RADIATION CHEMOTHERAPY
• ESTROGEN BLOCKERS
• RECONSTRUCTION POSSIBLE

115
PUBERTY

• INVOLVES SAME HORMONES AS IN MALES
• HYPOTHALAMUS SECRETES GnRH
• ? PITUITARY SECRETES FSH LH
• ? DEVELOPMENT OF OVARIAN FOLLICLES
• ? SECRETE ESTROGENS, PROGESERONE, INHIBIN,
  ANDROGENS
• HORMONE LEVELS GRADUALLY RISE
• GRADUAL RISE FROM 8 12
• RISE SHARPLY IN EARLY TEENS

116
PUBERTY

• THELARCHE
• DEVELOPMENT OF BREASTS
• INDUCED BY ESTROGENS
• PUBARCHE
• PUBIC AND AXILLARY HAIR
• SEBACEOUS APOCRINE GLANDS
• INDUCED BY ANDROGENS
• MENARCHE
• FIRST MENSTRUAL PERIOD
• REQUIRES 17 BODY FAT
• DELAYED IN SOME ATHLETES
• TYPICALLY ANOVULATORY FOR FIRST YEAR

117
PUBERTY

• EFFECTS OF ESTROGENS
• GROWTH OF OVARIES
• GROWTH OF SECONDARY SEX ORGANS
• GROWTH HORMONE SECRETION
• RAPID INCREASE IN HEIGHT
• WIDENING OF HIPS
• STIMULATES FAT DEPOSITION
• MONS PUBIS, LABIA MAJORA, HIPS, THIGHS, BUTTOCKS,
  BREASTS

118
PUBERTY

• EFFECTS OF ANDROGENS
• GROWTH OF PUBIC AXILLARY HAIR
• GROWTH OF SEBACEOUS APOCRINE GLANDS
• LIBIDO
• WOMEN PRODUCE 0.5 MG/DAY
• MEN PRODUCE 6 8 MG/DAY

119
CLIMACTERIC MENOPAUSE

• CLIMACTERIC
• MIDLIFE CHANGE IN HORMONE SECRETION
• WITH AGE
• FOLLICLES FEWER IN NUMBER
• FOLLICLES LESS RESPONSIVE TO GONADOTROPINS
• ? SECRETE LESS ESTROGEN PROGESTERONE
• ? ATROPHY OF UTERUS, VAGINA, BREASTS
• BONE MASS DECLINES (? OSTEOPOROSIS)
• CONSTRICTION DILATION OF BLOOD VESSELS
• ? HOT FLASHES HEADACHES
• ACCOMPANIED BY MENOPAUSE
• CESSATION OF MENSTRUATION
• OCCURS AGE 45 55

120
OOGENESIS

• FEMALE GERM CELLS
• DERIVED FROM YOLK SAC OF EMBRYO
• COLONIZE GONADAL RIDGES
• DIFFERENTIATE INTO OOGONIA
• MULTIPLY
• ARREST DEVELOPMENT (5TH MONTH)
• TRANSFORM INTO PRIMARY OOCYTES
• 2 MILLION AT BIRTH
• 400,000 AT PUBERTY
• BEGIN MEIOSIS I

121
OOGENESIS

• BEGINNING IN ADOLESCENCE, FSH PERIODICALLY
  STIMULATES PRIMARY OOCYTES TO COMPLETE MEIOSIS I
• ? 2 HAPLOID CELLS
• UNEQUAL CYTOKINESIS
• ONE LARGE (SECONDARY OOCYTE)
• ONE SMALL (FIRST POLAR BODY GARBAGE)
• SECONDARY OOCYTE ? METAPHASE II
• HALTS UNTIL AFTER OVULATION

122
OOGENESIS

• SECONDARY OOCYTE
• DIES IF NOT FERTILIZED
• COMPLETES MEIOSIS II IF FERTILIZED
• SECONDARY POLAR BODY PRODUCED
• NUCLEI FUSE
• ZYGOTE FORMS
• MITOSIS ????OFFSRING

123
(No Transcript)
124
FEMALE SEXUAL CYCLE

• AVERAGE CYCLE LENGTH IS 28 DAYS
• VARIABLE, 20 45 DAYS
• HIERARCHY OF CONTROL
• HYPOTHALAMUS?PITUITARY?OVARIES?UTERUS
• INCLUDES OVARIAN UTERINE CYCLES

125
OVARIAN CYCLE

• FOLLICULAR PHASE
• MENSTRUAL PHASE
• DAYS 1 - 5
• PREOVULATORY PHASE
• DAYS 6 - 14
• POSTOVULATORY PHASE
• LUTEAL PHASE
• DAYS 15 - 26
• PREMENSTRUAL PHASE
• DAYS 27 - 28

126
OVARIAN CYCLE

• MENSTRUAL PHASE
• DAYS 1 5 OF CYCLE
• MENSTRUAL FLUID DISCHARGED
• 20 25 OOCYTES BEGIN MEIOSIS I
• STIMULATED BY FSH
• STIMULATION BEGINS DAY 25 OF PREVIOUS CYCLE
• FOLLICLES AROUND THESE OOCYTES DEVELOP

127
OVARIAN CYCLE

• PREOVULATORY PHASE
• DAYS 6 14 OF TYPICAL CYCLE
• END OF MENSTRUATION ? OVULATION
• GROWING FOLLICLES SECRETE MORE ESTROGEN
• REDUCES FSH SECRETION BY PITUITARY
• MAKES FOLLICLES MORE SENSITIVE TO FSH
• (MORE FSH RECEPTORS)
• ONE FOLLICLE BECOMES DOMINANT
• MATURE FOLLICLE, 2.5 CM IN DIAMETER
• COMPLETES MEIOSIS I ? METAPHASE II
• PRODUCES LH RECEPTORS
• OTHER FOLLICLES DEGENERATE

128
OVARIAN CYCLE

• PREOVULATORY PHASE
• HIGH ESTROGEN LEVEL
• STIMULATES GnRH, FSH, LH PRODUCTION
• HIGH FSH LH LEVELS
• CILIA IN UTERINE TUBE CREATE CURRENT INTO TUBE
• LH INCREASES BLOOD FLOW INTO FOLLICLE
• FOLLICLE SWELLS
• OVULATION
• RUPTURE OF FOLLICLE, RELEASE OF OOCYTE
• DAY 14 OF TYPICAL CYCLE

129
OVARIAN CYCLE

• LUTEAL PHASE
• DAYS 15 26 OF TYPICAL CYCLE
• OOCYTE TRAVELS DOWN UTERINE TUBE
• OVULATED FOLLICLE BECOMES CORPUS LUTEUM
• LH SECRETION CONTINUES (PITUITARY)
• SUPPORTS CORPUS LUTEUM
• CORPUS LUTEUM PRODUCES ANDROGEN
• ANDROGEN ? PROGESTERONE
• ? STIMULATES UTERINE DEVELOPMENT

130
OVARIAN CYCLE

• LUTEAL PHASE
• PROGESTERONE INHIBITS SECRETION OF GnRH LH
• WHEN LH LEVELS DROP (10 DAYS)
• NOT PREGNANT
• CORPUS LUTEUM ATROPHIES (?CORPUS ALBICANS)
• PROGESTERONE LEVELS DROP
• MENSTRUATION INITIATED
• GnRH SECRETION BEGINS, START OVER
• PREGNANT
• LH REPLACED BY HCG FROM EMBRYO
• CORPUS LUTEUM REMAINS ACTIVE 3 MONTHS
• ENDOCRINE FUNCTION LATER ASSUMED BY PLACENTA

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132
MENSTRUAL CYCLE

• MENSTRUATION
• DAYS 1 - 5
• PROLIFERATIVE PHASE
• DAYS 6 13
• SECRETORY PHASE
• DAYS 14 - 26
• PREMENSTRUAL PHASE
• DAYS 27 - 28

133
MENSTRUAL CYCLE

• PROLIFERATIVE PHASE
• DAYS 6 13 OF TYPICAL CYCLE
• REBUILDING OF ENDOMETRIAL TISSUE
• ENDOMETRIUM 0.5 MM THICK (DAY 5)
• ESTROGEN STIMULATES MITOSIS, BLOOD VESSEL
  REGROWTH
• ENDOMETRIUM 2 - 3 MM THICK (DAY 14)
• ESTROGEN STIMULATES ENDOMETRIUM TO PRODUCE
  PROGESTERONE RECEPTORS
• PREPARATION FOR SECRETORY PHASE

134
MENSTRUAL CYCLE

• SECRETORY PHASE
• DAYS 15 26 OF TYPICAL CYCLE
• FURTHER THICKENING OF ENDOMETRIUM
• SECRETION, NOT MITOSIS
• CORPUS LUTEUM SECRETES PROGESTERONE
• STIMULATES ENDOMETRIAL GLANDS TO ACCUMULATE
  GLYCOGEN
• GLYCOGEN-RICH SECRETION INTO LUMEN
• ENDOMETRIUM 5 - 6 MM THICK (DAY 26)
• NUTRIENT-RICH BED FOR IMPLANTATION

135
MENSTRUAL CYCLE

• PREMENSTRUAL PHASE
• DAYS 27 28 OF TYPICAL CYCLE
• NOT PREGNANT
• CORPUS LUTEUM ATROPHIES
• PROGESTERONE LEVELS PLUMMET
• SPIRAL ARTERIES OF ENDOMETRIUM SPASM
• TISSUE NECROSIS, BLOOD POOLS
• NECROTIC ENDOMETRIUM SHED
• MENSTRUAL FLUID

136
MENSTRUAL CYCLE

• MENSTRUAL PHASE
• DAYS 1 5 OF TYPICAL CYCLE
• MENSTRUAL FLUID DISCHARGED
• BLOOD, SEROUS FLUID, DEGENERATED TISSUE
• BEGINS WHEN ENOUGH MENSTRUAL FLUID ACCUMULATES IN
  UTERUS
• 75 ML AVERAGE DISCHARGE
• FIBROLYSIN PREVENTS CLOTTING

137
(No Transcript)
138
FEMALE SEXUAL RESPONSE

• FOUR PHASES
• EXCITEMENT
• PLATEAU
• ORGASM
• RESOLUTION

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140
FEMALE SEXUAL RESPONSE

• EXCITEMENT PHASE
• SIMILAR TO MALE RESPONSE
• INITIATED BY EROTIC STIMULI
• SIGHT, SOUND, AROMA, TOUCH, ETC.
• VASOCONGESTION
• SWELLING OF GENITALS WITH BLOOD
• MYOTONIA
• MUSCLE TENSION
• INCREASED HEART RATE
• INCREASED BLOOD PRESSURE
• INCREASED RESPIRATORY RATE

141
FEMALE SEXUAL RESPONSE

• EXCITEMENT PLATEAU PHASES
• LABIA
• LABIA MINORA CONGESTED
• LABIA MINORA PROTRUDE BEYOND LABIA MAJORA
• LABIA MAJORA REDDENED ENLARGED, FLATTEN
  SPREAD AWAY FROM VAGINAL ORIFICE
• VAGINA
• VAGINAL WALL HYPEREMIC
• SEROUS FLUID SEEPS INTO CANAL
• VESTIBULE MOISTENED, LUBRICATED
• INNER END DILATES
• LOWER THIRD CONSTRICTS
• ORGASMIC PLATFORM
• TIGHTENS AROUND PENIS

142
FEMALE SEXUAL RESPONSE

• EXCITEMENT PLATEAU PHASES
• CLITORIS
• HOMOLOGOUS TO PENIS
• HIGH CONCENTRATION OF SENSORY NERVES
• (NERVES LARGELY ABSENT FROM VAGINA)
• BECOMES ENGORGED
• MECHANISM SIMILAR TO PENILE ERECTION
• DEEP ARTERIES, CORPORA CAVERNOSA
• SWELLS TO 2 3 TIMES NORMAL SIZE
• WITHDRAWS BENEATH PREPUCE
• THRUSTING OF PENIS PULLS ON LABIA MINORA, PULLS
  ON PREPUCE, STIMULATES CLITORIS

143
FEMALE SEXUAL RESPONSE

• EXCITEMENT PLATEAU PHASES
• UTERUS
• TILTS FORWARD LESS
• CERVIX WITHDRAWS FROM VAGINA
• BREASTS
• CONGESTED SWOLLEN
• NIPPLES BECOME ERECT
• STIMULATION ENHANCES SEXUAL AROUSAL

144
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145
FEMALE SEXUAL RESPONSE

• ORGASM PHASE
• INVOLUNTARY PELVIC THRUSTING,
• 1 2 SECONDS OF SUSPENSION, THEN
• ORGASM
• INTENSE SENSATION
• 3 5 STRONG CONTRACTIONS BY ORGASMIC PLATFORM
• CERVIX PLUNGES INTO VAGINA ( SEMEN IF PRESENT)
• PERISTALTIC CONTRACTIONS OF UTERUS
• MAY DRAW SEMEN FROM VAGINA
• PERIURETHRAL GLANDS EXPEL FLUID
• INCREASED HEART RESPIRATORY RATES
• BREASTS ENLARGE FURTHER
• AREOLAE BECOME ENGORGED

146
FEMALE SEXUAL RESPONSE

• RESOLUTION PHASE
• UTERUS DROPS FORWARD TO RESTING POSITION
• ORGASMIC PLATFORM QUICKLY RELAXES
• INNER END OF VAGINA SLOWLY RETURNS TO NORMAL
  DIMENSIONS
• FLUSH DISAPPEARS QUICKLY
• NIPPLES AREOLAE QUICKLY RETURN TO NORMAL
• BREASTS SLOWLY RETURN TO NORMAL SIZE
• NO REFRACTORY PERIOD
• MAY QUICKLY EXPERIENCE ADDITIONAL ORGASMS

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148
PREGNANCY CHILDBIRTH

• GESTATION
• FERTILIZATION ? BIRTH
• 266 DAYS
• LMP ? BIRTH
• 280 DAYS (40 WEEKS)
• MEASURED FROM FIRST DAY OF LAST MENSTRUAL PERIOD
  (LMP)
• DIVIDED INTO TRIMESTERS
• 3-MONTH INTERVALS

149
PREGNANCY CHILDBIRTH

• EARLY FETAL DEVELOPMENT
• FERTILIZATION
• DISTAL HALF OF UTERINE TUBE
• REQUIRES MULTIPLE SPERM
• ONLY ONE SPERM FERTILIZES EGG
• ZYGOTE FORMED
• CELL DIVISIONS
• 5 6 DIVISIONS EN ROUTE TO UTERUS
• BLASTOCYST
• IMPLANTATION
• ATTACES TO ENDOMETRIUM 4 DAYS AFTER ARRIVAL
• PLACENTA DEVELOPS
• MATERNAL BLASTOCYST TISSUE

150
PREGNANCY CHILDBIRTH

• EARLY FETAL DEVELOPMENT
• FUNCTIONS OF PLACENTA
• FETAL NUTRITION
• WASTE REMOVAL
• HORMONE SECRETION
• MAMMARY DEVELOPMENT
• FETAL DEVELOPMENT

151
PREGNANCY CHILDBIRTH

• HORMONES OF PREGNANCY
• SECRETED PRIMARILY BY PLACENTA
• SECRETED BY CORPUS LUTEUM
• FIRST 7 12 WEEKS, THEN DEGENERATES
• FUNCTIONS REPLACED BY PLACENTA

152
PREGNANCY CHILDBIRTH

• HORMONES OF PREGNANCY
• HUMAN CHORIONIC GONADOTROPIN
• ESTROGENS
• PROGESTERONE
• HUMAN CHORIONIC SOMATOMAMMOTROPIN

153
PREGNANCY CHILDBIRTH

• HORMONES OF PREGNANCY
• HUMAN CHORIONIC GONADOTROPIN
• HCG
• SECRETED BY TROPHOBLAST
• REPLACES LH
• CORPUS LUTEUM IS RETAINED
• DETECTED IN PREGNANCY TEST
• HIGH LEVELS IN URINE
• DETECTABE 8 9 DAYS POST-FERTILIZATION

154
PREGNANCY CHILDBIRTH

• HORMONES OF PREGNANCY
• ESTROGENS
• INCREASE THROUGHOUT GESTATION
• REACH 30 TIMES NORMAL LEVEL
• SECRETED FROM CORPUS LUTEUM
• FIRST 12 WEEKS
• SECRETED BY PLACENTA THEREAFTER
• STIMULATES
• FETAL TISSUE GROWTH
• GROWTH OF UTERUS, EXTERNAL GENITALIA, BREASTS
• MAMMARY GLANDS TO GROW

155
PREGNANCY CHILDBIRTH

• HORMONES OF PREGNANCY
• PROGESTERONE
• SECRETED FROM CORPUS LUTEUM
• FIRST 12 WEEKS
• SECRETED BY PLACENTA THEREAFTER
• SUPPRESSES FSH LH
• PREVENTS MORE FOLLICLE MATURATION
• MAINTAINS ENDOMETRIUM
• SUPPRESSES UTERINE CONTRACTIONS
• STIMULATES DEVELOPMENT OF SECRETORY ACINI

156
PREGNANCY CHILDBIRTH

• HORMONES OF PREGNANCY
• HUMAN CHORIONIC SOMATOMAMMOTROPIN (HCS)
• A.K.A. HUMAN PLACENTAL LACTOGEN
• CAUSES MAMMARY GROWTH LACTATION IN OTHER
  ANIMALS, BUT NOT HUMANS
• HUGE AMOUNT SECRETED
• gtALL OTHER HORMONES COMBINED
• SECRETED BY PLACENTA
• BEGINS 5TH WEEK INCREASES
• EFFECTS SIMILAR TO GROWTH HORMONE
• REDUCES MOTHERS GLUCOSE USAGE
• MORE AVAILABLE TO FETUS/EMBRYO
• PROMOTES RELEASE OF FREE FATTY ACIDS

157
PREGNANCY CHILDBIRTH

• HORMONES OF PREGNANCY
• OTHER HORMONES
• THYMOTROPIN
• PROLACTIN
• ADRENOCORTICOTROPIC HORMONE

158
CHILDBIRTH

• PARTURITION
• ACHIEVED BY CONTRACTIONS OF UTERINE AND ABDOMINAL
  MUSCLES
• PROGESTERONE INHIBITS UTERINE CONTRACTIONS
• PRODUCTION ECREASES IN LAST TRIMESTER
• ESTROGEN PROMOTES UTERINE CONTRACTIONS
• PRODUCTION CONTINUALLY INCREASES
• NEAR TERM, PITUITARY RELEASES OXYTOCIN (OT)
• UTERUS ALSO PRODUCES MORE OXYTOCIN RECEPTORS
• STIMULATES PROSTAGLANDIN RELEASE
• STIMULATES UTERINE CONTRACTIONS
• STRETCHING OF UTERUS INVOLVED IN INITIATION

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(No Transcript)
160
CHILDBIRTH

• LABOR CONTRACTIONS
• BEGIN 30 MINUTES APART
• BECOME MORE INTENSE MORE FREQUENT
• ULTIMATELY EVERY 1 3 MINUTES
• INDUCED BY STRETCHING OF CERVIX
• FETUS HEAD
• CONTRACTIONS CAUSE MORE STRETCHING
• STRETCHING ALSO INCREASES OT SECRETION
• POSTIVE FEEDBACK
• EXPULSION OF FETUS AIDED BY ABDOMINAL MUSCLES

161
CHILDBIRTH

• LABOR CONTRACTIONS
• PAIN
• ISCHEMIA OF MYOMETRIUM
• TEMPORARILY DEPRIVED OF BLOOD DURING CONTRACTIONS
• INCREASED STRETCHING OF CERVIX, VAGINA, PERINEUM
• TEARING OF VAGINAL TISSUE
• EPISIOTOMY WIDENS VAGINAL ORIFICE, REDUCES TEARING

162
CHILDBIRTH

• WHY IS CHILDBIRTH MORE PAINFUL IN HUMANS THAN IN
  OTHER ANIMALS?
• HUMAN ADAPTATIONS
• INCREASED BRAIN (SKULL) SIZE
• PELVIS ADAPTED TO BIPEDALISM
• THESE ADAPTATIONS ? PAIN

163
LACTATION

• ESTROGEN CAUSES DUCTS OF MAMMARY GLANDS TO GROW
  BRANCH
• GROWTH HORMONE, INSULIN, GLUCOCORTICOIDS,
  PROLACTIN CONTRIBUTE
• PROGESTERONE STIMULATES BUDDING DEVELOPMENT OF
  ACINI AT ENDS OF DUCTS

164
LACTATION

• CLOSTRUM
• FILL ACINI DUCTS IN LATE PREGNANCY
• SIMILAR TO MILK
• LACTOSE
• MORE PROTEIN
• MORE IMMUNOGLOBULINS (IgA)
• LESS FAT
• ONLY FOOD FOR 1 3 DAYS

165
LACTATION

• BREAST MILK
• SYNTHESIS PROMOTED BY PROLACTIN
• BEGINS WEEK 5 OF PREGNANCY
• 20 TIMES NORMAL LEVEL AT BIRTH
• STEROID HORMONES ANTAGONIZE EFFECTS
• LOSS OF PLACENTA REMOVES ANTAGONISM
• MILK SYNTHESIS BEGINS
• ALSO REQUIRES GROWTH HORMONE, CORTISOL, INSULIN,
  PTH

166
LACTATION

• BREAST MILK
• SYNTHESIS PROMOTED BY PROLACTIN
• 20 TIMES NORMAL LEVEL AT BIRTH
• QUICKLY DROPS TO NONPREGNANT LEVEL
• NURSING INFANT INCREASES 10 20 FOLD
• WITHOUT NURSING ( PROLACTIN SURGES), MILK
  PRODUCTION STOPS
• LACTATION SUPPRESSES GnRH PRODUCTION
• SUPPRESSES FSH LH PRODUCTION
• SUPPRESSES FOLLICULAR DEVELOPMENT
• PREVENTS PREGNANCY (90 EFFECTIVE)

167
(No Transcript)
168
LACTATION

• MILK EJECTION
• CONTINUALLY SECRETED INTO ACINI
• DOES NOT EASILY FLOW INTO DUCTS
• NURSING STIMULATES NERVES
• OXYTOCIN RELEASED
• HYPOTHALAMUS PITUITARY
• MYOEPITHELIA CELLS CONTRACT
• SURROUND ACINI
• MILK SQUEEZED FROM ACINI
• NO MILK FOR FIRST 30 60 SECONDS OF SUCKLING

169
CONTRACEPTION

• BEHAVIORAL METHODS
• ABSTINENCE
• REFRAINING FROM INTERCOURSE
• COMPLETELY RELIABLE IF USED
• RHYTHM METHOD
• PERIODIC ABSTINENCE
• AVOIDING INTERCOURSE NEAR TIME OF OVULATION
• 25 FAILURE RATE
• HELPFUL IN GETTING PREGNANT
• WITHDRAWAL
• COITUS INTERRUPTUS
• 20 FAILURE RATE
• LACK OF WILLPOWER
• SPERM IN PREEJACULATORY FLUID

170
CONTRACEPTION

• BARRIER / SPERMICIDAL METHODS
• MALE CONDOM
• LATEX, RUBBER, OR ANIMAL MEMBRANE
• MOST EFFECTIVE WITH SPERMICIDES
• 15 20 FAILURE RATE
• PROTECT AGAINST DISEASE TRANSMISSION
• FEMALE CONDOM
• POLYURETHANE SHEATH
• RINGS FIT OVER CERVIX LABIA MAJORA
• 15 20 FAILURE RATE
• PROTECT AGAINST DISEASE TRANSMISSION
• DIAPHRAGM
• RUBBER CAP OVER CERVIX
• EXAMINATION FOR PROPER FIT
• USED WITH SPERMICIDES
• 20 FAILURE RATE

171
CONTRACEPTION

• HORMONAL METHODS
• BIRTH-CONTROL PILLS
• ESTROGEN PROGESTERONE
• MIMIC NEGATIVE FEEDBACK ON FSH LH
• PREVENT OVULATION
• 5 FAILURE RATE
• NORPLANT
• SLOW RELEASE PROGESTERONE INSERTED UNDER SKIN
• EFFECTIVE UP TO 5 YEARS
• ALTERS CILIA (PREVENTS EGG TRANSPORT)
• ENDOMETRIUM UNRECEPTIVE TO IMPLANTATION
• 0.05 FAILURE RATE
• DEPO-PROVERA
• PROGESTERONE INJECTIONS 2 4 TIMES / YEAR
• 0.3 FAILURE RATE

172
CONTRACEPTION

• SURGICAL STERILIZATION
• VASECTOMY
• SEVERING OF VAS DEFERENS
• 0.15 FAILURE RATE
• TUBAL LIGATION
• SEVERING UTERINE TUBES
• 0.5 FAILURE RATE

173
CONTRACEPTION

• PREVENTING IMPLANTATION
• INTRAUTERINE DEVICE (IUD)
• PLASTIC DEVICE SCOURS UTERUS
• 1 4 YEAR LIFESPAN
• 1 FAILURE RATE
• MORNING AFTER PILL
• HIGHER PROGESTERONE ESTROGEN
• HIGHER DOSE OF BIRTH-CONTROL PILL
• RU486 CONTRAGESTIVE
• PROGESTERONE ANALOG
• INTERRUPTS PROGESTERONE SIGNAL
• ENDOMETRIUM CANNOT BE MAINTAINED