Reproduction Exam 3 Flashcards
__________ – normal physiologic process that occurs without incidence the majority of the time
Conception
Risk Factors
Adolescent population – reproductive high risk population
____________ – defective genes, inherited disorders
Psychosocial – smoking, excessive caffeine intake, alcohol,
Sociodemographic – low income, inadequate prenatal care
_________________ – industrial pollution, tobacco, radiation
Biophysical
Environmental
__________ Puberty - Occurs when the secondary sex characteristics develop later
Causes:
- Hypergonadotropic Hypogonadism (↑FSH ↑ LH)
Turner Syndrome; Klinefelter Syndrome
- Hypogonadotropic Hypogonadism (↓LH, ↓FSH)
Reversible – Physiologic delay; weight loss/anorexia; strenuous exercise
Irreversible – ↓ Gonadotropin-releasing hormone; hypopituitarism - Eugonadism
Congenital Anomalies; Androgen insensitivity syndrome
Delayed
____________ Puberty – sexual maturation occurring before 6 in African American girls; 7 in Caucasian girls and 9 in boys
_______ Precocious Puberty - Premature development of appropriate characteristics for the child’s gender
_______ Precocious Puberty - Partial development of appropriate secondary sex characteristics
_____ Precocious Puberty - Development of some secondary sex characteristics of the opposite gender
Precocious
Complete
Partial
Mixed
Primary - painful menstrual cycle in absence of pelvic disease
Secondary - result of underlying disease, such as endometriosis or PID
Pain from primary caused by increased prostaglandin levels
Dysmenorrhea
Absence of spontaneous menstruation in women of reproductive age
Primary - absence of menarche by age 15
Secondary - cessation of regular menstruation for at least 3 months in absence of pregnancy, lactation, hormone medication, or menopause
Contributing factors: PCOS, high stress, excessive exercise, malnutrition, obesity, OCPs, antipsychotic medications
Amenorrhea
Any abnormal bleeding from the uterus not associated with tumor, inflammation, or pregnancy
Hormonal insufficiency caused by an increase in endogenous or exogenous estrogen production
Most common in women who have just started their menstrual cycle and those who are perimenopausal or menopausal
Left untreated, may lead to hyperplasia and malignancy
Dysfunctional Uterine Bleeding
____menorrhea: Cycles shorter than 3 weeks
_____menorrhea: Cycles longer than 6-7 weeks
____orrhagia: Intermenstrual bleeding or bleeding of light character irregularly between cycles
_____menorrhea: Excessive flow
___orrhea/___orrhagia: increased amount and duration of flow
_______rorrhagia: Prolonged flow associated with irregular and intermittent spotting between bleeding episodes
Polymenorrhea
Oligomenorrhea
Metrorrhagia
Hypermenorrhea
Menorrhe/Menorrhagia
Menometrorrhagia
Definitive cause unknown; possible serotonin deficiency
Deficiencies of magnesium or calcium may be cause
Other theories include alterations in endorphins and rapid hormonal shifts
Premenstrual Syndrome (PMS)
acute inflammatory process caused by infection – many caused by sexually transmitted microorganisms
Inflammatory process leads to necrosis with repeated infections
Pelvic Inflammatory Disease (PID)
Hyperplastic growth of the endometrial glands and stroma
Exact etiology unknown
Thought to be result of imbalance of estrogen and progesterone
Endometrial Polyps
Invasion of glandular endometrial tissue into the uterine myometrium
Exact etiology unknown
Thought that invasive procedures such as C-section and D&C allow endometrial tissue to invade the uterine myometrium
Adenomyosis
Exact etiology unknown
Estrogen and progesterone promote growth of these fibroids
Most common in reproductive years and regress in menopause
Leiomyomas
Benign Growths and Proliferative Conditions
__________ cysts - caused by variations of normal physiologic events
_________ cysts – transient condition in which the dominant follicle fails to rupture
______ Luteum cyst – instracystic hemorrhage in the vascularization stage
_______ Cysts – ovarian teratomas that contain elements of all three germ layers
Functional
Follicular
Corpus Luteum
Dermoid
Presence of functional endometrial tissue or implants outside the uterus
Endometriosis
Vaginal tightness that causes discomfort, burning, pain, penetration problems, or complete inability to have intercourse
Exact etiology unknown
Usually linked to female anxiety or fear of intercourse
Pain with intercourse
Vaginismus
Pain with intercourse
No single etiology, but may be caused by various reproductive conditions
Pain with or after intercourse
Dyspareunia
Never reaching orgasm, difficulty reaching orgasm, or substantially decreased intensity of orgasm
Primary - Never achieved orgasm; usually genetic or trauma-related
Secondary - Usually related to hypoactive sexual desire disorder
Orgasmic Dysfunction
Any gestation that occurs outside of the endometrial lining, most frequently in the fallopian tube
Risk factors: damage to fallopian tubes, previous ectopic pregnancy, smoking, infertility medications, multiple sex partners, advanced maternal age, history of STI
Triad of symptoms: abdominal pain, amenorrhea, and vaginal bleeding
Ectopic Pregnancy
Results from an abnormal function of the hypothalamic-pituitary-ovarian axis
Elevated hormones or androgens cause symptoms
Appear within 2 years of puberty, often includes dysfunctional uterine bleeding or amenorrhea, hirsutism, acne and infertility
Menstrual dysfunction
Anovulation
Hyperandrogenism (hirsutism and acne)
Polycystic Ovary Syndrome (PCOS)
Defined as the inability to conceive after 1 year of unprotected sex
Causes – infections or inflammation, endocrine or hormonal disorders, immunologic problems in which men produce antibodies to their own sperm, environmental and lifestyle factors
Female – malfunctions of the fallopian tubes, ovaries, reproductive hormones and thyroid disorders
Infertility
Pain in the breasts
Palpable mass
Nipple discharge
Benign Breast Disease
Discharge of milk or milk-like substance from the breast
Systemic findings may include: headache, changes in weight/appetite, history of thyroid or endocrine disorder, visual changes
Galactorrhea
Most often appear within 4-6 weeks after childbirth
Local tenderness, swelling, warmth, erythema, and consistent or intermittent pain in one breast while breastfeeding
Flu-like symptoms, fever, chills, body aches, headache, loss of appetite
Mastitis
May be asymptomatic in early disease
Changes in size or shape of breast, skin changes (dimpling, inverted nipple, thickening of skin, red and scaly rash)
Blood-tinged nipple discharge, red and scaly nipples, ulceration of breast tissue
Mass felt in breast or axillary tissue that is hard, fixed, and nonmobile
Breast Cancer
Both are congenital abnormalities of the penis found in newborns
Hypospadias: Meatus develops on the ventral (underneath) part of the penis
Epispadias: Rare defect where the meatus develops on the dorsal (upper) part of the penis
Hypospadias and Epispadias
Disorders of the foreskin of the penis
_______: Condition where the foreskin cannot be retracted over the glans penis
_______: Irretractable foreskin of the penis
____________: Occurs in uncircumcised or partially circumcised males when the retracted foreskin is trapped behind the coronal sulcus
____________: Swollen and painful glans penis in a client who is circumcised or partially circumcised
Phimosis and Paraphimosis
Prolonged erection that continues for hours
Painful condition of blood not being able to leave the penis
Uncommon in the general population but more common in males with sickle cell disease
Other causes: blood disorders, prescription medications (antidepressants and blood thinners), erectile dysfunction medications, spider and scorpion bites, spinal cord injury, gout, penile cancer
Priapism
Caused by fibrous plaque that affects the tunica albuginea, causing the penis to curve or bend
Etiology is unknown, but may involve prior injury to the penis or an autoimmune disease
Bend in the penis causes painful erections
Peyronie Disease
Most common male sexual disorder
Inability to maintain or sustain an erection sufficient to permit satisfactory intercourse
Occurs in men of all ages and may be chronic, intermittent, or episodic
A disruption of the normal neurovascular event requiring functional autonomic and somatic nerves, smooth and striated muscles in the penile shaft and pelvic floor, and adequate arterial blood flow
Erectile Dysfunction
____________: Inflammation of the epididymis; may be acute or chronic; infectious process but difficult to identify the infectious agent
____________: Pain and swelling over several days
________: Inflammation of one or both of the testes; may be caused by a viral or bacterial infection; viral cases usually from STIs and bacterial usually occurs in sexually active men with BPH
________: Sudden symptoms and include swelling in one or both testicles, pain, tenderness, fever, nausea, and vomiting
Epididymitis
Orchitis
Spermatic cord twists within the testicle, cutting off blood supply to the ipsilateral testis
Medical emergency
Intravaginal: The tunica vaginalis is genetically set too high, allowing the spermatic cord to rotate
Extravaginal: The tunica vaginalis is not yet firmly secured, the tunica vaginalis and spermatic cord twist as a unit; most often occurs in newborns
Testicular Torsion
Male Disorders - Urethra
Urethritis – inflammatory process often caused by a sexually transmitted microorganism
Symptoms – itching, burning, frequency and urgency
Urethral Stricture – narrowing of the urethra caused by scarring – likely due to trauma
Symptoms – diminished force and caliber of urine stream
Study
Male Disorders - Penis
_________ – inflammation of the glans penis
__________ – abnormal dilation of the testicular vein and the pampiniform plexus within the scrotum
_________ – collection of fluid between the layers of tunica vaginalis (most common cause of scrotal swelling)
Balanitis
Varicocele
Hydrocele
Impairment of any or all of the processes of: erection, emission and ejaculation
Causes –
- Chronic diseases and their treatment
- Low energy levels, stress or depression
- Chemical –alcohol and other CNS depressants, anti-hypertensives, anti-histamines and hormonal preparations.
Sexual Dysfunction
Healthy Pregnancy
Pregnancy spans 9 months or 10 lunar months
40 weeks or 280 days
3 Trimesters (1 – 13; 14 – 26; 27 – 40)
Pregnancy is considered term if it advances to the completion of __ weeks
Blood volume increases by 30 – 45%
The need for Na increases
Decrease is systemic vascular resistance = reduced blood pressure
___ increases 20 – 30%
___ increases in the second trimester and peaks in the third trimester
37
RBC
WBC
_______ Labor - Regular contractions that is accompanied by cervical dilation and effacement
_______ Birth – any birth that occurs between 20 0/7 and 36 6/7
Preterm
Infection is the only definitive association factor of PTL/PTB
Other Causes: periodontal disease; bleeding at the site of implantation; stress; uterine overdistention; allergic reaction; decrease in progesterone
Risk Factors: poverty; lack of education; lack of access to prenatal care; genetics
Clinical monitoring: cervical length; fetal fibronectin test
Although preterm birth is often not preventable, early recognition is still essential
Preterm Labor/Delivery
Pregnancy that ends as a result of natural causes before 20 weeks gestation
Approximately 10 – 15% of all clinically recognized pregnancies end in miscarriage
Types: 1) threatened; 2) inevitable; 3) incomplete; 4) complete; 5) missed
_____ loss (<12 weeks gestation)
25% are due to chromosomal abnormalities
Endocrine imbalance
Immunologic factors
\_\_\_\_ loss (12 – 20 weeks) Risk factors – race, ethnicity, pregnancy history; obesity; alcohol use; caffeine
CM: presence of uterine bleeding; uterine contractions or abdominal pain
If occurs prior to the 6th week a woman may report a heavy period
Treatment: Delivery; Medication Management; D & C
Spontaneous Abortion
Early
Late
?
Causes – direct trauma (childbirth), pelvic floor surgery, damage to pelvic innervation
Symptoms – urinary frequency; incontinence, constipation; urgency; vaginal, bladder, rectal pain; lower back pain
Treatment – Isometric exercises (Kegel) Estrogen Surgery Weight Loss Avoidance of constipation
____ocele – descent of the bladder an anterior vaginal canal
_____rocele – sagging of the urethra
____ocele – bulging of the rectum and posterior vaginal wall into the vaginal canal
_____ocele – herniation of the rectouterine pouch into the rectovaginal septum
Pelvic Organ Prolapse
Cystocele
Urethrocele
Rectocele
Enterocele
