Female reproductive system

The female reproductive system consists of the paired ovaries and fallopian tubes, the uterus, the vagina, and the external genital structures. The egg cells, or ova, are produced in the ovaries and travel though the fallopian tubes to the uterus, where a fertilized ovum can implant and grow. The ovaries produce hormones necessary for the secondary sex characteristics and for maintenance of pregnancy. The breasts or mammary glands are accessory organs of the reproductive system that are able to provide milk for the infant.

Female reproductive system

FIGURE. Female reproductive system.

The ovaries are oval structures about 1 inch long, each housing several hundred thousand primary follicles present at birth. Close to 400 of these follicles will produce mature ova. The mature follicle responds to LH from the anterior pituitary, causing ovulation. During this time, the ruptured follicle, at this stage called the corpus luteum, secretes progesterone and estrogen. The corpus luteum, now called the ovum, is pulled into one of the two fallopian tubes where it is propelled toward the uterus. The fallopian tubes are each about 4 inches in length and are composed of ciliated epithelial tissue capable of moving the ovum toward the uterus. Fertilization usually occurs in the fallopian tubes; if it does not, the ovum dies within 24 to 48 hours. The fertilized ovum becomes a zygote and is swept into the uterus in about 4 to 5 days.

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The uterus is pear shaped, about 3 inches long and 2 inches wide. During pregnancy, the uterus expands significantly to allow the developing fetus to grow. The upper portion of the uterus is called the fundus; the body is the central part, and the cervix is the lower end of the uterus. The two-layer lining of the uterus is the endometrium. One layer is permanent, but the other layer, known as the functional layer, is regenerated and lost during each menstrual cycle. Under the hormonal action of estrogen and progesterone, blood vessel growth thickens the functional layer in preparation for a possible pregnancy. If fertilization does not occur, this layer sloughs off in menstruation. During pregnancy, the endometrium also forms the maternal portion of the placenta.

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The vagina is a muscular tube about 4 inches in length that extends from the cervix to the vaginal opening in the perineum. It is posterior to the urethra and anterior to the rectum. The vagina receives the penis and its semen during sexual intercourse, provides the exit for menstrual flow, and is the birth canal at the end of pregnancy. The vulva includes the clitoris, labia majora and minora, and Bartholin glands. The clitoris is erectile tissue that responds to sexual stimulation. The Bartholin glands keep the mucosa of the vagina moist and lubricated during sexual intercourse. Both the labia majora and minora are paired folds of skin on either side of the urethral and vaginal openings that prevent drying of their mucous membranes.

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Vulva of female external genitals; inferior view of the perineum

FIGURE. Vulva of female external genitals; inferior view of the perineum. (From Scanlon, VC, and Sanders, T: Essentials of Anatomy and Physiology, ed 5. FA Davis, Philadelphia, 2007, p 467, with permission.)

The breasts or mammary glands produce milk to nourish the infant. After birth, the alveolar glands produce milk that enters the lactiferous ducts on its way to the nipple. Milk formation is dependent on hormone action of prolactin from the anterior pituitary. Also, the infant’s sucking at the nipple stimulates the hypothalamus to send impulses to the posterior pituitary gland to secrete oxytocin, causing the release of milk. The pigmented area around the nipple is called the areola.

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The breast

FIGURE. The breast. (From Scanlon, VC, and Sanders, T: Essentials of Anatomy and Physiology, ed 5. FA Davis, Philadelphia, 2007, p 467, with permission.)

Abruptio placentae ICD-9: 641.2 Description Abruptio placentae is the premature separation of a normally implanted placenta from the uterine wall at about the 20th week of gestation. The condition is most common in multigravidas. Etiology The cause is unknown, but predisposing factors include trauma, PIH, multiparity, diabetes, advanced maternal age, smoking, heavy use of alcohol during pregnancy, and cocaine abuse. Signs and Symptoms Abruptio placentae presents a wide range of symptoms depending on the separation of the placenta and the amount of blood loss. There may be mild to moderate bleeding; continuous pain; or sudden, severe abdominal pain with boardlike rigidity, tenderness of the uterus, hemorrhage, and the onset of shock. Diagnostic Procedures Ultrasonography, pelvic examination, and history will help confirm the diagnosis. A CBC is likely ordered. Treatment The goals of treatment are to control the bleeding, deliver a healthy infant, and prevent complications. Ho...
Prostatitis ICD-9: 601.x Description Prostatitis is inflammation of the prostate gland. The condition may be acute or chronic, with the chronic type being more common in males older than age 50. Acute prostatitis is more common in young and middle-aged men. Etiology Prostatitis may be either bacterial or nonbacterial in origin. Bacterial causes of the disease include Escherichia coli, Klebsiella, Enterobacter, Proteus, Staphylococcus, Streptococcus, and Pseudomonas. Routes of infection can be via either the urethra or the bloodstream. In nonbacterial prostatitis, no infectious agent is detectable. Signs and Symptoms Acute prostatitis clients may describe low back pain, pain in the pelvic region, perineal fullness or pain, fever, dysuria, and urinary frequency and urgency. The prostate, when palpated, may be enlarged, tender, and boggy. An individual with chronic prostatitis may be asymptomatic or experience sporadic, mild forms of acute symptoms and be prone to urinary tract infe...
Syphilis ICD-9: 097.9 Description Syphilis is a highly infectious, chronic STD characterized by lesions that may involve any organ or tissue. After a brief decline in cases in the late 1990s, cases have again begun to rise. Etiology Syphilis is caused by the bacterium Treponema pallidum. The bacteria are transmitted via direct contact with infected lesions, typically through vaginal, oral, or anal sexual intercourse or through contact with infected bodily fluids. Syphilis also may be contracted as a consequence of transfusion with infected blood (a rare occurrence). In pregnant females, T. pallidum can cross the placenta and infect the fetus, causing serious fetal damage. The bacteria rapidly penetrate skin or mucous membranes. From the point of infection, they spread into the lymphatic system and the blood, producing a systemic infection. Typically, the bacteria will have been carried throughout the body long before the first clinical symptoms appear. Signs and Symptoms When ...
Epididymitis ICD-9: 604.90 Description Epididymitis is inflammation of the epididymis due to infection. The condition is typically unilateral and is one of the most common infections of the male reproductive system, especially those in the age bracket of 19 to 35 years. Etiology Epididymitis can occur as a result of prostatitis, a UTI, tuberculosis, or STDs such as gonorrhea and chlamydia. Chlamydia trachomatis and Neisseria gonorrhoeae are the most common infectious agents that cause epididymitis in sexually active males. Signs and Symptoms The epididymis may become enlarged, hard, and tender, causing pain. Scrotal and groin tenderness, fever, and malaise also may occur. Groin tenderness is the result of enlarged lymph nodes in the groin. Clients may “waddle” as they walk, trying to protect the scrotal area. There may be blood in semen, a discharge from the penis, and enlarged lymph nodes in the groin area. Diagnostic Procedures A swab sample from urethral discharge is used...
Chlamydial infections ICD-9: 079.98 Description Chlamydial infection is a sexually transmitted infection that is now highly prevalent and is among the most potentially damaging of all the STDs in the United States. In 2008, the CDC reported 1.2 million cases of chlamydia infection, and that perhaps twice that number were undetected. Etiology Chlamydial infection is caused by the bacterium Chlamydia trachomatis. Transmission is usually through oral, vaginal, or anal sexual contact with an infected person. A neonate exposed to the bacteria in the birth canal during delivery may develop an eye infection called conjunctivitis. Signs and Symptoms An individual may be asymptomatic or present with very mild symptoms; this disease is sometimes called the “silent” STD because symptoms are often absent. Sexual transmission occurs unknowingly. Clinical manifestations in many females may resemble those of gonorrhea and include itching and burning in the genital area, mucopurulent vaginal discharge...