The Reproductive System

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Learning Outcomes
31.1 List the organs of the male reproductive system
and give the locations, structures, and functions
of each.
31.2 Describe how sperm cells are formed.
31.3 Describe the substances found in semen.
31.4 Describes the process of erection and ejaculation.

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 31-3

Learning Outcomes (cont.)

31.5 List the actions of testosterone.
31.6 Describe the causes, signs and symptoms, and
treatment of various disorders of the male
reproductive system.
31.7 List the organs of the female reproductive system
and give the locations, structures, and functions
of each.
31.8 Explain how ova develop.

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 31-4

Learning Outcomes (cont.)

31.9 List the actions of estrogen and progesterone.
31.10 Explain how and when ovulation occurs.
31.11 Describe what happens to an ovum after
ovulation occurs.
31.12 List the purpose and events of the menstrual
cycle.
31.13 Define menopause and explain what causes it.

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 31-5

Learning Outcomes (cont.)

31.14 Describe the causes, signs and symptoms, and
treatments of various disorders of the female
reproductive system.
31.15 Explain how and where fertilization occurs.
31.16 Describe the process of implantation.
31.17 Explain the difference between an embryo and a
fetus.

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 31-6

Learning Outcomes (cont.)

31.18 Describe the changes that occur in a woman
during pregnancy.
31.19 List several birth control methods and explain
why they are effective.
31.20 List the causes of and treatments for infertility.
31.21 Describe the causes, signs and symptoms, and
treatments of the most common sexually
transmitted diseases.

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Introduction
 Male and female reproductive systems
 Function together to produce offspring
 Female reproductive system nurtures developing
offspring
 Produce important hormones

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Male Reproductive System

 Testes – sac that holds the testes
Scrotum
  Primary organs
Seminiferous tubules
 Develop in the abdominal pelvic cavity of fetus
 On top of testes
 Descend into scrotal sac shortly before or after birth

 Filled
Producewith
thespermatogenic
male sex cells cells that produce sperm cells
(sperm)
 Interstitial
 Produce cells produce
the male hormone testosterone
testosterone

Male
System

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Male Reproductive System (cont.)

Spermatogenesis Spermatogenesis

Spermatogonia (46 chromosomes)

Mitosis – makes primary spermatocytes

Undergo meiosis  two secondary spermatocytes

Divides – two spermatids = 4 spermatids

Develop flagella to become mature sperm cells

with 23 chromosomes
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Male Reproductive System (cont.)

 Sperm cells
 Head
Tail
 Flagellum
Nucleus with
that23propels
chromosomes
sperm forward
 Acrosome – enzyme-filled sac
 Helps sperm penetrate ovum
 Midpiece
 Mitochrondria that generate cell’s energy

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Male Reproductive System:
Internal Accessory Organs
 Epididymis
 Sits on top of each testis
 Receives spermatids from
seminiferous tubules
 Spermatids become sperm
cells
 Vas deferens
 Tube connected to
epididymis
 Carries sperm cells to
urethra
31-13
 Seminal vesicle
 Secrete
 Fluid rich in sugar used to
make energy
 Prostaglandins – stimulate
muscular contractions in
female to propel sperm
forward
 Seminal fluid
 Released into vas deferens
just before ejaculation
 60% of semen volume
Male
System
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Internal Accessory Organs
Male Reproductive System:
Internal Accessory Organs (cont.)
 Prostate gland
 Surrounds urethra
 Produces and secretes a
milky, alkaline fluid into
urethra just before
ejaculation
 Fluid protects sperm in the
acidic environment of the
vagina
 40% of semen
31-14
 Bulbourethral (Cowper’s)
glands
 Produce a mucus-like fluid
 Secreted just before
ejaculation
 Lubricates end of penis
 Semen
 Alkaline mixture
 Nutrients
 Prostoglandins
 1.5 to 5.0 ml per ejaculate
 Sperm count of 40 to 250
million / ml
Male
System
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Male Reproductive System:

Internal Accessory Organs (cont.)
 Scrotum  Penis
 Holds testes away from
 Shaft
body  Erectile tissues surround
urethra
 Temperature 1° below body  Glans penis
temperature  Cone-shaped structure on
 Lined with serous end of penis
membrane that secrets fluid  Prepuce
 Testes move freely  Skin covering glans penis
in uncircumcised males
 Functions
 Deliver sperm
 Urination
Male
System

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Male Reproductive System:

Erection, Orgasm, and Ejaculation
 Erection
 Parasympathetic nervous system stimulates erectile tissue
 Become engorged with blood

 Orgasm
 Sperm cells propelled out of testes into urethra
 Secretions from accessory organs also released into urethra

 Ejaculation
 Semen is forced out of urethra
 Sympathetic nerves then stimulate erectile tissue to release blood
 Penis returns to flaccid state

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Male Reproductive System: Hormones

 Hypothalamus
 Gonadotropin-releasing hormone (GnRH)
 Stimulates anterior pituitary to release
 Follicle-stimulating hormone (FSH) – initiates
spermatogenesis
 Luteinizing hormone (LH) – stimulates interstitial cells in
the testes to produce testosterone
 Testosterone
 Secondary sex characteristics
 Maturation of male reproductive organs
 Regulated by negative feedback

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Apply Your Knowledge

Matching: ANSWER:
D Vasectomy
___ A. Spermatogenesis
___
F Mixture of sperm and fluids B. Testes
___
A Sperm cell formation C. Penis
___
G Secrete alkaline fluid / prostaglandins D. Vas deferens
___ Produce testosterone E. Hypothalamus
B
___
E GnRH F. Semen
___ Erectile tissue G. Seminal vesicle
C

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Diseases and Disorders of the Male

Reproductive System
Disease/Disorder Description
Benign prostatic Nonmalignant enlargement of the prostate
hypertrophy (BPH) gland; common in older men
Epididymitis Inflammation of an epididymis; usually
starts as an urinary tract infection
Impotence or Disorder in which erection cannot be
erectile dysfunction achieved or maintained; about 50% of males
(ED) between 40 and 70 have some degree of ED

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 31-20

Diseases and Disorders of the Male

Reproductive System
Disease/Disorder Description
Prostate cancer Most common form of cancer in men over
40; risks of developing it increase with age
Prostatitis Inflammation of the prostate gland; may be
acute or chronic

Testicular cancer Malignant growth in one or both testicles;

more common in males 15–30 years; more
aggressive malignancy

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 31-21

Apply Your Knowledge

Your patient has an elevated PSA. What is a PSA
and what does it indicate?
ANSWER: The PSA is a prostate-specific antigen
in the blood. Elevations of the PSA may indicate
prostate cancer.

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 31-22

Female Reproductive System:

Ovaries and Ovum Formation
 Ovaries (2)
 Primary sex organs produce
 Sex cells called ova
 Hormones estrogen and progesterone
 Located in the pelvic cavity
 Medulla
 Inner area; contains nerves, lymphatic vessels, and blood vessels
 Cortex
 Outer area; contains ovarian follicles
 Covered by epithelial and dense connective tissues Female
System

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Female Reproductive System:
Ovaries and Ovum Formation (cont.)
 Primordial follicles
develop before birth and
contain
 A primary oocyte or
immature ovum (born with
maximum number)
 Follicular cells
31-24
 Oogenesis is the process of
ovum formation
 At puberty, primary oocytes
are stimulated to continue
meiosis
 Becomes 1 polar body (a
nonfunctional cell) and
 A secondary oocyte
 Secondary oocyte released
during ovulation
 If fertilized, the oocyte
divides to form a mature,
fertilized ovum
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Female Reproductive System:

Internal Accessory Organs
 Fallopian tube – oviduct
 Infundibulum and fimbriae
 Fringed, expanded end of fallopian tube near ovary
 Function to “catch” an ovum

 Muscular tube
 Lined with mucous membrane and cilia
 Propels ovum toward uterus
Internal Accessory
Organs

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Female Reproductive System:

Internal Accessory Organs (cont.)
 Uterus Internal Accessory
Organs

 Hollow, muscular organ  Wall of uterus

 Receives embryo and sustains its development
 Endometrium

 Divisions  Innermost lining

 Vascular
 Fundus – domed upper portion  Tubular glands –
 Body – main portion mucus
 Cervix – narrow, lower section Myometrium
 extending into vagina
(cervical orifice)  Middle, thick,
muscular layer
 Perimetrium
 Thin layer covering
the myometrium
 Secretes
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Companies, fluid
Inc. All rights reserved
 31-27

Female Reproductive System:

Internal Accessory Organs (cont.)
 Vagina
 Tubular, muscular organ
 Extends from uterus to outside body (vaginal introitus)
 Muscular folds – rugae – enable expansion
 Receive erect penis
 Passage for delivery of offspring and uterine secretions
 Wall
 Innermost mucosal layer
 Middle muscular layer
 Outer fibrous layer
Internal Accessory
Organs

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Internal Female Organs

Back

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Female Reproductive System:

External Accessory Organs
 Mammary glands
 Secretion of milk
 Structures
 Nipple
 Oxytocin induces
lactiferous ducts to deliver
milk through openings
 Areola – pigmented area
around nipple
 Alveolar glands – within
mammary glands
 Make milk when
stimulated by prolactin

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Female Reproductive System:

External Genitalia
 Collectively known as the vulva

 Labia majora
 Rounded folds of adipose tissue and skin
 Protect other external reproductive organs

 Labia minora
 Fold of skin between labia majora
 Very vascular
 Merge to form hood over clitoris
 Vestibule – space enclosed by labia minora External
Genitalia
 Bartholin’s glands secrete mucus during sexual arousal

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Female Reproductive System:

External Genitalia (cont.)
 Clitoris
 Anterior to urethral meatus
 Contains female erectile tissue
 Rich in sensory nerves
 Perineum
 Between vagina and anus
 Area for episiotomy, if needed, during birth
process
External
Genitalia

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Female Reproductive System:

Erection, Lubrication, and Orgasm
 Nervous stimulation
 Clitoris becomes erect
 Bartholin’s glands activates – lubrication
 Vagina elongates
 Orgasm
 Sufficient stimulation of clitoris
 Walls of uterus and fallopian tubes contract to
propel sperm up tubes

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Female Reproductive System: Hormones

Hypothalamus Anterior pituitary

GnRH
secretes GnRH releases FSH & LH

Stim
ula
tes

Estrogen and progesterone

Ovaries to produce
estrogen and  Responsible for development
progesterone of secondary sex characteristics

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 31-35

Female Reproductive System:

Reproductive Cycle
 Menstrual cycle
 Regular changes in uterine
lining, resulting in monthly
bleeding

 Menarche – first menstrual

period

 Menopause – termination
of cycle due to normal
aging of ovaries

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Female Reproductive System:

Reproductive Cycle (cont.)
Anterior pituitary
Ovarian follicle Uterine lining thickens
releases FSH
matures and secretes
Then releases estrogen Lining more vascular
and glandular
LH
Triggers
ovulation Without fertilization
 Corpus luteum degenerates
 Estrogen and progesterone
Follicular cells levels fall
become  Uterine lining breaks down
corpus luteum
– menses starts
which secretes
progesterone  Cycle begins again with
release of FSH
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 31-37

YIPPEE!
Apply Your Knowledge
True or False: ANSWER:
F The ovaries only produce estrogen. They also produce progesterone.
___
___
F Ovulation is the process of ovum formation. Oogenesis
___
T The fallopian tube is also called the oviduct.
___
F The endometrium is the outer layer of the uterine wall. inner layer
___
T Alveolar glands produce milk. lactiferous ducts
___Oxytocin
F induces the alveolar glands to deliver milk through the
nipples. the first
F
___ Menarche is the termination of the menstrual cycle. menstrual cycle
T
___ Menopause occurs due to normal aging of the ovaries.
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 31-38

Diseases and Disorders of the Female

Reproductive System
Disease/Disorder Description
Breast cancer Second leading cause of cancer deaths in
women; classified as stage 0 to 4
Cervical cancer Slow to develop; Pap smear detects
abnormal cervical cells
Cervicitis Inflammation of the cervix usually due to an
infection
Dysmenorrhea Condition with severe menstrual cramps
limiting normal activities

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 31-39

Diseases and Disorders of the Female

Reproductive System (cont.)
Disease/Disorder Description
Endometriosis Tissues of uterine lining growing outside of
the uterus
Fibrocystic breast Abnormal cystic tissue in the breast; size
disease varies related to menstrual cycle; common in
60% of women between 30 and 50
Fibroids Benign tumors in the uterine wall; affect
25% of women in their 30s and 40s
Ovarian cancer Considered more deadly than other types;
detection difficult and often spreads before
detection

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 31-40

Diseases and Disorders of the Female

Reproductive System (cont.)
Disease/Disorder Description
Premenstrual Collection of symptoms occurring just
syndrome (PMS) before a menstrual period
Vaginitis / Inflammation of the vagina / inflammation
vulvovaginitis of vagina and vulva; both associated with
abnormal vaginal discharge
Uterine Most common in post-menopausal women;
(endometrial) cancer causes about 6% of cancer deaths in women

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 31-41

Apply Your Knowledge

Matching: ANSWER:
E Inflammation of the cervix
___ A. Dysmenorrhea
___
G Cancer common in post-menopausal women B. Cervical cancer
___
B Develops slowly; detected by Pap smear C. Fibroids
___
F Uterine tissue grows outside uterus D. Breast cancer
___
D Second leading cause of cancer death in women E. Cervicitis
___
A Severe menstrual cramps F. Endometriosis
___ Benign tumors in the uterine wall G. Uterine cancer
C

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 31-42

Pregnancy: Fertilization
 Pregnancy – condition of having a developing
offspring in the uterus

 Fertilization – process in which a sperm cell unites

with an ovum; results in pregnancy
 Only one sperm cell penetrates the follicular cells and the
zona pellucida that surround the ovum’s cell membrane

 After fertilization, ovum releases enzymes that cause the

zona pellucida to become impenetrable to other sperm

 Zygote forms from union of ovum and sperm

 Contains 46 chromosomes
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 31-43

Pregnancy: The Prenatal Period

 Time before birth
 Zygote – undergoes rapid mitosis
 First week after fertilization
 Cleavage – rapid cell division
 Morula – ball of cells resulting from cleavage
 Travels down fallopian tube to uterus
 Becomes blastocyst which implants in endometrial wall
 Blastocyst
 Some cells (inner cell mass) become embryo
 Others, along with cells from uterus, form placenta

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 31-44

Pregnancy: The Prenatal Period (cont.)

 Embryonic period  Formation of
 Week 2 through 8  Placenta
 Amnion
 Umbilical cord
 Inner cell mass
organizes into three  Yolk sack
primary germ layers  Most internal
 Ectoderm organs and external
 Mesoderm structures of
 Endoderm embryo

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 31-45

Pregnancy: The Prenatal Period (cont.)

 Fetal period
 Week 8 through birth
 Rapid growth
 5 month – skeletal muscles active
th
 6th month – gains weight
 Last 3 months – fetal
brain cells rapidly
divide
GI and respiratory
systems last to
develop

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 31-46

Pregnancy: Fetal Circulation

 Placenta and umbilical blood vessels carry out
the exchange of nutrients, oxygen, and waste
products

 Unique differences from normal circulation

 Foramen ovale – hole between right and left atria
enables most of fetal blood to bypass lungs
 Ductus arteriosus – connection between
pulmonary trunk and aorta
 Ductus venosus – vessel that bypasses liver

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 31-47

Pregnancy: Hormonal Changes

 Embryonic cells secrete human chorionic
gonadotropin (HCG)
 Maintains the corpus luteum

 Estrogen and progesterone

 Secreted by corpus luteum and placenta
 Functions
 Stimulate uterine lining to thicken, development of mammary
glands, enlargement of female reproductive organs
 Inhibit release of FSH and LH from anterior pituitary gland
(preventing ovulation) and uterine contractions

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 31-48

Pregnancy: Hormonal Changes (cont.)

 Relaxin
Aldosterone
 From adrenal
corpus luteum
gland
 Inhibits uterine
Increases sodiumcontractions
and water retention
and relaxes
ligaments of pelvis
 Lactogen
 Parathyroid hormone (PTH)
 From placenta
 Helps maintain high calcium levels in the blood
 Stimulates enlargements of mammary glands

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 31-49

Apply Your Knowledge

What are the primary germ layers and what tissue develops from
them?
ANSWER: The primary germ layers are the:
 Ectoderm – nervous tissue and some epithelial tissue
 Mesoderm – connective tissue and some epithelial tissue
 Endoderm – epithelial tissue only

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 31-50

The Birth Process

 Begins when progesterone levels fall

 Prostaglandins secreted by uterus stimulate uterine

contractions

 Uterine contractions stimulate posterior pituitary

gland to release oxytocin

 Oxytocin stimulates strong uterine contractions

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 31-51

The Birth Process (cont.)

 Three stages
 Dilation
 Cervix thins and softens (effacement)
 Lasts 8 – 24 hours

 Expulsion or parturition
 Actual birth
 May take 30 minutes or less

 Placental stage – 10 to 15 minutes after the birth, the

placenta separates from uterine wall and is expelled

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 31-52

The Birth Process (cont.)

 The postnatal
Milk production
period
and secretion
 Six-week –period
Prolactin production
following
of milk
birth
 Neonatal period – first four weeks
 Oxytocin – ejection of milk from mammary gland
ducts
 Neonate is adjusting to life outside uterus

 Production continues as long as breast-feeding

continues

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 31-53

Apply Your Knowledge

What are the three stages of the birth process and what
occurs during each?
ANSWER: The three stages are:
 Dilation – the cervix thins, softens, (effacement) and dilates to
approximately 10 cm
 Expulsion – also called parturition; the actual birth stage
 Placental stage – placenta separates from uterine wall and is
expelled

Impressive!
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 31-54

Contraception
Method Description
Coitus Penis is withdrawn from vagina before
interruptus ejaculation; not a reliable method
Rhythm method Requires abstinence around time of ovulation;
not a reliable method
Mechanical Prevent sperm from entering female
barriers reproductive tract
Chemical Destroy sperm in the female reproductive tract;
barriers primarily spermicides; often used with
mechanical barriers

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 31-55

Contraception (cont.)
Method Description
Oral Birth control pills; prevent ovulation by
contraceptives preventing LH surge
Injectable Prevent ovulation and alter lining of uterus to
contraceptives prevent implantation of blastocyst
Insertable Ring inserted vaginally and removed at the
contraceptives beginning of the 4th week to allow menstruation
Contraceptive Small rods of progesterone implanted beneath
implants skin; prevent ovulation

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 31-56

Contraception (cont.)
Method Description
Transdermal Contraceptives in the form of a patch; applied
contraceptives weekly for 3 weeks; not used the 4th week to
allow menstruation
Intrauterine Small, solid devices placed into uterus by MD;
device (IUD) prevents implantation of blastocyst
Surgical Tubal ligation – fallopian tube fulgurated to
methods prevent sperm from reaching oocyte
Vasectomy – vas deferens is fulgurated to
prevent ejaculation of sperm

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 31-57

Apply Your Knowledge

Your patient has just been told that she is pregnant, but
she does not understand why she could get pregnant.
She states, “ I have been using the rhythm method of
birth control very carefully.” What patient teaching
would you do to assist her to understand?
ANSWER: The rhythm method is not as effective
as other birth control, because it is sometimes
difficult to tell when ovulation occurs.

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 31-58

Infertility
 Inability to conceive a child
 Primary – no prior pregnancy, unable to achieve
pregnancy in 12 months
 Secondary – at least one prior pregnancy, unable
to achieve pregnancy after one year
 Causes
 15% unknown
 35% male-related problems
 50% female-related problems

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 31-59

Infertility (cont.)

 Female-related
Male-related
 Scarring from STDs
 Impotence
 Pelvic inflammatory disease

 Retrograde ejaculation
Inadequate diet

 Low or absentorsperm
No ovulation countcycle
menstrual
 Endometriosis
Medications / drugs

 Abnormal
Decreased shape of uterus or cervix
testosterone
 Hormonal imbalances
 Scarring from STDs
 Cysts in ovaries

 Prior
Oldermumps
than 40infection
years
 Inflammation of
epididymis or testes

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 31-60

Infertility (cont.)
 Tests
Treatments
 Surgicalanalysis
Semen repair of abnormalities
 Monitoring
Fertility drugs
of morning body temperature
 Blood hormone
Hormone therapies
measurements
 Endometrial
Artificial insemination
biopsy
 Urine
In vitroanalysis
fertilization
for LH
 Hysterosalpingogram
Use of surrogate
 laparoscopy

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 31-61

Apply Your Knowledge

Indicate whether each cause of infertility is male-related (M),
female-related (F), or both (B).
ANSWER:
___ Retrograde ejaculation
M
___
Very
F Pelvic inflammatory
disease

___
M Mumps infection
good
___ Hormone imbalances
F

___
F Inadequate diet M
!
___ Use of some medications

___ ___
F Being over 40 years old
B Scarring from STDs

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 31-62

Sexually Transmitted Diseases

STD Cause
AIDS HIV virus causes AIDS; described in Chapter 21
Chlamydia Caused by bacterium; most commonly reported;
often no symptoms in female
Genital warts Caused by HPV; not everyone infected has
symptoms
Gonorrhea Bacterial cause

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 31-63

Sexually Transmitted Diseases (cont.)

STD Cause
Herpes Caused by viruses; type I causes cold sores; type
simplex II commonly known as genital herpes; may be
passed from mother to child during childbirth
Pubic lice Parasitic infestation; commonly called crabs
Syphilis Caused by bacteria; decreasing in women but
increasing in males who have sex with other
males
Trichomoniasis Caused by protozoan parasite; also called
trichomonas infection or “trich”

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 31-64

Apply Your Knowledge

Match: ANSWER: S
D Most commonly reported STD in the U.S.
___ A. Gonorrhea
U
F Two types; both caused by a virus
___ B. Genital warts

___
E Crabs C. Syphilis
P
___
C Increasing incidence in males D. Chlamydia
E
___
A Common bacterial STD; can also grow in mouth E. Pubic lice
R
___
B Caused by HPV virus F. Herpes simplex !
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
 31-65

In Summary
 Ability to reproduce is a basic characteristic
of life
 Female and male systems work together to
produce offspring
 Medical assistant must have knowledge of
reproductive systems to
 Assist with exams and procedures
 Provide patient education

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

 31-66

End of Chapter

The reproduction
of mankind is a
great marvel and
mystery.

~Martin Luther

© 2009 The McGraw-Hill Companies, Inc. All rights reserved