January 23, 2012

1. NOTE:This is Handout #1 of 2Be sure to also print out Handout #2 January 23, 2012 Nursing 330 Human Reproductive Health

2. Office Hours • Mondays, 5:30pm – 6pm • Salazar Hall • Turnitin • Class ID: 4691909 • Password: NURS330 • Course Packets

3. Course Website • Syllabus • Reading Assignments • Essay • Extra Credit • Quarter Schedule • Lecture Notes • Print out or download on to laptop • May be taken down at anytime so it is your responsibility to print or download before each lecture

4. Essay • Reproductive Health issue in a current mainstream newspaper or magazine article (journal articles are not acceptable) • 50 points • Due 2/27/12 ( Turnitin –AND- In Class) • Article • Should be dated between December 5, 2011 – February 27, 2012 • Bring articles to class for approval (1/30/12 – 2/20/12)

5. Essay (cont) • Sample topics: Puberty, Menopause, Male Climacteric Syndrome, Cancer – breast, cervical, testicular, prostate, Rape, Sex Education, Abortion, Female Genital Mutilation, Pregnancy, STDs & HIV, Infertility, Breast Feeding, Contraception, Population Control, Same Sex Marriages, Sexuality. • If you have other topics not listed here, submit it to the instructor for review and approval • Answer specific questions

6. Extra Credit (EC) Up to 25 points To be done throughout the quarter May only submit one EC per lecture Last day to submit EC: 3/5/12

7. Extra Credit (cont) Five Options Reproductive Health Exam/STD screening – 15 points 5K/10K Health Walk/Run/Bike Ride– 15 points Volunteer Work – 10 points Attend a Workshop – 10 points Humor – 5 points May only complete one option once

8. Important Dates Mid-term: February 13, 2012 EssayDue: February 27, 2012 • Electronically [Turnitin] • Hard Copy + Article [In Class] Extra Credit Due: March 5, 2012 Final Exam: March 19, 2012

9. Puberty

10. Puberty • Not a synonym for adolescence • Defined as the biological state when reproduction becomes possible • Refers to physical changes that occur during adolescence

11. Puberty (cont) • Pubertal changes in girls begin between ages 9 and 14. • Pubertal changes in boys generally begin about 2 years later than in girls.

12. Physical occurrences from puberty • Growth Spurt • The primary sex characteristics develop • The secondary sex characteristics develop

13. Growth Spurt 1. Limbs 2. Body’s trunk 3. Shoulders and chest • Bones become harder and more dense • Muscle and fat contribute to an adolescent increase in weight

14. Girls Develop Breast Acquire Hips Higher fat to muscle ratio Boys Wider shoulders More muscular neck Lose fat during adolescence Body Composition

15. Primary Sex Characteristics • Differences in male and female anatomy which are present at birth • –ovaries and testes • Defined as the change necessary to prepare girls’ and boys’ bodies to produce children • Marker events • Girls • Menarche • Boys • Spermarche • As the primary sex organs mature, the secondary sex characteristics distinguish males from females

16. Secondary Sex Characteristics • Defined as changes that make boys and girls look like mature men and women • Girls -Breast Development -Body Odor -Body fat -Body Hair • Boys -Voice Deepens -Body Odor -Shoulders broaden -Body Hair

17. Phases of Development - girls

18. Phases of Development - boys

19. Nocturnal Emissions • Aka • Wet Dreams • Involuntary Orgasm • An ejaculation of semen experienced during sleep

20. Hormones • Estrogen • Responsible for many changes that occur during puberty. • Cause the breasts, uterus, and vagina to mature and the body to take feminine proportions • Contribute to regulation of the menstrual cycle • Testosterone • Responsible for changes of male puberty • Leads to muscle growth, body and facial hair, and other male sex characteristics • Contributes to gains in body size

21. Sexual Anatomy & Physiology

22. Female Sex Organs: • All embryos appear as female at first. Genetic and hormonal signals trigger the development of male organs in those embryos destined to be male. • Sex organs serve a reproductive purpose, but they perform other functions also: giving pleasure, attracting sex partners, and bonding in relationships.

23. Vulva • The external female genitals are known collectively as the vulva. It includes: • Mons pubis • Clitoris • Clitoral Hood (or Prepuce) • Labia Majora • Labia Minora • Urethral Opening • Anus

24. Vulva (cont) • mons pubis is a pad of fatty tissue that covers the area of the pubic bone. • clitoris is the center of sexual arousal in the female. • labia majora (outer lips) are two folds of spongy flesh extending from the mons pubis and enclosing the other external genitals. • labia minora (inner lips) are smooth, hairless folds within the labia majora that meet above the clitoris.

26. Female Genital Mutilation (FGM) • aka Female Circumcision • What is it? • Types • Areas where it is practiced

27. What is FGM?

28. Types of FGM • Type I • excision of the prepuce, with or without excision of part or all of the clitoris • Type II • excision of the clitoris with partial or total excision of the labia minora

29. Types of FGM (cont) • Type III • Aka infibulation; the most extreme • excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening • Type IV • pricking, piercing or incising of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization by burning of the clitoris and surrounding tissue

30. Where is FGM practiced? Over 28 African countries Parts of the Middle East Parts of Asia

31. Internal Organs The internal female sexual structures and reproductive organs include: • Vagina • Uterus • Cervix • Ovaries • Fallopian tubes

32. The Vagina • A flexible muscular organ, approximately 3-4 inches long (in unaroused state) that has the vaginal opening at one end and the cervix at the other. • Purpose of the vagina: • Menstruation • Childbirth • Intercourse

33. The Vagina (cont) • Introitus or Vaginal Os • The opening of the vagina • Hymen • a thin, perforated membrane, that covers the introitus prior to first intercourse or other intrusion. • a Greek word meaning "virginal membrane" or "thin skin".

34. Cervix • Located between the vagina and the uterus • Cervical Os • Opening to the vagina • Allows menstrual blood to flow out of the uterus into the vagina

35. Uterus • Also known as the womb • A pear-shaped organ located between the bladder and the lower intestine • Consists of three parts • Body of the uterus (about the size of a fist in a non-pregnant female) • Cervix • Fundus • Endometrium • Lining of the uterus • is built up and then shed and expelled through the cervical os (opening) during menstruation.

36. Ovaries • Egg-producing organs • Hold between 200,000 and 400,000 follicles (sacks) • Found on each side of the uterus

37. Fallopian Tube • Also known as the Uterine Tube or Oviduct • Two leading off each side of the uterus • Site of fertilization

38. G-Spot • Controversial research has posited the existence of an erotically sensitive area, the Grafenberg spot (G-spot), on the front wall of the vagina midway between the introitus and the cervix.

39. Female Sexual Physiology • At birth, the human female’s ovaries contain 400,000-700,000 female gametes (sex cells). • During puberty hormones trigger the completion of oogenesis, the production of oocytes, commonly called eggs or ova.

40. The Menstrual Cycle • Follicular (Proliferative) phase • Days 1 through 6 • Beginning of menstrual flow to end of blood flow • Days 7 – 13 endometrium thickens • Luteal (Secretory) phase • aka premenstrual phase • Days 15 to 28 • The endometrium thickens to prepare the egg for implantation • These two phases are separated by: • Ovulation • Day 14

41. Ovulation • The process in the menstrual cycle by which a mature ovarian follicle ruptures and releases an ovum (also known as an egg or an oocyte) • The released egg, unless fertilized, only lasts 12 to 24 hours.

42. Menstrual Cycle • Order of the Menstrual Cycle: • Menstrual → Proliferative → Secretory • The menstrual cycle is divided into 3 phases. 1. Menstruation 2. Proliferative Phase: Endometrial tissue builds up during this phase 3. Secretory Phase: Produces nutrients to sustain an embryo

44. Corpus Luteum • A mound of yellow tissue • Develops as a result of the ruptured follicle • During pregnancy, it serves to produce estrogen and progesterone

45. If fertilization occurs, • Fertilized egg attaches to blanket of blood vessels which supplies nutrients for the developing placenta. Corpus luteum continues to produce estrogen and progesterone. • If fertilization does NOT occur: • Corpus luteum deteriorates. Estrogen and progesterone levels drop. The blood vessel lining sloughs off and menstruation begins.

46. Hormones • Hormones are chemical substances that serve as messengers, traveling through the bloodstream.

47. Hormones • Pituitary Hormones • Luteinizing Hormone (LH) • Follicle Stimulating Hormone (FSH) • Ovarian Hormomes • Estrogen • Progesterone

48. Reaches uterus about 2-4 days after ovulation Movesslowlytowarduterus Sweptinto fallopian tube Releasedfrom follicle The Path of the Egg • Released from follicle • Swept into fallopian tube • Moves slowly toward uterus • Reaches uterus in about 4 days The egg, unless fertilized, only survives 12-24 hours.

49. PMS • Premenstrual syndrome (PMS) is a group of symptoms related to the menstrual cycle

50. PMS • Physical and emotional disorder • Caused by hormonal changes • Widely recognized as a medical condition • 85% of menstruating women have at least one symptom • 5-10% debilitating symptoms • Symptoms present two weeks before menstruation