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CHAPTER
32
The Reproductive
System
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32-2
Learning Outcomes (cont.)
32.1
32.2
Summarize the organs of the male reproductive
system including the locations, structures, and
functions of each.
Describe the causes, signs and symptoms, and
treatment of various disorders of the male
reproductive system.
32.3
Summarize the organs of the female reproductive
system including the locations, structures, and
functions of each.
32.4
Describe the causes, signs and symptoms, and
treatment of various disorders of the female
reproductive system.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-3
Learning Outcomes (cont.)
32.5
Explain the process of pregnancy, including
fertilization, the prenatal period, and fetal circulation.
32.6
Describe the birth process, including the postnatal
period.
32.7
Compare several birth control methods and their
effectiveness.
32.8
Explain the causes of and treatments for infertility.
32.9
Describe the causes, signs and symptoms, and
treatments of the most common sexually transmitted
infections.
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32-4
Introduction
• Male and female reproductive systems
– Function together to produce offspring
– Produce important hormones
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32-5
The Male Reproductive System
• Testes
– Produce sperm and
testosterone
– Divided into lobules
– Held in the scrotum
• Seminiferous
tubules
– In the lobules of the
testes
– Contain
spermatogenic cells
• Interstitial cells
produce testosterone
Male
System
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32-7
Sperm Cell Formation
Spermatogenesis
Spermatogonium (46 chromosomes)
Mitosis
Primary spermatocytes
(46 chromosomes)
Meiosis at puberty
Secondary
spermatocyte
Secondary
spermatocyte
2nd meiotic
division
Spermatid
Spermatid
Spermatid
Spermatid
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32-8
Sperm Cell Formation (cont.)
• Head
– Nucleus with 23
chromosomes
– Covered by an
acrosome
• Tail
– Flagellum
– Propels
the sperm
• Midpiece - mitochondria
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32-9
Internal Accessory Organs – Male
• Epididymis –
where spermatids
mature into sperm
• Vas deferens –
carries sperm cells
to urethra
• Seminal vesicles –
secrete seminal
fluid
– Sugar
– Prostaglandins
Male
System
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-10
Internal Accessory Organs – Male
• Prostate gland
– Alkaline fluid that
protects sperm
– Contractions assist
with expulsion of
semen
(cont.)
• Cowper’s glands
– fluid to lubricate
end of penis
• Semen
– Sperm cells
– Fluids
Male
System
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32-11
External Organs – Male
• Penis
• Scrotum
– Pouch that holds
the testes away
from the body
– Lined with serous
membrane that
secrets fluid
– Shaft
– Glans penis
– Prepuce
– Functions
• Deliver sperm
• Urination
Male
System
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32-12
Erection, Orgasm, and Ejaculation
• Erection – erectile tissue becomes
engorged with blood
• Orgasm - emission occurs
• Ejaculation – semen is forced out of the
urethra
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32-13
Male Reproductive Hormones
• Gonadotropin-releasing hormone (GnRH)
• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Testosterone
– Secondary sex characteristics
– Maturation of male reproductive organs
– Regulated by negative feedback
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32-14
Apply Your Knowledge
Matching: ANSWER:
D Vasectomy
___
A. Spermatogenesis
B. Testes
F Mixture of sperm and fluids
___
C. Penis
___
A Sperm cell formation
D. Vas deferens
___
G Secrete alkaline fluid/
prostaglandins
E. Hypothalamus
B Produce testosterone
___
G.Seminal vesicle
F. Semen
E GnRH
___
___
C Erectile tissue
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32-15
Common Diseases and Disorders of the Male
Reproductive System
Disease/Disorder
Benign prostatic
hypertrophy (BPH)
Epididymitis
Description
Nonmalignant enlargement of
the prostate gland
Inflammation of an epididymis;
usually starts as an urinary
tract infection
Impotence or
Disorder in which erection
erectile dysfunction cannot be achieved or
(ED)
maintained; about 50% of
males between 40 and 70
have some degree of ED
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32-16
Common Diseases and Disorders of the Male
Reproductive System (cont.)
Disease/Disorder Description
Prostate cancer
Most common form of cancer in
men over 40; risk increases
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; aggressive
malignancy
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32-17
Apply Your Knowledge
ANSWER:
Match:
C More common in men over 40 years
old.
A Common in older men; symptoms
include difficulties with urination.
A. BPH
B. Epididymitis
C. Prostrate
cancer
D. Testicular
cancer
D More common in males 15-30 years
old; aggressive.
B Often starts as urinary tract infection;
symptoms include swelling of the
scrotum and painful ejaculation.
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32-18
The Female Reproductive System
• Ovaries
– Produce ova, estrogen, and progesterone
– Medulla ~ nerves and lymphatic and blood
vessels
– Cortex ~ ovarian follicles
Female
System
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32-20
Ovaries and Ovum Formation
Primordial follicles
• Primary oocyte
• Follicular cells
Polar body
Oogenesis
At puberty
Primary oocyte
stimulated to
continue meiosis
Secondary
oocyte
Released during ovulation
Ovum, if fertilized
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32-21
Internal Accessory Organs – Female
• 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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32-22
Internal Accessory Organs – Female (cont.)
• Vagina
• Uterus
– Receives embryo
and sustains its
development
– Extends from
uterus to outside
body
– Divisions
– Rugae
– Wall ~ three layers
– Wall ~ three layers
Internal Accessory
Organs
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32-24
External Accessory Organs - Female
• Mammary glands
– Secretion of milk
– Structures
• Nipple
• Areola
• Alveolar glands
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32-25
External Genitalia – Female
• Vulva
• Clitoris
– Labia majora
• Adipose tissue and skin
• Form the mons pubis
– Labia minora
•
•
•
•
Vascular folds of skin
Form hood over clitoris
Vestibule
Bartholin’s glands
– Contains female
erectile tissue
– Rich in sensory nerves
• Perineum – between
vagina and anus
Female
System
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32-26
Erection, Lubrication, and Orgasm
• Nervous stimulation
– Clitoris becomes erect
– Bartholin’s glands activate
– Vagina elongates
• Orgasm
– Sufficient stimulation of clitoris
– Walls of uterus and fallopian tubes contract to
propel sperm
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32-27
Female Reproductive Hormones
Hypothalamus
secretes GnRH
Ovaries to
produce
estrogen and
progesterone
GnRH
Anterior pituitary
releases FSH & LH
 Estrogen and progesterone are
responsible for development of
secondary sex characteristics
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32-28
Reproductive Cycle
• Menstrual cycle
– Regular changes in uterine lining
– Shedding of lining and bleeding
• Menarche – first menstrual period
• Menopause – termination of cycle due to normal
aging of ovaries
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32-29
Reproductive Cycle (cont.)
Anterior pituitary
releases FSH
Then
releases LH
Ovarian follicle
matures and secretes
estrogen
Uterine lining thickens
Lining more vascular
and glandular
Triggers
ovulation
Follicular cells
become
corpus luteum,
which secretes
progesterone
Without fertilization
 Corpus luteum degenerates
 Estrogen and progesterone
levels fall
 Uterine lining breaks down
– menses starts
 Cycle begins again with
release of FSH
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32-30
YIPPEE!
Apply Your Knowledge
True or False:
ANSWER:
F The ovaries only produce estrogen.
___
produce estrogen and 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.
___
F
___Oxytocin
induces the alveolar glands to deliver milk through the
nipples.
lactiferous ducts
___
F Menarche is the termination of the menstrual cycle.
first
T Menopause occurs due to normal aging of the ovaries.
___
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32-31
Common Diseases and Disorders of the
Female Reproductive System (cont.)
Disease/Disorder Description
Endometriosis
Tissues of uterine lining grow
outside of the uterus
Fibrocystic breast Abnormal cystic tissue in the
disease
breast; size varies related to
menstrual cycle
Fibroids
Benign tumors in the uterine
wall
Ovarian cancer
More deadly than other types;
detection difficult and often
spreads before detection
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32-32
Common Diseases and Disorders of the
Female Reproductive System
Disease/Disorder Description
Breast cancer
Cervical cancer
Cervicitis
Dysmenorrhea
Second leading cause of
cancer deaths in women
Generally slow to develop; Pap
smear detects abnormal
cervical cells
Inflammation of the cervix
usually due to an infection
Condition with severe
menstrual cramps that limit
normal activities
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32-33
Diseases and Disorders of the Female
Reproductive System (cont.)
Disease/Disorder Description
Premenstrual
Collection of symptoms
syndrome (PMS) occurring just before a
menstrual period
Vaginitis/
Inflammation of the vagina or
vulvovaginitis
inflammation of vagina and
vulva; both associated with
abnormal vaginal discharge
Uterine
Most common in post(endometrial)
menopausal women; causes
cancer
about 6% of cancer deaths
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32-34
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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32-35
Pregnancy
• Condition of having a developing offspring
in the uterus
• Fertilization
– Sperm penetrates cell membrane
– Zona pellucida becomes impenetrable
– Zygote
• Union of ovum and sperm nuclei
• 46 chromosomes
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32-36
The Prenatal Period
• Zygote – undergoes rapid mitosis
• Morula – ball of cells
• Blastocyst
– Implants in the endometrial wall
– Inner cell mass becomes the embryo
– Others plus cells from uterus form the
placenta
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32-37
The Prenatal Period (cont.)
• Embryonic period
– Inner cell mass
organizes into the
primary germ
layer
• Ectoderm
• Mesoderm
• Endoderm
– Formation of
• Placenta
• Amnion
• Umbilical cord
• Yolk sack
• Internal organs and
external structures
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32-38
The Prenatal Period (cont.)
• Fetal period – fetus
– Rapid growth
– 5th month
• Skeletal muscles
active
• Growth rate slows
– 6th month – gains
weight
– Last 3 months –
fetal brain cells
rapidly divide
– GI and respiratory
systems last to
develop
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32-39
Fetal Circulation
• Placenta and umbilical blood vessels –
exchange nutrients, oxygen, and waste products
• Unique differences
– Foramen ovale ~ bypass lungs
– Ductus arteriosus ~ between pulmonary trunk and
aorta
– Ductus venosus ~ bypasses liver
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32-40
Hormonal Changes During Pregnancy
• Human chorionic gonadotropin (HCG)
– Secreted by embryonic cells
– Maintains the corpus luteum
• Estrogen and progesterone
– Secreted by corpus luteum and placenta
– Stimulate uterine lining to thicken
– Inhibit release of FSH and LH from anterior pituitary
gland
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32-41
Hormonal Changes During Pregnancy (cont.)
• Relaxin
– Inhibits uterine
contractions
– Relaxes ligaments of
pelvis
• Lactogen – stimulates
enlargements of
mammary glands
• Aldosterone –
increases sodium and
water retention
• Parathyroid hormone
(PTH) – blood
calcium levels
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32-42
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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32-43
The Birth Process
• Begins when progesterone levels fall
• Prostaglandins stimulate uterine contractions
• Uterine contractions stimulate release of
oxytocin
• Oxytocin stimulates strong
uterine contractions
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32-44
The Birth Process (cont.)
• Dilation
– Effacement
– Lasts 8 – 24 hours
• Expulsion or parturition
– Actual birth stage
– May take 30 minutes or less
• Placental stage
– Blood vessels constrict
– Placenta separates from uterine wall and is expelled
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32-45
The Postnatal Period
• Six-week period
– Neonatal period –
first four weeks
– Neonate adjusts to
life outside uterus
• Milk production and
secretion
– Prolactin
– Oxytocin
– Production continues
as long as breastfeeding continues
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32-46
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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32-47
Contraception
Method
Description
Coitus
interruptus
Rhythm
method
Mechanical
barriers
Chemical
barriers
Penis is withdrawn from vagina before
ejaculation; not a reliable method
Requires abstinence around time of
ovulation; not a reliable method
Prevent sperm from entering female
reproductive tract
Destroy sperm in the female reproductive
tract; primarily spermicides; often used
with mechanical barriers
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-48
Contraception (cont.)
Method
Description
Oral
contraceptives
Injectable
contraceptives
Birth control pills; prevent ovulation by
preventing LH surge
Prevent ovulation and alter lining of
uterus to prevent implantation of
blastocyst
Insertable
Ring inserted vaginally and removed
contraceptives at the beginning of the 4th week to
allow menstruation
Contraceptive Small rods of progesterone implanted
implants
beneath skin; prevent ovulation
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32-49
Contraception (cont.)
Method
Description
Transdermal Contraceptives in the form of a patch;
contraceptives applied weekly for 3 weeks; not used
the 4th week to allow menstruation
Intrauterine
Small, solid devices placed into uterus
device (IUD)
by MD; prevents implantation of
blastocyst
Surgical
Tubal ligation – fallopian tube is cut
methods
and tied
Vasectomy – vas deferens is cut and
tied
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-50
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 very careful in using the rhythm
method of birth control.” 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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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-51
Infertility
•
•
•
•
Inability to conceive
Primary
Secondary
Causes
– 15% unknown
– 35% male-related problems
– 50% female-related problems
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-52
Infertility (cont.)
• Some male-related
factors
• Some female-related
factors
– Pelvic inflammatory
disease
– Impotence
– Retrograde ejaculation
– Low or absent sperm
count
– Decreased testosterone
– No ovulation or
menstrual cycle
– Endometriosis
– Older than 40 years
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-53
Infertility (cont.)
• Tests
– Semen analysis
– Monitoring of morning body temperature
– Blood hormone measurements
– Endometrial biopsy
– Urine analysis for LH
– Hysterosalpingogram
– Laparoscopy
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32-54
Infertility (cont.)
• Treatments
– Surgical repair of abnormalities
– Fertility drugs
– Hormone therapies
– Artificial insemination
– In vitro fertilization
– Use of surrogate
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32-55
Apply Your Knowledge
Indicate whether each cause of infertility is male-related
(M), female-related (F), or both (B).
ANSWER:
___
M Retrograde ejaculation
M Mumps infection
___
F Inadequate diet
___
___
F
Pelvic inflammatory
disease
___
F
Hormone imbalances
M
___
Use of some
medications
___
F
Being over 40 years
old
B Scarring from STDs
___
Very good!
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32-56
Sexually Transmitted Disease Infections
Occurring in Both Sexes
STD
Cause
AIDS
HIV virus causes AIDS
Chlamydia Caused by bacterium Chlamydia
trachomata.; most commonly reported;
often no symptoms in female
Genital
Condyloma acuminat; caused by HPV;
warts
not everyone infected has symptoms
Gonorrhea Bacterial cause: Neisseria gonorrhoea
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-57
Sexually Transmitted Diseases (cont.)
STD
Cause
Herpes
simplex
Viral cause: type II commonly
known as genital herpes
Pubic lice
Parasitic infestation; commonly
called crabs; Pediculosis pubis
Syphilis
Bacterial cause: Treponema
pallidum; decreasing in women but
increasing in homosexual males
Trichomoniasis Protozoan: Trichomonas vaginalis
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-58
Apply Your Knowledge
Match:
ANSWER:
___
D Most commonly reported STD
in the U.S.
F Two types; both caused by a
___
virus
E Crabs
___
C Increasing incidence in
___
males
A Common bacterial STD; can
___
also grow in mouth
B Caused by HPV virus
___
A. Gonorrhea
B. Genital warts
C. Syphilis
D. Chlamydia
E. Pubic lice
F. Herpes simplex
S
U
P
E
R
!
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-59
In Summary
32.1 The organs of the male reproductive system
include the testes, responsible for sperm and
hormone production; the accessory organs
of vas deferens, seminal vesicles, prostate,
and bulbourethral glands; scrotum; and
penis.
32.2 The diseases of the male reproductive
system vary widely between simple
inflammation and cancers.
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-60
In Summary (cont.)
32.3 The organs of the female reproductive
system include the ovaries, fallopian tubes,
uterus, and vagina.
The external accessory organs include the
mons pubis, labia majora and minora,
clitoris, urethral meatus, vaginal orifice,
Bartholin’s glands, perineum, and mammary
glands.
32.4 The diseases of the female reproductive
system vary widely between simple
inflammation and cancers.
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-61
In Summary (cont.)
32.5 Fertilization occurs with the union of a sperm
cell and an ovum, usually within the fallopian
tubes.
The fertilized ovum, now a blastocyst,
implants in the endometrial wall of the
uterus.
The embryonic period occurs from week 2
through week 8 of the pregnancy; the fetal
period is from week 9 through delivery.
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-62
In Summary (cont.)
32.6 The birth process ends pregnancy and
occurs in three stages: Dilation (effacement),
expulsion (parturition), and placental stage
(afterbirth).
32.7 Some of the contraceptive methods include
coitus interruptus; barrier methods; chemical
barriers; oral contraceptives; injectable,
implantable, and insertable contraceptives;
and intrauterine devices.
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-63
In Summary (cont.)
32.8 The causes of infertility are varied, with about
15% of infertility from unknown causes.
There are a number of infertility tests and
treatments; the treatment plan depends on
the reason for the infertility.
32.9 There are many sexually transmitted
infections, all passed between sexual
partners (both heterosexual and same-sex
partners).
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
32-64
End of Chapter 27
The reproduction
of mankind is a
great marvel and
mystery.
~Martin Luther
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.