LECTURE 1 NCM 101 LECTURE

ANATOMY & PHYSIOLOGY OF THE MALE AND FEMALE

REPRODUCTIVE SYSTEM

Human Sexuality
A. Concepts
1. A person’s sexuality encompasses the complex behaviors, attitudes emotions and
preferences that are related to sexual self and eroticism.
2. Sex – basic and dynamic aspect of life
3. During reproductive years, the nurse performs as resource person on human
sexuality.
B. Definitions related to sexuality:

o Gender identity – sense of femininity or masculinity

- 2-4 yrs/3 yrs gender identity develops.
o Role identity – attitudes, behaviors and attributes that differentiate roles

o Sex – biologic male or female status. Sometimes referred to a specific sexual

behavior such as sexual intercourse.

o Sexuality - behavior of being boy or girl, male or female man/ woman. Entity life
long dynamic change.
- developed at the moment of conception.

II. Sexual Anatomy and Physiology

A. Female Reproductive System

1. EXTERNAL

a. Mons pubis/veneris - a pad of fatty tissues that lies over the symphysis pubis covered
by skin and at puberty covered by pubic hair that serves as cushion or protection to the
symphysis pubis.

Stages of Pubic Hair Development

Tanner scale tool - used to determine sexual maturity rating.

Stage 1 – Pre-adolescence. No pubic hair. Fine body hair only
Stage 2 – Occurs between ages 11 and 12 – sparse, long, slightly pigmented
& curly hair at pubis symphysis
Stage 3 occurs between ages 12 and 13 – darker & curlier at labia
Stage 4 – occurs between ages 13 and 14, hair assumes the normal
appearance of an adult but is not so thick and does no appear to the inner
aspect of the upper thigh.
Stage 5 sexual maturity- normal adult- appear inner aspect of upper thigh .

b. Labia Majora - large lips longitudinal fold, extends symphisis pubis to perineum
c. Labia Minora – 2 sensitive structures
clitoris- anterior, pea shaped erectile tissue with lots sensitive nerve endings sight
of sexual arousal (Greek-key)
fourchette- Posterior, tapers posteriorly of the labia minora- sensitive to
manipulation, torn during delivery.
Site – episiotomy.

1
d. Vestibule – an almond shaped area that contains the hymen, vaginal orifice and
bartholene’s glands.

1. Urinary Meatus – small opening of urethra, serves for urination

2. Skenes glands/or paraurethral gland – mucus secreting subs for lubrication
3. Hymen – covers vaginal orifice, membranous tissue
4. Vaginal orifice – external opening of vagina
5. Bartholene’s glands- paravaginal gland or vulvo vaginal gland -2 small mucus
secreting subs – secrets alkaline subs.
Alkaline – neutralizes acidity of vagina
Ph of vagina - acidic
Doderleins bacillus – responsible for acidity of vagina
Carumculae mystiformes-healing of torn hymen

e. Perineum – muscular structure – loc – lower vagina & anus

INTERNAL:
A. Vagina – female organ of copulation, passageway of mens & fetus, 3 – 4inches or 8 – 10
cm long, dilated canal
Rugae – permits stretching without tearing

B. Uterus- Organ of menstruations is a hollow, thick walled muscular organ. It varies in

size, shape and weight.
 Size- 1 x 2 x 3
 Shape: non-pregnant pear shaped / pregnant - ovoid
 Weight – non-pregnant – 50 -60 kg- pregnant – 1,000g
 Pregnant/ Involution of uterus:
 4th stage of labor - 1000g
 2 weeks after delivery - 500g
 3 weeks after delivery - 300 g
 5-6 weeks after delivery- returns to original, state 50 – 60

2
 Three parts of the uterus
1. fundus - upper cylindrical layer
2. corpus/body - upper triangular layer
3. cervix - lower cylindrical layer
* Isthmus lower uterine segment during pregnancy
Cornua-junction between fundus & interstitial

MUSCULAR COMPOSITIONS: there are three main muscle layers which make expansion
possible in every direction.

1. Endometrium- inside uterus, lines the non-pregnant uterus. Muscle layer for menstruation.
Sloughs during menstruation.
Decidua- thick layer.
Endometriosis-proliferation of endometrial lining outside uterus.
Common site: ovary.
S/sx: dysmennorhea, low back pain.
Dx: biopsy, laparoscopy
Meds: 1. Danazole (Danocrene) a. to stop mens b. inhibit ovulation
2. Lupreulide (Lupron) –inhibit FSH/LH production

2. Myometrium – largest part of the uterus, muscle layer for delivery process
• Its smooth muscles are considered to be the living ligature of the body.
- Power of labor, esp- contraction of the uterus
3. Perimetrium – protects entire uterus
C. Ovaries – 2 female sex glands, almond shaped
Function: 1. ovulation
2. Production of hormones
d. Fallopian tubes – 2-3 inches long that serves as a passageway of the sperm from the
uterus to the ampulla or the passageway of the mature ovum or fertilized ovum from the
ampulla to the uterus.
4 significant segments
1. Infundibulum – distal part of FT, trumpet or funnel shaped, swollen at ovulation
2. Ampulla – outer 3rd or 2nd half, site of fertilization
3. Isthmus – site of sterilization – bilateral tubal ligation
4. Interstitial – site of ectopic pregnancy – most dangerous

3
. MALE REPRODUCTIVE SYSTEM
1. External
penis – the male organ of copulation and urination. It contains of a body of a shaft
consisting of 3 cylindrical layers and erectile tissues. At its tip is the most sensitive
area comparable to that of the clitoris in the female – the glands penis.
3 Cylindrical Layers
2 corpora cavernosa
1 corpus spongiosum

Scrotum – a pouch hanging below the pendulous penis, with a medial septum dividing into two
sacs, each of which contains a testes.
- cooling mechanism of testes
- < 2 degrees C than body temp.
- Leydig cell – release testosterone

4
• Secretory Glands
o Seminal vesicle , Prostrate gland , secretes 1/3 of the volume of sperm
o Prostate gland – produces a highly alkalotic substance which contains high levels of
acid phosphatase and serves as a vehicle for the spermatozoa
o Bulbourethral (Cowper's) gland , secrete a sticky alkaline fluid which lubricates the
penile urthra and vaginal acidity.

• Fluids from these glands:

o Make the semen more alkaline (promotes sperm mobility)
o Add other substances which are believed to promote fertilization (fructose ,
prostaglandins, zinc, ascorbic acid, etc..)

5
2. Internal
The Process of Spermatogenesis – maturation of sperm

Testes – 900 coiled (½ meter long at age

Hypothalamus
13 onwards) (Seminiferous tubules)

GnRH Epididymis – 6 meters coiled

tubules site for maturation of sperm

Ant Pit Gland Vas Deferens – conduit for

spermatozoa or pathway of sperm

Seminal vesicle – secretes:

FSH LF 1.) Fructose – glucose has
nutritional value.
2.) Prostaglandin – causes reverse
contraction of uterus

Fx: Sperm Fx: Hormones for

Maturation Testosterone Production Ejaculatory duct – conduit of semen

Prostate gland- secrets alkaline substance

Cowpers gland secrets alkaline substance

Urethra

Male and Female homologues

Male Female
Penile glans Clitoral glans
Penile shaft Clitorial shaft
Testes ovaries
Prostate Skene’s gands
Cowper’s Glands Bartholin's glands
Scrotum Labia Majora

6
Erection of the Penis is Requires Specialized Vascular Tissue

• Erection of penis is necessary to deliver sperm into vagina during intercourse

• Erection is analogous to blowing up a balloon: arterioles dilate and allow special vascular
chambers to fill with blood
• Erectile tissue:
o Corpora cavernosa (2)
o Corpus spongiosum
• This is a parasympathetic reflex coming from the sacral region; the reflex is strongly
influenced by impulses coming from the brain

Ejaculation is a Spinal Reflex (Sympathetic System)

• Sperm suspended in semen are delivered to the female by ejaculation
• About 4 mL, containing 300,000,000 sperm
• Ejaculation is a reflex of the sympathetic nervous system, originating from the lumbar spinal
cord
• Erection and ejaculation involve different branches of the autonomic nervous system: an
example where they work together instead of opposing each other
• Ejaculation is caused by rhythmic contractions of bulbocavernosus muscle

III. Basic Knowledge on Genetics and Obstetrics

1. DNA – carries genetic code
2. Chromosomes – threadlike strands composed of hereditary material – DNA
3. Normal amount of ejaculated sperm 3 – 5 cc., 1 tsp (normal sperm count 100 M per ml)
4. Ovum is capable of being fertilized with in 24 – 36 hrs after ovulation
5. Sperm is viable within 48 – 72 hrs, 2-3 days
6. Reproductive cells divides by the process of meiosis (haploid)
Spermatogenesis – maturation of sperm
Oogenesis – process - maturation of ovum
Gematogenesis – formation of 2 haploid into diploid 23 + 23 = 46 or diploid
7. Age of Reproductivity – 15 – 44yo
8. Menstruation-
Menstrual Cycle – beginning of mens to beginning of next mens
Average Menstrual Cycle – 28 days
Average Menstrual Period - 3 – 5 days
Normal Blood loss – 50cc or ¼ cup
Related terminologies:
Menarche – 1st mens
Dysmenorrhea – painful mens
Metrorrhagia – bleeding between mens
Menorhagia – excessive during mens
Amenorrhea – absence of mens
Menopause – cessation of mens/ average : 51 years old
9. Functions of Estrogen and Progestin

* Estrogen “Hormone of the Woman” –

Primary function: development secondary sexual characteristic female.
Others:
1. inhibit production of FSH ( maturation of ovum)
2. hypertrophy of myometrium
3. Spinnbarkeit & Ferning ( billings method/ cervical)

7
 4. development ductile structure of breast
5. increase osteoblast activities of long bones
6. increase in height in female
7. causes early closure of epiphysis of long bones
8. causes sodium retention
9. increase sexual desire

*Progestin “ Hormone of the Mother”

Primary function: prepares endometrium for implantation of fertilized ovum making it thick &
tortous (twisted)
Secondary Function: uterine contractility (favors pregnancy)
Others: 1. Inhibit prod of LH (hormone for ovulation)
2. Inhibit motility of GIT
3. Mammary gland development
4. Increase permeability of kidney to lactose & dextrose causing (+) sugar
5. Causes mood swings in moms
6. Increase BBT

10. Menstrual Cycle

4 phases of Menstrual Cycle
1. Phases of Menstrual Cycle:
1. Proliferative
2. Secretory
3. Ischemic
4. Menses

Parts of body responsible for menstruation:

1. Hypothalamus
2. Anterior pituitary gland – master clock of body
3. Ovaries
4. Uterus

Initial phase – 3rd day – decreased estrogen

13th day – peak estrogen, decrease progesterone
14th day – Increase estrogen, increase progesterone
15th day – Decrease estrogen, increase progesterone

I. On the initial 3rd phase of menstruation , the estrogen level is decreased, this level
stimulates the hypothalamus to release GnRH or FSHRF

II. GnRH/FSHRF – stimulates the anterior pituitary gland to release FSH

Functions of FSH:
1. Stimulate ovaries to release estrogen
2. Facilitate growth primary follicle to become graffian follicle (secrets large amt
estrogen & contains mature ovum.)

III. Proliferative Phase – proliferation of tissue or follicular phase, post mens phase.
Pre-ovulatory. -phase of increase estrogen.

Follicular Phase – causing irregularities of mens

Postmenstrual Phase
Pre-ovulatory Phase – phase increase estrogen

8
 IV. 13th day of menstruation, estrogen level is peak while the progesterone level is down,
these stimulates the hypothalamus to release GnRF on LHRF
Mittelschmerz – slight abdominal pain on L or RQ of abdomen, marks ovulation day.
2.) Change in BBT, mood swing

V. GnRF/LHRF stimulates the anterior pituitary gland to release LH.

Functions of LH:
1. (13th day-decreased progesterone) LH stimulates ovaries to release progesterone
2. hormone for ovulation

VI. 14th day estrogen level is increased while the progesterone level is increased causing
rupture of graffian follicle on process of ovulation.

VII. 15th day, after ovulation day, graafian follicle starts to degenerate yellowish known as
corpus luteum (secrets large amount of progesterone)

VIII. Secretory phase-

Lutheal Phase
Postovulatory Phase Increased progesterone
Premenstrual Phase

IX. 24th day if no fertilization, corpus luteum degenerate ( whitish – corpus albicans)

X. 28th day – if no sperm in ovum – endometrium begins to slough off to begin mens

Cornix- where sperm is deposited

Sperm- small head, long tail, pearly white
Phonones-vibration of head of sperm to determine location of ovum
Sperm should penetrate corona radiata and zona pellucida.
Capacitation- ability of sperm to release proteolytic enzyme to penetrate corona radiata and zona
pellucida.

11. Stages of Sexual Responses (E P O R)

Initial responses:
Vasocongestion – congestion of blood vessels
Myotonia – increase muscle tension

1. Excitement Phase – (sign present in both sexes, moderate increase in HR, RR,BP, sex
flush, nipple erection) – erotic stimuli cause increase sexual tension, lasts minutes to hours.

2. Plateau Phase – (accelerated V/S) – increasing & sustained tension nearing orgasm. Lasts
30 seconds – 3 minutes.

3. Orgasm – (involuntary spasm throughout body, peak v/s) involuntary release of sexual
tension with physiologic or psychologic release, immeasurable peak of sexual experience.
May last 2 – 10 sec- most affected are is pelvic area.

4. Resolution – (v/s return to normal, genitals return to pre-excitement phase)

9
Refractory Period – the only period present in males, wherein he cannot be re-stimulated for
about 10-15 minutes

10