ADVANCED PATHOPHYSIOLOGY NURS
611 UPDATED STUDY GUIDE
Chapter 24: Structure & Function of the Reproductive Systems
1. Development of the Reproductive Systems
a. Structure and function of the male and female systems depend on steroid
hormones/sex hormones
b. Table 24.1 lists sex and reproductive hormones and the actions – don’t memorize, but
become familiar with what each hormone does
2. Female Reproductive System
a. External Genitalia
i. Table 24.4 along with descriptions of structures below
b. Internal Genitalia
i. Figure 24.5
3. Female Sex Hormones
a. Estrogen
i. Estradiol – most potent and plentiful, mainly produced by ovaries; limited
amounts secreted by adrenal glands and placenta during pregnancy
ii. Estrone – androgens are converted to estrone in ovarian and peripheral adipose
tissue
iii. Estriol – peripheral metabolite of estrone and estradiol
iv. Summary of effects of estrogen in box 24.1, p. 734
b. Progesterone
i. Luteinizing hormone (LH) from anterior pituitary stimulates corpus luteum to
secrete progesterone, second major female sex hormone
ii. Estrogen and progesterone control the ovarian menstrual cycle
, iii. LH surge occurs when there is a peak level of estrogen, 24-36 hours before
ovulation
iv. LH promotes luteinization
v. Complementary and opposing effects of estrogen and progesterone – table
24.2, p. 736
c. Ovarian cycle
i. For FNP majors, know this for your OBGYN rotation
4. Male Reproductive System
a. External Genitalia
i. Figure 24.14, anatomy of testes
b. Internal Genitalia
i. Figure 24.13, anatomy of internal genitalia and pelvic organs
c. Male sex and reproductive hormones
i. Testosterone is the primary male sex hormone, and other androgens are
produced mainly by Leydig cells of the testes
, ii. Norepinephrine stimulates GnRH secretion, and serotonin and dopamine inhibit
GnRH secretion.
iii. GnRH is transported by portal flow to the median eminence of the pituitary
gland, where it binds to receptors and stimulates the synthesis and secretion of
the gonadotropins LH and FSH.
iv. These gonadotropins are named for their effects in the female reproductive
system, but have important effects on the male system as well.
v. LH acts on the Leydig cells to regulate testosterone secretion
vi. FSH acts on the seminiferous tubule Sertoli cells to promote spermatogenesis
5. Aging and Reproductive Function
a. In women the transition from fertility to menopause (perimenopause) starts about 2 to
8 years before the last menstrual period and ends the following years.
b. During this transition period the ovaries produce erratic and high levels of estrogen that
contribute to such symptoms as hot flashes, breast tenderness and nodularity, and
migraine headaches.
c. Menstrual cycles shorten and then become irregular as anovulation occurs.
d. Menstruation ceases, and women move into menopause.
e. Hormonal replacement therapy is possible for women experiencing hot flashes
(vasomotor symptoms), however this is contraindicated with unexplained vaginal
bleeding. What is the reason behind this?
f. Men maintain reproductive capacity into their later years.
g. In some men there are gradual changes with testosterone deficiency, hypogonadism,
proliferative disorders of the prostate, and erectile dsyfunction
Chapter 25: Alterations of the Female Reproductive System
1. Alterations of Sexual Maturation
a. Disorders of the female reproductive System
i. Primary Dysmenorrhea
1. Painful menstruation
2. Excessive endometrial prostaglandin production, primarily released
during the first 48 hours of menstruation, when symptoms are most
intense
3. Those with dysmenorrhea produce 10 times as much prostaglandins
4. What is the pathophysiology behind prostaglandins in the body?
5. Clinical manifestations?
ii. Amenorrhea
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