NCM 107 LEC REPRODUCTIVE AND SEXUAL External Structures:

HEALTH ● Scrotum​- during hot days it relaxes;

JULY 22,2020 during cold days it contracts— bag of
skin that holds and helps to protect the
CONCEPT OF UNITIVE AND PROCREATIVE testicles.
HEALTH ● testes- ​two oval-shaped male
● Procreative Dimension- ​is purposefully reproductive glands that produce sperm
suppressed and ignored. and the hormone testosterone.
● Unitive Dimension-​ separated from the ● penis​- a male erectile organ of
procreative. copulation by which urine and semen
are discharged from the body
1. A ​forced act ​of physical love by one's Internal Structures:
spouse upon the other violates the ● epididymis​- a highly convoluted duct
unitive dimension ​of marital love. behind the testis, along which sperm
2. The impairment of the capacity to passes to the vas deferens.
transmit human life violates the ● vas deferens​-the duct which conveys
procreative dimension. sperm from the testicle to the urethra.
● seminal vesicle​- each of a pair of glands
Both dimensions are intrinsincally good and which open into the vas deferens near
inherent to the act of [Link] to its junction with the urethra and
in marital, one cannot separate the procreative secrete many of the components of
dimension. semen.
● prostate gland​- a gland surrounding the
● Artificial birth control- ​involves an neck of the bladder in male mammals
impairment or suppression of one and releasing prostatic fluid.
inherent dimension. ● bulbourethral gland- pea-sized gland in
● Marital love- is designed to be both the male located behind and to the side
unitive and procreative; to suppress or of the urethra that discharges a
to violate either one contradicts the component of seminal fluid into the
design of God. urethra.

THE NURSING ROLE THE REPRODUCTIVE AND

SEXUAL HEALTH: Anatomy and Physiology of
reproductive system— The MALE ● urethra- the duct by which urine is
conveyed out of the body from the
● Andrology- study of male reproductive bladder, and which in male vertebrates
system also conveys semen.

THE NURSING ROLE THE REPRODUCTIVE AND

SEXUAL HEALTH: Anatomy and Physiology of
reproductive system— The FEMALE

● Gynecology- study of the female

reproductive system.
 sperm cells from the uterus to the
released ova.
● Uterus- ​hollow muscular organ located
in the female pelvis between the
bladder and rectum. The ovaries
produce the eggs that travel through
the fallopian tube.
1. Uterine Wall layers
External structures: 2. Uterine Blood Supply
● Mons Veneris- ​the fatty cushion of flesh 3. Uterine Nerve Supply
in human females situated over the 4. Uterine Supportive Structures
junction of the pubic bonesCompare ● Vagina- ​muscular canal lined with
mons pubis; the area of flesh covering a nerves and mucus membranes. It
woman's pelvic bones, above her sex connects the uterus and cervix to the
organs outside of the body, allowing for
● Labia Minora- ​the inner highly vascular menstruation, intercourse, and
largely connective-tissue folds of the childbirth.
vulva bounding the vestibule. Uterine Deviations
● Labia Majora- ​the outer fatty folds of ● Bicornuate Uterus
the vulva bounding the vestibule. ● Anteversion
● Vestibule- ​surrounds the opening of the ● Retroversion
vagina, or introitus, and the opening of ● Anteflexion
the urethra, or urethral meatus. ● Retroflexion
● Clitoris- ​A small erectile body situated
at the anterior portion of the vulva and
projecting between the branched
extremities of the labia minora forming
its prepuce and frenulum.
● Skene Glands- ​small glands that open
into the female urethra near its opening
● Bartholin Glands- located on each side
of the vaginal opening. They secrete
fluid that helps lubricate the vagina
● Fourchette- ​a small fold of membrane
connecting the labia minora in the
Mammary Glands
posterior part of the vulva.
● Hymen- ​thin piece of mucosal tissue
that surrounds or partially covers the
external vaginal opening. It forms part
of the vulva, or external genitalia, and is
similar in structure to the vagina.
Internal structures:
● Ovaries- ​Maturation of oocytes
● Fallopian tubes- ​one of a pair of long,
slender ducts in the female abdomen
● A woman’s reproductive system works
that transport ova from the ovary to the
on a ​28 days cycle. This is called the
uterus and, in fertilization, transport
Menstrual Cycle.
● Menarche- beginning of menstruation.
( ave. onset age 9-17y)(normal cycle: 28
days) ( sometimes 29-35 days not
unusual)( ranges; 2-7 days) abnormal
range: 1-9 days)
● The Menstrual cycle consists of a
number of stages.
1. Day 1–7: the lining of the uterus comes
away and exits through the vagina as
blood. 5. Day 18-28: if the egg is not fertilized the
linig of the uterus begins to break
down.

2. Day 7-13: the blood flow stops and the THE CYCLE STARTS ALL OVER AGAIN UNTIL
lining of the uterus begins to build up FERTILIZED.
again. At this time the egg starts to
mature in one of the ovaries.

3. Day 14 ( middle of the cycle): an egg is

released by the ovary into the oviduct.
Fig. A: shows the plasma hormone
concentration in the normal female
reproductive cycle.

4. Day 14-17: the egg can last up to 3 days

after it is released from the ovary.

Fig. B: ovarian events and uterine changes

during the menstrual cycle
 contains an immature egg.
STAGES OF MENSTRUAL CYCLE
Only the healthiest egg will eventually
● Menstrual phase- ​The menstrual phase mature. (On rare occasions, a woman
is the first stage of the menstrual cycle. may have two eggs mature.) The rest of
It’s also when you get your period. the follicles will be reabsorbed into your
body.
This phase starts when an egg from the
previous cycle isn’t fertilized. Because The maturing follicle sets off a surge in
pregnancy hasn’t taken place, levels of estrogen that thickens the lining of your
the hormones estrogen and uterus. This creates a nutrient-rich
progesterone drop. environment for an embryo to grow.

The thickened lining of your uterus, The average follicular phaseTrusted

which would support a pregnancy, is no Source lasts for about 16 days. It can
longer needed, so it sheds through your range from 11 to 27 days, depending on
vagina. During your period, you release your cycle.
a combination of blood, mucus, and
tissue from your uterus. ● Ovulation phase- ​Rising estrogen levels
during the follicular phase trigger your
You may have period symptoms like pituitary gland to release luteinizing
these: hormone (LH). This is what starts the
process of ovulation.
-cramps (try these home remedies)
-tender breasts Ovulation is when your ovary releases a
-bloating mature egg. The egg travels down the
-mood swings fallopian tube toward the uterus to be
-irritability fertilized by sperm.
-headaches
-tiredness The ovulation phase is the only time
-low back pain during your menstrual cycle when you
-On average, women are in the can get pregnant. You can tell that
menstrual phase of their cycle for 3 to 7 you’re ovulating by symptoms like
days. -Some women have longer these:
periods than others.
- a slight rise in basal body temperature
● Follicular phase- The follicular phase - thicker discharge that has the texture
starts on the first day of your period (so of egg whites
there is some overlap with the - Ovulation happens at around day 14 if
menstrual phase) and ends when you you have a 28-day cycle — right in the
ovulate. middle of your menstrual cycle. It lasts
about 24 hours. After a day, the egg will
It starts when the hypothalamus sends die or dissolve if it isn’t fertilized.
a signal to your pituitary gland to
release follicle-stimulating hormone DID YOU KNOW?
(FSH). This hormone stimulates your Because sperm can live up to five days,
ovaries to produce around 5 to 20 small pregnancy can occur if a woman has sex
sacs called follicles. Each follicle as much as five days prior to ovulation.
 ● Luteal phase SEXUALITY
After the follicle releases its egg, it ● A multi-dimensional phenomenon:
changes into the corpus luteum. This physical, emotional, social, and
structure releases hormones, mainly intellectual.
progesterone and some estrogen. The ● Biological Gender- chromosomal
rise in hormones keeps your uterine sexual development: Male( XY);
lining thick and ready for a fertilized egg Female(XX).
to implant. ● Gender Identity- ​the inner sense of the
person being male or female.
If you do get pregnant, your body will ● Gender role- the behavior of a person—
produce human chorionic gonadotropin may not be the same of biologic gender.
(hCG). This is the hormone pregnancy DEVELOPMENT OF GENDER IDENTITY
tests detect. It helps maintain the Biologic Gender- ​amount of
corpus luteum and keeps the uterine testosterone secreted in the utero. ​sex typing
lining thick. Gender Role- ​influenced by the
environment; role model cultural influences ;
If you don’t get pregnant, the corpus according to the norms standards of the society.
luteum will shrink away and be
resorbed. This leads to decreased levels 1. Infancy- ​start of the orientation
of estrogen and progesterone, which in a manner of handling as
causes the onset of your period. The evidenced by toys, dress/wear
uterine lining will shed during your and saying “ ​boys don’t cry..”
period. 2. Preschool- already distinguish
male from female; able to tell
During this phase, if you don’t get sex of own; kind of games; colr
pregnant, you may experience choices,nner of dressing differs;
symptoms of premenstrual syndrome Oedipus Electra Complex ; role
(PMS). These include: modelling —“ is that the way a
lady sits?”
-bloating 3. School age- separating
-breast swelling, pain, or tenderness activities and expecting beliefs
-mood changes that boys are poorer readers,
-headache writes less neatly, acts tougher,
-weight gain etc.
-changes in sexual desire 4. Adolescent- begins the process
-food cravings of establishing a sense of
-trouble sleeping identity, boys for boys, girls for
-The luteal phase lasts for 11 to 17 days. girls; issues to face: sexually
The average lengthTrusted Source is 14 active 50-90% Gr. 9 boys, 75%
days. of college sophomores,
MENOPAUSE:CHANGES. IN FEMALE increased incidence of STD ,
REPRODUCTIVE SYSTEM CYCLE some got identity confusion -
● Signals end of menstruation increasing suicidal rate
● End of the fertile period in women 5. Young Adult- ​more defined as
● Stops the production of the ova he/she leaves home to establish
● 40-55 y own career; others marry
● Not assoc w/ age of menarche legally or not, with or without
 commitment 2. ​Plateu​- just before orgasm
and assume parental roles, ✓ Vasocongestion clitoris is drawn forward
others got difficulty because of ✓ Full distention of penis vaginal congestion
the sexual orientation they’ve (orgasmic platform), nipple engorgement
got.
6. Middle-AgedAdult-​Sexuality 3. ​Orgasm​- discharge of accumulated sexual
achieved stability; Greater tension.
intimacy in sexual and social ✓ Muscle contractions
relationship; Changes in ✓Clitoral orgasm (can project semen into the
reproductive life:menopausal, proximal urethra.
sex drive,erectile power, ✓ 3-7 propulsive ejaculation at 1/0.8sec
achievement of orgasm- nurses interval
can help promote a positive stimulated even non- coital acts)
response towards these. ✓Vaginal orgasm- (G spot) through intercourse
7. Older Adult- concerns on ✓8-15x contractions, inter val:1/0.8sec.
reproductive life: lesser erectile ✓ Dissipating fluid from area of congestion
function and ejaculatory force,
lesser vaginal secretions; a 4. ​Resolution​- the return to an unaroused state.
nurse educates them on: ✓ Refractory period – further orgasm is
responsible and safer sex impossible.
practices, aids to maintain ✓Absence of refractory
satisfaction on sexual ✓Ability to have multiple orgasm
intercourse. ✓ 30 minutes lasting
Physically challenged individuals:
– Males and females w/ upper spinal cord injury Types of Sexual Orientation
– Those with colostomy- (disfiguring? Or fear • 1. Heterosexuality
to) – Arthritis • 2. Homosexuality
– Individuals with Urinary catheters • 3. Bisexuality
*Establishment of Satisfying Sexual relationship • 4. Transsexuality
as ADL
Types of Sexual Expression
Human Sexual Response 4 Stages: 1. Sexual Abstinence
1. Excitement 2. Masturbation
[Link] 3. Erotic Stimulation
[Link] 4. Fetishism
[Link] 5. Transvestism
6. Voyeurism
Stage: 7. Sadomasochism
1. ​Excitement​- sensual stimulation by both 8. Others: exhibitionism, bestiality, pedophilia
physical (sight, sound, touch, smell) and
psychological (thought, emotion). DISORDERS OF SEXUAL FUNCTIONING
Sympathetic stimulation: arterial dilatation and • Inhibited Sexual Desire
venous constriction in the genitals • Failure to Achieve Orgasm
✓ Scrotal thickening clitoris enlarge • Erectile Dysfunction— Focus on
✓ Elevation of testes vagina widens, lengthens, Pharmacology:
became lubricated, nipples erect Sildenafil Citrate (Viagra)
DISORDERS OF SEXUAL FUNCTIONING Odds (3 out of every 1,000 births).
• Premature Ejaculation Dizygotic twins- two separate ova are fertilized
• Persistent Sexual Arousal Syndrome by two different sperm cells. genetically
• Pain Disorders identical humans. Odds (3 out of every 1,000
• Vaginismus births).
• Dyspareunia and Vestibulitis Dizygotic twins- two separate ova are fertilized
by two different sperm cells.
Genetics and Prenatal Development
1. Child Development Is it a boy or girl?
• 22 of our 23 chromosome pairs can be
A. Genetics distinguished from one another. These are
• We have 46 chromosomes each (23 pairs from called autosomes. The 23rd pair consists of sex
each parent). chromosomes.
• Chromosomes-threadlike structures--carry • Females-XX and males-XY. The X is long, the Y
genetic information that directs development. short and carries less genetic material.
• Chromosomes made up of DNA molecules
(double helix) Who determines the sex?
What is DNA (deoxyribonucleic acid): • Males- the X and Y- chromosomes separate
• A long, double-stranded molecule that looks into different sperm cells.
like a twisted ladder. • X- sperm cells; Y-sperm cells.
• Each Of The Latter Consists Of a specific pair • Females-gametes carry X chromosomes only.
of chemical substances called bases, joined • Male’s sperm determines baby’s sex.
together between the two sides.
• Humans have 4 base pairs. Who determines the sex?
• Males- the X and Y- chromosomes separate
What is a gene? into different sperm cells.
• A segment of DNA along the length of the • X- sperm cells; Y-sperm cells.
chromosome. • Females-gametes carry X chromosomes only.
• DNA can replicate itself, leading to the • Male’s sperm determines baby’s sex.
development of a human being from 1 cell.
• This process is mitosis. Sex Chromosome Anomalies
• Turner’s Syndrome
Sex Cells (Gametes) • Klinefelter’s syndrome
• Gametes- sperm and ova • XXY males
•Contain only 23 Chromosomes. Formed • Fragile X
through meiosis-which halves the # of
chromosomes present in the body. Genetic inheritance
• In males- sperm produced throughout life, in a • 2ormoreformsofeach gene occurs at the same
female- she is born will all ova she will have place on the chromosomes.
(350-450 during maturity). • Each Different Form Of A gene is called an
allele (1-mother, 1-father).
Multiple offspring
Monozygotic twins- a fertilized egg (zygote) Alleles
separates into two distinct cell clusters that • homozygous (AA, aa)
form into Multiple offspring • heterozygous (Aa, aA)
Monozygotic twins- a fertilized egg (zygote) • Here, relationships between alleles determine
separates into two distinct cell clusters that if a trait will appear.
form into two genetically identical humans.
What happens if a child is heterozygous? • Will lead to mental retardation, but if caught
e.g., eye color, Bb (B- brown, b-blue) early can be treated with diet restrictions.
• One Allele Will Be dominant for a trait,
whereas the other will be recessive. Chromosomal abnormalities
• This child will have Brown eyes! • Damage to the chromosomes may result in
birth defects/disease.
Possible Outcomes with heterozygous Allele • Most Common—Down’sSyndrome
patterns: • Results when an extra chromosome is present
1. Dominant allele (e.g., brown eyes winning on the 21st pair.
out over blue.)
2. The trait expressed may be in between the B. Prenatal Diagnosis
dominant and recessive • Good News!!!
3. Both alleles may be expressed simultaneously • 95 % of fetuses examined through prenatal
at full intensity (called codominance) diagnosis are normal.

Heterozygous genes and disease 1. Prenatal Diagnostic Tests

Genetic conditions- mutated allele dominant or -​Amniocentesis- A hollow needle is
recessive inserted through the abdominal wall to
Ex: Huntington’s disease, Familial obtain a sample of fluid in the uterus.
hypercholesterolemia -May be performed 11-14 wks following
conception. 1-2 weeks for results.
Dominant and Recessive Characteristics 2. Chorionic Villi sampling
• Dominant • A hollow probe is inserted through
• Dark hair the vagina. Sample collects chorionic
• Normal hair villi, hairlike projections surrounding
• Curly hair the organism.
• Non Red hair • Performed (6 to 8 weeks following
• Facial dimples conception), results known within 24
• Normal hearing hours.
• Normal vision 3. Fetoscopy
• Normally pigmented skin A small tube with light source at one
• Type A blood end is inserted into the womb to
• Type B blood inspect the fetus for defects of the
• Rh-positive blood limbs & face. Blood may be taken.
Recessive Diagnosis- hemophilia, sickle-cell
-Blond hair anemia, & neural tube defects.
-Pattern baldness Straight hair Performed between 15 & 18 weeks post
-Red hair conception
-No dimples deafness 4. Ultrasound
-myopia • High-frequency sound waves beamed
-Albinism at the uterus & their reflection is
-Type O blood Type O blood Rh-negative blood recorded.
• Provides a picture of the fetus.
PKU-a recessive disease • Detect Fetal Age,multiple
• Phenylketonuria-(phenylalanine). pregnancies, & identification of gross
• phenylalanine quickly builds to toxic levels in physical defects.
brain 5. Maternal Blood Analysis
• A blood test done at the 2nd month of
 pregnancy. survival (24 weeks-50% survival rate).
• Looks For Elevated levels of alpha- • Fetus gains weight (about 5 lbs.)
fetoprotein --may detect neural tube
defects & Down’s Syndrome • And Continues Growing.
• Baby Prepares For Birth. – (24 weeks)
C. Prenatal Development •30 weeks
• Female releases a mature egg (ovum) once a
month. The egg travels from the ovaries to the D. Childbirth:
fallopian tubes where it awaits a sperm cell to •Stage 1: Dilation and effacement of the cervix
fertilize it. (avg 12-14 hrs.)
• When sperm meets egg, the egg is fertilized • Stage 2: Delivery of the baby.
and travels down to the uterus. • Stage 3: Birth of the placenta

>Period of zygote: from fertilization to Complications

Implantation (two week period). • Failure to progress
• 7th -9th day post conception. • Fetal Distress
• Zygote becomes a blastocyst, a hollow, fluid- • Placental Abruption
filled ball. Often results in C-section delivery, where the
• Cells inside, form embryonic disk (will become baby is surgically removed from the mother.
baby).
>Period of the embryo
• Implantation -8th week of pregnancy.
• Period marks most rapid prenatal
changes (organ development).
Ectoderm-NS & skin
• Mesoderm-muscle,skeletal
• Endoderm-digestive tract,
• (6 weeks)
>The Second Month
• Eyes, ears, nose, jaw, & neck form.
• Tiny Buds Become Arms,legs,fingers,
• & toes.
• Organs become more distinct – (heart)
• Is 1 inch long, can move. – (8 weeks)
>​Third Month
• Fetus can kick, bend its arms, forms a fist,
curls its toes, & opens it mouth.
• By the 12th week, the external genitals are
well formed.
(12 weeks)
>​The Second Trimester:
• By the end of the 2nd trimester (6 months) all
major organs are formed.
• Baby continues growing,
• It felt moving by mother.
>​Third Trimester (6-9 mos.)
• Babies born during this time have a chance of