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Human Diseases A Systemic Approach Sixth Edition

Human Diseases A Systemic Approach Sixth Edition. Mary Lou Mulvihill Mark Zelman Paul Holdaway Elaine Tompary Jill Raymond. Chapter 12 Diseases of the Reproductive Systems. Female Reproductive System. Organs of the Female Reproductive System Breasts Fallopian tubes Ovaries Vagina

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Human Diseases A Systemic Approach Sixth Edition

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  1. Human DiseasesA Systemic ApproachSixth Edition Mary Lou Mulvihill Mark Zelman Paul Holdaway Elaine Tompary Jill Raymond Chapter 12Diseases of the Reproductive Systems

  2. Female Reproductive System • Organs of the Female Reproductive System • Breasts • Fallopian tubes • Ovaries • Vagina • Vulva • Uterus

  3. Click on the screenshot to view an animation on the female pelvis.

  4. Sagittal section of the female pelvis, showing organs of the reproductive system.

  5. The uterus, ovaries, and associated structures.

  6. Pear shaped Hollow Contains thick muscular wall Lined with mucous membrane Rich blood supply Lies in the center of the pelvic cavity Between bladder and rectum Bent forward - anteflexion Held in position by ligaments which anchor it to the perimetrium 3 sections Fundus - upper Corpus - body Cervix - lower or neck Uterus

  7. Endometrium • Inner layer of uterus • Contains rich blood supply • Reacts to hormonal changes • Prepares to receive ovum • Fertilized egg implants here • Provides nourishment and protection

  8. Menstruation • When pregnancy does not occur • Endometrial lining is sloughed off • Menstrual period • Menarche – early teens • Menopause – 40–55

  9. Ovaries • 2,located on each side • Within pelvic area • Almond shaped glands • Produce ovum and hormones • Follicle stimulating hormones and luteinizing hormones secreted by the anterior pituitary • Stimulate ovulation • Estrogen and progesterone • Prepare endometrium to receive fertilized ovum

  10. Click on the screenshot to view an animation showing oogenesis.

  11. Uterine tubes Oviduct 5½ inches long Project from either side of uterus End with finger-like projections Fimbriae Purpose is to propel ovum from ovary to uterus Fertilization occurs within upper half of fallopian tubes. Fallopian Tubes

  12. Thin muscular tube Lined with mucous membranes Extends from cervix to outside of the body Allows for passage of menstrual flow During intercourse, receives the male penis and semen Serves as the birth canal Hymen is a thin membranous tissue Covers external vaginal opening Vagina

  13. Vulva • General term meaning female external genitalia • Bartholin’s glands • Secrete mucus for lubrication • Located on outer side of vaginal orifice • Labia majora and minora are folds of skin • Serve as protection • Urinary meatus

  14. Breasts • Mammary glands • Produce milk • Lactation • Milk-producing glands release milk at the nipple. • Areola is the pigmented area around the nipple.

  15. Physiology of the Female Reproductive System • Reproductive cycle • Regulation via secretion of female hormones • Estrogen, progesterone • Governed by gonadotropic hormones of the anterior pituitary which is controlled by the hypothalamus

  16. Female Reproductive Cycle • Menarche: 10 to 15 years of aage • Menopause: 40 to 50 years of age • Gonadotropic hormones stimulate ovarian follicles to develop • Graffian follicles • Ovulation

  17. First Half of the Cycle • Estrogen is secreted • Endometrium becomes more vascular • Preparation for proliferative phase • Corpus luteum follows release of the ovum • Progesterone continues stimulation of endometrial growth and storage of nutrients for nourishing a fertilized ovum

  18. Following Ovulation • Corpus luteum ceases to secrete hormones approximately 8 to 12 days after ovulation. • At the end of the monthly cycle, the level of estrogen and progesterone drops, and menstruation, the sloughing of the endometrial lining, occurs. • If pregnancy occurs, the placenta gradually assumes the role of the corpus luteum in secreting these hormones.

  19. Placenta and Umbilical Arteries • The placenta is formed from both maternal and embryonic tissue. • The endometrium thickens, becomes highly vascular, and develops large blood sinuses. • An embryonic membrane, the chorion, develops fingerlike projections called villi, which dip into the maternal blood sinuses. This interdigitation of embryonic and maternal tissue constitutes the placenta. • The umbilical arteries extend into the chorionic villi, where the exchange of carbon dioxide for oxygen and waste material for nutrients occurs. • Maternal and fetal bloods do not mix; the exchange of these substances is by diffusion across the blood vessel walls. Oxygen and nutrients return to the fetus through the umbilical vein.

  20. Pregnancy • Gestation period • 40 weeks • Birth before 37 weeks considered premature • Embryo – from fertilization until 8 weeks • Fetus – from 8 weeks to birth

  21. Provides nourishment for fetus from mother Spongy structure that forms in the uterus next to the fetus Afterbirth Fetus attached to the placenta by the umbilical cord Surrounded by 2 membranous sacs Amnion – holds amniotic fluid in which the fetus floats Chorion – protective sac Placenta

  22. Click on the screenshot to view a video on the topic of the placenta.

  23. Labor

  24. Click on the screenshots to view videos showing labor.

  25. Click on the screenshots to view videos showing labor.

  26. Click on the screenshots to view videos showing labor.

  27. Diseases of the Female Reproductive System • Infections, tumors, and cysts develop in the reproductive organs and in the breasts. Abnormalities of the menstrual cycle and of pregnancy also occur.

  28. Pelvic Inflammatory Disease • Inflammation of the pelvic reproductive organs as a result of bacterial, viral, fungal, or parasitic invasion. • Subsequent infection can ascend to the cervix (cervicitis) the endometrium (endometritis), fallopian tubes (salpingitis), and ovaries (oophoritis). • The most common cause of PID is sexually transmitted disease; including gonorrhea and chlamydia. Streptococcal and staphylococcal organisms can enter the female reproductive tract after an abortion or delivery in which sterile procedures were not carefully followed.

  29. Pelvic Inflammatory Disease (continued) • Symptoms: lower abdominal pain, fever resulting from the infection, chills, and leukorrhea, a white, foul-smelling vaginal discharge. • Treatment: antibiotics, aspirin, bed rest, and fluids • Untreated infections: risk of formation of abscesses, risk of ectopic pregnancy, and infertility from adhesions

  30. Puerperal Sepsis • An infection of the endometrium after childbirth or an abortion. • Trauma and blood loss encountered during delivery provide a portal of entry for invading microorganisms through the birth canal. • Lesions of the endometrium favor bacterial growth. • Streptococci are the principal causative organisms, but staphylococci and E. coli enter the uterus through a lack of aseptic technique. Necrosis of the endometrium develops from the infection.

  31. Puerperal Sepsis (continued) • Infected blood clots can break loose and travel as septic emboli. • Without proper treatment a systemic infection of the blood, or septicemia, or thrombophlebitis may result. • The symptoms of puerperal sepsis are fever, chills, profuse bleeding, foul-smelling vaginal discharge, and pain in the lower abdomen and pelvis. • Treatment: antimicrobials

  32. Neoplasms of the FemaleReproductive Organs • Early detection, diagnosis, and treatment of any abnormal mass or lump are extremely important in preventing the growth and spread of cancer. Many tumors and cysts are harmless, but tests are required to differentiate between malignant and benign growths.

  33. Click on the screenshot to view a video on the topic of cancer of the female reproductive organs.

  34. Carcinoma of the Cervix • Carcinoma of the cervix is one of the cancers most easily diagnosed in the early stages. Incidence of this malignancy has decreased significantly since the development of the Pap smear. • Carcinoma in situ, a malignant lesion, is the earliest stage of cancer; the underlying tissue has not yet been invaded. • Progression from carcinoma in situ to an invasive malignancy may be slow. • Symptoms: ulceration, causing vaginal discharge and bleeding.

  35. Carcinoma of the Cervix (continued) • Cervical cancer may spread to surrounding organs: vagina, bladder, rectum, and pelvic wall. • Widespread cancer becomes inoperable, and radiation therapy is the usual treatment. • Carcinoma of the cervix is strongly associated with infection by human papilloma virus. Early sexual activity and promiscuity are also related to the incidence of this cancer.

  36. Carcinoma of the Endometrium • Carcinoma of the endometrium, the lining of the uterus, occurs most often in postmenopausal women who have had no children. • The malignant tumor may grow into the cavity of the uterus or invade the wall itself. • Ulcerations develop, and erosion of blood vessels causes vaginal bleeding. Surgery and radiation are the usual treatments.

  37. Fibroid Tumors (Leiomyomas) • Benign tumors of the smooth muscle of the uterus, or fibroid tumors • The most common tumors of the female reproductive system and frequently cause no symptoms. • Fibroids are often multiple and vary greatly in size. • The cause of fibroid tumors is unknown although their growth is stimulated by estrogen. • Symptoms include abnormal bleeding between periods or excessively heavy menstrual flow and pelvic pain.

  38. Leiomyomas (continued) • Fibroid tumors can also interfere with delivery of the newborn. • Treatment for fibroid tumors depends on severity and childbearing plans. • Myolyosis, a laparoscopic technique, may be used to knock out the blood vessels of the tumor, the tumor may be removed surgically or hysterectomy may be necessary.

  39. Types of uterine fibroids.

  40. Ovarian Neoplasm • The ovaries are a common site for cancer to develop. • The ovaries’ position deep in the pelvis makes early detection of the tumor difficult. • Often extensive metastasis will occur before there are noticeable symptoms. • Symptoms include abdominal and pelvic pain, weight loss, general malaise, and digestive disturbances. • The cause of ovarian cancer is not known. • Treatment may include surgical removal of the mass, hysterectomy, radiation, and chemotherapy.

  41. Hydatidiform Mole • A benign tumor of the placenta, it can develop after a pregnancy or be associated with an abnormal one. • Hydatidiform mole is a developmental anomaly that occurs when the chorionic villi develop into a mass of grape-like vesicles. • The mass secretes chorionic gonadotropic hormone (CGH) • The uterus enlarges • Bleeding usually occurs, and the mole is expelled • Treatment: scraping of the uterus, the procedure of dilatation of the cervix and curettage (D&C), removes any fragments of the mass or placenta

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