• Family centered; assessment must include both

A Framework for Maternal & Child Health Nursing family and individual assessment data.
Obstetrics, or the care of women during childbirth, is • Community centered; the health of families depends
derived from the Greek word obstare, which means “to on and influences the health of communities.
keep watch.”
• Evidence based, because this is the means whereby
Pediatrics is a word derived from the Greek word pais, critical knowledge increases.
meaning “child.”
• A challenging role for nurses and a major factor in
Major focus of nursing practice is the care of keeping families well and optimally functioning
childbearing and childrearing families , because to
have healthy adults you must have healthy children A maternal and child health nurse:
thus we have to promote health for the next generation. • Considers the family as a whole and as a partner in
Although the field of nursing typically divides its care when planning and implementing or evaluating
concerns for families during childbearing and the effectiveness of care
childrearing into two separate entities, maternity care • Serves as an advocate to protect the rights of all
and child health care, the full scope of nursing practice family members, including the fetus.
in this area is not two separate entities but rather a
continuum: maternal and child health nursing • Demonstrates a high degree of independent nursing
functions, because teaching and counseling are major
The primary goal of maternal and child health nursing interventions.
care can be stated simply as the promotion and
maintenance of optimal family health to ensure cycles • Promotes health and disease prevention because
of optimal childbearing and childrearing these protect the health of the next generation.

The goals of maternal and child health nursing care are • Serves as important resources for families during
necessarily broad because the scope of practice (the childbearing and childrearing as these can be
range of services and care that may be provided by a extremely stressful times in a life cycle.
nurse based on state requirements) is so broad. The
• Respects personal, cultural, and religious attitudes
range of practice includes:
and beliefs influence the meaning and impact of
• Preconceptual health care childbearing and childrearing on families.

• Care of women during three trimesters of pregnancy • Encourages developmental stimulation during both
and the puerperium (the 6 weeks after childbirth, health and illness so children can reach their ultimate
sometimes termed the fourth trimester of pregnancy) capacity in adult life

• Care of infants during the perinatal period (6 weeks • Assesses family for strengths as well as specific
before conception to 6 weeks after birth) needs or challenges

• Care of children from birth through adolescence • Encourages family bonding through rooming-in and
family visiting in maternal and child health care
• Care in settings as varied as the birthing room, the settings
pediatric intensive care unit, and the home
• Encourages early hospital discharge options to
Regardless of the setting , a family-centered approach reunite families as soon as possible in order to create a
is the preferred focus of nursing care. The health of the seamless, helpful transition process
individual and his or her ability to function as a
member of family can strongly influence and improve • Encourages families to reach out to their community
overall family functioning so the family can develop a wealth of support people
they can call in a time family crisis

Maternal and Child Health Goals and Standards

Contribution of Health Care Technology in the
✽ Philosophy of Maternal and Child Health Nursing advancement of Maternal and Child Health care
Maternal and child health nursing is: 1. Immunization – cause almost eradication of
childhood diseases
 2. Fertility drugs and fertility techniques – a;;pw (5) Gender Equality & empower women
more couples to conceive
(6) Clean Water and Sanitation
3. Prevention of preterm birth – improve the
(7) Affordable and Clean Energy
quality of life for preterm babies
(8) Decent Work and Economic Growth
4. Identifying specific genes responsible for child
health disorders; stem cells – may replace (9) Industry, Innovation and Infrastructure
diseased cells with new growth cells and cure
illnesses (10) Reducing Inequality

5. Growing trend toward health care (11) Sustainable Cities and Communities

consumerism or self-care – make people active (12) Responsible Consumption and Production
participants in their own health monitoring
(13) Climate Action
Access to health care and social determinants of health
impact the role of the nurse and the health of the (14) Life Below Water
patient. These factors have expanded the roles of
(15) Life On Land
nurses in MCN and made the delivery of quality
maternal and child health nursing care a challenge. (16) Peace, Justice, and Strong Institutions
(17) Partnerships for the Goals
2020 National Health Goals
1. To increase the quality and years of healthy The global health goals concentrating on improving
life the health of women and children are:
2. To eliminate health disparities ● To end poverty and hunger
Implementation include: ● To achieve universal primary education
1. Inclusion in nursing curriculum core content ● To promote gender equality and empower
on counseling for health promotion and women
disease prevention
● To reduce child mortality
2. Cultural diversity to include lesbian, gay,
bisexual, transgender (LGBT) ● To improve maternal health

3. Environmental health ● To combat HIV/AIDS, malaria and other

diseases
4. Public health system and global health
● To ensure environmental sustainability
5. Use of practice and research
● To develop a global partnership for
6. Goals serve as basis for grant funding and development
financing of evidence based practice

PROFESSIONAL STANDARDS AND NURSING

WHO’S 17 Sustainable Development Goals PROCESS
- To improve health worldwide Professional standards ensure that the highest level of
quality nursing care is promoted. Excellent nursing
(1) No Poverty
practice is a reflection of sound ethical standards.
(2) Zero Hunger Client care requires more than just the application of
scientific knowledge. A nurse must be able to think
(3) Good Health and Well-being critically, solve problems, and find the best solution
(4) Quality Education for client’s needs to assist clients in maintaining,
regaining, or improving their health. Critical thinking
requires the use of scientifically based and practice- • Health maintenance
based criteria for making clinical judgments. These
• Health restoration
criteria may be scientifically based on research
findings or practice based on standards developed by • Health rehabilitation
clinical experts and quality improvement initiatives.

1. Nursing Process – assessment, diagnosis,

Association of Women’s Health, Obstetric, and planning, implementation and evaluation
Neonatal Nurses Standards and Guidelines Standards
of Professional Performance 2. Nursing theory – designed to offer helpful
ways to view patients so nursing activities can
be created to best meet patient needs.
Examples:
Standard I: Quality of Care The nurse systematically
evaluates the quality and effectiveness of nursing Summary of Nursing Theories
practice.
Terry is a 7-year-old girl who is hospitalized because
Standard II: Performance Appraisal The nurse her right arm was severely injured in an automobile
evaluates his/her own nursing practice in relation to accident. There is a high probability she will never
professional practice standards and relevant statutes have full use of the arm again. Terry’s mother is
and regulations. concerned because Terry showed promise in art.
Previously happy and active in Girl Scouts, Terry has
Standard III: Education The nurse acquires and
spent most of every day since the accident sitting in
maintains current knowledge in nursing practice.
her hospital bed silently watching television.
Standard IV: Collegiality The nurse contributes to the
professional development of peers, colleagues, and
others.
Standard V: Ethics The nurse’s decisions and actions
on behalf of patients are determined in an ethical
manner.
Standard VI: Collaboration The nurse collaborates
with the patient, significant others, and health care
providers in providing patient care.
Standard VII: Research The nurse uses research
findings in practice.
Standard VIII: Resource Utilization The nurse
considers factors related to safety, effectiveness, and
cost in planning and delivering patient care.
Standard IX: Practice Environment The nurse
contributes to the environment of care delivery within
the practice settings.
Standard X: Accountability The nurse is professionally
and legally accountable for his/her practice. The
professional registered nurse may delegate to and
supervise qualified personnel who provide patient care.
Framework for Maternal & Child Health Nursing
Maternal and child health nursing can be visualized
within a framework in which nurses, using nursing
process, nursing theory, and evidence-based practice,
care for families during childbearing and childrearing
years through four phases of health care:
• Health promotion
Theorist Major Concepts of Theory Emphasis of Care

Patricia Benner Nursing is a caring relationship. Nurses grow Assess Terry as a whole. An expert
from novice to expert as they practice in clinical nurse is able to do this intuitively from
settings knowledge gained from practice

Dorothy Johnson A person comprises subsystems that must Assess the effect of lack of arm
remain in balance for optimal functioning. Any function on Terry as a whole; modify
actual or potential threat to this system balance care to maintain function to all
is a nursing concern systems, not just musculoskeletal

Imogene King Nursing is a process of action, reaction, Discuss with Terry the way she views
interaction, and transaction; needs are identified herself and illness. She views herself
based on client’s social system, perceptions, and as a well child, active in Girl Scouts
health; the role of the nurse is to help the client and school; structure care to help her
achieve goal attainment meet these perceptions

Madeleine Leininger The essence of nursing is care. To provide Assess Terry’s family for beliefs about
transcultural care, the nurse focuses on the study healing. Incorporate these into care
and analysis of different cultures with respect to
caring behavior

Florence Nightingale The role of the nurse is viewed as changing or Turn Terry’s bed into the sunlight;
structuring elements of the environment such as provide adequate covers for warmth;
ventilation, temperature, odors, noise, and light leave her comfortable with electronic
to put the client into the best opportunity for games to occupy her time
recovery

Betty Neuman A person is an open system that interacts with Assess for stressors such as loss of
the environment; nursing is aimed at reducing selfesteem and derive ways to prevent
stressors through primary, secondary, and further loss such as praising her for
tertiary prevention combing her own hair

Dorothea Orem The focus of nursing is on the individual; clients Arrange overbed table so Terry can
are assessed in terms of ability to complete self- feed herself; urge her to participate in
care. Care given may be wholly compensatory care by doing as much for herself as
(client has no role); partly compensatory (client she can
participates in care); or supportive-educational
(client performs own care)

Ida Jean Orlando The focus of the nurse is interaction with the Ask Terry what she feels is her main
client; effectiveness of care depends on the need. Terry says that returning to
client’s behavior and the nurse’s reaction to that school is what she wants most. Stress
behavior. The client should define his or her activities that allow her to maintain
own needs contact with school, such as doing
homework or telephoning friends

Rosemarie Rizzo Nursing is a human science. Health is a lived Ask Terry what being sick means to
experience. Man-living-health as a single unit her. Allow her to participate in care
guides practice decisions based on her response

Parse Hildegard The promotion of health is viewed as the Plan care together with Terry.
Peplau forward movement of the personality; this is Encourage her to speak of school and
accomplished through an interpersonal process accomplishments in Girl Scouts to
that includes orientation, identification,
 exploitation, and resolution retain self-esteem

Martha Rogers The purpose of nursing is to move the client Help Terry to make use of her left side
toward optimal health; the nurse should view as much as possible so that she returns
the client as whole and constantly changing and to school and to her previous level of
help people to interact in the best way possible functioning as soon as possible
with the environment

Sister Callista Roy The role of the nurse is to aid clients to adapt to Assess Terry’s ability to use her left
the change caused by illness; levels of hand to replace her right-hand
adaptation depend on the degree of functions, which are now lost; direct
environmental change and state of coping nursing care toward replacing deficit
ability; full adaptation includes physiologic with other factors, selfconcept, role
interdependence function, and skills.

fingertip touching. Armed with Rubin’s findings and

integrating these findings into practice, nurses became
3. QSN: Quality and Safety Education for Nurses
better able to differentiate healthy from unhealthy
5 competencies that originated from study of bonding behavior in postpartum women
Institute of Medicine needed for quality care:
● Patient-centered care
Measuring Maternal and Child Health
● Teamwork and collaboration
1. Birth Rate
● Quality improvement
2. Fertility Rate
● Informatics
3. Fetal Death Rate -is defined as the death in
● Evidence-based practice utero of a child (fetus) weighing 500 g or
more, roughly the weight of a fetus of 20
Overall goal is to address the challenge of preparing
weeks’ or more pregnancy
future nurses with the abilities necessary to
continuously improve the quality and safety of the 4. Neonatal Death Rate - The first 28 days of life
healthcare system in which they work are known as the neonatal period, and an
infant during this time is known as a neonate
4. Evidence-based Practice - is the conscientious,
explicit, and judicious use of current best 5. Infant mortality rate –
evidence in making decisions about the care of
patients 6. Maternal mortality rate

5. Nursing Research - the controlled 7. Child mortality rate

investigation of problems that have
8. Child morbidity rate
implications for nursing practice, provides
evidence for practice and justification for
implementing activities for outcome
achievement, ultimately resulting in improved ✽ Statistical Terms Used to Report Maternal and
and cost-effective patient care. Child Health

A classic example of how the results of nursing ● Birth rate: Number of births per 1000
research can influence nursing practice is the population.
application of the research carried out by Rubin (1963) ● Fertility rate: Number of pregnancies per
on a mother’s approach to her newborn. Before the 1000 women of childbearing age.
publication of this study, nurses assumed that a woman
who did not immediately hold and cuddle her infant at ● Fetal death rate: Number of fetal deaths
birth was a “cold” or unfeeling mother. After (weighing more 500 g) per 1000 live births.
observing a multitude of new mothers, Rubin
concluded that attachment is not a spontaneous
procedure; rather, it more commonly begins with only
 ● Neonatal death rate: Number of deaths per ● Infant mortality rate: Number of deaths per
1000 live births occurring at birth or in the 1000 live births occurring at birth or in the
first 28 days of life. first 12 months of life.
● Perinatal death rate: Number of deaths of ● Childhood mortality rate: Number of deaths
fetuses weighing more than 500 g and within per 1000 population in children, 1 to 14 years
the first 28 days of life per 1000 live births. of age.
● Maternal mortality rate: Number of maternal
deaths per 100,000 live births that occur as a
Trends in Maternal and Child Health Care and
direct result of the reproductive process.
Implications for Nurses

Trend Implications for Nursing

Families are smaller than in previous Fewer family members are present as support in a time of crisis.
decades
Nurses must fulfill this role more than ever before

Single parents are increasing in number A single parent may have fewer financial resources; this is more
likely if the parent is a woman. Nurses need to inform parents of
care options and to provide a backup opinion when needed

An increasing number of women work Health care must be scheduled at times a working parent can
outside the home bring a child for care. Problems of latch-key children and the
selection of child care centers need to be discussed

Families are more mobile than previously; Good interviewing is necessary with mobile families so a health
there is an increase in the number of database can be established; education for health monitoring is
homeless women and children important

Abuse is more common than ever before Screening for child or intimate partner abuse should be included
in family contacts. Be aware of the legal responsibilities for
reporting abuse

Families are more health-conscious than Families are ripe for health education; providing this can be a
previously major nursing role

Health care must respect cost containment Comprehensive care is necessary in primary care settings
because referral to specialists may no longer be an option

Trends in Health Care Environment 9. Increased Use of Alternative Treatment

Modalities
1. Cost Containment
10. Increased Reliance on Home Care
2. Alternative Settings and Styles for Health Care
11. Increased Use of Technology
3. Strengthening the Ambulatory Care System
Health Care Concerns and Attitudes
4. Shortening Hospital Stays
1. Increasing Concern Regarding Health Care
5. Including the Family in Health Care Costs
6. Increase in the Number of Intensive Care 2. Increasing Emphasis on Preventive Care
Units
3. Increasing Emphasis on Family-Centered Care
7. Regionalization of Intensive Care
4. Increasing Concern for the Quality of Life
8. Increased Reliance on Comprehensive Care
Settings 5. Increasing Awareness of the Individuality of
Clients
 6. Empowerment of Health Care Consumers 6. Neonatal Nurse Practitioner
A neonatal nurse practitioner (NNP) is an advanced-
practice role for nurses who are skilled in the care of
Advanced-Practice Roles for Nurses in Maternal and newborns, both well and ill. NNPs may work in level
Child Health 1, level 2, or level 3 newborn nurseries, neonatal
1. Clinical Nurse Specialist follow-up clinics, or physician groups

Clinical nurse specialists are nurses prepared at the 7. Family Nurse Practitioner
master’s or doctorate degree level who are capable of A family nurse practitioner (FNP) is an advanced-
acting as consultants in their area of expertise, as well practice role that provides health care not only to
as serving as role models, researchers, and teachers of women and children but also to the family as a whole.
quality nursing care. In conjunction with a physician, an FNP can provide
Examples of areas of specialization are neonatal, prenatal care for a woman with an uncomplicated
maternal, child, and adolescent health care; genetics; pregnancy
childbirth education; and lactation consultation 8. Certified Nurse-Midwife
2. Case Manager A certified nurse-midwife (CNM) is an individual
A case manager is a graduate-level nurse who educated in the two disciplines of nursing and
supervises a group of patients from the time they enter midwifery and licensed according to the requirements
a health care setting until they are discharged from the of the American College of Nurse-Midwives (ACNM)
setting or, in a seamless care system, into their homes who plays an important role in assisting women with
as well, monitoring the effectiveness, cost, and pregnancy and childbearing
satisfaction of their health care LEGAL CONSIDERATIONS OF MATERNAL-
3. Nurse Practitioner CHILD PRACTICE

Nurse practitioners are nurses educated at the master’s 1. Nurses are legally responsible for protecting
or doctoral level. Recent advances in technology, the rights of their clients, including
research, and knowledge have amplified the need for confidentiality, and are accountable for the
longer and more in-depth education for nurse quality of their individual nursing care and that
practitioners as they play pivotal roles in today’s of other health care team members.
health care system. Doctor of nursing practice
2. In a society in which child abuse is of national
programs are designed to prepare nurse practitioners
concern, nurses are becoming increasingly
with the highest level of practice expertise integrated
responsible for identifying and reporting
with the ability to translate scientific knowledge into
incidents of suspected abuse in children.
complex clinical interventions
3. Documentation is essential in protecting a
nurse and justifying his or her actions
4. Women’s Health Nurse Practitioner
4. Nurses need to be conscientious about
A women’s health nurse practitioner has advanced obtaining informed consent for invasive
study in the promotion of health and prevention of procedures and determining that pregnant
illness in women. Such a nurse plays a vital role in women are aware of any risk to the fetus
educating women about their bodies and sharing with associated with a procedure or test
them methods to prevent illness; in addition, they care
for women with illnesses such as sexually transmitted 5. Personal liability insurance is strongly
infections, and offer information and counsel them recommended for all nurses, so that they do
about reproductive life planning not incur great financial losses during a
malpractice or professional negligence suit.
5. Pediatric Nurse Practitioner
6. If a nurse knows that the care provided by
A pediatric nurse practitioner (PNP) is a nurse another practitioner was inappropriate or
prepared with extensive skills in physical assessment, insufficient, he or she is legally responsible for
interviewing, and well-child counseling and care. In reporting the incident. Failure to do so can
this role, a nurse interviews parents as part of an lead to a charge of negligence or breach of
extensive health history and performs a physical duty
assessment of the child
In summary, What do maternal child and health
nurse do?
● Monitor children's health.
● Support maternal health and wellbeing.
● Identify health and development concerns
early.
● Provide intervention and referral when
necessary.
● Deliver health promotion and education
programs.
● Provide parenting support.
 MALE REPRODUCTIVE SYSTEM 12 feet long; 64 days for sperm to reach
maturity; 12-20 days- sperms ability to
travel the length of epididymis.

Ductus Deferens (Vas Deferens)

-it ascends along the posterior border of the testis,
emerge from the scrotum, passes through inguinal
canal, reaches the pelvic cavity. It joins the duct of
the seminal vesicle to form the ejaculatory duct.
Ejaculatory Duct – formed by the union of
of a ductus deferens & a duct from the
seminal vesicle. The 2 ejaculatory ducts
enter the posterior surface of the prostate
Testes gland & course through its substance
-suspended outside the abdominal cavity in a sac before they end in the prostatic portion of
called scrotum which is made up of skin & smooth the urethra.
muscle known as dartos muscle.
-synonymous to female ovaries Urethra
18-20 cm L
Functions: 3 Parts:
Spermatogenesis –process of spermatozoon Prostatic urethra-surrounded by prostate gland.
formation. Sides are ejaculatory duct
2 phases: Membranous urethra – extends from the lower
Spermatocytogenesis – influence by FSH pole of the prostate to the bulb of the corpus
secreted by the APG. spongiosum of the penis
Spermiogenesis – spermatids undergo Penile urethra or spongy urethra – 15 cm. Long
complete transformation leading to the and passes longitudinally through the corpus
formation of spermatozoa spongiosum of the penis.

Spermatogonium→Primary spermatocytes→ Accessory Structures:

Secondary spermatocytes →Spermatids Seminal vesicle – pouchlike structure that lie
between the bladder & the rectum.
-produce secretions to aid in motility & survival of
sperm. Secretions contain sugar & protein;
alkaline in ph furnishing nutrition in sperm.
Prostate gland – located below the internal urethral
space. Secretes enzymes that are alkaline in nature
neutralizing the acidity of the vagina. Main source
of citric acid and acid phosphates of semen
-homologous to Skene’s duct

3. Bulbo-urethral glands(Cowper’s glands)

-homologous to Bartholin’s gland
Sex determination – 46 chromosomes, 22 pairs of -pea sized glands that lie on either side of
autosomes & a pair of sex chromosomes membranous urethra
Blood & Nerve supply, Lymphatic vessels – blood -also secrete alkaline fluids to help counteract the
supply comes from testicular artery and branch of acid secretion of urethra ensuring safe passage of
abdominal aorta. sperm
Penis – male organ of copulation. Average 6-8 in.
Duct System Contains cavernous bodies responsible for
Ductuli Efferentes – 12 or more ductuli erection. Covered by hair & skin called Prepuce.
efferentes; emerge on the surface of the 2 Parts:
testes. Provide passageway of shaft – main part of the penis
spermatozoa from the testes to its capsule. glans – the tip sometimes called the head
Ductus epididymis – ductuli efferentes
combine to form epididymis. Sperms are
stored here until they mature. Process is
RIPENING
 Testosterone Interstitial Cause descent of
cells of testes from the
Leydig abdominal
(testes) cavity
to the scrotum &
dev’t of primary
& sexual charac.

LH or Pituitary testosterone
Interstitial gland production
Stimulating
hormone
FSH APG Spermatogenesis
Mechanism of Erection: Androgens Adrenal premature sexual
Sexual excitement → contraction of ischio- glands maturity in
cavernous bodies → causing venous congestion → young males
leading to distention and erection
Phimosis – condition of tigthnes of the foreskin of
the penis
Semen – ph 8.5 (alkaline); contain sugar and
mucin (protein)
Head – contains nuclear chromatin material DNA
responsible for fertilizing ovum
Body – provides energy for movement
Tail – capable of propelling motion

Pathway of Sperm:
Seminiferous tubules (where spermatozoa are
formed) ↓
Tubuli Recti
↓
Rete testes
↓
Ductuli Efferentes
↓
Epididymis
↓
Ductus deferens ↔ Seminal Vesicle
↓
Ejaculatory duct
↓
Urethra

Male Sexual Response

1. Erection
2. Lubrication
3. Emmission & Ejaculation
Male Fertility
1. Effect of temperature on spermatogenesis
2. effect of sperm count
3. Effect of sperm morphology & motility
4. Function of hyaluronidase & proteinase
5. Infectious diseases

Summary of Male Hormones

Hormone Produced Function

by
 Anatomy and physiology of the male and Like the ovaries (to which they are
female reproductive system homologous), testes are components of both
Judith M. Manuel, R.N., MAN, Ed.D the reproductive system (being gonads) and
Structure of Male Reproductive Tract the endocrine system (being endocrine
glands). The respective functions of the testes
are:
producing sperm (spermatozoa)
producing male sex hormones of which
testosterone is the best-known

Both functions of the testicle, sperm-

forming and endocrine, are under control of
gonadotropic hormones produced by the
anterior pituitary:
- luteinizing hormone (LH)
- follicle-stimulating hormone (FSH)
External Structures
 Testes Spermatogenesis
 Scrotum
 Penis
Internal Structure
 Epididymis
 Vas deferens
 Seminal Vesicles
 Ejaculatory ducts
 Prostate gland
 Bulbourethral glands
 Urethra

TESTES/TESTICLES Scrotum
(male gonads) scrotum is a rugated skin- covered and
- Testes are two ovoid glands, 2 to 3 cm muscle containing the testicles. It is an
wide, that lie in the scrotum. extension of the abdomen, and is located
- Each testes is encased by a protective between the penis and anus.
white fibrous capsule and is composed Its function is to support the testes and
of a number of lobule containing help to regulate the temperature of sperm.
interstitial cells (Leydig’s cells) and
seminiferous tubule.
- Leydig’s cells are responsible for
production of the male hormone
testosterone.

Cont.. TESTES/TESTICLES
Functions:
 Penis Two ejaculatory ducts pass through the
Is composed of three cylindrical masses of prostate gland and join the seminal vesicles to
erectile tissue in the penis shaft. the urethra.
Penis serves as the outlet for both the urine
and the reproductive tracts in men.

Duct system
Urethra
- Ductus epididymis Is a hollow tube leading from the bladder, which
- Ductus deferens (vas deferens) after passing through the prostate gland, continues
- Ejaculatory ducts to the outside through the shaft and glans of the
- Urethra penis.
- Approximately 8 inch (18 to 20
Epididymis cm) in long
The seminiferous tubule of each testis 3 Parts:
leads to a tightly coiled tube, the epididymis. Prostatic urethra-surrounded by prostate
Approximately 20 ft. gland. Sides are ejaculatory duct
Responsible for conducting sperm from Membranous urethra – extends from the
the testis to the vas deferens. lower pole of the prostate to the bulb of the
It is narrow along its entire length, corpus spongiosum of the penis
infection of the epididymis can easily lead to Penile urethra or spongy urethra – 15 cm.
scarring of the lumen that prohibits passage of Long and passes longitudinally through the
sperm beyond the scarred point. corpus spongiosum of the penis.
Sperm storage (12-20 days travel time)
Site of sperm maturation (64 days) Accessory Structures:
Process is RIPENING - Seminal vesicles
- Prostate glands
- Bulbourethral glands

Seminal Vesicles
Two convoluted pouches that lie along the
lower portion of the posterior surface of the
bladder and empty into the urethra by way of
the ejaculatory ducts.
These glands secrete s viscous portion of
Vas Deferens semen.
Is an additional hollow tube surrounded by produce secretions to aid in motility &
arteries and veins and the protected by a thick survival of sperm. Secretions contain sugar &
fibrous coating. protein; alkaline in ph furnishing nutrition in
It carries sperm from epididymis through sperm.
the inguinal canal into the abdominal cavity
where it ends at the seminal vesicles and the
ejaculation ducts.
Mature sperm pass to the vas deferens.
Site of vasectomy

Ejaculatory ducts
 Prostate gland
located below the internal urethral
space. Secretes enzymes that are alkaline in
nature neutralizing the acidity of the vagina.
Main source of citric acid and acid phosphates
of semen
- homologous to Skene’s duct

Bulbourethral glands
Also know as Cowper’s glands lie beside
the prostate gland.
Like prostate gland and seminal vesicles,
they secrete an alkaline fluid that helps the
counteract the acid secretion of urethra and
ensure the safe passage of spermatozoa.
- homologous to Bartholin’s gland

Urethra
Is a hollow tube leading from the bladder, Phimosi
which after passing through the prostate gland, s – condition of tightness of the foreskin of the
continues to the outside through the shaft and penis
glans of the penis. Semen – ph 8.5 (alkaline); contain sugar and
Approximately 8 inch (18 to 20 cm) in mucin (protein)
long Head – contains nuclear chromatin material
DNA responsible for fertilizing ovum
Mechanism of Erection Body – provides energy for movement
erection is triggered by the Tail – capable of propelling motion
parasympathetic division of the autonomic
nervous system (ANS), causing nitric oxide (a Pathway of sperm
vasodilator) levels to rise in the trabecular Seminiferous tubules (where spermatozoa are
arteries and smooth muscle of the penis. The formed) ↓
arteries dilate causing the corpora cavernosa Tubuli Recti
of the penis (and to a lesser extent the corpora ↓
spongiosum) to fill with blood; simultaneously Rete testes
the ischiocavernosus and bulbospongiosus ↓
muscles compress the veins of the corpora Ductuli Efferentes
cavernosa restricting the egress and circulation ↓
of this blood. Erection subsides when Epididymis
parasympathetic activity reduces to baseline. ↓
Ductus deferens↔ Seminal Vesicle
Mechanism of Erection: ↓
Sexual excitement → contraction of ischio- Ejaculatory duct
cavernous bodies → causing venous ↓
congestion → leading to distention and Urethra
erection

Male Sexual Response

1. Erection
2. Lubrication
3. Emmission & Ejaculation
Male Fertility
1. Effect of temperature on
spermatogenesis
2. Effect of sperm count
3. Effect of sperm morphology &
motility
4. Function of hyaluronidase &
proteinase
5. Infectious diseases

Internal Female Reproductive Structures

Summary of Male Hormones

Mons Veneris / Pubis
Hormone Produced Function
by
Is a pad of adipose tissue located over the
Testosterone Interstitial Cause descent of symphsis pubis, the pubic bone joint.
cells of testes from the It is covered by a triangle of coarse, curly
Leydig abdominal hairs.
(testes) cavity The purpose of the mons veneris is to
to the scrotum & protect the junction of the pubic bone from
dev’t of primary trauma.
& sexual charac. Labia minora
The labia minora are two soft folds of
LH or Pituitary testosterone skin between the labia majora and to either
Interstitial gland production side of the opening of the vagina.
Stimulating
Normally the folds of the labia minor are
hormone
FSH APG Spermatogenesis
pink.
Androgens Adrenal premature sexual The area is abundant with sebaceous
glands maturity in glands.
young males Labia Majora
The labia majora are lip-like structures
comprised mostly of skin and adipose tissue
covered by loose connective tissue and
epithelium.
After puberty, it is typically covered with
pubic hair.
Protection for the external genitalia and
the distal urethra and vagina.

Clitoris
External Female Genitalia Is approximately 1- 2 cm.
 Rounded organ of erectile tissue at the 3. Hormone production- progesterone
forward junction of the labia minora. and estrogen
Sensitive to touch and temperature and is 4. Initiate and regulate menstrual cycles
the center of sexual arousal and orgasm in the 5. Development of follicles (Oogenesis-
female. O for ova) - Oogenesis- is a
Bartholin's glands process by which a primitive egg is
Called Bartholin glands or greater developed to a matured ovum
vestibular glands) are two glands located
slightly below and to the left and right of the Oogenesis
opening of the vagina in women.
Secretions from both of these glands help
to lubricate the external genitalia.
The alkaline ph of their secretion helps to
improve sperm survival in the vagina.

Fourchette
Is the ridge of tissue formed by the
posterior joining of the two labia minora and
labia majora.
This is the structure that is sometimes cut
(episiotomy) during child birth to enlarge the
vaginal opening.
Hymen
Is a tough but elastic semicircle of tissue
that covers the opening of the vagina during
childhood.
It is often torn with the first sexual
intercourse.

Ovaries
Ovaries are oval shaped
measure approximately 4cm long by 2 cm in
diameter.
The ovary is located close to and on both sides
of the uterus in the lower abdomen.

Functions:
1. Produce, mature and discharge of
egg/ova
2. Ovulation
 Fallopian tube from blood vessels which develop exclusively
There are two Fallopian tubes attached to for this purpose.
either side of the cornual end of the uterus.
Each terminates at or near one ovary Cont…Uterus
forming a structure called the fimbria. The fertilized ovum becomes an embryo,
The Fallopian tubes are not directly develops into a fetus and gestates until
attached to the ovaries, but open into the childbirth. If the egg does not embed in the
peritoneal cavity (essentially the inside of the wall of the uterus, a woman gets her period
abdomen); they thus form a direct and the egg is flushed away.
communication between the peritoneal cavity Three divisions:
and the outside via the vagina. 1. Corpus
The Fallopian tubes are about 10 cm long 2. Isthmus- between the body and
in mature woman. cervix, portion most commonly cut
during CS.
Cont.. Fallopian tube 3. Cervix- opening canal
The Fallopian tubes or oviducts are two Fundus is the portion that can be palpated
very fine tubes leading from the ovaries of abdominally to determine the amount of
females into the uterus. uterine growth occurring during pregnancy.
On maturity of an ovum, the follicle and
the ovary's wall rupture, allowing the ovum to The layers, from innermost to outermost, are as
escape and enter the Fallopian tube. This trip follows:
takes hours or days.
Endometrium- inner lining of the uterine cavity.
There are four regions of the fallopian tube endometrium builds a lining periodically which is
from the ovary to the uterus: shed or reabsorbed if no pregnancy occurs.
Shedding of the functional endometrial lining in
Infundibulum - contains fimbria humans is responsible for menstrual bleeding.
Ampulla - usual site of fertilization
Isthmus - Myometrium-  The uterus mostly consists of
Interstitial tube - inside wall of uterus smooth muscle, middle layer. The innermost layer
of myometrium is known as the junctional zone,
which becomes thickened in adenomyosis.

Perimetrium- The loose surrounding tissue,

outer of connective tissue.

Vagina
The vagina is a fibromuscular tubular tract
leading from the uterus to the exterior of the body
in female.
The vagina is the place where semen from the
male is deposited into the female's body at the
Uterus climax of sexual intercourse, commonly known as
Approximately 5 to 7 cm long, 5 cm wide, ejaculation.
2.5 cm deep, wt. 60 g. in non pregnant state. Around the vagina, pubic hair protects the
After pregnancy approximately 9 cm long, vagina from infection and is a sign of puberty.
6 cm wide, 3 cm thick and 80 g. in wt.
The uterus or womb is the major female
reproductive organ of humans. One end, the
cervix, opens into the vagina; the other is
connected on both sides to the fallopian tubes.
The uterus is a pear-shaped muscular
organ. Its major function is to accept a
fertilized ovum which becomes implanted into
the endometrium, and derives nourishment
 Cervix
The cervix is the lower, narrow portion of the
uterus where it joins with the top end of the
vagina.
It is cylindrical or conical in shape and
protrudes through the upper anterior vaginal wall.
Approximately half its length is visible; the
remainder lies above the vagina beyond view.