The Reproductive System

PowerPoint® presentation to accompany:

Medical Assisting
Third Edition

Booth, Whicker, Wyman, Pugh, Thompson

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

 31-2

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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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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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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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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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  Scrotum – sac that holds
 Primary organs the testes
 Develop in the abdominal  Seminiferous tubules
pelvic cavity of fetus
 Descend into scrotal sac  On top of testes
shortly before or after
birth  Filled with spermatogenic
cells that produce sperm
 Produce the male sex cells cells
(sperm)
 Produce the male hormone  Interstitial cells produce
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
 Nucleus with 23  Flagellum that propels
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  Seminal vesicle
 Sits on top of each testis  Secrete
 Fluid rich in sugar used to
 Receives spermatids from make energy
seminiferous tubules  Prostaglandins – stimulate
 Spermatids become sperm muscular contractions in
cells female to propel sperm
forward
 Seminal fluid
 Vas deferens  Released into vas deferens
 Tube connected to just before ejaculation
epididymis  60% of semen volume
 Carries sperm cells to Male
urethra System

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Internal Accessory Organs

Male Reproductive System:

Internal Accessory Organs (cont.)
 Prostate gland  Bulbourethral (Cowper’s)
 Surrounds urethra glands
 Produces and secretes a  Produce a mucus-like fluid
milky, alkaline fluid into  Secreted just before
ejaculation
urethra just before
 Lubricates end of penis
ejaculation
 Fluid protects sperm in the
 Semen
acidic environment of the  Alkaline mixture
vagina  Nutrients
 Prostoglandins
 40% of semen
 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
 Shaft
 Holds testes away from
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
 Skin covering glans penis
 Testes move freely
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

___
B Produce testosterone E. Hypothalamus
E GnRH
___ F. Semen

___
C Erectile tissue G. Seminal vesicle

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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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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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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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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  Oogenesis is the process of
develop before birth and ovum formation
contain  At puberty, primary oocytes
are stimulated to continue
 A primary oocyte or
meiosis
immature ovum (born with
maximum number)  Becomes 1 polar body (a
nonfunctional cell) and
 A secondary oocyte
 Follicular cells
 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  Wall of uterus
organ  Endometrium
 Receives embryo and  Innermost lining
sustains its  Vascular
 Tubular glands – mucus
development
 Myometrium
 Divisions  Middle, thick, muscular
 Fundus – domed upper layer
portion  Perimetrium
 Body – main portion  Thin layer covering the
 Cervix – narrow, lower myometrium
section extending into  Secretes serous fluid to
vagina (cervical orifice) coat and protect uterus

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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
 Bartholin’s glands secrete mucus during sexual arousal External
Genitalia

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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

Estrogen and progesterone

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

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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
corpus luteum  Uterine lining breaks down
which secretes – menses starts
progesterone
 Cycle begins again with
release of FSH
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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
F
___Oxytocin 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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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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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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 31-39

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 of
vulvovaginitis 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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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

___
C Benign tumors in the uterine wall G. Uterine cancer

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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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 31-42

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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 31-43

Pregnancy: The Prenatal Period (cont.)

 Embryonic period  Formation of
 Week 2 through 8  Placenta

 Amnion

 Inner cell mass  Umbilical cord

organizes into three  Yolk sack
primary germ layers  Most internal
 Ectoderm organs and external
 Mesoderm structures of
 Endoderm embryo

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Pregnancy: The Prenatal Period (cont.)

 Fetal period  Last 3 months – fetal
 Week 8 through birth brain cells rapidly divide

 Rapid growth  GI and respiratory

systems last to develop
 5th month – skeletal
muscles active

 6th month – gains

weight

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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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 31-46

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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Pregnancy: Hormonal Changes (cont.)

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

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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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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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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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The Birth Process (cont.)

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

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

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 31-59

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

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Apply Your Knowledge

Indicate whether each cause of infertility is male-related (M),

Very
female-related (F), or both (B).
ANSWER:
___
F Pelvic inflammatory

good!
M Retrograde ejaculation
___ disease

___
M Mumps infection ___
F Hormone imbalances

___
F Inadequate diet ___
M Use of some medications

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

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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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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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Apply Your Knowledge

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

E
E Crabs
___ C. Syphilis

C Increasing incidence in males

R
___ D. Chlamydia

A Common bacterial STD; can also grow in mouth E. Pubic lice

___

B Caused by HPV virus

___ F. Herpes simplex !
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
 31-64

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

 31-65

End of Chapter

The
reproduction of
mankind is a
great marvel
and mystery.

~Martin Luther

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