female reproductive system

• External genitalia


  Structures that can be readily identified through inspection

  
• Internal genitalia


  Female reproductive organs

  
• Reproductive System Functions


  • Production of gametes
  • Fertilization
  • Development and nourishment of a new individual
  • Production of reproductive hormones
• Female Reproductive System


  • Ovaries
  • Uterine tubes
  • Uterus
  • Vagina
  • External genitalia
  • Mammary glands

  
• Vulva


  External female sex organs including mons pubis, labia majora and minora, clitoris, and vestibule

  
• Mons pubis


  Fatty layer of skin covering pubic symphysis
• Labia majora


  Larger, outer folds of skin, equivalent to male scrotum
• Labia minora


  Thin, inner folds of skin
• Clitoris


  Small erectile structure located in vestibule, equivalent to male penis
• Prepuce


  Where 2 labia minora unite over clitoris
• Vestibule


  Space in which vagina and urethra are located
• Ovaries


  • Primary female reproductive organ
  • Produces oocytes and sex hormones
  • One on either side of uterus
  • Ovarian ligaments anchor ovaries to uterus
  • Suspensory ligaments anchor ovaries to pelvic cavity
  • Ovarian follicle: cells in ovaries that contain oocytes
• Uterine (Fallopian) tubes


  • Part of uterus which extends toward ovaries and receive oocytes
  • Fimbriae are fringe-like structures around opening of uterine tubes that help sweep oocyte into uterine tubes
  • Tubal ligation (sterilization of female)
• Uterus


  • Pear sized structure located in pelvic cavity
  • Functions: receive, retain, and provide nourishment for fertilized oocyte, where embryo resides and develops
  • Body: main part
  • Cervix: narrow region that leads to vagina

  
• Uterus wall layers


  • Perimetrium (serous): outermost layer
  • Myometrium (muscular): middle layer composed of smooth muscle
  • Endometrium: innermost layer that is sloughed off during menstruation
• Vagina


  • Extends from uterus to outside of body
  • Female copulation organ that receives penis during intercourse
  • Allows menstrual flow
  • Involved in childbirth
  • Contains very muscular walls and a mucous membrane
  • Very acidic to keep bacteria out
• Estrogen


  • Proliferation of endometrial cells
  • Development of mammary glands (especially duct system)
  • Control of LH and FSH secretion
  • Development and maintenance of secondary sex characteristics
• Progesterone


  • Enlargement of endometrial cells and secretion of fluid from uterine glands
  • Maintenance of pregnancy state
  • Development of mammary glands (especially alveoli)
  • Control of estrogen, FSH, and LH secretion
  • Development of secondary sex characteristics
• Cervical Cancer Risk Factors


  • Human papilloma virus (HPV) infection
  • Smoking
  • Immunosuppression
  • Chlamydia infection
  • Diet low in fruits and vegetables
  • Being overweight
  • Intrauterine device use
  • Having multiple full-term pregnancies
  • Being younger than 17 at first full-term pregnancy
  • Poverty
  • Having a mother who took diethylstilbestrol (DES) while pregnant
  • Family history of cervical cancer
• Cervical Cancer Risk Reduction


  • Avoid risky sexual practices
  • Get HPV vaccination
  • Follow USPSTF guidelines for routine Pap smears
  • If mother took DES, maintain careful preventive screening schedule
  • Eat nutritious food and have routine care for illnesses that weaken immune system
  • Talk to partner about sexual health expectations
• The lowest cervical cancer rates are found in Eastern Mediterranean countries
• An unusually high rate of cervical cancer was found in the African region where income levels tend to be low
• Teaching Opportunity: Risk Reduction


  • Establish trusting relationship with client during exam
  • Teach self-examination
  • Explain that self-examination helps detect abnormalities early
• History of Current Health Problem


  • Menstrual cycles
  • Age at time of first menstrual period
  • Menopause
  • Vaginal discharge
  • Pain or itching in genitalia or groin
  • Lumps, swelling, or masses in genitalia or groin
  • Urinating difficulty, changes in urine color, or developed an odor
  • Difficulty controlling urine
  • Sexual performance
  • Sexual activity pattern
  • Fertility problems
• Past and Family History


  • Previous gynecologic problems and results of any treatment
  • Date of last pelvic exam by a physician
  • Date of last Pap smear and results
  • Fever diagnosed with STD
  • Pregnancies
  • Reproductive or genital cancer
• Lifestyle and Health Practices


  • Smoking
  • Sexual partners
  • Contraceptives
  • Genitalia problems
  • Sexual preference
  • Comfort level in communication about sexuality
  • Fears and stress with sex
  • Fertility concerns
  • Menopause concerns
  • Genital self-exam
  • HIV results
  • Estrogen replacement
  • Toxic shock syndrome
  • Sexually transmitted diseases
• Equipment


  • Stool
  • Light
  • Vaginal speculum
  • Water-soluble lubricant
  • Large swabs for vaginal examination
  • Nonsterile gloves
  • Bifid spatula
  • Endocervical broom
  • pH paper
  • Feminine napkins
  • Hand-held mirror
• Physical Assessment: External Genitalia


  • Inspection: Mons pubis, Labia majora and perineum, Labia minora, clitoris, urethral meatus, and vaginal opening
  • Palpation: Bartholin glands, Urethra

  
• Physical Assessment: Internal Genitalia


  • Inspection: Vaginal opening, Vaginal musculature, Cervix, Vagina
  • Bimanual examination: Palpation of the cervix, the uterus, the ovaries
  • Rectovaginal examination

  
• Findings


  • External genitalia and vaginal opening
  • Cervix
  • Vaginitis
  • Uterine enlargement
  • Adnexal masses

  
• Common Variations in Positions of the Uterus
• Older Client Findings


  • Vaginal infection because of atrophy of the vaginal mucosa
  • Gray, thinning pubic hair
  • Cervix appears pale after menopause
  • Urinary incontinence from muscle weakness or loss of urethral elasticity
• Data Analysis


  • Nursing diagnoses
  • Collaborative problems
  • Referrals