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Female Reproductive System
Transcript of Female Reproductive System
The Female Reproductive System
Infants and Adolescents During childhood the ovaries are located in the abdomen. The uterus is small with a straight axis and no antiflexion. At puberty,estogens stimulate the growth of cells in the reproductive tract and the development of secondary sex characteristics. First signs of puberty are breast and pubic hair development between the ages of 8 1/2 and 13.
Menarche occurs during the latter half of this sequence. Irregularity of the menstrual cycle is common during adolescene because the girl's occasional failure to ovulate.
With menarche , the uterine body flexes on the cervix. The ovaries now are in the pelvic cavity. Sex Maturity ratings (smr) in Girls Stage 2: Growth sparse and mostly on labia, downy hair, slightly pigmented, straight or only slightly curly Stage 3: Growth sparse and spreading over mons pubis. Hair is darker, coarser, curlier Stage 4: Hair is adult in type but over smaller area; none on medial thigh Stage 5: Adult in type and pattern; inverse triangle. Also on medial thigh surface. Stage 1: Preadolescent. No public hair. Mons and labia covered with fine vellus hair as on abdomen. The Pregnant Female Shortly after the first missed menstrual period, the genitalia show signs of the growing fetus
The cervix softens (Goodell's sign) at 4 to 6 weeks, and the vaginal mucosa and cervix look cyanotic (Chadwick's sign) at 8 to 12 weeks. These changes occur because of increased vascularity and edema of the cervix and hypertophy and hyperplasia of the cervical glands. The isthmus of the uterus softens (Hegar's sign) at 6 to 8 weeks.
The uterus increases capacity by 500 to 1000 times its nonpregnant state because of hormone stimulation and increasing size of contents.
A clot of thick mucus forms in the spaces of the cervical canal (the muscus plug), which protects the fetus from infection.
The mucus plug dislodges when labor begins at the end of term, producing a sign of labor called "bloody show."
Cervical and caginal secreations increase during pregnancy and are thick, white, and acidic.
The increased acidity occurs because of the action of Lactobacillus acidophilus, which changes glycogen into lactic acid.
The acidic pH keeps pathogenic bacteria from multiplying in the vagina, but the increase in glycogen increases the risk of candidiasis ( commonly known as yeast infection) during pregnancy.
The Aging Adult Menapause
Uterus shrinks in size because of decreased myometrium.
The ovaries atrophy to 1 to 2 cm and are not palable after menapause.
The sacral ligaments relax and the pelvic musculature weakens, so the uterus droops The cervix shrinks and looks paler with a thick, glistening epithelium
The vagina becomes shorter, narrower, and less elastic because of increased connetive tissue.
The vagina eputhelium atrophies becomes thinner, drier and itchy.
Excitment: Reduced amount of vaginal secretion and lubrication
Plateau: Less expansion of vagina, Labia majora do not elevate against perineum, size of clitoris decreases after age 60
Orgasm Resolution: shorter duration, occurs more rapidly
Subjective Data Mentrual History
STD risk reduction objective Data Infants and Children Preparation:
Infants-place on examination table
Toddler/Preschooler-place on parents lap. Frog-leg position. Preshooler may want to separate her own labia. No drapes the young girl wants to see what you are doing.
School-age child-place on examination table. Frog-leg position, no drapes.
During childhood, a routine screening is limited to inspection of the external genitalia to determine 1) the strutures are intact 2) the vagina is present and 3) the hymen is patent The Newborn's gentalia are somewhat engorged. The labia majora are swollen, the labia minora are prominent and protrude beyond the labia majora, the clitoris looks large and the hymen appears thick.
A sanguineous vaginal discharge or leukorrhea (mucoid discharge) are normal during the first few weeks because of the maternal estrogen effect. Between ages of 2 months and 7 years, the labia majora are flat, the labia minora are thin, the clitoris is relatively small, and the hymen is tissue- paper thin. In the young-school age girl, the mons pubis thickens, the labia majora thicken, and the labia minora become slightly rounded. Pubic hair begins to appear around the age of 11 years. The hypmen is normally perforate. The Adolescent Exam her alone, without the mother present. Assure her of confidentiality and privacy.
Allow plenty of time for health education and discussion of pubertal progress.
Asses her growth and mentrual history and use SMR charts to teach brest and pubic hair development The first experience of the first pelvic examination determines how the adolescent will approach future care. The Aging Adult With bimanual examination, you may need to insert only one gloved finger if vaginal stenosis exists. The uterus feels smaller and firmer, and the ovaries are not normally palpable Summary Checklist: Female Genitalia Exam 1. Inspect external genitalia
3.Inspect cerivx and Vagina
4.Obtain specimens for cytologic
5.Perform bimanual examination: cervix, uterus, adnexa
6.Perform rectovaginal examination
7.Test stool for occult blood
Abnormal Findings Perdiculosis Pubis (Crab Lice)
Herpes Simple Virus-Type 2 (Herpes Genitalis) Syphilitic Chancre Red Rash-Contact Dermatitis Human Paplillomavirus (HPV) Genital Warts Abscess of Bartholin's Gland Urethral Caruncle Cystocele (with prolapse)
Rectocele Uterine Prolapse Polyp Carcinoma Gonorrhea Myths About STD's