MATERNAL/OB NOTES

Human Sexuality
A. Concepts
1. A persons sexuality encompasses the complex behaviors, attitudes emotions and preferences that are related to
sexual self and eroticism.
2. Sex basic and dynamic aspect of life
3. Durin reproductive years, the nurse performs as resource person on human sexuality.
B. Definitions elate! to sexuality"
!ender identity sense of femininity or masculinity
2"# yrs$3 yrs ender identity develops.
%ole identity attitudes, behaviors and attributes that differentiate roles
Sex bioloic male or female status. Sometimes referred to a specific sexual behavior such as sexual intercourse.
Sexuality " behavior of bein boy or irl, male or female man$ &oman. 'ntity life lon dynamic chane.
" developed at the moment of conception.
##. Sexual Anatomy an! $%ysiolo&y
A. 'emale Repo!ucti(e System
1. 'xternal value or pretender
a. Mons pu)is/(eneis " a pad of fatty tissues that lies over the symphysis pubis covered by s(in and at puberty covered by
pubic hair that serves as cushion or protection to the symphysis pubis.
Sta&es of $u)ic Hai De(elopment
)annerscale tool " used to determine sexual maturity ratin.
Stae 1 *re"adolescence. +o pubic hair. ,ine body hair only
Stae 2 -ccurs bet&een aes 11 and 12 sparse, lon, slihtly pimented . curly hair at pubis
symphysis
Stae 3 occurs bet&een aes 12 and 13 dar(er . curlier at labia
Stae # occurs bet&een aes 13 and 1#, hair assumes the normal appearance of an adult but is not so
thic( and does no appear to the inner aspect of the upper thih.
Stae / sexual maturity" normal adult" appear inner aspect of upper thih .
). La)ia Ma*oa " lare lips lonitudinal fold, extends symphisis pubis to perineum
c. La)ia Minoa 2 sensitive structures
clitoris" anterior, pea shaped erectile tissue &ith lots sensitive nerve endins siht of sexual arousal 0!ree("(ey1
fourchette" *osterior, tapers posteriorly of the labia minora" sensitive to manipulation, torn durin delivery.
Site episiotomy.
!. +esti)ule an almond shaped area that contains the hymen, vainal orifice and bartholenes lands.
1. 2rinary 3eatus small openin of urethra, serves for urination
2. S(enes lands$or paraurethral land mucus secretin subs for lubrication
3. hymen covers vainal orifice, membranous tissue
#. vainal orifice external openin of vaina
/. bartholenes lands" paravainal land or vulvo vainal land "2 small mucus secretin subs secrets al(aline subs.
Al(aline neutrali4es acidity of vaina
*h of vaina " acidic
Doderleins bacillus responsible for acidity of vaina
5arumculae mystiformes"healin of torn hymen
e. $eineum , muscular structure loc lo&er vaina . anus
6nternal7
A. (a&ina female oran of copulation, passae&ay of mens . fetus, 3 #inches or 8 19 cm lon, dilated canal
%uae permits stretchin &ithout tearin
B. uteus- -ran of mens is a hollo&, thic( &alled muscular oran. 6t varies in si4e, shape and &eihts.
Si4e" 1x2x3
Shape7 nonprenant pear shaped $ prenant " ovoid
1
:eiht " nonprenant /9 ";9 (" prenant 1,999
*renant$ 6nvolution of uterus7
#
th
stae of labor " 1999
2 &ee(s after delivery " /99
3 &ee(s after delivery " 399
/"; &ee(s after delivery " returns to oriinal, state /9 ;9
T%ee pats of t%e uteus
1. fundus " upper cylindrical layer
2. corpus$body " upper trianular layer
3. cervix " lo&er cylindrical layer
< 6sthmus lo&er uterine sement durin prenancy
5ornua"=unction bet&een fundus . interstitial
Muscula compositions" there are three main muscle layers &hich ma(e expansion possible in every direction.
1. 'ndometrium" inside uterus, lines the nonprenant uterus. 3uscle layer for menstruation. Slouhs durin menstruation.
Decidua" thic( layer.
'ndometriosis"proliferation of endometrial linin outside uterus. 5ommon site7 ovary.
S$sx7 dysmennorhea, lo& bac( pain.
Dx7 biopsy, laparoscopy
3eds7 1. Dana4ole 0Danocrene1 a. to stop mens b. inhibit ovulation
2. >upreulide 0>upron1 inhibit ,S?$>? production
2. 3yometrium larest part of the uterus, muscle layer for delivery process
6ts smooth muscles are considered to be the livin liature of the body.
" *o&er of labor, resp" contraction of the uterus
3. *erimetrium protects entire uterus
C. o(aies 2 female sex lands, almond shaped. 'xt" vestibule int ovaries
,unction7 1. ovulation
2. *roduction of hormones
!. 'allopian tu)es 2"3 inches lon that serves as a passae&ay of the sperm from the uterus to the ampulla or the passae&ay of the
mature ovum or fertili4ed ovum from the ampulla to the uterus.
. si&nificant se&ments
1. 6nfundibulum distal part of ,), trumpet or funnel shaped, s&ollen at ovulation
2. Ampulla outer 3
rd
or 2
nd
half, site of fertili4ation
3. 6sthmus site of sterili4ation bilateral tubal liation
#. 6nterstitial site of ectopic prenancy most danerous
B. Male Repo!ucti(e System
/. Extenal
penis the male oran of copulation and urination. 6t contains of a body of a shaft consistin of 3 cylindrical layers
and erectile tissues. At its tip is the most sensitive area comparable to that of the clitoris in the female the lands
penis.
0 Cylin!ical Layes
2 corpora cavernosa
1 corpus sponiosum
Scotum a pouch hanin belo& the pendulous penis, &ith a medial septum dividin into t&o sacs, each of &hich contains a testes.
" coolin mechanism of testes
" @ 2 derees 5 than body temp.
" >eydi cell release testosterone
2
1. #ntenal
T%e $ocess of Spemato&enesis , maturation of sperm

Male an! 'emale %omolo&ues
Male 'emale
*enile lans 5litoral lans
*enile shaft 5litorial shaft
)estes ovaries
*rostate S(enes ands
5o&pers !lands AartholinBs lands
Scrotum >abia 3a=ora
'pididymis ; meters coiled
tubules site for maturation of sperm
Cas Deferens conduit for
spermato4oa or path&ay of sperm
Seminal vesicle secretes7
1.1 ,ructose lucose has
nutritional value.
2.1 *rostalandin causes reverse
contraction of uterus
Alan(D 5ant eraseD
?ypothalamus
!n%?
Ant *it
!land
,S? >,
,x7
Sperm
3aturation
,x7 ?ormones
for
)estosterone
*roduction
)estes E99 coiled 0F meter lon
at ae 13 on&ards1
0Seminiferous tubules1
'=aculatory duct conduit of semen
*rostate land" secrets al(aline substance
5o&pers land secrets al(aline substance
2rethra
3
###. Basic 2no3le!&e on 4enetics an! O)stetics
1. D+A carries enetic code
2. 5hromosomes threadli(e strands composed of hereditary material D+A
3. +ormal amount of e=aculated sperm 3 / cc., 1 tsp
#. -vum is capable of bein fertili4ed &ith in 2# 3; hrs after ovulation
/. Sperm is viable &ithin #8 G2 hrs, 2"3 days
;. %eproductive cells divides by the process of meiosis 0haploid1
Spermatoenesis maturation of sperm
-oenesis process " maturation of ovum
!ematoenesis formation of 2 haploid into diploid 23 H 23 I #; or diploid
G. Ae of %eproductivity 1/ ##yo
8. 3enstruation"
3enstrual 5ycle beinnin of mens to beinnin of next mens
Averae 3enstrual 5ycle 28 days
Averae 3enstrual *eriod " 3 / days
+ormal Alood loss /9cc or J cup
%elated terminoloies7
3enarche 1
st
mens
Dysmenorrhea painful mens
3etrorrhaia bleedin bet&een mens
3enorhaia excessive durin mens
Amenorrhea absence of mens
3enopause cessation of mens$ averae 7 /1 years old
E. ,unctions of 'stroen and *roestin
5 Esto&en K?ormone of the :omanL
*rimary function7 development secondary sexual characteristic female.
-thers7
1. inhibit production of ,S? 0 maturation of ovum1
2. hypertrophy of myometrium
3. Spinnbar(eit . ,ernin 0 billins method$ cervical1
#. development ductile structure of breast
/. increase osteoblast activities of lon bones
;. increase in heiht in female
G. causes early closure of epiphysis of lon bones
8. causes sodium retention
E. increase sexual desire
<$o&estin K ?ormone of the 3otherL
*rimary function7 prepares endometrium for implantation of fertili4ed ovum ma(in it thic( . tortous 0t&isted1
Secondary ,unction7 uterine contractility 0favors prenancy1
-thers7 1.inhibit prod of >? 0hormone for ovulation1
2.inhibit motility of !6)
3. mammary land development
#. increase permeability of (idney to lactose . dextrose causin 0H1 suar
/. causes mood s&ins in moms
;. increase AA)
/6. Menstual Cycle
# phases of 3enstrual 5ycle
1. *hases of 3enstrual 5ycle7
1. *roliferative
2. Secretory
3. 6schemic
#. 3enses
*arts of body responsible for mens7
1. hypothalamus
2. anterior pituitary land master cloc( of body
3. ovaries
#
#. uterus
6nitial phase 3
rd
day decreased estroen
13
th
day pea( estroen, decrease proesterone
1#
th
day 6ncrease estroen, increase proesterone
1/
th
day Decrease estroen, increase proesterone
6. -n the initial 3
rd
phase of menstruation , the estroen level is decreased, this level stimulates the hypothalamus to release
!n%? or ,S?%,
66. !n%?$,S?%, stimulates the anterior pituitary land to release ,S?
'unctions of 'SH7
1. Stimulate ovaries to release estroen
2. ,acilitate ro&th primary follicle to become raffian follicle 0secrets lare amt estroen . contains mature ovum.1
666. *roliferative *hase proliferation of tissue or follicular phase, post mens phase. *re"ovularoty.
"phase of increase estroen.
,ollicular *hase causin irreularities of mens
*ostmenstrual *hase
*reovulatory *hase phase increase estroen
6C. 13
th
day of menstruation, estroen level is pea( &hile the proesterone level is do&n, these stimulates the hypothalamus
to release !n%, on >?%,
1.1 3ittelschmer4 sliht abdominal pain on > or %M of abdomen, mar(s ovulation day.
2.1 5hane in AA), mood s&in
C. !n%,$>?%, stimulates the ant pit land to release >?.
'unctions of LH7
1. 013
th
day"decreased proesterone1 >? stimulates ovaries to release proesterone
2. hormone for ovulation
C6. 1#
th
day estroen level is increased &hile the proesterone level is increased causin rupture of raffian follicle on process of
ovulation.
C66. 1/
th
day, after ovulation day, raafian follicle starts to deenerate yello&ish (no&n as corpus luteum 0secrets lare amount of
proesterone1
C666. Secretory phase"
>utheal *hase
*ostovulatory *hase6ncreased proesterone
*remenstrual *hase
6N. 2#
th
day if no fertili4ation, corpus luteum deenerate 0 &hitish corpus albicans1
N. 28
th
day if no sperm in ovum endometrium beins to slouh off to bein mens
5ornix" &here sperm is deposited
Sperm" small head, lon tail, pearly &hite
*honones"vibration of head of sperm to determine location of ovum
Sperm should penetrate corona radiata and 4ona pellocida.
5apacitation" ability of sperm to release proteolytic en4yme to penetrate corona radiata and 4ona pellocida.
/