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Chapter 9 Urinary and Reproductive Systems 181
Semen
Although semen is not an accessory organ, it is required
for the transport of the sperm. It is necessary to nourish
the sperm and protect it from the acidic environment
of the male urethra and female vaginal canal. It has an
alkaline pH of 7.2 to 7.8 (7.0 is neutral, neither acidic
nor alkaline). The seminal vesicles produce a large part
of the semen’s volume, which is made up of simple sugar
and other substances.
Prostate Gland
The prostate gland is located inferior to the urinary bladder. The urethra from the bladder is surrounded by the
prostate. Imagine a donut, the prostate gland, and the urethra going through the donut hole. The prostate gland also
secretes an alkaline substance that is added to the semen.
The gland is muscular allowing it to assist in the ejaculation
of the sperm from the body. Below the prostate gland are
two small organs called the bulbourethral glands (Cowper
glands). These glands secrete a substance that lubricates the
urethra and tip of the penis during sexual stimulation.
The Penis
The urethra extends through the length of the penis and
carries urine and semen. During sexual arousal, blood
lls the spongy tissue of the penis causing it to become
erect (erection). At the end of the penis, there is a loose
fold of skin called the foreskin, also known as the prepuce. A circumcision is the surgical removal of the foreskin. It is typically performed on infants for cultural or
religious reasons but also thought to improve cleanliness of the penis and promote disease prevention.
The erect penis is better able to deliver the semen with
sperm into the female vagina through a process called
ejaculation, the forceful expulsion of semen through the
urethra. When this occurs, an involuntary sphincter near
the bladder closes so that urine cannot be released. It
only takes one sperm to fertilize the female ovum; however, there can be as many as 50 to 150 million sperm in
1 mL of semen.
Male Hormones
Hormones are substances that stimulate processes and
changes in the body. The male reproductive system functions under the control of two hormones:
FSH—follicle-stimulating hormone to promote the
r
formation of sperm.
LH—luteinizing hormone produces testosterone and
r
development of the sperm.
Testosterone
Testosterone is produced in the testes and is responsible
for development of sperm and maintenance of the male
reproductive system, but one of the primary functions is
the development of secondary sex characteristics. These
include development of the body with more muscle tissue, broader shoulders, deepening of the voice, and body
hair growth.
C
O
G
MALE REPRODUCTIVE
SYSTEM DISORDERS
Cultural Connection
There are many cultural rituals surrounding the birth
of a baby; however, one of the more recognized is
the circumcision of a male infant. Even though many
Jews may not follow all the parts of Judaism, circumcision is almost always observed. The Brit Milah,
the Covenant of Circumcision, is the celebration of
the circumcision when the actual procedure is performed on the 8th day of the child’s life. The circumcision, surgical removal of the foreskin of the penis,
is performed by a mohel (the circumciser), a Jew who
is educated in Jewish law and surgical techniques. A
regular physician does not qualify to perform the Brit
Milah unless he or she is also religiously qualied.
Even though circumcision is performed as a Jewish
rite, non-Jewish men are frequently circumcised
because of the hygienic benets. Also, circumcised
males have a lower risk of certain cancers.
The structures of the male reproductive system can
become infected and inamed, may be deformed from
birth or through injury, and are subject to developing
tumors. Table 9-1 is a list of the more common disorders
affecting the male reproductive system.
Cancer of Male Reproductive System
The most common location of cancer in the male is in
the prostate gland and the testicle.
Prostate Gland Cancer
Cancer of the prostate gland usually affects males over
50 years of age. The prostate gland is located below
the bladder and surrounds the urethra. The physician
examines the prostate by palpating the gland during
a rectal examination. If a nodule is detected, further
investigation of the gland is recommended to determine
if there is a problem with the prostate including cancer.
The physician will order a blood test to check the PSA
level, prostate-specic antigen. The PSA is a protein that
182 Section II Anatomy and Physiology
Table 9-1
Cryptorchidism Undescended testicle; could result in infertility if uncorrected; usually requires surgi-
Testicular torsion Testis rotates in the scrotum; the spermatic cord twists interfering with the blood
Phimosis Foreskin of the penis is tight and cannot be drawn back; surgical correction with
Inguinal hernia Weakened area of the abdominal wall allows part of the small intestine to pass
Epididymitis Inammation of the epididymis; may be caused by a bacterial infection, including
Prostatitis Inammation of the prostate gland; may be caused by infection or injury to the
Orchitis Inammation of the testis; may be caused from other infected area of the repro-
Genital herpes Common sexually transmitted infection (STI), formerly STD, sexually transmitted
Syphilis Caused by a spirochete, Treponema pallidum; STI that causes genital ulcers
Erectile dysfunction Inability to obtain or maintain an erection; affects men of any age, but higher
Benign prostatic hyperplasia
(BPH)
Male Reproductive System Disorders
cal correction
supply.
circumcision
through the inguinal canal into the scrotum; typically results from heavy lifting
that puts excess stress on the weakened area; surgical repair required to correct
problem
sexually transmitted infections (STIs), such as gonorrhea or chlamydia
prostate
ductive structures and following an infection from the virus that causes mumps
disease; caused by a virus characterized by blisters in the genital region
incidence with age
Nonmalignant prostate enlargement; the gland enlarges putting pressure on
the urethra, interfering with urination. Treatment includes medication to shrink the
prostate, surgical removal of the prostate, or reducing the urethral obstruction by
implanting a stent. Figure 9-8 is a comparison of a healthy prostate gland and
one that has enlarged around the urethra
increases when there is cancer in the prostate gland.
The risk factors for prostate cancer include the patient’s
age, family history and high-fat diet. The cure rate for
prostate cancer is good. Treatments include radiation
therapy, surgical removal of the prostate, or hormone
therapy.
Normal Enlarged prostate gland
Bladder
Urethra
Prostate gland
Urine
Testicular Cancer
This type of cancer typically affects young to middleaged adults. As with other cancers, early detection is the
key to a good prognosis and outcome. Testicular selfexamination is recommended for all young men and is
part of the regular physical examination by a health care
Figure 9-8 Benign prostatic
hyperplasia. (Image from Shutterstock.
com.)
Chapter 9 Urinary and Reproductive Systems 183
provider. In the event that a testicle would need to be
removed, sperm banking is recommended to preserve
sperm for future fertilization.
C
O
G
The female reproductive system consists of the primary
glands or gonads, the ovaries where the ova are matured
and several accessory organs. Figure 9-9 is a diagram of
the major female reproductive structures.
THE FEMALE
REPRODUCTIVE SYSTEM
The Ovaries
The right and left ovaries are located in the pelvic cavity near the end of the fallopian tubes. Females are born
with all the ova (eggs) they will ever produce. In the
newborn, there are more than a million immature follicles containing the eggs, which will begin to develop as
the female enters puberty. Then each month during the
female cycle, an individual ovum will mature. During
puberty, the follicles begin to develop and mature the
ova. Each month of a female’s reproductive years, a follicle will release a mature egg ready for fertilization.
Female Reproductive
AccessoryOrgans
The organs that support the female reproductive system
include the uterus, uterine tubes (fallopian tubes), and
vagina. The female breasts are also included in these
organs since they support the further nourishment of
the newborn.
The Uterus
The uterus is a muscular organ that serves only one function, to allow a fetus to develop. It is located in the pelvic
cavity between the bladder and the rectum. The upper
Figure 9-9 Female reproductive system. (Reprinted from Kronenberger J, Ledbetter J. Lippincott Williams & Wilkins’
Comprehensive Medical Assisting. 5th ed. Philadelphia, PA: Wolters Kluwer; 2016.)
184 Section II Anatomy and Physiology
Ovarian
Fundus
Body
Uterus
Cervix
Frontal view
Figure 9-10 Anterior uterus. (Reprinted from Cohen BJ. Memmler’s The Human Body in Health and Disease. 13th ed.
Philadelphia, PA: Wolters Kluwer; 2014.)
ligament
OvaryOvary
Uterine layers:
Peritoneum
Myometrium
Endometrium
Broad ligament
Cervical canal
Cervical opening
Vaginal rugae
Uterine tube
Fimbriae
region of the uterus is the body. The lower portion of
the uterus narrows toward the inferior end becoming the
cervix (neck). The superior, rounded part of the uterus is
the fundus. The uterus has three layers, the endometrium
(inner), the myometrium (muscular, middle), and the
perimetrium (outer). The endometrium is the layer that
prepares to receive the fertilized egg; however, if no egg is
implanted on the endometrial layer, the layer is shed during the monthly cycle called menstruation. Figure 9-10
is an anterior view of the uterus showing the location of
the fundus, body, cervix, and the three layers.
The Uterine Tubes
These tubes, known as the fallopian tubes, are approximately 5 inches long and extend laterally from the uterus
to an area where they end close to the ovaries. At the end
of each tube is a small extension that looks like tiny
ngers called mbriae. These extensions collect the egg
as it is released from the ovary. The egg is then carried
down the uterine tube assisted by the cilia that line the
tube. From the time the egg starts down the tube, it takes
approximately 5 days for the egg to reach the uterus.
This provides enough time for sperm to locate and fertilize the egg so it can be implanted on the uterus.
The Vagina
The vagina is a muscular tube about 3 inches long. The
cervix of the uterus is visible at the uppermost part of
the vagina. The vagina has rugae (folds) that enlarge
the size of the vagina during childbirth. The vagina
also receives the penis during sexual intercourse. The
Bartholin glands are also found just above the opening
of the vagina. These glands produce mucus that provides
lubrication during intercourse.
External Female Genitalia
The vulva and perineum make up the external female
genitalia. The external region includes the labia majora,
labia minora, and the clitoris, a small organ that is
highly sensitive to stimulation. The perineum is technically the entire oor of the pelvic cavity; in the female, it
is usually only referring to the area between the vaginal
opening and the anus.
C
O
G
THE CYCLE OF
REPRODUCTION
The female cycle is controlled by hormones that increase
and decrease causing the various stages of the cycle.
Menstruation is the most common part of the cycle
causing vaginal bleeding due to the shedding of the
endometrial lining of the uterus. The rst day of the
menstrual ow is the rst day of the cycle, which occurs
every 28 days on average; however, some women have a
cycle length between 22 and 45 days. Figure 9-11 shows
the typical 28-day menstrual cycle.
Chapter 9 Urinary and Reproductive Systems 185
Day
22
21
23
20
24
19
27
26
25
e
n
o
r
e
m
t
u
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o
C
18
17
16
28
15
1
B
r
e
Ovulation
Day
14
2
n
13
3
s
t
r
u
a
l
P
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y
s
4
e
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t
11
8
l
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e
-
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e
9
c
10
Figure 9-11 Menstruation cycle. (Reprinted
from Cohen BJ, Wood DL. Memmler’s The Human
Body in Health and Disease. 11th ed. Philadelphia,
PA: Lippincott Williams & Wilkins; 2009, with
M
e
a
k
d
o
w
permission.)
Ovulation
Ovulation is the process of releasing an egg from the
ovary follicle. There are two phases to the process:
Preovulatory phase—also known as the follicular
r
phase; it is stimulated by follicle-stimulating hormone (FSH) produced in the pituitary gland; causes
growth and maturing of the follicle; estrogen is also
released causing the endometrium to prepare for a
fertilized egg.
Postovulatory phase—also known as the luteal
r
phase; it is stimulated by luteinizing hormone (LH);
the follicle ruptures and the egg is released, ovulation;
LH also promotes the transformation of the follicle
into the corpus luteum, which secretes progesterone,
a hormone necessary to help the fertilized ovum
survive.
Menstruation
During an average cycle of 28 days, ovulation usually occurs on the 14th day, and then if fertilization did not occur, the menstrual flow starts
2 weeks later. Menstruation, also called menses, is
the shedding of the lining of the uterus, the endometrium causing bleeding. An average menstrual
cycle lasts from 2 to 6 days with an average of 4 to
5 days.
Menopause
Menopause occurs when menstruation no longer takes
place. Women can begin to experience symptoms of
menopause in their mid 40s or 50s. The ovaries gradually begin to decrease their function during this time.
Since the ovaries are no longer functioning, there is a
decrease in the amount of estrogen and progesterone
causing changes to take place in the female reproductive
organs. They begin to atrophy, and the vaginal canal
becomes dryer and more sensitive due to the lack of
mucus production. Although menopause is a normal
occurrence in all women, it brings about varying effects
or symptoms. Some of these include hot ashes, anxiety,
and insomnia. Some physicians may suggest hormone
replacement therapy (HRT) to help manage these symptoms. HRT may have benets; however, it also increases
the risk of breast cancer and development of blood clots.
C
O
G
DISORDERS OF THE
FEMALE REPRODUCTIVE
SYSTEM
The female reproductive organs are subject to conditions
including infections, menstrual disorders, and cancer.
Table 9-2 provides information about some of the most
common conditions affecting the female organs.
186 Section II Anatomy and Physiology
Table 9-2
Amenorrhea Absence of menstrual ow; may be due to lack of hormone stimulation, psychological
Dysmenorrhea Painful or difcult menstruation related with muscular cramping of the uterus; in most women,
Abnormal uterine bleeding (symptom)
Endometriosis Condition when the endometrial tissue grows outside the uterus, attaching to the ovaries,
Premenstrual syndrome
(PMS)
Vaginitis Any inammation of the vaginal canal; may be caused from bacteria, yeast, or parasite
Ovarian cysts Small ovarian uid-lled sac that forms from the corpus luteum; causes pain; however,
Genital warts Caused by HPV, human papillomavirus; linked to development of cancer in the reproduc-
Sexually transmitted
infections (STI)
Salpingitis In the female, inammation of the uterine (fallopian) tubes usually caused from gonorrhea
Pelvic inammatory
disease (PID)
Fibroids Tumors of the uterus that are usually benign; may enlarge putting pressure on surround-
Endometrial cancer Typically affects women during or after menopause; may be due to high levels of estrogen
Ovarian cancer Cancer of the ovary that might result from ovarian cysts; vague symptoms make this type
Cervical cancer Cancer of the cervix that is linked to HPV infection; the virus is sexually transmitted, so sexual
Female Reproductive System Disorders
disorders, and women who are very athletic or have dietary or eating disorders
there is no known cause unless there are other conditions present such as endometriosis
Menorrhagia is excessive bleeding; there may be other than during the menstrual cycle;
these may indicate underlying disease
peritoneum, or pelvic organs; results in inammation that may require surgical removal
of the uterus (hysterectomy) or all the reproductive organs (TAH ), total abdominal
hysterectomy
Occurs 1 to 2 wk before the start of the menstrual period; symptoms include bloating,
headache, fatigue, irritability, and depression usually due to the changes in hormone levels.
may rupture causing severe abdominal pain; may require surgery to remove ovary
(oophorectomy)
tive organs
Includes gonorrhea, genital herpes, chlamydia, syphilis, and HIV, human immunodeciency
virus; these infections may lead to infertility or, in some cases, may pass from the mother to
the fetus
or chlamydia
Infection, occasionally caused from multiple bacterial organisms, invades the reproductive
organs and into the pelvic cavity sometimes involving the peritoneum; also may result in
infertility
ing structures; some broids may be surgically removed; however, a hysterectomy may be
necessary
through HRT; cancer is determined by tissue biopsy
of cancer difcult to detect
activity at an early age and with multiple partners may contribute to the development of
this cancer; a vaccine against HPV is recommended for females from 11 to 12 y of age
C
O
G
CARING FOR THE FEMALE
REPRODUCTIVE SYSTEM
The female reproductive organs sometimes need the
attention of a gynecologist, a specialist that cares
for women’s disorders. One of the most common
procedures performed by the gynecologist is a pap
smear, Papanicolaou test, named after the inventor and Greek physician, Georgios Papanikolaou.
The procedure involves collection of cells from the
cervix for microscopic examination. This is the earliest way to detect the presence of cancer cells. All
women are encouraged to start annual testing when
they become sexually active or as soon as 18 years
of age.
Infertility
Several of the disorders of the female reproductive system may contribute to infertility, which is the inability to
achieve pregnancy. The diagnosis is not determined until
after at least 1 year of unprotected, regular sexual intercourse. Either the male or female, or both, may have a
problem that is the cause of the infertility. In the male, it
could be due to oligospermia, low sperm count. This condition could be due to infections causing blockage to the
ducts, exposure to x-rays, or even excessive heat to the
area such as a hot tub. The female who is infertile may
also have a history of infections or other abnormalities
of the reproductive organs that contribute to the infertile
environment. STI are commonly the cause of the development of scar tissue that blocks the fallopian tubes.
Chapter 9 Urinary and Reproductive Systems 187
Birth Control
Birth control is the process of preventing pregnancy
until it is desired. Contraception is the termed used to
describe an articial method to prevent the fertilization
of the egg and implantation on the uterine wall. There
are several methods of birth control that include the
following:
Surgical sterilization—in the female, tubal ligation,
r
and in the male, vasectomy; these procedures interrupt the fallopian tube (female) or the vas deferens
(male) by severing them or cauterizing the ducts.
Hormone contraception—delivered to the body by
r
pill, injection, skin patch, or implant; interferes with
the maturation of the follicle and development of the
egg, preventing ovulation.
Morning after pill—RU-486 (mifepristone) is an
r
emergency contraceptive pill that is taken within several hours of intercourse; forces the uterus to shed
its lining and release the fertilized egg; it has been
referred to as the “abortion pill.”
Condom—a sheath that ts over the penis or into
r
the vagina designed to act as a barrier for semen to
enter the female; also used as a means to protect from
transfer of STI between partners.
Abstinence—voluntarily withholding from sexual
r
intercourse in an effort to avoid pregnancy; probably
not the most reliable method of birth control.
C
O
G
So we have looked at both the male and female reproductive systems, and if all systems are working properly,
a pregnancy may occur. Now let’s see how the pregnancy
develops with the fertilization of the egg through the
birth of the baby. The normal time of gestation, period
of development, is 280 days, or 40 weeks from the rst
day of the woman’s last menstrual period (LMP). The
due date is called the estimated date of connement
(EDC). When a woman is pregnant, she will usually seek
medical care from an obstetrician, a specialist who oversees pregnancy, prenatal, delivery, and postnatal periods.
PREGNANCY AND
CHILDBIRTH
Getting Pregnant
The natural rst step in becoming pregnant is the deposit
of semen in the vagina by the male. Millions of sperm
are in the semen and their goal is to travel (swim) to
the egg and fertilize it. The egg cell (oocyte) needs to be
present in the fallopian tube where the sperm will surround it. Only one sperm will be allowed to puncture
through the cell wall and fertilize it. The head of the
sperm uses the enzymes to dissolve the coating around
the egg. Once the sperm and the egg unite, the single
cell is called a zygote, which has the 46 required human
chromosomes. The zygote now makes it way down the
uterine tube toward the uterus where it will implant and
begin to develop. After implantation on the uterine wall,
it is called an embryo.
After implantation, human chorionic gonadotropin
(hCG) is produced for about 12 weeks. This is the substance that is the indicator for pregnancy tests. The urine
pregnancy tests used in the physician’s ofce and the
home kits check for hCG in the urine. At the beginning of
the 3rd month of pregnancy, the embryo is now called the
fetus. There are two supporting structures for the fetus:
Placenta—an organ composed of a spongy network
r
of blood-lled areas and capillaries that provide
nourishment, respiration, and excretion for the fetus;
gases are exchanged, nutrients supplied, and waste
products eliminated.
Umbilical cord—the connection of the fetus to the
r
placenta; this is the blood supply for the fetus.
The Developing Fetus
The pregnancy is divided into equal 3 month segments
called trimesters. By the end of the 2nd month of pregnancy, the embryo has started to develop the heart, brain,
nervous system, and limb buds. The heartbeat is detectable by the end of the rst month, and it is the most
sensitive to harmful substances, smoking and drinking
being among the primary ones. Miscarriage, the loss
of an embryo or fetus, more frequently occurs during
this time. The fetus is contained within a sac of uid
called the amniotic sac. At birth, this sac ruptures and
the amniotic uid is released. We say that the mother’s
“water broke.” Figure 9-12 is a picture of a full-term
pregnancy with developed fetus ready for delivery.
The Pregnant Mother
One of the rst symptoms that a pregnant woman may
experience is nausea and vomiting. There are hormonal
changes taking place, and now the pregnancy needs to
supply all the required nourishment and oxygen to the
developing fetus as well as provide for the elimination
of the waste products. The mother’s body metabolism
changes to accommodate the growing fetus for these
organs:
Heart—increased blood supply pumped to the fetus
r
Kidneys—increased kidney function to excrete wastes
r
from the fetus
Lungs—increased oxygen intake and elimination of
r
carbon dioxide
Digestive—increased nutrients during pregnancy and
r
milk production following birth
188 Section II Anatomy and Physiology
Fetus
Urinary
bladder
Pubic
symphysis
Wall of uterus
Placenta
Umbilical cord
Amniotic sac
Amniotic fluid
Urethra
Vagina
Cervix
Perineum
As the pregnancy progresses, the mother may also
start to experience frequent urination and occasionally
constipation. Throughout the pregnancy, the obstetrician may perform an ultrasound to study the progression
of the fetus, the fetal age, and location of the placenta.
Ultrasonography is a safe, painless, noninvasive procedure
that uses reected high-frequency sound waves to provide
an image of the soft tissue on the monitor. It is also possible to determine some fetal abnormalities and defects.
The Birth of the Baby
The mother and baby work in concert to accomplish
the delivery of the baby. The rst event that initiates a
normal delivery is the contraction of the uterus, which
involves the following:
Uterine contractions begin as the uterine muscles
r
stimulate prostaglandins, hormone-like substances
that affect smooth muscle contraction.
The baby stimulates release of the hormone oxytocin
r
by putting pressure on the cervix further stimulating
uterine contractions; this is an example of positive
Rectum
Anus
Figure 9-12 Full-term fetus. (Reprinted
from Cohen BJ. Memmler’s The Human
Body in Health and Disease. 13th ed.
Philadelphia, PA: Wolters Kluwer; 2014.)
feedback, amplifying stimulation to accomplish a
temporary goal.
The baby’s adrenal cortex affects a decrease in the
r
mother’s progesterone and thus an increase in estrogen, which stimulates uterine contractions.
The uterine contractions signal the beginning of
labor, which has four stages:
First stage—regular uterine contractions causing the
r
cervix to become thinner; also, rupture of the amniotic sac of uid.
Second stage—complete dilation of the cervix and
r
delivery of the baby through the birth canal; should
be delivered head rst.
Third stage—delivery of the placenta, the afterbirth.
r
Fourth stage—bleeding is controlled by contraction
r
of the uterine muscles acting to close the blood vessels
where the placenta was located.
During the delivery, it may be necessary for the
obstetrician, or health care provider, to perform an
episiotomy. This is a procedure that involves making
a small incision between the vagina and the anus to
Chapter 9 Urinary and Reproductive Systems 189
increase the size of the delivery area, avoiding tearing
the vaginal opening. After the nal stage of labor, the
incision is sutured.
If there is a concern for the mother or baby completing
a normal vaginal delivery, a
cesarean section (C-section)
may be performed. This involves a surgical incision made
in the abdominal wall and uterus to remove the baby.
The decision to perform a C-section may be due to the
abnormal position of the fetus with the buttocks presenting rst, not the head, or if the fetus is too large to safely
deliver through the vaginal canal. A woman may start to
have premature labor causing risk to the fetus. C-section
also ensures a speedy delivery, taking only a few minutes.
Multiple Births
Occasionally, a pregnancy will produce more than one
baby. Multiple births include twins, two babies; triplets,
three babies; quadruplets, four babies; and quintuplets,
ve babies. Many of the multiple births have resulted
from the use of fertility drugs. There have been multiple births that result in more than ve babies; however,
these are not very common and are extremely high risk
for the life of the mother and the babies. Since twins are
the most common multiple birth scenario, there are two
types of twins:
Fraternal twins—different individuals result from fer-
r
tilization of two different eggs and by two different
sperm; each fetus has a placenta and amniotic sac.
Identical twins—always the same sex and have the
r
same traits (appear alike); develop from a single egg
and sperm; however, during development, the embryo
separates into two units; there is a single placenta but
a separate umbilical cord for each fetus.
Pregnancy Conditions
There is joy at the birth of a healthy, bouncing baby;
however, there are also situations and conditions that
may lead to complications. The initial health and condition of a newborn is determined by an Apgar score. The
infant is graded on its respiration, heart rate, color, and
responses to stimulation. A maximum Apgar score is 10,
and babies with a low Apgar require immediate medical
attention. Table 9-3 lists some of the terms used during
pregnancy and the various situations encountered.
The Female Breasts
Following the delivery of the infant, the mother will experience changes in the breasts as they prepare to nurse the baby.
The mammary glands, in the breasts, provide the nourishment for the baby. The mammary glands are composed of
several lobes, which secrete the milk through the lactiferous
ducts. The rst amount of milk that is secreted is very thin,
watery liquid called colostrum. The most nutritious milk
will not be available for several days following the birth.
Most pediatricians, baby doctors, will recommend nursing
Table 9-3
Term infant Infant born at full gestation period of 37–42 wk
Live birth Infant delivered and able to breathe unassisted and has heartbeat
Preterm Infant born prior to 37 wk; called premature and usually weighs <5 pounds; may have breathing
Spontaneous
abortion
Induced abortion A deliberate interruption of the pregnancy
Stillbirth Death of the baby after 24 wk but before birth; intrauterine means the fetus died while in the uterus
Ectopic
pregnancy
Placenta previa Placenta attaches too close to the internal opening of the cervix; risk of premature detachment
Abruptio
placentae
Gestational
diabetes mellitus
Preeclampsia Also known as pregnancy-induced hypertension (PIH); later in the pregnancy, the mother experi-
Postpartum
depression
Pregnancy Conditions
problems; the term viable means able to live outside the uterus
Also known as a miscarriage; occurs naturally; however, may be the result of chromosome abnormalities or maternal diseases including infections and chronic disorders (diabetes); abortion is a
general term that means the loss of the embryo or fetus prior to week 20 of the pregnancy
Develops outside the uterine cavity; most common location is in the uterine tube (tubal pregnancy); the tube will eventually rupture if not surgically removed; more prevalent in women with
history of PID and endometriosis
of the placenta risking the fetal blood and oxygen supply
Premature separation of the placenta from the uterine wall causing hemorrhage; may require
termination of the pregnancy
Diagnosis of diabetes only during pregnancy; most return to normal following the delivery; however, some women may go onto develop type 2 diabetes
ences high blood pressure and proteinuria (protein in the urine)
A psychologic condition that occurs within the rst year following childbirth; may be due to hormonal changes and stress of the new family
190 Section II Anatomy and Physiology
an infant for the rst few weeks to months because of the
immune properties (antibodies) of the mother’s milk that
are passed on to the baby. Nursing an infant also ensures
bonding between the mother and the infant.
Breast Disorders
One of the most common types of cancer occurring in
women is breast cancer. The common factors that increase
the chances of developing breast cancer is the age of the
women, over 40 years of age, family history, and long-term
use of hormones. A growth in the breast may be benign or
malignant, so all masses should be investigated. A
mogram
is an x-ray study of the breast and will detect
mam-
even small growths. A physician may want to perform
a needle biopsy of the growth to collect cells for microscopic examination. Treatment of breast cancer includes
radiation and chemotherapy and surgical removal of
Preparing for Externship
As you approach your externship, keep your eye on
the “prize.” In this case, the prize is successful completion of the externship and on to graduation. Don’t
let anything interfere with your ability to be successful during the externship course. Sometimes there are
issues that arise that are caused by personality conicts. Even though the medical ofce accepts extern
students, not all the ofce staff may be excited about
the prospect of having a student in the ofce for a few
weeks. When a student is in the ofce, the other medical assistants may feel burdened by the responsibility
of watching over the new student. You can be more
assertive asking what you can do to assist everyone
the lump or the entire breast (mastectomy). Mastitis,
inammation of the breast, is also a condition caused by
an infection. The mammary glands become infected and
painful. Antibiotics are used to treat this condition.
Study Skill
As an educator, I frequently ask students if they
studied for an exam and 9 times of 10, I get the
answer “yes, I studied for hours.” Research has
shown that students do better retaining information when they study in blocks of time usually no
more than 1 hour at a time. Make a study schedule
and stick to it. Organize a study location and try to
do your studying in that same location, around the
same time. This plan helps you build a good study
habit. Good habits usually equal success.
and not seem like extra work for the staff. There may
be a staff member who feels threatened about losing
his or her job to a new employee. That new employee
just might be you. If there is a specic incident that
causes conict between you and a staff member, do
not argue and make the matter worse. Talk with your
school instructor or externship coordinator about the
situation and the best way to handle it. When a negative situation arises, a student may ask to be moved
to a new extern site but that is not the best solution.
Try to nd a way to resolve the conict. You cannot always avoid a situation and run away from it. Become
the professional and work toward a win–win result.
Chapter Recap
● The urinary system is another vital system in the body,
which helps to maintain homeostasis by regulating
uid and electrolyte balance.
● The nephron is the microscopic, functional unit of the
kidney and the structure that actually produces the urine.
● The kidneys are constantly ltering blood, as much as
180 L of plasma (liquid part of the blood) each day.
● Urine is 95% water, and the rest of it is dissolved
solids and gases.
● The urinary tract from the kidneys to the urethra can be
affected by infections, structural problems, and cancer;
however, urinary tract infections (UTIs) are probably
the most common condition affecting the urinary tract.
● The male reproductive system produces the sperm
and delivers it to the female in order to fertilize the
female ova (eggs) resulting in reproduction of the
human species.
● The testes are the male gonads (sex glands), and the
ovaries are the female gonads.
● The male and female may experience infertility due
to infections or underlying diseases that alter the
ability of the organs to function properly.
● Both the male and female reproductive organs
are at risk to the development of various types of
cancer.
● During pregnancy, there are many conditions that
can affect the development of the fetus to term.
● The mother’s breasts are the primary accessory
organs that support the infant in the early stages of
development after delivery.