Human Sexuality

Chapter 1 Human Sexuality and the Reproductive
System
1
RHO VINCE C. MALAGUEO
MATERNITY NURSING
Chapter 1 Human Sexuality and the

Reproductive System
HUMAN SEXUALITY
Human Sexuality encompasses various sexually
related aspects of human life, including physical and
psychological development and behaviours, attitudes,
and social customs associated with the individuals
sense of gender, relationships, sexual activity, mate
selection, and reproduction. Sexuality permeates many
areas of human life and culture, thereby setting humans
apart from other members of the animal kingdom, in
which the objective of sexuality is more often confined to
reproduction.
Sex is basic and dynamic aspect of life. Generally, it is
Gods perfect way to maintain the stability of human
population. That is, it is evolutionarily well-developed to
retain the sufficient number of human beings and to
preserve the human species.
During the reproductive years (15 to 44 years old), the
nurse performs a vital role in promoting sexual health.
Definitions related to Human Sexuality
Gender Identity the possession by somebody of a
conviction of belonging to a particular sex, regardless of
whether this corresponds to his or her anatomical sex.
Homosexuality sexual attraction to or sexual
relations with somebody of the same sex.
Sex biologic categorization based on reproductive
function as a male or a female. Sometimes refers to
specific sexual behaviour such as sexual intercourse.
Sexuality same as sexual orientation; behaviour of
being a girl or a boy, subjected to life long dynamic
change; developed from the moment of conception.
Nursing Implications on Human Sexuality
Nurses should know necessary information regarding the
clients sexual orientation in order for her to carry out
nursing interventions effectively. Statistics shows that
females have
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ANATOMY AND PHYSIOLOGY OF

THE REPRODUCTIVE SYSTEM
HUMAN SEXUAL CHARACTERISTICS
Sexual characteristics are divided into two types.
Primary sexual characteristics are directly related to
reproduction and include the sex organs (genitalia).
Secondary sexual characteristics are attributes other
than the sex organs that generally distinguish one sex
from the other but are not essential to reproduction,
such as the larger breasts characteristic of women and
the facial hair and deeper voices characteristics of men.
Female Reproductive System
MATERNITY NURSING

Reproductive System
External Genitalia
Vulva is the
Do you know that some
individuals want to cut or
collective term of
shave their pubic hair? It is
female external
because they believe that long
genitalia.
pubic hair diminishes sexual
Pudenda is the
arousal and makes the
genitals look dirty. Shaving
term used to
pubic hair also decreases the
denote the
risk of acquiring certain STIs
external
such as pubic lice. Short pubic
genitalia of
hair also inhibits foul odor at
the genital part. Long pubic
either sex.
hair invites infection,
a. Mons Pubis also
therefore, it is a must to cut or
called the Mons
Veneris
meaning
Mountain of Venus, is a mound of fatty tissues that
lies over the symphysis pubis covered by skin and
at puberty is covered by pubic hair that serves as
cushion or protection to the symphysis pubis.
b. Labia majora large lips; longitudinal fold of
pigmented skin that extends from the symphysis
pubis to the perineum.
Dartus muliebris responsible for the
wrinkle-like appearance of the labia
majora.
c. Labia minora nymphae; soft and thin
longitudinal fold located in between labia majora.
The labia minora are two thin folds of
connective tissue that joins anteriorly to
form the prepuce and posteriorly to form
the fourchette.
It is moist, highly vascular, sensitive and
richly supplied with sebaceous glands.
In nulliparous women, the labia minora
covers the vaginal introitus, vestibule and
urethra.
Being very fragile, it is usually torn during
vaginal delivery
Fourchette formed by the posterior
joining of the labia minora and majora
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which is very sensitive to manipulation,
often lacerated and torn during normal
spontaneous vaginal delivery; common
site for episiotomy (midline).
d. Clitoris it is highly sensitive and erectile tissue
situated under the prepuce of the labia minora. It is
known to be the seat of a womans sexual arousal
and orgasm as it is the most sensitive part of the
female external genitalia. It is highly sensitive to
both touch and temperature.
It is composed of two erectile tissues
called corposa cavernosa that are
connected to the pubic bone. During
sexual
arousal,
the
ischiocavernous
muscle surrounding it contracts blocking
the flow of blood and this result in clitoral
congestion and erection.
It is supplied with many sebaceous glands
that produce a cheese-like secretion called
smegma.
e. Fossa navicularis This is the space between the
fourchette and vaginal introitus that is usually
obliterated during delivery.
f.
Vestibule It is an almond shape area that

contains the urinary meatus, Skenes glands,
hymen, vaginal orifice and Bartholins glands.
Urinary Meatus urethral opening for
micturition or urination.
Skenes Glands (Paraurethral Glands
or lesser vestibular) a pair of glands
which is situated at each inner side of the
urethral meatus. These glands secrete
mucous during sexual stimulation for
lubrication during penile penetration. It is
the most common site of external genital
infection in females.
Bartholins glands also known as
Paravaginal or Vulvovaginal glands
and greater vestibular because each
gland lies at each inner side beneath the
MATERNITY NURSING

Reproductive System
vaginal orifice. It secretes alkaline

substance responsible for neutralizing the
acidic environment of the vagina to
enhance sperm survival.
Vaginal Orifice The external opening of
the vagina in which the penis is inserted.
Hymen It is a thin circular membrane
made of elastic tissue situated at the
vaginal opening that separates the female
internal organs from the external organs.
It is naturally torn during the first sexual
intercourse, which may cause pain and
bleeding. However, the presence of
hymen, pain and bleeding during during a
womans first coitus cannot be used as a
standard sign of virginity as the hymen
may also be torn during other activities
(tampon insertion, active sports) aside
from coitus. Furthermore, some women
are born without hymen.
Carunculae myrtiformes (hymenal
caruncles) term for the residual tags
of
the
torn
hymen
post
instrumentation, use of tampons,
coitus or vaginal delivery.
g. Perineum It is a muscular structure in between

vagina and anus. Contains arteries and veins that
supply blood. It also consists of pubococcygeal
muscles and levator ani muscles for support and
pudendal nerve. In males, it is behind the scrotum.
NERVE SUPPLY
The anterior portions
nerve supply is derived
from the L1 and the
posterior
portion
is
derived from S3.
BLOOD SUPPLY
The blood supply to the
vulva is provided by the
MATERNITY NURSING
Imperforate
Hymen is a hymen
that completely
covers the vaginal
introitus preventing
the passage of
menstrual discharge
or sexual
intercourse.
Hymenotomy or
hymenectomy is the
surgical incision of

System
7
pudendal artery and rectus artery. This rich
blood supply facilitates rapid healing during the
postpartum period. However, it also predisposes
the woman to hemorrhage caused by
lacerations during delivery.
INTERNAL GENITALIA The internal sex organs of

the female consist of the vagina, uterus, fallopian tubes
(or oviducts), an
a. Vagina It is a flexible tube-shaped organ of

copulation that is the passageway between the
uterus and the opening in the vulva. It is 3 to 4
inches or 8 to 10 cm long of dilatable canal
located in front of the rectum and behind the
bladder. Its upper portion is separated from the
rectum by the cul-de-sac of Douglas.
Vaginal wall is composed of connective and
elastic tissues, and muscle fibers. Its surface is
lined by stratified squammous epithelium. The
external opening of the vagina is encircled by the
bulbocavernous muscle that acts as a voluntary
sphincter. Kegels exercise improves the tone of
this muscle and helps to prevent excessive
lacerations during the birth of the baby.
Its lymphatic drainage is via the inguinal, internal
iliac and sacral glands. Innervation of the vagina
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Reproductive System
is provided by the uterovaginal plexus or Lee
Franken hauser plexus and S1 to S3 nerves.
The functions of the vagina are:
1. Organ of copulation When a man and
a
woman
engage
in
vaginal
intercourse, the penis is inserted into
the vagina.
2. Discharges menstrual flow The
womans menstrual flow comes out of
the uterus and through the vagina.
3. Serves as the Birth Canal Because
during birth the baby travels from the
uterus through the vagina, the vagina
is also known as the birth canal.
Rugae are transverse folds of skin in the vaginal
wall that is absent in childhood, appear after
puberty and disappears at menopause. They are
most numerous in nulliparous women and lessen
with each childbirth and advancing age. The
important function of rugae is to allow the vaginal
canal to stretch and enlarge considerably during
delivery.
Vaginal Column are the longitudinal folds of skin
in the vaginal canal which also allows the vaginal
canal to enlarge during delivery in order to
accommodate the fetus.
The cervix projects into the vagina forming four
recesses or depression around the vaginas upper
portion called fornices (sing. fornix): anterior
fornix, lateral fornices, and posterior fornix. The
posterior wall of the vagina which measuresv 10
cm is longer than the anterior wall which only
measures 7 cm causing the posterior fornix to be
deeper than the other fornices, as a result, it is in
this area that vaginal secretions collect and
semen pools.
Vaginal pH
The vaginal pH before puberty is 6.8 to 7.2, which
is neutral to alkaline. After puberty vaginal pH
becomes acidic, going down to a pH of 4-5. The
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change to acidic pH during puberty is due to the
fact that before puberty, a girl does not produce
substantial estrogen to stimulate cervical mucus
secretion but with the advent of puberty, her
ovary begins to produce increasing amounts of
estrogen which stimulates mucus production in
the cervix. Cervical mucus is rich in glycogen. The
glycogen content of vaginal mucus is concerted
to lactic acid lactic acid by Doderlein bacilli (a
bacterium normally present in the vagina) making
the vaginal environment acidic - Low vaginal pH
helps control the growth of pathogenic
microorganisms that can cause vaginal infections.
b. Uterus The uterus or womb is a hollow
muscular canal resembling an inverted pear. It is
situated in the true pelvis. It is 2.5 to 3 inches
long, an inch thick, two inches wide and weighs
between 50 to 60 grams in non-pregnant woman.
In childhood, the cervix is larger than the corpus.
During pregnancy, it increases in size and
reaches its maximum size at age 17. In
nulligravid women, the corpus and cervix are of
the same size. In multiparous women, the corpus
is larger than the cervix. After delivery, it does
not return to its pre-pregnant condition.
Functions of the uterus:
1. Its cardinal function is as an organ of
reproduction.
2. Organ of menstruation
3. Uterine contraction to expel the fetus during
labor and to seal torn blood vessels after
delivery of the placenta. The uterus has
intrinsic motility which makes it capable of
contraction even if the nerves that supply it
are cut.
Parts of the Uterus
1. Fundus The uppermost convex portion
located between the insertions of the fallopian
tubes. This is the most muscular area of the
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Reproductive System
uterus; as such it is the thickest and the most
contractile portion. The fundus is used as an
obstetrical
landmark:
during
pregnancy
palpation of its height is used to assess
uterine growth and during the postpartum
period, to assess for uterine involution. During
labor, the fundus, being the most contractile
portion is palpated to assess uterine
contractions and labor progress. Another
significant role of the fundal area is that it is
also the ideal site for implantation of the
zygote because it is rich in blood supply and it
can
properly
anchor
the
placenta.
Implantation in the lower portion of the uterus
can result in placenta previa.
2. Isthmus This is the upper third of the cervix
which is very thin, becoming prominent only
near the end of pregnancy and during labor to
form the lower uterine segment together with
the cervix.
3. Cornua The areas at both sides of the uterus
where the fallopian tubes are attached.
4. Corpus This is the body of the uterus which
makes up two-third of the said organ. It
houses the fetus during pregnancy.
5. Cervix The cervix is located at the bottom of
the uterus and includes the opening between
the vagina and the uterus. It is considered as
the neck of the uterus. It measures about 2.5
cm long and 2.5 cm in diameter. In childhood
the cervix is approximately two times longer
than the corpus; during puberty and in
nulliparous women, the corpus is of the same
size as the cervix; in multiparous women, the
corpus is about thrice the length of the cervix.
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It chiefly consists of elastic and collagenous
tissues and with only 10 percent muscle
fibers. Women with incompetent cervix have
more muscle fibers.
The upper portion is lined by a mucous
membrane similar to the uterus and the lower
portion is lined by squammous epithelium
similar to the vagina. The cervix contains
many sebaceous glands that secrete a clear,
viscid and alkaline mucus. Sometimes these
glands are blocked giving rise to nonpathogenic cystic structure called Nabothian
Cysts.
Parts of the Cervix
a. Internal os The upper portion of the
cervix which opens to the corpus.
b. Cervical canal It is a spindle shaped area
that is actually a continuation of the
triangular uterine cavity and located
between the internal and external os.
c. External os The lower portion of the
cervix which opens to vagina. It is the site
for doing the Pap smear.
Layers of the uterus
The three layers of the uterus are endometrium,
myometrium, and the perimetrium.
MATERNITY NURSING
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Reproductive System
1. Endometrium It lines the uterus. It is the

innermost ciliated mucosal layer containing
numerous uterine glands that secrete a thin
alkaline fluid to keep the uterine cavity moist.
This layer undergoes changes in response to
the hormones at different phases of the
menstrual cycle to prepare the uterus for
implantation and pregnancy. This layer
sloughs off during menstruation. It is
composed of two layers:
Glandular layer This is composed
of columnar epithelium, this is the
MATERNITY NURSING

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layer which peels off during
menstruation
and
re-thickens
during proliferative and secretory
phase.
Basal Layer The layer adjacent to

the myometrium and gives rise to
the
new
endometrium
after
menstruation and delivery.
During pregnancy, the uterus undergoes
functional and structural changes and the
endometrium becomes the Decidua
(endometrium of the pregnant uterus).
2. Myometrium The firm middle muscular layer
responsible for uterine contractions during
labor. The myometrium is thickest at the
fundic area of the uterus. Efferent motor
fibers from T5 to T10 are responsible for uterine
contractions while parasympathetic fibers
from the sacral nerves are probably
responsible for vasodilation and inhibiting
myometrial contractions. It also has an
intrinsic motility making it capable of
contraction even if the nerves that supply it
are cut.
3. Perimetrium The outermost serosal layer
attached to the broad ligments which protects
the entire uterus (parietal and visceral
peritoneum).
Uterine Ligaments
The ten ligaments that support the uterus
permit it to move freely in the anteroposterior
plane and to enlarge without difficulty during
labor.These ligaments are the:
1. Cardinal (also known as TransverseCervical or Mackenrodt) Ligaments
(2) The lower portion of the broad
MATERNITY NURSING
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Reproductive System
2.
3.
4.
5.
ligaments. It is the main support of the

uterus. Damage to this ligament
causes uterine prolapse.
Broad
Ligaments/Peritoneum
Ligaments (2) Originate from the
sides of the corpus and extend to the
lateral pelvic walls. It supports the
sides of the uterus and assists in
holding the uterus in anteversion or
forward tilting of the uterus. The
collection of several veins or the
pampiniform plexus is located here. It
has the following parts:
Mesometrium It is directly
attached to the uterus which
supports the corpus.
Mesosalphinx It supports the
fallopian tubes.
Mesovarium It supports the
ovaries.
Round Ligaments (2) The round
ligaments connects the uterus to the
labia majora. During pregnancy, these
ligaments
enlarge
or
become
hypertrophic to provide support and
stability to the enlarging uterus.
Uterosacral Ligaments (2) These
ligaments connect the supravaginal
cervical portion of the uterus to the
second and third sacral vertebra
passing on each side of the rectum.
They help keep the uterus in its normal
position by maintaining traction on the
cervix.
Anterior Ligament (1) The single
anterior ligament provides support by
connecting the anterior portion of the
supravaginal cervix to the posterior
surface of the bladder. When this
ligament overstretches, the bladder
will drop and herniated into the
vagina, a condition called cystocele.
MATERNITY NURSING

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6. Posterior Ligament (1) As the
name implies, this ligament connects
the posterior portion of the uterus to
the rectum. It forms a deep pouch
called the Cul-de-sac of Douglas which
is the lowest part of the abdominal
cavity so that blood, pus or other fluids
in the abdominal area tends to collect
here.
Blood Supply
1. Uterine artery This is a branch of the
internal iliac or hypogastric artery which
divides
into
two
main
branches:
cervicovaginal branch that supplies the upper
portion of vagina and lower portion of cervix,
and the main branch which divides into
fundal, tubal and ovarian arteries.
2. Ovarian artery It is a direct branch of aorta
which supplies the ovary and the fallopian
tube.
Nerve Supply
MATERNITY NURSING
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Reproductive System
1. Uterine contractions: The uterine contraction
is stimulated by the Efferent sympathetic
motor nerves from T5 to T10.
2. Uterine
Relaxation:
Stimulated
by
Parasympathetic fibers of sacral nerves.
3. Painful contraction: The 11th and 12th thoracic.
c. Fallopian Tubes (Oviducts) The fallopian
tubes or the oviducts are a pair of tube-like
structures originating from the cornua of the
uterus with distal ends leading to ovaries. The
fallopian tubes are 2 cm (about 0.75 in) thick,
inch in diameter, and 10 to 13 cm (4 to 5 in) long.
As the ovum leaves the ovary it passes
into the mouth (infundibulum) of the adjoining
fallopian tube and is propelled toward the uterus
by hairlike projections called cilia on the inner
surface of the tube. If the ovum is fertilized inside
the tube, where most fertilization takes place, it
usually implants in the uterus. Some fertilized
ova, however, implant in the fallopian tube or
elsewhere outside the uterus and must be
surgically removed. The condition called ectopic
pregnancy. Many cases of infertility in women are
caused by blocked oviducts, which can result
from infection, especially that which is contracted
from sexually transmitted disease. Surgical
severing or sealing (ligation) of the fallopian
tubes is a common method of preventing
pregnancy. These tubes were named after their
discoverer, the Italian anatomist Gabriello
Fallopio.
The blood supply of the oviducts is derived
from the ovarian artery.
The functions of the fallopian tubes are:
1. Transport ova from the ovary to the
uterus.
2. Serve as the site for fertilization.
3. Nourish the ovum during its travel to
the uterus.
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Parts of the Fallopian Tubes

1. Interstitial or intramural Thick walled,
located inside the uterus and is 1 cm long and
1 mm in diameter. It is the most dangerous
site for ectopic pregnancy because of its
narrow lumen.
2. Isthmus This is the narrowest portion of the
uterus and is about 1 cm long. This is the site
for tubal ligation.
3. Ampulla The middle portion and the widest
part. This is the common site of fertilization
and ectopic pregnancy.
4. Infundibulum This is the most distal
portion which is funnel or trumpet-shaped. It
has fimbria which is finger-like projections
that catch the mature ovum. The longest
fimbria, called fimbria ovarica is attached to
the ovary to guide the ovum to the oviduct
during ovulation.
Layers of the Fallopian Tubes
1. Mucosal Layer Composed of secretory cells
that secrete alkaline mucus which lubricates
the fallopian tubes; and ciliated cells that
move in sweeping motion to facilitate the
transportation of the ovum from the ovary to
the uterus.
2. Muscular Layer This is the layer that is
responsible for the peristaltic movement of
the fallopian tube. Rhythmic contractions the
fallopian tubes are strongest at the time of
ovulation and weakest during pregnancy.
3. Peritoneal Layer This is the outermost
layer attached to the ligaments that keep the
fallopian tubes
suspended in its normal
position.
d. Ovaries The ovaries are the two almondshaped female sex organs located on either side
of the uterus. It is a reproductive organ and at the
MATERNITY NURSING
18

Reproductive System
same time an endocrine gland. The ovaries are
movable organs on palpation. Before puberty, the
ovaries are smooth, flat and ovoid organs. After
several ovulations, they assume a nodular and
pitted appearance. Each ovary weighs between 6
to 19 g, 1.5 to 3 cm wide and 2 to 5 cm long. At
the time of ovulation, due to the development of
several follicles, the ovaries may double in size
temporarily.
Functions of the ovaries
1. Oogenesis These female gonads are
responsible for the development and
maturation of egg cell.
2. Ovulation The ovaries usually release
one egg at a time.
3. Hormone production The ovaries are
the main source of estrogen and
progesterone in nonpregnant women.
Layers of the ovaries
1. Tunica albuginea This is the outermost
protective covering surrounded by a single
layer of cuboidal epithelium called germinal
layer of Waldeyer.
2. Cortex This is the functional layer because it
is the site for oogenesis or the formation and
maturation of the ovum. It contains the
primordial follicles, Graafian follicles, corpus
luteum and the corpus albicans. As the
follicles decrease in number after each
ovulation, this layer becomes thinner and
more pitted in appearance. The number of
follicles in each ovary decreases in number as
the woman ages.
Two months intrauterine - 600,000 oogonia

5 months intrauterine 6,800,000 oogonia
At birth 2 million oocytes
Prepuberty/childhood 300,000 to 400,000
oocytes
36 years old 30,000 to 40,000 oocytes
MATERNITY NURSING

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Menopause absent
3. Medulla This layer contains blood vessels,

lymphatics, nerves and muscle fibers. The
blood supply of the ovary drains into the left
renal vein and the right ovary into the inferior
THE BREAST
vena cava.
Legend:
FEMALE SECONDARY SEX CHARACTERISTICS
.Chest
wall
Enlargement of breasts1 and
erection
of nipples.
2. Pectoralis muscles
Growth of body hair, most
3. Lobules
Nipple
prominently underarm 4.
and
pubic hair
5. Areola
Greater development of thigh muscles behind
6. Duct
the femur, rather than 7.
inFatty
fronttissue
of it
Skin to hip ratio than
Widening of hips; lower8.waist
adult males, on average
Increased secretions of oil and sweat glands,
often causing acne and body odor.
Upper arms approximately 2 cm longer, on
average,breasts
for a given
Anatomically,
are height.
modified sudoriferous
(sweat)
glands
producedistribution
milk in women, and
some rareand
cases, fat;
in
which
Changed
in inweight
men. Each
breast
has one nipplefat
surrounded
by the areola.
The
more
subcutaneous
and fat deposits
mainly
color of the areola varies from pink to dark brown and has
theglands.
buttocks,
severalaround
sebaceous
In thighs
women, and
the hips
larger mammary
glands within the breast produce the milk. They are distributed
throughout the breast, with two-thirds of the tissue found within
30 mm of the base of the nipple. These are drained to the nipple by
between 4 and 18 lactiferous ducts, where each duct has its own
opening. The network formed by these ducts is complex, like the
tangled roots of a tree. It is not always arranged radially, and
branches close to the nipple. The ducts near the nipple do not act
as milk reservoirs; Ramsay et al. have shown that conventionally
described lactiferous sinuses do not, in fact, exist. Instead, most
milk is actually in the back of the breast, and when suckling occurs,
the smooth muscles of the gland push more milk forward.
The remainder of the breast is composed of connective
tissue (collagen and elastin), adipose
tissue (fat),
and Cooper's
ligaments. The ratio of glands to adipose tissues rises from 1:1 in
nonlactating women to 2:1 in lactating women.[5]
The breasts sit over the pectoralis major muscle and usually extend
from
the
level diagram
of the 2nd rib to the level of the 6th rib anteriorly.
Breast
schematic
The
lateral
of the breast extends diagonally
(adultsuperior
human female
cross quadrant
section)
upwards towards the axillae and is known as the tail of Spence. (For
further explanation, see anatomical terms of location.)
The arterial blood supply to the breasts is derived from the internal
thoracic
artery (formerly
called
the internal
mammary
artery), lateral thoracic
artery, thoracoacromial
artery, and
posterior intercostal arteries. The venous drainage of the breast is
RHO
VINCEtoC. the
MALAGUEO
mainly
axillary vein, but there is some drainage to
MATERNITY
NURSING
the internal thoracic
vein and the intercostal veins. Both sexes have
a large concentration of blood vessels and nerves in their nipples.
20

Reproductive System
The breast is innervated by the anterior and lateral cutaneous

branches of the fourth through sixth intercostal nerves. The nipple
is supplied by the T4 dermatome.
Shape and support
Breasts vary in size, density, shape, sag and position on a woman's
chest, and their external appearance is not predictive of their
internal anatomy or lactation potential. The natural shape of a
woman's breasts is primarily dependent on the support provided by
the Cooper's ligaments and the underlying chest on which they rest
(the base). Cooper's ligaments, also known as the suspensory
ligaments of Cooper, suspend the breasts from the clavicle and the
clavi-pectoral fascia. As their fibers run around and through the
breast, these ligaments support the breasts in its position on the
chest wall and maintain their normal shape. The breast is also
attached at its base to the chest wall by the deep fascia over
the pectoral muscles. In a small number of women, the frontal
ducts (ampullae) in the breasts are not flush with the surrounding
breast tissue, which causes the sinus area to visibly bulge outward.
Relatively round breasts which protrude almost horizontally.

Some breasts are high and rounded, and protrude almost
horizontally from the chest wall. Such high breasts are common for
girls and women in early stages of development. The protruding or
high breasts are anchored to the chest at the base, and the weight
is distributed evenly over the area of the base of the approximately
dome- or cone-shaped breasts.
In the low breast, a proportion of the breasts' weight is actually
supported by the chest against which the lower breast surface
comes to rest, as well as the deep anchorage at the base. The
weight is thus distributed over a larger area, which has the effect of
reducing the strain. In both males and females, the thoracic
cavity slopes progressively outwards from the thoracic inlet (at the
top of the breastbone) above to the lowest ribs which mark its
lower boundary, allowing it to support the breasts.
The inframammary fold (or line, or crease) is an anatomic structure
created by adherence between elements in the skin and underlying
connective tissue and represents the inferior extent of breast
anatomy. Some teenagers may develop breasts whose skin comes
into contact with the chest below the fold at an early age, and
some women may never develop such breasts; both situations are
perfectly normal. The relationship of the nipple position to the fold
is described as ptosis, a term also applied to other body parts and
which refers in general to drooping or sagging. Due to breast
weight and relaxation of support structures, the nipple-areola
complex
breast tissue may eventually hang below the fold, and
RHO
VINCEand
C. MALAGUEO
in
some
cases
the breasts may extend as far as, or even beyond,
MATERNITY NURSING
the navel. The length from the nipple to the sternal notch (central,
upper border) in the youthful breast averages 21 cm and is a

System
21
Development
Male with severe gynecomastia

In both men and women, there is prenatal development where the
basic structure of the breasts is formed.
Girls substantially develop breasts during puberty, as a result of
changing sex hormones, chiefly estrogen, which also has been
demonstrated to cause the development of woman-like, enlarged
breasts in men, a condition called gynecomastia. The onset of this
secondary (postnatal) breast development is called thelarche.
In most cases, the breasts fold down over the chest wall
during Tanner stage development. It is typical for a woman's breasts
to be unequal in size particularly while the breasts are developing.
Statistically it is slightly more common for the left breast to be the
larger. In rare cases, the breasts may be significantly different in
size, or one breast may fail to develop entirely.
A large number of medical conditions are known to cause abnormal
development of the breasts during puberty. Virginal breast
hypertrophy is a condition which involves excessive growth of the
breasts, and in some cases the continued growth beyond the usual
pubescent age. Breasthypoplasia is a condition where one or both
breasts fail to develop.
Function
The
primary
function
of mammary glands is to nurture
young by producing breast milk.
The production of milk is
called lactation.
The
orb-like
shape of breasts may help limit
heat loss, as a fairly high
temperature is required for the
production of milk.
Milk production unrelated to pregnancy can also occur. This
condition, called galactorrhea, may be an adverse effect of some
medicinal drugs (such as some antipsychotic medications), extreme
physical stress or endocrine disorders. If it occurs in men it is
called male lactation, and is often classified as a pathological
symptom due to its strong correlation to pituitary disorders.
MATERNITY
NURSING
Newborn babies
are often capable of lactation because they receive
the hormones prolactin and oxytocin via the mother's bloodstream,
22

Reproductive System
breastfeeding
An
infant
MALE REPRODUCTIVE SYSTEM
ANATOMY OF THE MALE REPRODUCTIVE SYSTEM
External Genitalia
a. Penis - This is the male organ used in sexual
intercourse. It has three
MATERNITY NURSING

System
23
parts: the root, which attaches to the wall of
the abdomen; the body, or shaft; and the glans, which is
the cone-shaped part at the end of the penis. The glans,
also called the head of the penis, is covered with a loose
layer of skin called foreskin. This skin is sometimes
removed in a procedure called circumcision. The opening
of the urethra, the tube that transports semen and urine,
is at the tip of the penis. The penis also contains a
number of sensitive nerve endings.The body of the penis
is cylindrical in shape and consists of three circular
shaped chambers. These chambers are made up of
special, sponge-like tissue. This tissue contains
thousands of large spaces that fill with blood when the
man is sexually aroused. As the penis fills with blood, it
becomes rigid and erect, which allows for penetration
during sexual intercourse. The skin of the penis is loose
and elastic to accommodate changes in penis size during
an erection.
Semen, which contains sperm (reproductive cells), is
expelled (ejaculated) through the end of the penis when
the man reaches sexual climax (orgasm).
When the penis is erect, the flow of urine is blocked from
the urethra, allowing only semen to be ejaculated at
orgasm.
b. Scrotum - This is the loose pouch-like sac of skin that

hangs behind and below the penis. It contains the testicles
(also called testes), as well as many nerves and blood
vessels. The scrotum acts as a "climate control system" for
the testes. For normal sperm development, the testes must
be at a temperature slightly cooler than body temperature.
Special muscles in the wall of the scrotum allow it to
contract and relax, moving the testicles closer to the body
for warmth or farther away from the body to cool the
temperature.
Internal Genitalia
MATERNITY NURSING
24

Reproductive System
a. Testes - These are oval organs about the size of

large olives that lie in the scrotum, secured at
either end by a structure called the spermatic
cord. Most men have two testes. The testes are
responsible for making testosterone, the primary
male sex hormone, and for generating sperm.
Within the testes are coiled masses of tubes
called seminiferous tubules. These tubes are
responsible for producing sperm cells.
MATERNITY NURSING

System
25
b. Epididymis - The epididymis is a long, coiled

tube that rests on the backside of each testicle. It
transports and stores sperm cells that are
produced in the testes. It also is the job of the
epididymis to bring the sperm to maturity, since
the sperm that emerge from the testes are
immature and incapable of fertilization. During
sexual arousal, contractions force the sperm into
the vas deferens.
c. Vas Deferens The vas deferens is a long,
muscular tube that travels from the epididymis
into the pelvic cavity, to just behind the bladder.
The vas deferens transports mature sperm to the
urethra, the tube that carries urine or sperm to
outside of the body, in preparation for
ejaculation.
d. Ejaculatory Duct - These are formed by the
fusion of the vas deferens and the seminal
vesicles. It is the conduit of semen. The
MATERNITY NURSING
26

Reproductive System
ejaculatory duct empties the semen into the
urethra.
e. Seminal Vesicle - The seminal vesicles are saclike pouches that attach to the vas deferens near
the base of the bladder. The seminal vesicles
produce a sugar-rich fluid (fructose) that provides
sperm with a source of energy to help them
move. The fluid of the seminal vesicles makes up
most of the volume of a man's ejaculatory fluid,
or ejaculate.Each vesicle is about 4 cm long. The
thick, mucoid secretion of the seminal vesicle is
high in sugar and protein and has a low pH,
causing sperm cells to become more motile once
surrounded by this nourishing fluid.
f.
Prostate Gland - The prostate gland is a walnutsized structure that is located below the urinary
bladder in front of the rectum. The prostate gland
contributes additional fluid to the ejaculate.
Prostate fluids also help to nourish the sperm.
The urethra, which carries the ejaculate to be
expelled during orgasm, runs through the center
of the prostate gland. It secretes a thin milky
alkaline fluid that help to neutralize the acidic
nature of the male urethra caused by the urine
that passes through it and to reduce the acidity of
the vaginal secretions enhancing sperm survival.
g. Cowpers Gland (Bulbourethral Gland)

These are two small glands that are located
below the prostate and secrete an alkaline fluid
which helps to neutralize the acidic urethra and
vaginal secretions and ptovides additional
lubrication during intercourse.
h. Urethra - The urethra is the tube that carries
urine from the bladder to outside of the body. In
males, it has the additional function of ejaculating
semen when the man reaches orgasm. When the
MATERNITY NURSING

System
27
penis is erect during sex, the flow of urine is
blocked from the urethra, allowing only semen to
be ejaculated at orgasm.
The Sperm Cell
The mature sperm cell (spermatozoa) is 0.05 milliliters

long. It consists of a head, body and tail. The head is
covered by the ac cap and contains a nucleus of dense
genetic material from the 23 chromosomes.It is attached
from the neck to the body containing mitochondria that
supply the energy for the sperm's activity. The tail is
made of protein fibers that contract on alternative sides,
giving a characteristic wavelike movement that drives
the sperm through the seminal fluid, which also supplies
additional energy.
Some sperm have two heads or two tails and if the
testes are too warm they may die or spermatogenesis
may not occur.
MATERNITY NURSING
28

Reproductive System
Sperm swim at a rate of about 1 to 4 mm (0.12 inches)
per minute. Thats an average, its different for every
man. Some sperm cells are 'better' swimmers than
others. Why? They need to wave their tales more than
1000 times just to swim 1.25 cm or a half an inch. Why
some are better than others is still a mystery to many
fertility specialists. Anyway...Sperm cells are made in the
testes where it takes about 72 days for one sperm to
grow. Sperm production requires a temperature which is
three to five degrees below body temperature. The
scrotum has a built-in thermostat, which keeps the
sperm at the correct temperature while theyre being
stored. If it becomes too cool on the outside, the scrotum
will bring the testicles closer to the body for warmth as
you probably know from jumping into a cold pool of
water or ocean. Thats why the testes hang away from
the body -- so sperm can develop at the temperature
they need. (95 - 97 F or 35 to 36 C)
Semen contains small amounts of more than thirty
elements, including fructose, ascorbic acid, cholesterol,
creatinine, citric acid, lactic acid, nitrogen, vitamin B12,
and various salts and enzymes. Lets go back to the
inside of the head of the sperm. All normal cells have 46
chromosomes but sperm have half that number or, 23. If
and when the sperm joins ups with the females, egg
(ovum) which also has 23 chromosomes, together they
add up to 46 chromosomes.
The middle section controls the sperms activities. The
sperm or (spermatozoa -- which are the little swimming
critters) make up only about 5% of what a man
ejaculates each time he ejaculates. This represents
about 100 to 400 million of them! Therefore, they are
very, very, very tiny, in fact a single sperm is the
smallest cell in the body. The rest of what a man
ejaculates in his ejaculate, which is about a teaspoonful
(5 ml), is made up of water, sugar, protein, vitamin C,
zinc, and prostaglandins.
Semen or seminal fluid is the mixture of sperm and the
secretions of the seminal vesicles, prostate gland, and
the bulbourethral glands. Over the course of a mans life,
hell produce more than 12 trillion sperm.
MATERNITY NURSING

System
29
MALE SECONDARY SEX CHARACTERISTICS
Growth of body hair,

including underarm, abdominal, chest, and pubic
hair. Loss of scalp hair androgenic alopecia can
also occur
Greater mass of thigh muscles in front of the
femur, rather than behind it as is typical in
mature females
Growth of facial hair
Enlargement of larynx (Adam's apple) and
deepening of voice
Increased stature; adult males are taller than
adult females, on average
Heavier skull and bone structure
Increased muscle mass and strength
Broadening of shoulders and chest; shoulders
wider than hips.
Increased secretions of oil and sweat glands,
often causing acne and body odor[3]
Coarsening or rigidity of skin texture, due to less
subcutaneous fat
Higher waist to hip ratio than prepubescent or
adult females or prepubescent males, on average
Secondary Sexual Development

What triggers puberty is still unknown; however, there
are distinct changes in the hypothalamic-pituitary axis
associated with the onset of puberty. These changes
result in an increase in gonadotropin-releasing hormone
(GnRH), which stimulates increases in leutenizing
hormone (LH) and follicle stimulating hormone (FSH),
hormones responsible for the development of secondary
sex characteristics. In males, LH stimulates testosterone
production and FSH stimulates gametogenesis. In
females, LH stimulates ovarian cells to produce
androgens and progesterone and stimulates ovulation
and FSH increases estrogen production (Neinstein,
2002). Other hormones that effect puberty include
thyroid hormones, growth hormones and insulin-like
growth factors.
MATERNITY NURSING
30

Reproductive System
Development of secondary sex characteristics is
measured through the use of a Sexual Maturity Rating
(SMR) scale, sometimes called the Tanner scale. Because
initiation and rate of growth during adolescence are so
variable, age is a poor indicator and predictor of change.
SMRs are essential in evaluating adolescents and
provide a method to gauge developmental progress,
using a five-point scale of measurement. For females,
ratings measure breast development and pubic hair
growth, and for males, they measure genital
development and pubic hair growth. Development of
secondary sex characteristics follows a general
sequence over time. Alteration in this sequence may be
an indication of abnormal pubertal progression.
As the age of onset of puberty varies, so too does the
length of time in each stage. Female pubertal
development begins on average at 11.2 years of age
(range 9.0 - 13.4) and lasts about 4 years. Breast
budding is most frequently the first physical sign of
puberty.
Breast
development
and
pubic
hair
development can progress at different rates and be at
different SMR levels at any given time. On average, the
adolescent female's growth spurt starts about one year
before breast development begins. Peak height velocity
is reached about one year and one month after breast
development begins. Menarche typically occurs one year
after peak height velocity is reached, usually at SMR 3
(19%) or 4 (56%) at the average age of 12 years 4
months (range 9-17). See Table A for SMR parameters of
female breast and pubic hair development (Tanner,
1962). Although it has been noted that the mean age for
onset of secondary sex characteristics has decreased in
girls, the overall effect on mean age at initiation of
menstruation has only decreased by six months and only
in girls of African-American ethnicity (Neinstein, 2002).
Male pubertal development begins on average at 11.6
years of age (range 9.5 - 13.5). Testicular enlargement is
most commonly the first physical sign of puberty in
males. SMR levels for pubic hair development and
TANNERS SEXUAL MATURITY RATING: Male

and Female Genitalia Development and
Pubic Hair Growth
MATERNITY NURSING

System
31
genital development (testes, scrotum and penis) can
differ at any given time in the same individual. See Table
A for male SMR parameters. The average length of time
for completion of puberty in males is three years. Spermarche
usually occurs early in puberty during SMR 2.5 (Tanner, 1962).
Female
Breast
PenisPubic HairPubic Hair
No development
No pubic hair
Breast bud, areola

widens
Long, slightly pigmented,

straight hair along labia
Breast larger, more

Increased in quantity,
elevation
darker, more curly and
Extends beyond areolar coarser, present in typical
parameter
female triangle
Breast larger and more
elevation
Hair more dense, curled

and adult in distribution
Areola and papilla form
but in a smaller quantity
a mound projecting from
the breast contour
Breast adult appearance
Areola and breast in
same plane, with papilla
projecting above areola
Testes and
Scrotum
Testicular volume less than 1.5ml
Abundant, adult-type
pattern
Hair extends to medial
aspect of thigh
Childlike
MATERNITY NURSING
None
32

Reproductive System
Testicular volume No change
Light, downy hair
1.6 - 6ml, Scrotum
laterally
reddened, thinner,
larger
Testicular volume - 6- Increased length Extended across
12ml, Scrotum - great
pubis
enlargement
Testicular volume - Increased length More abundant
12-20ml, Scrotum - and circumference with curling and
further enlargement
darkening
Testicular volume Adult male
Adult quantity and
>20 ml
appearance
distribution with
Scrotum - adult
hair present on
appearance
inner thighs
*Ratings for each developmental characteristic may
differ in the same individual at one point in
time (Tanner, 1962).
Male
MALE AND FEMALE EQUIVALENCE

MALE
Scrotum
Glans Penis
Penile shaft
Testes
Prostate gland
Cowpers gland
Vas deferens
FEMALE
Labia Majora
Glans Clitoris
Clitoral shaft
Ovaries
Skenes gland
Bartholins gland
Fallopian tube
Development of the reproductive system

The development of the reproductive system is a
part of prenatal development, and concerns the sex
organs. It is a part of the stages of sexual differentiation.
Because its location to a large extent overlaps the
urinary system, the development of them can also be
MATERNITY NURSING

System
33
described together as the development of the urinary
and reproductive organs.
The
reproductive
organs
are
developed
from
the intermediate mesoderm. The permanent organs of
the adult are preceded by a set of structures which are
purely embryonic, and which with the exception of the
ducts disappear almost entirely before the end of fetal
life.
These
embryonic
structures
are
the Wolffian and Mllerian
ducts,
also
known
as
mesonephric and paramesonephric ducts, respectively.
The Wolffian duct remains as the duct in males, and the
Mllerian as that of the female.
Wolffian (mesonephric) Duct
The Wolffian duct originates from a part of the ovary
where the urinary system grows.
Origin
In the outer part of the intermediate mesoderm,
immediately under the ectoderm, in the region from the
fifth cervical segment to the thirdthoracic segment, a
series of short evaginations from each segment
grows dorsally and extends caudally, fusing successively
from before backward to form the pronephric duct. This
continues to grow caudalward until it opens into the
ventral part of the cloaca; beyond the pronephros it is
termed the Wolffian duct. Thus, the Wolffian duct is
what remains of the pronephric duct after the atrophy of
the pronephros.
Development in male
In the male the Wolffian duct persists, and forms
the tube of the epididymis, the ductus deferens and
the ejaculatory duct, while the seminal vesicle arises
during the third month as a lateral diverticulum from its
hinder end. A large part of the head end of the
mesonephros atrophies and disappears; of the
remainder the anterior tubules form the efferent ducts
of the testis; while the posterior tubules are represented
by the ductuli aberrantes, and by the paradidymis,
MATERNITY NURSING
34

Reproductive System
which is sometimes found in front of the spermatic
cord above the head of the epididymis.
Atrophy in female
In the female the Wolffian bodies and ducts

atrophy. The nonfunctional remains of the Wolffian
tubules are represented by the epoophoron, and
the parophoron, two small collections
of rudimentary blind tubules which are situated in
the mesosalpinx.
Remnants
Section of the fold in the mesonephros of a chick embryo of the fourth day.
The lower part of the Wolffian duct disappears, while the

upper part persists as the longitudinal duct of
the epophoron, called Gartner's duct.
There are also developments of other tissues from the
Wolffian duct that persist, e.g. the development of the
suspensory ligament of the ovary.
MATERNITY NURSING

System
35
The Mllerian (paramesonephric) Duct
A.Diagram of the primitive urogenital organs in the embryo previous

to sexual distinction. The common genital cord is labeled with gc.
* 3. Ureter.
* 4. Urinary bladder.
* 5. Urachus.
* cl. Cloaca.
* cp. Elevation which becomes clitoris or penis.
* i. Lower part of the intestine.
* ls. Fold of integument from which the labia majora or scrotum are
formed.
* m, m. Right and left Mllerian ducts uniting together and running
with the Wolffian ducts in gc, the common genital cord.
* ot. The gonadal ridge from which either the ovary or testis is formed.
* ug. Sinus urogenitalis.
* W. Left Wolffian body.
* w, w. Right and left Wolffian ducts.
Shortly after the formation of the Wolffian ducts a

second pair of ducts is developed; these are the
Mllerian ducts. Each arises on the lateral aspect of
the corresponding Wolffian duct as a tubular invagination
of the cells lining the abdominal cavity. The orifice of the
invagination remains open, and undergoes enlargement
and modification to form the abdominal ostium of the
fallopian tube. The ducts pass backward lateral to the
Wolffian ducts, but toward the posterior end of the
embryo they cross to the medial side of these ducts, and
thus come to lie side by side between and behind the
MATERNITY NURSING
36

Reproductive System
latterthe four ducts forming what is termed
the common genital cord, to distinguish it from
the genital cords of the germinal epithelium seen later in
this article. The Mllerian ducts end in an epithelial
elevation, the Mllerian eminence, on the ventral part of
the cloaca between the orifices of the Wolffian ducts. At
a later stage the eminence opens in the middle,
connecting the Mllerian ducts with the cloaca.
Atrophy in males
In the male the Mllerian ducts atrophy, but traces of
their anterior ends are represented by the appendices
testis (hydatids of Morgagni of the male), while their
terminal fused portions form the utriculus in the floor of
the prostatic urethra. This is due to the production
of Anti-Mllerian
hormone by
the Sertoli
cells of
the testes.
Development in females
In the female the Mllerian ducts persist and undergo
further development. The portions which lie in
the genital cord fuse to form the uterus and vagina. This
fusion of the Mllerian ducts begins in the third month,
and the septum formed by their fused medial walls
disappears from below upward.
The parts outside this cord remain separate, and each
forms the corresponding Fallopian tube. The ostium of
the fallopian tube remains from the anterior extremity of
the original tubular invagination from the abdominal
cavity.
About the fifth month a ring-like constriction marks the
position of the cervix of the uterus, and after the sixth
month the walls of the uterus begin to thicken. For a
time the vagina is represented by a solid rod of epithelial
cells. A ring-like outgrowth of this epithelium occurs at
the lower end of the uterus and marks the future vaginal
fornix. At about the fifth or sixth month the lumen of the
vagina is produced by the breaking down of the central
cells of the epithelium. The hymen represents the
remains of the Mllerian eminence.
MATERNITY NURSING

System
37
Gonads
The gonads are the precursors of the testes in males
and ovaries in females. They initially develop from the
mesothelial layer of the peritoneum.
Ovaries
The ovary is differentiated into a central part, the
medulla of ovary, covered by a surface layer, the
germinal epithelium. The immature ovaoriginate from
cells from the dorsal endoderm of the yolk sac. Once
they have reached the gonadal ridge they are
called oogonia. Development proceeds and the oogonia
become fully surrounded by a layer of connective tissue
cells (pre-granulosa cells) In this way, the rudiments of
the ovarian follicles are formed. The embryological origin
of granulosa cells, on the other hand, remains
controversial. Just as in the male, there is
a gubernaculum in the female, which pulls it downward,
albeit not as much as in males. The gubernaculum later
becomes the proper ovarian ligament and the round
ligament of the uterus.
Testes
The periphery of the testes is converted into the tunica
albuginea. Cords of the central mass run together and
form a network which becomes the rete testis, and
another network, which develops the seminiferous
tubules. Via the rete testis, the seminiferous tubules
become
connected
with
outgrowths
from
the
mesonephros, which form the efferent ducts of the
testis.
In short, the descent of the testes consists of the
opening of a connection from the testis to its final
location at the anterior abdominal wall, followed by the
development
of
the
gubernaculum,
which
subsequently pulls and translocates the testis down into
the developing scrotum. Ultimately, the passageway
closes behind the testis. A failure in this process can
cause indirect inguinal hernia or an infantile hydrocoele.
Division of cloaca
MATERNITY NURSING
38

Reproductive System
Tail end of human embryo thirty-two to thirty-three days old. The

entodermal cloaca is visible at center left, labeled in green
After the separation of the rectum from the dorsal part of

the cloaca, the ventral part becomes the primary
urogenital sinus. The urogenital sinus, in turn, divides
into the superficial definitive urogenital sinus and the
deeper anterior vesico-urethral portion.
Definitive urogenital sinus
The definitive urogenital sinus consists of a caudal
cephallic portion and an intermediate narrow channel,
the pelvic portion.
Vesico-urethral portion
The vesico-urethral portion is the deepest portion,
continuous with the allantois. It absorbs the ends of the
Wolffian ducts and the associated ends of the renal
diverticula, and these give rise to the trigone of urinary
bladder and part of the prostatic urethra. The remainder
of the vesico-urethral portion forms the body of the
bladder and part of the prostatic urethra; its apex is
prolonged to the umbilicus as a narrow canal,
the urachus, which later is obliterated and becomes
the median umbilical ligament of the adult.
The Prostate
The prostate originally consists of two separate portions,
each of which arises as a series of diverticular buds from
the epithelial lining of the urogenital sinus and vesicourethral part of the cloaca, between the third and fourth
months. These buds become tubular, and form the
glandular substance of the two lobes, which ultimately
meet and fuse behind the urethra and also extend on to
MATERNITY NURSING

System
39
its ventral aspect. The median lobe of the prostate is
formed as an extension of the lateral lobes between the
common ejaculatory ducts and the bladder.
Skene's glands in the female urethra are regarded as the
homologues of the prostatic glands.
The bulbourethral glands in the male, and Bartholin's
gland in the female, also arise as diverticula from the
epithelial lining of the urogenital sinus.
External genitalia
The mesoderm extends to the midventral line

Until about the ninth week of gestational age the
external genitalia of males and females look the same,
and follow a common development. This includes the
development of a genital tubercle and a membrane
dorsally to it, covering the developing urogenital
opening, and the development of labioscrotal folds.
Even after differentiation can be seen between the
sexes, some stages are common, e.g. the disappearing
of the membrane. On the other hand, sex-dependent
development include further protrusion of the genital
tubercle in the male to form the penis. Furthermore, the
labioscrotal folds evolve into the scrotum in males, while
they evolve into labia in females.
Common development
Before differentiation
Urogenital membrane
MATERNITY NURSING
40

Reproductive System
There is initially a cloacal membrane, composed of
ectoderm and endoderm, reaching from the umbilical
cord to the tail, separating the cloaca from the exterior.
After the separation of the rectum from the dorsal part of
the cloaca, the ventral part of the cloacal membrane
becomes the urogenital membrane.
Genital tubercle
Mesoderm extends to the midventral line for some
distance behind the umbilical cord, and forms the lower
part of the abdominal wall; it ends below in a prominent
swelling, the cloacal tubercle, which after the separation
of the rectum becomes the genital tubercle. Dorsally to
this tubercle the sides aren't really fused. Rather, the
urogenital part of the cloacal membrane separates the
ingrowing sheets of mesoderm.
Phallus
The genital tubercle develops into the phallus, the first
rudiment of the penis or clitoris.
The terminal part of the phallus, representing the future
glans becomes solid. The remainder of the phallus,
which remains hollow, is converted into a longitudinal
groove by the absorption of the urogenital membrane.
The term genital tubercle, however, still remains, but
only refers to the future glans.
Urogenital opening
In both sexes the phallic portion of the urogenital
sinus extends on to the under surface of the cloacal
tubercle as far forward as the apex. At the apex the walls
of the phallic portion come together and fuse,
obliterating the urogenital opening. Instead, a solid
plate, the urethral plate, is formed. The remainder of the
phallic portion is for a time tubular, and then, by the
absorption of the urogenital membrane, it establishes a
communication with the exterior. This opening is for a
while the primitive urogenital opening, and it extends
forward to the corona glandis.
After differentiation
MATERNITY NURSING

System
41
The following developments occur in both males and
females, although a difference in the development
between the sexes already can be seen:
The corpora cavernosa of the penis or clitoris and of the
urethra arise from the mesodermal tissue in the phallus;
they are at first dense structures, but later vascular
spaces appear in them, and they gradually become
cavernous.
The prepuce in both sexes is formed by the growth of a
solid plate of ectoderm into the superficial part of the
phallus; on coronal section this plate presents the shape
of a horseshoe. By the breaking down of its more
centrally situated cells the plate is split into two lamell.
Thus, a cutaneous fold, the prepuce, is liberated and
forms a hood over the glans.
Female
In the female, a deep groove forms around the phallus.
The sides of it grow dorsalward as the labioscrotal folds,
which ultimately form the labia majora in females. The
labia minora, in contrast, arise by the continued growth
of the lips of the groove on the under surface of the
phallus; the remainder of the phallus forms the clitoris.
The immature glans becomes the clitoral glans.
Male
In the male the pelvic portion of the cloaca undergoes
much greater development, pushing before it the phallic
portion.
The labioscrotal folds extend around between the pelvic
portion and the anus, and form a scrotal area. During the
changes associated with the descent of the testes this
scrotal area is drawn out to form the scrotal sacs. The
penis is developed from the phallus.
As in the female, the urogenital membrane undergoes
absorption, forming a channel on the under surface of
the phallus; this channel extends only as far forward as
the corona glandis.
MATERNITY NURSING
42

Reproductive System
Urogenital opening
In the male, by the greater
growth of the pelvic portion
of the cloaca, a longer
urethra is formed, and the
primitive opening is carried
forward with the phallus, but
it still ends at the corona
glandis. Later, this opening,
which is located on the
dorsal side of the penis,
closes from behind forward.
Meanwhile, the urethral plate
of the glans breaks down
centrally to form a median
groove continuous with the
primitive ostium. This groove
also closes from behind
forward, leaving only a small
pipe running in the middle of
the
penis.
Thus,
the
urogenital opening is shifted
forward to the end of the
glans.
Diagram
of
internal
differentiation
MATERNITY NURSING

System
43
Diagrams to show the

development of male
and female generative
organs from a common
type
A.Diagram of
the primitive
urogenital organs
in the embryo
previous to sexual
distinction.
3. Ureter.
4. Urinary bladder.
5. Urachus.
cl. Cloaca.
cp. Elevation
which becomes
clitoris or penis.
i. Lower part of
the intestine.
ls. Fold of
integument from
which the labia
majora or scrotum
are formed.
m, m. Right and
left Mllerian ducts uniting together and running with the
Wolffian ducts in gc, the genital cord.
ot. The genital ridge from which either the ovary or testis
is formed.
ug. Sinus urogenitalis.
MATERNITY NURSING
44

Reproductive System
W. Left Wolffian body.
w, w. Right and left Wolffian ducts.
B.Diagram of the female type of sexual organs.
C. Greater vestibular gland, and immediately above it
the urethra.
cc. Corpus cavernosum clitoridis.
dG. Remains of the left Wolffian duct, such as give rise to
the duct of Grtner, represented by dotted lines; that of
the right side is marked w.
f. The abdominal opening of the left uterine tube.
g. Round ligament, corresponding to gubernaculum.
h. Situation of the hymen.
i. Lower part of the intestine.
l. Labium major.
n. Labium minus.
o. The left ovary.
po. Epoophoron.
sc. Corpus cavernosum urethrae.
u. Uterus. The uterine tube of the right side is marked m.
v. Vulva.
va. Vagina.
W. Scattered remains of Wolffian tubes near it
(parophoron of Waldeyer).
C.Diagram of the male type of sexual organs.
C. Bulbo-urethral gland of one side.
cp. Corpora cavernosa penis cut short.
e. Caput epididymis.
g. The gubernaculum.
i. Lower part of the intestine.
m. Mllerian duct, the upper part of which remains as
the hydatid of Morgagni; the lower part, represented by
a dotted line descending to the prostatic utricle,
constitutes the occasionally existing cornu and tube of
the uterus masculinus.
pr. The prostate.
s. Scrotum.
sp. Corpus cavernosum urethrae.
t. Testis in the place of its original formation.
t, together with the dotted lines above, indicates the
direction in which the testis and epididymis descend
from the abdomen into the scrotum.
vd. Ductus deferens.
MATERNITY NURSING

System
45
vh. Ductus aberrans.
vs. The vesicula seminalis.
W. Scattered remains of the Wolffian body, constituting
the organ of Giralds, or the paradidymis of Waldeyer.
MATERNITY NURSING

Human Sexuality

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Human Sexuality

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Chapter 1 Human Sexuality and the Reproductive

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

ANATOMY AND PHYSIOLOGY OF

Female Reproductive System

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

Vestibule It is an almond shape area that

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

vaginal orifice. It secretes alkaline

g. Perineum It is a muscular structure in between

Chapter 1 Human Sexuality and the Reproductive

INTERNAL GENITALIA The internal sex organs of

a. Vagina It is a flexible tube-shaped organ of

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

1. Endometrium It lines the uterus. It is the

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

Basal Layer The layer adjacent to

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

ligaments. It is the main support of the

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

Parts of the Fallopian Tubes

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

Two months intrauterine - 600,000 oogonia

36 years old 30,000 to 40,000 oocytes

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the Reproductive

3. Medulla This layer contains blood vessels,

FEMALE SECONDARY SEX CHARACTERISTICS

Chapter 1 Human Sexuality and the

The breast is innervated by the anterior and lateral cutaneous

Relatively round breasts which protrude almost horizontally.

Chapter 1 Human Sexuality and the Reproductive

Male with severe gynecomastia

Chapter 1 Human Sexuality and the

MALE REPRODUCTIVE SYSTEM

ANATOMY OF THE MALE REPRODUCTIVE SYSTEM

Chapter 1 Human Sexuality and the Reproductive

b. Scrotum - This is the loose pouch-like sac of skin that

RHO VINCE C. MALAGUEO

Chapter 1 Human Sexuality and the

a. Testes - These are oval organs about the size of