36607857 Pentagon Notes Maternity Nursing

Pentagon Notes (Maternity Nursing) I. Human Sexuality  A. Concepts

1. A persons sexuality encompasses the complex of behaviors, attitudes emotions emotions and preferences that is related to sexual self and eroticism 2. Sex is basic and dynamic aspect of life. 3. During reproductive years, the nurse performs as resources person on human sexuality. B. Definitions related to sexuality: 1. Gender Identity - sense of masc ulinity or feminity. 2. Role Identity  attitudes, behaviors and attributes that differentiates roles. 3. Sex  biologic male or female status. Sometimes reffered to a specific sexual behavior such as s exual intercouse 4. Sexuality  II. Sexual Anatomy and Physiology  A. Female Reproductive System 1. External a. Mons pubis/veneris  a pad of fatty tissues that lies over the symphisis pubis covered by a s kin and at puberty covered by pubic hair that serves as cushion or protection to t he symphysis pubis. Stages of Pubic Hair Development

Stage 1

Pre-adolescence

Stage 2

Occurs between ages 11 and 12 years old

Stage 3

Occurs between ages 12 and 13 years old

Stage 4

Occurs between ages 13 and 14 years old.

Stage 5

Sexual maturity

No pubic hair except for fine body hair Sparse long, long, slightly pigmented pigmented and curly hair along the labia Hair becomes darker and curlier that  develops along the symphysis pubis Hair assumes the normal appearance of an adult pubic hair but is not so thick and does not appear to the inner aspect of t he thigh Normal appearance of an adult pubic hair.   Appears on the inner aspect of the upper thigh

* The pubic hair of females forms an inverveted triangle b. Labia majora (large lips)  is the longitudinal fold which extends from the symphysis pubis to the perineum c. Labia minora/nymphae - is the longitudinal fold located between the labia majora c.1. Clitoris (key)  is a pea shaped erectile tissu e composed of so many sensitive nerves which is a site of sexual aro usal for females. c.2. Fourchet

 tapers posteriorly of the labia minora - is so sensitive to stimulation

d. Vestibule an almond shape area that contains the hymen, vaginal orifice, urinary meatus, Skenes glands and Bartholenes glands d.1. Urinary meatus  small opening for urination d.2. Skenes Glands (Paraurethral glands)  secretes s ubstance for the lubrication d.3. Hymen  a membranous tissues that co ver the vaginal orifice d.3. Vaginal Orifice  external opening of the vagina d.4. Bartholenes Glands (Paravaginal glands)  secretes alkaline fluid that neutralizes the acidity of the vagina

e. Perineum  muscular structure between t he lower gentalia and anus 2. Internal a. Vagina

 female organ of copulation, passageway of menstruation and fetus - 3-4 inches or 8 -10 cm of dilatable canal containg rugae

* Rugae permits considerable amount of stretching without tearing b. Uterus

 isa hollow, thick walled muscular organ. It varies in siz e shape and weight. - is the organ of menstruation

Size Shape

Non-pregnant 1 height x 2 width x 3 length (inch) Pear shaped

Weight

50  60 g

Pregnant No pubic hair except for fine body hair Ovoid 1000 g 4th stage of labor  1000 g 2 wks after delivery  500 g 3 wks after delivery  300 g 5-6 wks after delivery  50 -60 g

Three parts of the Uterus 1. Fundus  upper cylindrical layer 2. Corpus/Body - upper triangular layer 3. Cervix  lower cylindrical layer * Muscular composition: There are three main muscle layers which make expansion possible in every direction. 1. Endometrium  lines the non-pregnant uterus muscle layer for menstuation * Endometriosis

2. Myometrium

 abnormal growth of endometrial lining outside the uterine cavity - ovaries are the common site of endometriosis - persistent back pain and dysmenorrhea are signs of endometriosis - biopsy and laparoscopy are used to diagnose this disease - the drug Danazol is used for the treat this disease

 it is a smoth muscle co nsidered to be the living ligature of  the body - it is the muscle layer for delivery - power layer - the largest part of the uterus

3. Perimetrium  protects the entire uterus c. Ovaries

 almond shape - 2 female sex glands that serve for circulation and production of estrogen and progesterone.

f. Fallopian tubes  2-3 inches long that serves as a passageway of the sperm from the uterus to the ampulla or the passageway of the mature ovum or fertilized ovum from the ampulla to the uterus 4 Significant Segments d.1. Infundibulum d.2. Ampulla d.3. Isthmus d.4. Interstitial

 most distal part  - trumpet or funnel shape - outer third or second half  - common site of fertilization - common site of female sterilization - most dangerous site for ectopic pregnancy

B. Male Reproductive System 1. External Penis  the male organ of copulation and urination. It c ontains a body or a sh aft consisting of 3 cylindrical layers and erectile tissues. At its tip is the most se nsitve area comparable to that of the clitoris in the female  the glans penis 3 Cylindrical Layers

* 2 Corpora cavernosa * 1 Corpus spongiosum Scrotum  a pouch hanging below the pendulous penis, with a medial septum dividing into two sacs, each of which contains a testis.

* For continuous spermatogenisis the temperature of the t estes must be <2 C o of the body temperature 2. Internal * Leydig cells  releases testosterone Maturation of the Sperm

Hypothalamus

Gonadotropin-releasing hormone (GnRH)

 Anterior Pituitary Gland

Follicle Stimulating Hormone (FSH)

Leutenizing Hormone (LH)

Maturation of the sperm The Process of Spermatiogenesis

Testes (Consist of seminiferous tubules)

Epididymis (6 m long tubule and is the site for t he maturation of the sperm)

 Vas Deferens (Conduit or pathway of sperm)

Seminal Vesicle (Secretes fructuose (form of glucose)  for sperm nutrition) (Secretes prostaglandin  causes reverse contration of the uterus) (Semen  the combination of sperm and seminal vesicle secretions)

Ejaculatory Duct  (Conduit or pathway of semen)

Prostate Gland (Releases alkaline fluid)

Cowpers gland/Bulbourethral gland (Releases alkaline fluid)

Urethra Male and Female Homologue Male Penile glans Penile shaft Testes Prostate gland Cowpers gland Scrotum

Female Clitoral glans Clitoral shaft  Ovaries Skenes gland Bartholenes gland Labia majora

III. Basic Knowledge on Genetics and Obstetrics 1. 2. Chromosomes  threadlike strands composed of her editary DNA 3. Normal ejaculated sperm  3 -5 cc 4. Ovum is capable of being fertilized within 24-36 hrs a fter ovulation 5. Sperm viabilty  within 48-72 hrs or 2-3 days 6. Reproductive cells divide by the process of meiosis (haploid number) * Spermatogenesis  the maturation of sperm - 4 end products *Oogenesis  the maturation of ovum - 1 end product  *Gametogenesis  formation of 2 haploid to diploid 7. Age of reproductivity  15-44 years old 8. Menstruation  * Menstrual cycle  beginning of menstruation to the beginning of next m enstruation *Average menstrual cycle  28 days * Average menstrual period  5 days * Normal blood loss  30 cc or ¼ cup - composed of fibrinolysin * Related teminologies Menarche  first menstruation Dysmenorrhea  painful menstruation Metrorrhagia  bleeding in between menstruation Menorhagia  excessive bleeding  Amenorrhea  absence of menstruation Menopause  cessation of menstruation - caused by estrogen depletion - prone to osteoporosis 9. Functions of Estrogen and Progestin * Estrogen Hormone of the Woman *Primary Function : Development of secondary sexual characteristics Others: 1. Inhibit Follicle Stimulating Hormone Production 2. Responsible for hypertrophy of the myometrium 3. Responsible for Spinnbarkeit and Feming pattern 4. Development of ductile structure of breast