*On days 1-5 of the cycle, the Endometrium sloughs off, accompanied by 1-2 ounces [30-60 mL] of blood loss. *Ther Anterior Pituitary Gland begins to release follicle-stimulating hormone [FSH]; as the level of FSH increases, the egg matures within the graafian follicle [a pocket or envelope shaped structure where the ovaries prepare the ovum

What occurs during the Preovulatory phase?

*Days 6-13 Estrogen is released from the maturing graafian follicle. This Estrogen causes vascularization of the uterine lining. *On day 14, the Anterior Pituitary Gland releases luteinizing hormone [LH], which causes the rupture of the graafian follicle and release of the mature ovum.

What are the parts of the male and female reproductive system and function?

Male: Testes "testicles" Accessory Glands: *Seminal Vesicles *Prostate Gland *Cowper's Glands Female: Ovaries, Fallopian Tubes, Uterus *The endometrium *The myometrium *The perimetrium

What occurs during the Postovulatory phase?

During days 15-28, the developing corpus luteum releases Estrogen and Progesterone

What happens when pregnancy occurs during the Postovulatory phase? what does it maintain?

The corpus luteum continues to release estrogen and progesterone to maintain the uterine lining until the placenta is formed, which then takes over the job of hormonal release

What do the finger like projections of the fallopian tubes [fimbriae] sweep during the Preovulatory phase?

The ovum into the fallopian tube

During the Preovulatory phase, what happens once the ovum matures and expels?

The follicle is transformed into a glandular mass called the Corpus Luteum

What happens if pregnancy does not occur during the Postovulatory phase?

The corpus luteum lasts 8 days and then disintegrates *Normally corpus luteum shrinks and is replaced by scar tissue called corpus albicans. At this point, the hormone level decreases over several days and menstruation starts again

What age does menstruation begin?

"Menarche", the 1st menstrual cycle usually begins at approx 12 yrs of age. Each month, for the next 30-40 yrs, an Ovum matures and is release about 14 days before the next menstrual flow, which occurs on average every 28 days

If fertilization occurs, mentrual cycling subsides and the

Body adapts to the developing fetus

What are the layers of the Uterus in the female system?

*Endometrium *Myometrium *Perimetrium

Is the inner layer that lines the uterus. It is made up of glandular cells that make secretions. [layer of the uterus]

Endometrium

Is the middle and thickest layer of the uterus wall. It is made up mostly of smooth muscle. [layer of the uterus]

Myometrium

Is the outer serous layer of the uterus [layer of the uterus]

Perimetrium

What are the male accessory glands?

*Seminal Vesicles *Prostate Gland *Cowper's Glands

Are paired structures that lie at the base of the bladder and produce 60% of the volume of semen. The fluid is released into the ejaculatory ducts to meet with the sperm [accessory gland]

Seminal Vesicles

The single doughnut shaped prostate gland surrounds the neck of the bladder and urethra. Firm size of a chestnut composed of muscular and glandular tissue [accessory gland]

Prostate Gland

Are two pea sized glands under the male urethra. Corresponds to Bartholin's glands in women and provide lubrication during sexual intercourse. [accessory gland]

Cowper's Gland

The sense of being feminine or masculine. As soon as the infant is born, the outside world labels child as girl or boy. Adults adjust their behavior to relate to a female or male infant. Varied patterns of intertaction influence the infant's developing sense of gender identity. [sexual identity]

Gender identity

The manner in which a person acts as a woman or man. Many believe that society influences female and male behavior and is thus the primary source of femaleness or maleness. Because society encourages certain behaviors according to one's gender, differences between individuals sexual behaviors develop. Sexual behavior is a combined interaction of biologic and environmental factors. [Sexual identity]

Gender Role

The clear and persistent orotic desire of a person for one sex or the other. There are heterosexual, homosexual, lesbian, and bisexual individuals but the origins of sexual orientation are still not understood.

Sexual orientation

For some people, the inward sense of sexual identity does not match their biologi body. These people are known as

Transgendered *Researchers do not clearly understand how this mismatch occurs. Transgendered ppl do not see their sexual identity as a choice; it is a clear and persistent orientation dating back to early childhood

Most often a heterosexual man who periodically dresses like a woman, however, may be a homosexual

Transvestite *Cross dressing usually is done in private and kept secret from those closest to him

What is sexuality linked to?

Every aspect of living, any sexual choice involves personal, family, cultural, religious and social standards of conduct

What are important examinations for women?

Pap and human papilloma virus (HPV) tests. ... Sexually transmitted diseases (STD) tests. ... Pregnancy test. ... Mammogram. ... Skin check. ... Colonoscopy. ... Bone density test. ... Hearing test.

What are Endoscopic procedures for visualization of pelvic organs? *Endoscopic: is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body.

*Colposcopy; Visualization of vagina and cervix under low power magnification *Culdoscopy; Insertion of a culdoscope through posterior vaginal vault into Douglas's cul-de-sac for visualization of fallopian tubes and ovaries *Laparoscopy; Insertion of a laparoscope with patient under general anesthesia through small incision in abdominal wall inferior margin of umbilicus then insufflation of abdomen with carbon dioxide permits visualization of all pelvic organs

What can douching or having intercourse within 24 hrs of a Colposcopy exam do?

May mask abnormal cells and reduce the specimens available for collection. Prepare pt and explain procedure

What do you encourage pt to do before a Colposcopy?

Void or have a bowel movement *A speculum is inserted into the vagina, may be swabbed with an iodine or vinegar solution to remove surface mucus to improve visualization

What is a Colposcope?

A microscope adapted to visualize the vaginal walls and cervix

Procedure usually not performed during menstruation and tissue color, presence of growths and lesions and vascular condition are

Observed and specimens obtained as necessary

A diagnostic procedure that provides visualization of uterus and uterine appendages [ovaries, and fallopian tubes], pt given local spinal or general anesthetic *Areas examined are; tumors, cysts, and endometriosis

Culdoscopy *Pt will be assisted in knee chest position

During a Culdoscopy, conization which is a

Removal of eroded or infected tissue may be done, generally is performed on an outpatient basis. After operation, you assess for bleeding vital signs and monitor voiding

Examination of the abdominal cavity with a laparoscope inserted through small incision beneath the umbilicus. Provides direct visualization of the uterus and its appendages

Laparoscopy *Preparation includes insertion of a foley catheter to maintain bladder decompression for an open view and done with general anesthesia

Carbon dioxide may be introduced during a Laparoscopy to

Distend the abdomen for easier visualization. If biopsy is to be done or organs are to be manipulated, a 2nd incision may be made in the lower abdomen to allow for instrument insertion

What are the ovaries and fallopian tubes observed for during a Laparoscopy?

Masses, Ectopic pregnancy, Adhesions, and Pelvic Inflammatory PID *Tubal ligations may be done using this procedure *Instruct pt of shoulder pain afterward because of carbon dioxide introduced into abdomen

A simple way to detect cervical cancer in women. Speculum is used to widen the vagina allowing access to the cervix. Exfoliate and peeling and sloughed off tissue or cells are collected from the cervix stained and examined

Papanicolaou test [Pap Smear] *traditional paps, cells are spread on a glass slide and then sprayed with a fixative and sent to the lab for analysis *In newer paps, such as sure path and thinprep, specimens are obtained and then rinsed in a liquid solution

Which pap smear is said to being more effective in the diagnosis of cancer?

Newer paps such as Thinprep and Sure path tests

How should the specimens for pap smears be labeled?

Date, time of last menstrual period, and whether the woman is taking estrogen or birth control pills *Instruct pt to not douche use tampons or vaginal meds or intercourse for at least 24 hrs before the examination

What does the American Cancer Society highly recommend?

Every woman begin annual pap tests within 3 yrs of becoming sexually active or no later than 21 yrs of age

How often should women be tested for pap smears?

Every year for regular pap smears, or every 3 yrs for thinprep pap test *Women age 30 or older may choose to have pap screening every 3 yrs or if combined with HPV screening every 5 yrs instead of annually

Women age 65 or older who have had screening over the past 10 yrs with normal findings may decide to stop having

Cervical screenings

Women who have had a hysterectomy may stop having

Cervical cancer screenings unless their surgery was done as a treatment for cervical cancer or precancerous cells

Why may the provider recommend more frequent testing for some women?

If they have history of multiple sexual partners or sexually transmitted infections STI's, a family history of cervical cancer or those whose mothers used diethylstilbestrol during pregnancy

Why is the Bethesda system preferred?

Allows better communication between the cytologist and the clinician. This system evaluates the adequacy of the same and provides a general classification of normal or abnormal findings and a descriptive diagnosis of the pap smear

Pap tests have long been used to look for what?

Cervical cancer and precancerous cells

Nearly all cases of cervical cancer can be attributed to

High risk types of HPV

How many types of HPV have been identified as being high risk?

Procedures in which samples of tissue are taken for evaluation to confirm or locate a lesion. Tissue is aspirated by special needles or removed by forceps or through an incision

Biopsy

What is a breast biopsy performed for?

Differentiate between benign or malignant conditions of the breast *Breast biopsy is indicated for pts with palpable masses; suspicious areas appearing on mammography and persistent encrusted purulent inflamed or sanguineous discharge from the nipples

If the mass of the breast is palpable, the procedure is typically done on an

Outpatient basis

Biopsy may be performed by

* Fine needle aspiration * Stereotactic or ultrasound guided core needle biopsy * Open surgical biopsy

Fluid is aspirated from a palpable breast mass and expelled into a specimen bottle. Pressure is placed on the site to stop the bleeding, and an adhesive bandage is applied. May or may not require a local anesthetic and typically done in health care office

Fine needle aspiration

A reliable diagnostic technique to obtain a breast biopsy if an abnormal mass is seen on the mammogram. Skin is anesthetized and small incision is made. A biopsy gun is used to fire the core needle into the lesion to remove sample of the mass. Compared with an open surgical biopsy, procedure produces less scarring requries only local anesthesia less expensive and done on outpatient basis

Stereotactic or ultrasound guided core needle biopsy

What must be advised to patients with stereotactic or ultrasound guided core biopsy?

Stop aspirin or blood thinning products and to avoid talcum powder and deodorant the day of the procedure

An excisional biopsy usually is performed in a portion of the breast to expose the lesion and then remove the entire mass Specimens of selected tissue may be frozen and stained for rapid diagnosis. The wound is sutured and a bandage applied. The incision site is monitored for bleeding, tenderness and erythema

Open surgical biopsy

What is a cervical biopsy done to evaluate?

Cervical lesions and to diagnose cervical cancer. *Generally done without anesthesia and area is packed with gauze or a tampon to check the blood flow

Performed to collect tissue for diagnosis of endometrial cancer and analysis for infertility studies. Generally performed at the time of menstruation when cervix is dilated and cells are obtained more easily

Endometrial biopsy *Cervix is anesthetized locally, a curette is inserted, and tissue is obtained from selected sites of the endometrium

What is a curette?

Spoon shaped instrument used to obtain samples from the wall of a cavity *used in endometrial biopsy