CARE OF MOTHER, CHILD, ADOLESCENT G.

Vaginal Orifice: external opening of the

(WELL CLIENTS) LEC / NCM 107 vagina. Covered by a thin membrane (hymen) in
virgins located lateral to the vaginal opening on
CHAPTER 1: FEMALE REPRODUCTIVE both sides are the Bartholin’s Glands
SYSTEM (Vulvovaginal Glands). It lubricates the external
EXTERNAL STRUCTURES vulva during coitus and the alkaline Ph of their
secretion helps to improve sperm survival in the
A. Mons Pubis: Rounded, soft fullness of vagina.
subcutaneous fatty tissue, prominence over the
symphysis pubis that forms the anterior border **Vagina= Moderately Acidic
of the external reproductive organs. Pattern of H. Urethral Meatus: openings of skene’s glands
hair growth triangular shaped. Covered with (Paravecthral Glands).
varying amounts of pubic hair.
I. Hymen: opening of the vagina.
B. Labia Majora: two rounded, fleshy folds of
tissue that extended from the mons pubis to the
perineum. Lengthwise. 2-thick folds of fatty skin
extending from mons to the perineum that
protects the labia minora urinary meatus and
vaginal mucosa.
C. Labia Minora: located between the labia
majora, are narrow. The lateral and anterior
aspects are usually pigmented. The inner
surfaces are similar to vaginal mucosa, pink,
 Annular Hymen (Normal)
and moist. Their rich vascularity. Thinner.
 Septate Hymen (Divide by two)
Lengthwise folds of hairless skin encircling
clitoris anteriorly (prepuce) and unite posteriorly  Cribiform Hymen (Small with lots of
(fourchette). holes)
 Parous Introitous (Biggest Opening)
D. Clitoris: term clitoris came from a greek word
meaning key. Erectile organ. It’s rich vascular, J. Fourchette: between vagina opening and
highly sensitive to temperature, touch, and vaginal orifice. Formed by merging of labia
pressure sensation. majora & minora below the vaginal orifice.

E. Vestibule: oval shaped are formed between

the labia minora, clitoris, and fourchette.
Contains the external urethral meatus, vaginal
introitus, and Bartholins Glands.
F. Perineum: the most posterior part of the
external female reproductive organs. It extends
from fourchette anteriorly to the anus posteriorly.
Composed of fibrous and muscular tissue that
support pelvic structures. Has hair, between
vaginal opening and anus.

INTERNAL STRUCTURES
A. Vagina: 3-4 inch long, contains Rugae (which
permits considerable stretching w/o tearing).
Passage way of menstruation and fetus. Organ
of copulation. Doderlien’s Bacillus: maintains
normal flora of the vagina, which vagina PH
acidic.
B. Uterus: 3x2x2, 50g-60g (non-preg). Organ
implantation (nidation) & menstruation. Receives
the ova from fallopian tube. Furnish protection
for a growing fetus. Is a hollow, pear shaped,
and muscular organ. Its normal position is
anteverted (rotated forward and slightly
antiflexed (flexed forward).
DIVISIONS OF UTERUS
1. Cervix: lowermost portion called the neck.
a. external cervical OS- distal opening
to the vagina
b. cervical canal- the cavity
c. internal cervical COS- opening to the
uterus.
2. Fundus: popper portion with a triangular part.
Can be palpated to determine uterine growth
during pregnancy and force contractions. Most
vascular portion. Normal Implantation site.
3. Corpus: central part called the body.
4. Cornua: upper portion where the fallopian
tube are attached.
LAYERS
1. Endometrium- the inner layer. responsive to
the cyclic variations of estrogen and
progesterone during the female reproductive
cycle every month.
- The two or three layers of the endometrium
are:
 Compact Layer
 The basal Layer
 The functional or Sponge layer this
layer is shed during each menstrual
period and after child birth in the lochia.
2. Myometrium- middle layer of thick muscle
(oxytocin site) prevent hemorrhage. Most of the
muscle fibers are concentrated the upper uterus,
and their number diminishes progressively
toward the cervix.
- The myometrium contains three types of
smooth muscle fiber:
 Longitudinal Fibers (outer layer):
found mostly in the fundus and are
designed to expel the fetus efficiently
toward the pelvic outlet during birth.
 Middle Layer figure-8 fibers: these
fibers contract after birth to compress the
blood vessels that pass between them to
limit blood loss.
 Inner Layer Circular Fibers: forms
constrictions where the fallopian tubes
enter the uterus and surround the
internal OS. Circular fibers prevent reflux
of menstrual blood and tissue into the
fallopian tubes. Promote normal
implantation of the fertilized ovum by
controlling its entry into the uterus.
Retain the fetus until the appropriate
time of birth.
3. Perimetrium- outer peritoneal layer of serous
membrane that covers most of the uterus.
Laterally, the perimetrium is continuous with the
borad ligaments on either side of the uterus.
C. Fallopian Tube / Oviducts / Uterinetubes:
place for fertilization. Two tubes extended from
the cornu of the uterus extended to the ovary. It
runs in the upper free border of the broad
ligament. Length 8 – 14cm average 10cm. Its
divided into 4 parts.
1. Interstitial Part: runs into uterine
cavity. Passes through the myometrium
between the fundus and body of the
uterus. About 1-2 cm in length.
2. Isthmus: a narrow part of the tube
adjacent to the uterus. Straight and cord
like about 2-3cm in length. This is where
ligations happened (cut or clip.
3. Ampulla: Fertilization zone. The wider
part about 5cm in length.
4. Infundibulum: It is funnel or trumpet
shaped. Fimbriae are fingerlike
processes, one of these is longer than
the other and adherent to the ovary. The
fimbriae becomes swollen almost
erectile at ovulation.
D. Ovaries: responsible for the production
maturation and discharge of ova. Organ of
ovulation. Located on each side of the uterus,
below and behind uterine tubes. Oval solid
structure, 1.5 cm in thickness, 2.5 cm in in width
and 3.5 cm in length respectively. Each weighs
about 4-8 gm. Fuction: Secrete estrogen &
Progesterone. Production of Ova
- Structure of the ovaries:
 Cortex
 Medulla
 Hilum
 CHAPTER 1: MALE REPRODUCTIVE 1. Spermatogenesis: process by which the
SYSTEM spermatocytes are developed into mature
spermatozoa.
EXTERNAL STRUCTURES
2. Hormone Production:
A. Mons Pubis: Firm, cushion like elevation of
adipose tissue over the symphysis pubis. a. Testosterone: The primary male sex
Pattern of hair growth is diamond in shape. hormone. An androgen or masculinizing
hormone responsible for growth &
B. Penis: Male organ of copulation. Instrument development of secondary sex
by which seminal fluid is brought into vaginal characteristics.
cavity. It contains spongy tissue that becomes
turgid and erect when filled with blood. b. FSH: Follicle Stimulating Hormone.
Causes rapid sperm production by the
tubule.
c. ICSH: Interstitial Cell Stimulating
Hormone. Stimulates Leydig’s cells to
increase testosterone production.
B. Prostate Gland: Secrete an alkaline
fluid which is believed to neutralize the
acid environment on the vagina where
spermatozoa is first deposited.
C. Bulbourethral Glands/ Cowper’s
Glands: Counterpart of Bartholin’s
Glands in females, Secretes substance
ERECTILE TISSUES
which is an important part of the seminal
 Corpus Spongiosum: is the mass of fluid.
spongy tissue which surrounds urethra
THE DUCT SYSTEM
and involves in erection by allowing
rushing of blood into it.
 Corpus Cavernosa: is one of a pair of
songe-like regions of erectile tissue
which contains most of the blood in the
penis during penile erection.
 Urethra: a tube within the penis that
conveys semen out of the body during
ejaculation.
 Glans: the rounded, highly sensitive
head of the penis.
 Prepuce: a fold skin, covering the head
of the penis.
C. Scrotum: a pouch skin formed from the lower
1. Epididymis: Approximately 20 ft.
part of the abdominal wall. Keeps the testes at a
long, conducts sperm from testis to the
temperature slightly cooler than body
vas deferens. Sperm takes 12 to 20 days
temperature. Each Lobule contains interstitial.
to travel the length of the epididymis & a
Cells (Leydig’s Cells) and Seminiferous Tubules.
total of 64 days for them to reach
Seminiferous Tubules produce spermatozoa.
maturity.
Leydig’s Cells produce the hormone
testosterone. 2. Vas Deferens: Carries sperm from
epididymis through the abdominal cavity.
INTERNAL GENITALS ORGANS
The blood vessels & vas deferens
A. Testis (plural testes): are two-oval shaped together are referred to as the
male organs that produce sperm and hormone spermatic cord.
testosterone. Each testis is made of tightly
coiled structures called seminiferous tubules.
Among tubules are cells that produce
testosterone.
 3. Breast Development
4. Growth of Pubic Hair
5. Onset of Menstruation (Menarche)
6. Growth of Axillary Hair (Adrenarche)
7. Vaginal Secretions

SEQUENTAL ORDER OF PUBERTAL

CHANGES IN BOYS
1. Increase in Weight
2. Growth of Testis
3. Growth of Face, Axillary, and Pubic Hair
3. Seminal Vesicles or Seminal Ducts: 4. Voice Changes
Two pouches that lie along the portion of 5. Penile Growth
the posterior surface of bladder and 6. Increase in Height
empty into urethra by way of ejaculatory 7. Spermatogenesis
ducts.
4. Ejaculatory Ducts: Conveys the
seminal fluid to the urethra.
5. Urethra: 8-10 inches canal through
which the seminal fluid is transmitted.
Serves both urinary and reproductive
system in males.
6. Seminal Fluid: A grayish whitish
substance said to be the procreative
material of the male generative organs.
At the time of ejaculation, Approximately,
3-5 ML of semen is secreted with about
100 million spermatozoa per milliliter, or
about 250-500 Million spermatozoa at
each ejaculation. If the sperm count
drops to less than 20 million per milliliter
of semen, the rate is considered infertile.

PUBERTAL DEVELOPMENT
Puberty: Period of life in which the reproductive
organs become functional.
GIRLS= 9-12 years old
BOYS= 12-14 years old

SEQUENTAL ORDER OF PUBERTAL

CHANGES IN GIRLS
1. Growth Spurt
2. Increase in the transverse diameter of the
pelvis