1 inch is 2.

54 cm REMEMBER

OB NOTES
REPRODUCTIVE SYSTEM DEVELOPMENT
Puberty
- development of secondary sexual characteristics
- starts when the hypothalamus releases Gonadotrophin
releasing hormone---Releasing FSH and LH---Production
of estrogen and androgen---Secondary characteristics
A. MALE REPRODUCTIVE SYSTEM
DEVELOPMENT (12-14 y/o)
- 6 months later than female and is completed in 5 years
- Androgen: for muscular development, physical growth
and increase in sebaceuos gland secretion
- Secondary sexual characteristics
1. Weight Gain
2. Growth of testes
- enlargement; includes the darkening, thinning
and enlargement of the scrotum (rich in melanocyte)
-GnRH---FSH and LH---FSH for androgen
building protein and LH for testorterone release--sperm formation
3. Adrenarche/Hair Growth (face, axilla, genital)
- cephalocaudal (starts at base of penis)
4. Voice changes
5. Penile growth
6. Height increase
7. Spermatogenesis
- Wet dreams are psychologic (during REM) and
physiologic(increased oxygen to penis due to
position) in nature
- Male External structures include:
1. Scrotum
- rugates, skin covered, muscular pouch covering
testicles; helps regulate temp of sperm
- COLD-Closer to body (goes up)
- HOT-Away from the body (goes down)
2. Testes
- has Leydig cells in the lobules which is for
production of testosterone; Seminiferous tubule for
production of spermatozoa
- Right testicle is higher and smaller than the left
to prevent friction
3. Penis
- has 3 erectile tissues: 2 corpus cavernosa and 1
corpus spongiosum
- Erection (PNS): Nitric oxide released from BV
edothelium---dilation of BV (engorgement)---tissue
contracts and traps blood in erectile tissue (erection)
- Male Internal Structures
1. Epididymis
- over 20 feet long; produces alkaline fluid
surrounding sperm (5%) ; takes 12-20 days for a
sperm to travel in epididymis; sperm matures for 64
days thus therapy for aspermia and oligospermia only
takes effect after 2 months
2. Vas or Ductus deferens

- Where the sperm matures; carries sperm from

epididymis to seminal vesicle and ejaculatory ducts;
Not yet mobile
3. Seminal vesicle
-where sperms become mobile; secretes viscous
alkaline liquid (30%)
4. Ejaculatory ducts
5. Prostate gland (chestnut sized)
- secrete alkaline fluid (60%)
6. Bulbourethral glands (Cowpers glands)
-secrete alkaline fluid (5%)
7. Urethra

B. FEMALE REPRODUCTIVE SYSTEM

DEVELOPMENT
- 6 months earlier than males; lasts for 3 years
- Androgen---Tertosterone: enlarges labia majora and
clitoris and adrenarche
- Estrogen:breast development (thelarche), reproductive
system development
- Secondary sexual characteristics
1. Growth spurt
2. Increase transverse pelvic diameter
3. Thelarche
4. Adrenarche
5. Menstruation/Menarche (9-12 y/o onset) is
irregular till 1-2 years after and ovulation is consistent
6. Vaginal secretions
- Female external structures
1. Breasts
- Montgomery tubercles-sebaceous glands @ the
surface of the areola
2. Mons Veneris
- Fat protecting symphysis pubis (reverse
triangle with pubic hair)
3. Labia Minora
4. Labia Majora
5. Others (vestibule, clitoris)
- Skenes glands/Paraurethral (2;gilid ng urinary
meatus) and Bartholins glands/vulvovaginal (2; gilid
ng vaginal opening) help lubricate during coitus
- Fourchette (part that is cut in episiotomy)
- Pudendal artery supplies blood supply to vulva
and is innervated through L1
- Female internal structures

1 inch is 2.54 cm REMEMBER

1. Ovaries (almond shaped)

- contains fluid filles graafian follicle or
miniature corpus luteum (structure left behind after
ovum has been discharged)
2. Fallopian Tubes
- 3-4 inches long; If >4 risk for ectopic
- Isthmus is the site of bitubal ligation
- Ampulla is the site of fertilization

3. Ischemic phase
- corpus luteum regress 8-10 days and decreased
progesterone and estrogen---degeneration of
endometrium (24th/25th of cycle)
4. Menses
- end of menstrual cycle; first day of flow marks
beginning of new cycle
* Spinnbarkeit/Cervical mucus test- fertile if copious and
watery
- Menopause/Change of life
- cessation of menstrual cycles
-starts @ 40-55 years old where spotting is normal
- ovaries atrophy (decrease estrogen---hot flashes--vaginal dryness---osteoporosis)

3. Uterus
- 5-7 cm long; widest at upper part (where
implantation occurs)
- Cervix is largest part
- Three layers: Endometrium (common site of
implantation), Myometrium (Placenta Acreta if
implantation is here) and Perimetrium
- Operculum aka the mucus plug in pregnancy
- Due to enlargement @ pregnancy, ligaments
fail to suport other organs and can result in: Cystocele
bladder herniation in anterior vagina and Rectocele
rectum pouches into vaginal wall
C. MENSTRUATION
- Starts at 9-17 y/o; Average of 28 days cycle and range of
23-35 days; Bleeding for 2-7 days and also 1-9 days; 30-80
cc of blood; marigold odor
- FSH (active initially) for maturation of ovum and LH
(active midcycle) for release of mature egg, ovulation, and
growth of uterine lining
- Ovulatin occurs the 14th day before the onset of the next
cycle; minus 14 lagi no matter how long the cycle
- Temp goes down 1degree F day before ovulation and goes
up 1 degree F day after ovulation till the 24th day where
progesterone decreases
- HORMONES involved in these cycle
1. GnRH or LHRH
- Triggered by:
- Decreased during:
2. FSH
3. LH
4. Estrogen
5. Progesterone
6. Prolactin
7. Oxytocin
8. Prostaglandin
- Has 4 phases:
1. Proliferative/Estrogenic/Postmenstrual/Follicular
- 4-5 days initially in cycle (uterus is very thin)
then GnRH triggers FSH due to absence of hormones
and FSH triggers ovaries to produce estrogen--endometrium thickens
2. Secretory/Progestational/Luteal/Premenstrual
-LH secretion---corpus luteum releases
progesterone---egg is released and best for
fertilization

-Sexual Response:
- Excitement--Plateua--Orgasm--Resolution
- Disorders: ED and Premature Ejaculation
- Vaginismus
- Dyspareunia
-Vestibulitis
FAMILY PLANNING
A. NATURAL FP METHODS
a) Abstinence
b) Calendar/Rhythm method
i.
Abstain coitus 3-4 days before and 3-4 days
after ovulation
ii. Planning includes diary of 6 menstrual
cycles and subracting 18 to the shortest
cycle (first fertile day) and 11 to her longest
cycle (last fertile day)
c) Cervical mucus
i.
Fertile if thin and watery
ii. Not fertile if thick and scanty
d) Basal body temperature
i.
Take temp immediately after wakign up
(oral or ear); if she sees slight deep then
increase---avoid coitus for 3 days
e) Symptothermal
i.
Combi of BBT and Cervical mucus
ii. Observes for mittelschmertz or midcycle
abd pain
f) Lactation amenorrhea method
i.
No ovulation 3 months postpartum if
breastfeeding exclusively
B. ARTIFICIAL FP METHODS
a) OC
i.
Predcribed by physicin, NP, NM after
pelvic examination and pap smear
ii. Increase effects of caffeine and
corticosteroids
iii. Injectibles
b) IUD
c) Injectibles
d) Implants - takes 3 years before replacement;
inserted @ the subcutaneous layer of the upper
arm