CARE OF MOTHER, CHILD,

ADOLESCENT, AND FAMILY

IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

REPRODUCTIVE ANATOMY & PHYSIOLOGY CONCEPTION & FETAL STRUCTURE

• Purpose is to keep the testes cooler than

TOPIC OUTLINE:
the core body temperature
I. Functions of the Reproductive System
• Cremaster muscle: in charge of contracting
II. Male Reproductive Organs the testicle towards the body for warming
III. Female Reproductive Organs and relaxation for cooling
IV. Female Reproductive Cycle • Serves as both urinary and reproductive
V. Four Phases of Sexual Response organ
VI. Development and Physiology of the Fetus Testes
VII. Prenatal Development • A pair of oval, compound glandular organs
VIII. Sexual Maturity contained in the scrotum.
• functions:
FUNCTIONS OF THE REPRODUCTIVE SYSTEM o To serve as the site of
spermatogenesis
1. Production of Gametes o To produce testosterone
2. Fertilization Seminiferous tubules
3. Development and Nourishment of a New • Where spermatogenesis occurs
Individual • Tiny coiled tubes
4. Production of Reproductive Hormones Leydig cells
• Interstitial cells supporting the
MALE REPRODUCTIVE ORGAN seminiferous tubules and secrete
testosterone
Penis Sertoli cells
• elongated, cylindrical structure consisting • Respond to FSH secretion by nourishing
of a body and supporting sperm as they mature
o Shaft
o Gland Vas Deferens
• Organ for copulation in male • Also known as ductus deferens
• Serves as both urinary and reproductive • Is about 40cm long and connects the
organ epididymis with the prostate
• Its main function is to rapidly squeeze the
Erectile Tissues: sperm from their storage site into the
1. Corpus spongiosum – is the mass of spongy urethra.
tissue which surrounds urethra and is involved in
erection by allowing the rushing of blood into it. Urethra
• The male urethra is the passageway for
2. Corpus cavernosa – a pair of sponge-like regions
both urine and semen.
of erectile tissue which contains most of the blood
in the penis during penile erection.
Epididymis
Scrotum • It provides a reservoir for maturing
spermatozoa, when they are ejaculated
• Is pouch like structure that hangs in front of
they are motile and capable of fertilizing
the anus and behind the penis
ovum.
• Composed of skin and dartos muscle , the
scrotum shows increased pigmentation
and scattered hair.

PROPERTY OF ODLID
1
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IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

Accessory Glands • Oviducts

• Secretes seminal fluids that carry sperm
into vagina Four divisions
• Interstitial
1. Seminal vesicles – are 2 glands composed of o Runs into uterine cavity and lies
many lobes. within the uterine wall
• The epithelium lining the seminal vesicle • Isthmus
secretes an alkaline, vicious, clear fluid rich o Narrow part adjacent to the uterus
in high-energy fructose, prostaglandins, • Ampulla
fibrinogen and amino acid. o Wider area of the tube lateral to the
isthmus where fertilization occurs
2. Prostate Glands- encircle the upper part of the • Infundibulum
urethra and lie below the neck of the bladder. o Wide-funnel-shaped terminal end
• It secretes a thin, milky, alkaline fluid o Fimbriae surrounds the
containing high levels of zinc, calcium, citric infundibulum
acid and acid phosphatase.
• This fluid protects the sperm from the
acidic environment of the vagina and the
male urethra.

3. Bulbourethral gland

Seminal Fluid
• Nourish the sperm
• Protect the sperm from hostile pH of the Uterus
vagina • implantation site for the fertilized ovum.
• Enhance motility of the sperm • Hollow thick-walled muscular organ
• Washing the sperm from the urethra to shaped like a flat, upside-down pear
maximize the number deposited in the Layers
vagina (35-200 million) • Perimetrium - outer
• Myometrium - middle; muscle fibers
Sexual Development • Endometrium - inner
• Begins at conception when genetic sex is Divisions
determined by union of an ovum and a • Corpus
sperm o Upper division
• Sex organs are inactive during childhood o Fundus: uppermost part above the
area where the fallopian tubes enter
FEMALE REPRODUCTIVE ORGAN the uterus
• Isthmus
Ovaries
o Narrower transition zone
• produces female germ cell and female sex o Between the corpus and cervix
hormones • Cervix
Fallopian tubes o Tubular neck of lower uterus
• Captures the ovum o 2-3 cm in length
• Allow transport of the fertilized ovum to the o Effaces and dilates during cbirth
uterus.

PROPERTY OF ODLID
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CARE OF MOTHER, CHILD,
ADOLESCENT, AND FAMILY
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING
Cervix
• Connection of the vagina and the uterus
• Protective portal of the body of the uterus.
Vagina
• Passageway from the external genitals to
the uterus
• Provides for the discharge of menstrual
products out of the body.
• Female organ for coitus
• 8-10 cm long
• Rugae: multiple folds and a muscular layer
capable of marked distension during
childbirth
• 3 Major Functions
1. Allow discharge of menstrual flow
2. Female organ of coitus
3. Allow passage of fetus from uterus to
outside of mother’s body during childbirth
Vaginal fornix
• Pouch-like structure
PROPERTY OF ODLID
3
External Female Reproductive Organ
Mons Pubis
• Also known as mons veneris
• It covers the front portion of the symphysis
pubis
• It is covered with pubic hair.
• Rounded fleshy prominence
Labia Majora
• Mons pubis to perineum
• Longitudinal, raised folds of deeper
pigmented skin.
• It is covered by hair and sebaceous glands
• It protects the labia minora and vaginal
introitus.
Labia Minora
• Are soft folds of silky thin skin which is
waterproof.
• Run parallel to and within labia majora
• It increases in size during puberty and
decreases in menopause
Clitoris
• Small projection located between the
minoras
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IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

• It's partly covered by a fold of skin called
prepuce, or clitorial hood.
• its secretes smegma, has a unique odor
that may be stimulating to the male
• Composed of highly erectile tissue
Vaginal Vestibules
• Is a boat-shaped depression enclosed by
labia majora.
Bartholin glands
• Provide lubrication for the vaginal introitus
(sexual arousal)
Skene or periurethral glands
Ovarian Cycle
• Provide lubrication for the urethra
Follicular phase – 1-14 days
Vaginal introitus
• Surrounded by erectile tissue
• Blood flows dito kaya nagttighten sa penis
during sex
Hymen
• is a thin, elastic collar or semi-collar of
Ovulatory Phase
tissue/mucosa that surrounds the vaginal
opening.
Breasts
• Alveoli – Secrete milk after childbirth
(acinar cells within alveoli)
• Lactiferous ducts – collect milk from the
Luteal phase – 15-28 day
alveoli and conduct it to outside
• is composed of blood which is mixed with
fluid, cervical and vaginal secretions,
bacteria, mucus, leukocytes, and other
cellular debris.
• It is dark red in color and has a distinct
odor.
• Duration 2 to 8 days
• Average blood loss per day from 25 to 80
ml
• 0.5mg to 1 mg of iron loss per day
FEMALE REPRODUCTIVE CYCLE
• Primordial follicle matures under the
influence of FSH and LS up to the time of
ovulation.
• First day of menstruation
• Ovum matures
• Near the middle of a 28-day reproductive
cycle, about 2 days before ovulation
• LH rises
• Stigma: blister-like projection forms on the
wall of the follicle before it ruptures
• Marked by Ovulation
• Ovum leaves follicle
• Corpus luteum develops under LH
influence and produces high levels of
progesterone and low levels of estrogen.
• Chorionic gonadotropin - if ovum is
fertilized
• Corpus luteum nawaala pag di fertilized tas
magiging corpus albicans

Menstrual or Endometrial Cycle

Menstrual Cycle Menstruation
1. Menstrual phase – Day 1 to 6
• is a cyclic bleeding in response to cyclic
• the primary endometrium was shed
hormonal changes.
• estrogen levels are low
• Its occurs when the ovum is not fertilized
• cervical mucus is scant, viscous and
• It begins about 14 days after ovulation in a
opaque.
28 day cycle.
2. Proliferative phase – Day 7 to 14
• Cycle depends on 20-45 days (Hall, 2015)
• estrogen peaks just prior to ovulation
Menstrual flow or menses

PROPERTY OF ODLID
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CARE OF MOTHER, CHILD,
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IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING
• cervical mucus at ovulation is clear thin,
watery, alkaline, and more favourable to
sperm
• body temperature may rise sharply and
remain elevated under the influence of
progesterone.
• Ovum matures and is released during the
first half of the ovarian cycle
3. Secretory phase – Day 15 to 26
• estrogen drops sharply and progesterone
dominates
• Last half of the ovarian cycle
• endometrium is prepared for the
implantation of the fertilized ovum
4. Ischemic Phase
• both estrogen and progesterone level
drops
• if no fertilization occurs, the corpus luteum
begins to degenerate.
• necrosis of the endometrium begins, after 1
to 2 days bleeding starts.
• Necrotic areas of endometrium separate
from basal layers resulting in the menstrual
flow
• Women lose approximately 40 mL of blood
• starting of the another cycle
PROPERTY OF ODLID
5
Changes in Cervical Mucus
• Most of the reproductive cycle, mucus of
cervix is scant thick, and sticky
• Before ovulation: thin, clear, and elastic
• Spinnbarkeit: elasticity of mucus
FOUR PHASES OF SEXUAL RESPONSE
1. Excitement – it occurs with physical and
psychological stimulation that causes
parasympathetic nerve stimulation.
• Male: erection, increased in length and
diameter, scrotal thickening and elevation
of the testis.
• Female: vaginal lubrication, inner 2/3 of the
vagina lengthens and distends, external
genitals become congested and darker in
color, and the clitoris increase in size
* In both sexes, there is an increase in heart and
respiratory rates and blood pressure.
2. Plateau – stage before orgasm
• Male: Vaso congestion leads to full
distention of the penis, pre-orgasmic
emission of 2 to 3 drops of mucoid
substance, testis continue to elevate close
to the body to facilitate ejaculating
pressure.
• Female: clitoris drawn forward and retracts
under the clitoris prepuce, the lower part of
the vagina becomes extremely congested
(forming the orgasmic platform), increased
nipple engorgement.
In both: heart rate increases to 100 to 175
beats/min. And RR of 40 breaths/min
3. Orgasmic/orgasm – the shortest stage in the
sexual response cycle, its also experienced as
intense pleasure affecting the whole body.
• Male: rhythmic contraction occurs in 0.8
secs. interval, followed immediately by 3 to
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IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

7 propulsive ejaculatory contractions,

ejaculation with rhythmic contraction
capable of expelling semen to 60 cms (2ft)
• Female: strong rhythmic muscular
contraction occurs at .8sec interval,
number of contraction ranges from 3 to 15,
pelvic throbbing located in vagina and
lower pelvis

4. Resolution
• Male: 1st stage 50% of the erection lost
• The 2nd stage can last longer depending
on the maintenance of physical condition. Fertilized ovum able to implant in the upper part
• The 3rd stage is the refractory period – time of the posterior wall of the uterus.
necessary to complete the cycle again –
ranges from mins. for a few hours to a few
Embryonic and Fetal structure Decidua – refers
days.
to the pregnant endometrium
• Female: blood returns from the engorged
1. Decidua Basalis – portion under the blastocyst,
wall of the vagina, labia majora and minora
where chorionic villi top the maternal blood
return to unexcited state.
vessels
• Clitoris rapidly returns from under hood, 2. Decidua capsularis – portion covering the
normal size uterus decent, cervix dips into a blastocyst
seminal pool. 3. Decidua vera – portion lining the rest of the
uterus.
DEVELOPMENT AND PHYSIOLOGY OF THE
FETUS

Conception / fertilization
• the union of a single egg/ovum and a
sperm, marks the beginning of pregnancy

Ovum – egg cell from the female

• stays 24 hrs

Sperm – from the ejaculation during sexual

intercourse
• a teaspoon of semen containing 200 to 500
millions sperm
• it occurs on the fallopian tubes with in few
hours after ovulation, it takes about 65 to 75
Chorionic Villi
mins
• Finger like projection
• Develop out of the trophoblast and extend
Implantation – 7 to 9 days after ovulation
into the blood filled spaces of the
endometrium.

PROPERTY OF ODLID
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CARE OF MOTHER, CHILD,
ADOLESCENT, AND FAMILY
IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

Primary Germ Layer

a. Ectoderm – upper layer of the embryonic disk
• epidermis, sweat gland, nails, hair, lens of
the eyes
b. Mesoderm – middle layer
• dermis, wall of the digestive tract, kidneys
and ureter, reproductive organs,
connective tissue, skeleton, muscles,
cardiovascular
c. Endoderm – lower layer
• respiratory tract epithelium, lining of the
digestive tract, primary tissue of liver and
pancreas, urethra, urinary bladder, vagina.

Amniotic Fluid – 800 to 1200 ml of clear fluid or

liquid.

Function:
1. Maintain a constant body temperature
2. Serve as a source of oral fluid and as a repository
for waste.
3. It cushions the fetus from trauma by blunting
dispersing outside forces.
4. Freedom from movement from musculoskeletal
development.
5. Fluids keep the embryo from tangling with the
membranes.
6. Acts as extension of fetal extracellular space. 7.
Acts as wage during labor
8. Provide fluid for analysis to determine fetal
health and maturity

Membranes Umbilical cord – from the Latin word funis

a. Chorion – covering the fetal side of the placenta,
contains the major umbilical blood vessels that
branch out over the surface of the placenta.
b. Amnion – it form on the side opposite to the
developing blastocyst, the developing embryo
draws the amnion around itself to form a fluid filled
sac.
• 53cm or 21 incs. in long
• 2cm or ¾ incs. in thick
• 1 vein – carrying blood from the placental
villi to the fetus
• 2 arteries – carrying blood from the fetus
back to the placenta
Wharton Jelly – gives the cord body and prevents
pressure on the vein and arteries

PROPERTY OF ODLID
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CARE OF MOTHER, CHILD,
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IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING

• Father’s spermatozoa = either X or Y

chromosome
• If an X-bearing spermatozoan fertilizes the
ovum = female if Y = male
• 7th week: differences between female and
male reproductive organs internally appear
• 9th week: outer structures of genitalia
begin to change
• 12th week: external sexual organs is
complete
• Fetal life: secretion of primary hormones
o Testosterone
Placenta – comes from the Latin word flat cake ▪ Presence causes the
• Is the means of metabolic and nutrient development of male sex
exchange between the embryonic and organs
maternal circulation. ▪ Absence causes the
development of female sex
• Size of 29cm in diameter and 2 to 3 cm
organs
thickness
o Estrogen
• Weights 1/6 of the weight of the fetus.
▪ Not required to initiate
development of female sex
2 sides of placenta structures
1. Fetal side – chorion, shinny, where the umbilical Childhood
cord is attached to.
• Sex glands are inactive
2. Maternal side – amnion, it is attached to the
uterus, irregular appearance Contains 18 - 20
SEXUAL MATURITY
cotyledons.
• The hypothalamus stimulates the anterior
pituitary gland to produce hormones that
stimulate sex hormone production

Puberty

o Refers to the time during which the

reproductive organs become fully
functional
o Not a single event
o Series of changes occurring over several
years during late childhood and early
adolescence
Primary sex characteristics
• Relate to the maturation of the organs
directly responsible for reproduction
• e.g. maturation of ova in the ovaries and
PRENATAL DEVELOPMENT production of sperm in the testes
Secondary sex characteristics
• Mother’s ovum = X chromosome

PROPERTY OF ODLID
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IDIANALE BATCH 2024
ST. LUKE’S COLLEGE OF NURSING
• Changes in other systems that differentiate
females and males but do not directly
relate to reproduction
• E.g. breast development, distribution of fat
in breasts, buttocks, and thighs; muscle
mass
Initiation of Sexual Maturation
• Changes of puberty occur in an orderly
sequence in the somatic cells (body cells
other than the gametes) of both genders
• Hypothalamus can secrete GnRH to initiate
puberty during infancy and early childhood
o Not secreted in significant amounts
until late childhood
o Secretion of sex hormones inhibits
the secretions which prevents
premature onset of puberty
• Maturation of another brain area COULD
BE the one stimulating puberty
• 9-12 y/o: Increase in GnRH slowly until it
reaches adequate levels to stimulate
anterior pituitary to increase the
production of FSH and LH
• Ovaries and Testes increase production of
sex hormones and begin maturing
gametes (repro cells)
• Puberty varies among individuals
o Age
o Time required to complete
• Hormonal changes happen 6 months to 1
year earlier in girls than boys
o Growth spurt
o Height increase & Breast
development: 2 years before boys
• Height and weight increase are dramatic
during puberty but slow after puberty until
mature heights and weights are attained
Female Puberty Changes
• 8-13 years: development of the breasts
• 9-16 years: Menstruation occurs 2-2.5 years
after
Breast Changes
• Nipple enlargement
• Areola enlargement and protuberant
• Growth of glandular and ductal tissue
• Fat is deposited in the breasts
PROPERTY OF ODLID
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• Lopsided appearance until one breast
catches up w the other
Body contours
• Pelvis widens and assumes a rounded,
basin-like shape that favors passage of the
fetus during childbirth
• Selective deposit of fats
Body hair
• Pubic hair appears first, thicker as puberty
progresses
• Axillary hair appears near time of menarche
• Vary among women and ethnic groups
Skeletal growth
• Girls grow taller for several years during
early puberty = estrogen
• 1 year after breast development
• Estrogen also causes epiphyses to unite
with shafts of the bones which eventually
stops growth in height
Reproductive organs
• Female reproductive organs become larger
• Fat is deposited in the mons pubis, labia
majora, and labia minora
• Vaginal mucosa changes becoming
resistant to trauma and infection
Menarche
• 2-2.5 years after beginning of breast
development
• Early are irregular and scant
• Early menstrual cycles are not usually fertile
because ovulation occurs inconsistently
• Fertile reproductive cycles require
preparation of the uterine lining precisely
timed with ovulation
• Ovulation may occur during any female
reproductive cycle including the first
• Sexually active girl can conceive even
before her first menstrual period
• Primary amenorrhea
o Delayed onset of menstruation
o Girl’s period have not begun within
2 years after onset of breast
development or by 16 y/o
o If the girl is more than a year older
than her mother or sisters were
when their menarche occurred
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ST. LUKE’S COLLEGE OF NURSING
•Secondary amenorrhea
o Absence of menstruation for at least
three cycles after regular cycles
have been established or for 6
months
o Common cause is pregnancy
• Could be due to too little fat to produce
enough sex hormones to stimulate
ovulation and menstruation
• May result from inadequate pituitary
stimulation of the ovary or failure of the
ovary to respond to pituitary stimulation
• May be caused by excessive androgenic
hormones from the adrenal glands
Male Puberty Changes
• Testosterone secretion immediately
stimulates spermatogenesis
• Testes growth is the first outward sign of
male puberty which begins as early as 9.5
y/o
• Penile growth begins 1 year later
o Circumference and length of the
penis increase
• Skin of the scrotum thins and darkens as
sexual organs mature
• Final male sexual maturation is complete at
approximately 17 y/o
Nocturnal Emissions
• Wet dreams
• Spontaneous ejaculation of seminal fluid
during sleep and accompanied with sexual
dreams
Body Hair
• Begins at the base of the penis upward in
the midline of the abdomen
• 2 years later: axillary hair
• Facial hair begin as fine, downy then
kakapal
• Most boys have chest hair and some have
upper back hair
Body Composition
• Due to testosterone, men have a greater
average muscle mass than women
• Maturity: man’s muscle mass exceeds the
woman’s by an average of 50%
PROPERTY OF ODLID
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Skeletal Growth
• Boy’s linear growth begins approx. 1 year
later than a girl’s and may continue into his
20s
• Male’s greater average height at maturity is
the combined result of beginning growth
spurt at a slightly later age and continuing
it for a longer time
• Boy’s shoulders broaden as height
increases
• Pelvis more upright shape with narrower
diameters and heavier composition than
the female pelvis
o Structured for tasks requiring load
bearing
Voice Changes
• Hypertrophy of the laryngeal mucosa and
enlargement of the larynx
• Cracking, squeaking
Decline in Fertility
• Climacteric: a transitional period that starts
as female fertility declines and extends
through menopause and the
postmenopausal period
• 40-50 y/o for most women
• External and internal reproductive organs
atrophy
• Menopause: final menstrual period
o Permanent cessation
• Perimenopause: time from onset of
changes associated with the climacteric (2-
5 years later after last menstrual period)
• Men do not experience a distinct maker
event like menopause but production of
testosterone and sperm gradually declines
and sexual function decreases in the late
forties and fifties