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LABIA MAJORA -W/ hair outside but smooth inside fatty skin folds from MONS PUBIS to PERINEUM and protects the labia minora , urinary meatus & vagina
LABIA MINORA -Thin, pink, smooth, hairless, extremely sensitive to pressure, touch and temperature. The glands of labia minora lubricate the vulva. It is formed by the frenulum and the prepuce of the clitoris which is also very sensitive because it has rich nerve supply.
VAGINAL INTROITUS
CLITORIS
URETHRAL MEATUS
TWO GLANDS THAT LUBRICATE DURING SEX 1. SKENES GLANDS (Paraurethral Glands): lubricates the external genitalia 2. Bartholins Gland (Vulvovaginal Glands): alkaline in ph, helps improve sperm survival Doderleins Bacillus: causes the vaginal ph to be acidic, which forms lactic acid Hymen: the elastic tissue, symbolizes virginity. Thorn & bloody during forced sexual act RUGAE: thick folds of membranous stratified epitheliums on the internal wall of the vagina, capable of stretching during the birth process, to accommodate the delivery of the fetus.
-Composed of glans & shaft that is partially covered by prepuce -GLANS is small and round and is filled w/ many nerve endings and rich blood supply -SHAFT is a cord connecting the glans to the pubic bone; w/in it is the major blood supply of clitoris
MCHN
Mark Abejo
ORGAN
FUNCTIONS
NOTES Layers of the Uterus: 1. Endometrium: inner layer, most vascular, SHED DURING MENSTRUATION.THE NON-PREGNANT UTERUS 2. Myometrium: LARGEST PORTION EXPELS THE FETUS DURING THE BIRTH PROCESS. The part that contracts during hemorrhage. Prevents hemorrhage.
Uterus
Pear shape muscular organ which has three(3) main functions 1. receive the ova from the fallopian tube 2. provide a place for implantation of the ova 3. Nourishment for fetal growth.
I. Cervix : lowest portion , 1/3 of the total uterus External Os: where the nurse obtain the Pap Smear to the SQUAMOCOLUMNAR JUNCTION cells. This is where the cerclage is done for incompetent cervix. Namely: A. Shirodkar Barter Suture- permanent closure of the internal cervical os, until the 38th week after which is separated TREATMENT FOR INCOMPETENT CERVIX and PREVIOUS ABORTION. B. Mc Donalds or Purse String Cerclage of the external os: usually Normal spontaneous delivery will be done for the patient. II. Isthmus: shortest portion of the uterus, the portion that is cut when the fetus is delivered during cesarean birth. III. Fundus: Upper segment, this is the most vascular, the portion also where palpation is done. Also touching it by the tip of the fingers during contraction is the best method to determine the intensity of contractions during labor. Bandls Ring ( Pathological Retraction Ring): seen in Prolonged Labor or Dystocia
3. Perimetrium: Outer most layer. Aids for support & added strength.
MCHN
Mark Abejo
Fallopian tubes
4 Parts of the Fallopian tubes 1. Interstitial : lies within the uterine wall 2. Isthmus: the portion that is cut or sealed in TUBAL LIGATION ( site for sterilization) 3. Ampulla: where fertilization occurs , this is also the LONGEST portion, frequent site for ectopic pregnancy. 4. Infundibular: covered by the Fimbriae cells that help guide the ova to the Fallopian Tube. Pair of follicle containing organs on the other side of the uterus Ovaries: 4 by 2 cm in diameter, 1.5 cm thick. Responsible for the production, Maturation, and discharge of ova Secretion of estrogen and progesterone Cortex of the Ovaries; developing and graafian follicles are found here. Tube extending from the introitus to cervix
Fallopian tubes transport the ova from the ovaries to the uterus.
Ovaries
Vagina
organ mucus
C. Types 1. Gynecoid- normal female pelvis where inlet is well rounded forward and back; it is most ideal for childbirth. 2. Anthropoid- transverse diameter is narrow, AP diameter is larger than normal. 3. Platypelloid- inlet is oval, AP diameter is shallow. 4. Android- male pelvis where inlet has a narrow, shallow posterior portion and pointed anterior portion
MCHN
Mark Abejo
D.
Types of Pelvic Ligaments 1. Round: remain lax during non-pregnancy & become HYPERTROPHIED & elongated during pregnancy. 2. Cardinal: chief uterine supports 3. Broad ligaments: drapes over the fallopian tubes, uterus & ovaries
D. Measurements 1. External- suggestive only of pelvic size a. Intercristal- distance between the middle points of the iliac crests with an average= 28 cm. b. Interspinous- distance between the anterosuperior iliac spines with an average= 25 cm. c. Intertrochanteric- distance between the trochanters of the femur with an average= 31 cm. d. External Conjugate or Baudelocques- the distance between the anterior aspect of the symphysis pubis and depression below L5 with an average= 18-20 cm.
2.
Internal- gives the actual diameter of the inlet and outlet a. Diagonal Conjugate- distance between the sacral promontory and inferior margin of the symphysis pubis with an average= 12.5 cm. b. True Conjugate or Conjugata Vera- distance between the anterior surface of the sacral promontory and the superior margin of the symphysis pubis; it is very important measurement because it is the diameter of the pelvic inlet with an average=10.5-11 cm. c. Bi-ischial diameter or Tuberischii- transverse diameter of the pelvic outlet and measured at the level of the anus with an average= 11 cm.
MCHN
Mark Abejo
Accessory Structures
MAMMARY GLANDS -2 mammary glands located on each side of chest wall -Each breast 15-20 lobes containing clusters of ALVEOLI
ACINI -Saclike end of the glandular system -Lined both w/ epithelial cells that secrete colostrum( which is rich in IgA) & milk & w/ muscles that expel milk
DUCTULES -Exit alveoli & join to form larger canals LACTIFEROUS DUCTS -During lactation, milk flows to the alveoli and then thru the duct system further going to the balloon like storage sacs called LACTIFEROUS SINUSES
MCHN
Mark Abejo
Follicle Stimulating Hormone *Stimulates Graafian follicle to mature and resulting in increase levels of estrogen
Lutenizing Hormone -When follicle is ripe and mature, triggers follicular rupture and release of ovum -Peaks at 16-18 hours before ovulation. -stimulates ovulation & development of corpus luteum
Estrogen -Produce from ovaries, adrenal cortex, and placenta -Assists in maturation of Graafian follicle -Stimulates thickening of endometrium. Other functions a. Contracts smooth muscles Inhibits the secretion of FSH b. Responsible for the increase vaginal secretion in the vagina (LEUKORRHEA) c. Thickens the endometrium d. SUPPRESSES THE FSH & Prolactin e. Responsible for the devt of 2ndary sex characteristics in females f. Stimulates uterine contractions & smuscular peristalsis of the fallopian tubes for the passage of the ovum to the uterus. g. Mildly increases Na & water reabsorption h. Stimulates LH secretion & responsible for the production of cervical mucus associated in ferning & spinnbarkeit
Progesterone *Produce from corpus luteum, placenta -Secretes thick/viscous cervical secretions. A. Preparation of the uterus to receive a fertilized ovum B. Decrease uterine motility/ contractility during pregnancy C. Increases basal metabolism D. Enhances placental growth E. Stimulates the devt of acini cells in the breast(major cells for breast milk) Increase the endometriums supply of glycogen, oxygen & amino acids for maintaining pregnancy
LUTENIZING HORMONE AND ESTROGEN peak immediately before ovulation Most women ovulate two weeks before the beginning of the next period. Other Reproductive Hormones 1. Lactogenic Hormone (Prolactin) -Stimulates lactation 2. Melanocyte Stimulating Hormone -Responsible for the linea nigra & chloasma in pregnancy -Secreted by the anterior pituitary hormone MELANOTROPIN -Will end on the 2nd month of pregnancy 3. Human Chorionic Gonadotropin -Increases in nausea and vomiting Responsible for Hyperemesis Gravidarum
MCHN
Mark Abejo
MENSTRUATION Menarche: 1st menstrual period, usually age 12, but may begin as early as 9. Menopause: cessation of menstrual cycle that occurs normally from 40 & 55 y.o. Menstrual Cycle: 1. Menstrual Phase ( 1 14 days) -Corpus luteum dies. -Progesterone & Estrogen vanishes- triggers/stimulate the production of FSH. -Endometrium degenerated/ sheds- menstruation occurs. Sexual intercourse during menstruation is not harmful. 2. Proliferative Phase- Estrogen Phase ( 6 14 days) Graafian Follicle: Estrogen Anterior Pituitary Gland secretes FSH stimulates the development of the Graafian follicle (secretes Estrogen) suppresses FSH & stimulates LH LH stimulates ovulation Increase Estrogen kills/decreases FSH 3. Secretory Phase (15 to 21 days) Progesterone Phase (Corpus Luteum: Progesterone) Other Books it is called: Luteal Phase After Ovulation-----release of mature ovum from the Graafian follicle----Graafian Follicles die and replaced by Corpus Luteum-----secretes progesterone Functions of Progesterone: 4. Pre-Menstrual Phase (22 days to 28 days) -If fertilization does not occur, corpus luteum begins to die -Progesterone & Estrogen decreases -Endometrium degenerates -Menstruation stops during pregnancy because there is decrease secretion of hormones by the ovary.
21
CORPUS LUTEUM
28
LUTEAL REGRESSION
DEVELOPING FOLLICLES
FOLLICULAR PHASE Ovarian follicles mature under influence of FSH and estrogen LH surge causes ovulation
MCHN
Mark Abejo
Menstrual Cycle
Menstrual Disorders Dysmenorrhea - PrimaryNo known cause - SecondaryMay be caused by tumor/inflammatory conditions Premenstrual Syndrome Amenorrhea Menorrhagia Metrorrhagia - Irregular bleeding in between periods
-Edema of Primary-Excessive or lower Never prolonged extremities menstruated; bleeding - Abdominal structural/congenit bloating al abnormality - Weight gain Secondary - Headache Cessation of -Breast menstruation tenderness - Depression - Crying - Loss of concentrati on
MCHN
Mark Abejo