South Arkansas Community College Edited by B. Holmes MSN/Ed, RN Associate Professor Copyright © The McGraw-Hill Companies,...
Hole’s Human Anatomy and Physiology Twelfth Edition Shier    Butler    Lewis  Chapter  23 Pregnancy, Growth, And Develop...
23.1: Introduction <ul><li>A sperm and a secondary oocyte unite, forming a zygote, and the journey of prenatal development...
23.2: Pregnancy <ul><li>Pregnancy is the presence of a developing offspring in the uterus </li></ul><ul><li>It consists of...
Transport of Sex Cells <ul><li>Before fertilization can occur, a secondary oocyte must be ovulated and enter a uterine tub...
23.1 From Science to Technology Assisted Reproductive Technologies
Fertilization <ul><li>Fertilization is the union of an egg cell (secondary oocyte) and a sperm cell </li></ul>Copyright © ...
23.3: Prenatal Period <ul><li>The prenatal period usually lasts 38 weeks from conception </li></ul><ul><li>It can be divid...
Period of Cleavage <ul><li>The rapid cell division and distribution of the zygote’s cytoplasm into progressively smaller c...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Zona pellucida Zygote Day 0 O...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Blastocyst (a) Trophoblast Inn...
23.2 From Science to Technology Preimplantation Genetic Diagnosis
Hormonal Changes  During Pregnancy <ul><li>Secretion of  hCG  maintains the corpus luteum </li></ul><ul><li>The corpus lut...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Trophoblast cells secrete hCG...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 0 2 4 Months of pregnancy 1 3...
Other Changes  During Pregnancy <ul><li>Growth of the uterus can displace abdominal organs and disrupt meals, including th...
Embryonic Stage <ul><li>The embryonic stage extends from the beginning of the second week through the eighth week, when th...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Yolk sac Ectoderm Mesoderm Co...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. a,b: © 2007 Landrum B. Shettl...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. b: © Carroll Weiss/Camera M.D...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. – (e) 49  ±  1 day (28–30 mm)...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chorion Endometrium Amniotic ...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Artery Chorion Chorionic vill...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chorion Placenta Umbilical co...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. © Donald Yaeger/Camera M.D. S...
Fetal Stage <ul><li>The fetal stage begins at the end of the eighth week of prenatal development  </li></ul><ul><li>Here g...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 13 years 2 month embryo 3 mon...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Genital tubercle Urogenital f...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Umbilical cord Placenta Uteri...
23.1 Clinical Application Some Causes of Birth Defects
Fetal Blood and Circulation Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. P...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Aortic arch Superior vena cav...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Placenta Liver Lungs Ductus v...
23.2 Clinical Application Joined For Life
Birth Process <ul><li>Pregnancy terminates with the birth process called parturition </li></ul><ul><li>The process is comp...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Fetal head is forced toward c...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Placenta Urethra V agina Cerv...
Milk Production and Secretion
© Biophoto Associates/Photo Researchers, Inc.  (a) (b) Glandular tissue with secretions Glandular tissue Connective tissue...
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Release Duct Lumen Myoepithel...
23.3 Clinical Application Human Milk – The Perfect Food for Human Babies
23.4: Postnatal Period <ul><li>Following birth, both mother and newborn experience physiological and structural changes </...
Neonatal Period <ul><li>Neonatal period </li></ul><ul><ul><li>From birth to the end of the 4 th  week </li></ul></ul><ul><...
Infancy <ul><li>Infancy </li></ul><ul><ul><li>From the end of the 4 th  week to one year </li></ul></ul><ul><ul><li>The gr...
Childhood <ul><li>Childhood </li></ul><ul><ul><li>From one year to puberty </li></ul></ul><ul><ul><li>The growth rate is h...
Adolescence <ul><li>Adolescence  </li></ul><ul><ul><li>From puberty to adulthood </li></ul></ul><ul><ul><li>The person bec...
Adulthood <ul><li>Adulthood </li></ul><ul><ul><li>Adolescence to old age </li></ul></ul><ul><ul><li>The person remains rel...
Senescence <ul><li>Senescence  </li></ul><ul><ul><li>Old age to death </li></ul></ul><ul><ul><li>Degenerative changes cont...
23.4 Clinical Application Living To 100 – And Beyond
The End of Life <ul><li>Nearing the end of life is a personal process, influenced by belief as well as circumstance </li><...
23.5: Aging <ul><li>The aging process is difficult to analyze </li></ul><ul><li>The medical field of gerontology examines ...
Passive Aging <ul><li>Aging as a passive process is a breakdown of structures and slowing of functions </li></ul><ul><ul><...
Active Aging <ul><li>Aging also entails new activities or the appearance of new substances </li></ul><ul><ul><li>Lipofusci...
The Human Life Span <ul><li>The human life span is approximately 120 years </li></ul><ul><li>Life expectancy is a realisti...
Important Points in Chapter 23: Outcomes to be Assessed <ul><li>23.1: Introduction  </li></ul><ul><li>Distinguish between ...
Important Points in Chapter 23: Outcomes to be Assessed <ul><li>Explain how the primary germ layers originate and list the...
Important Points in Chapter 23: Outcomes to be Assessed <ul><li>Name the postnatal stages of development of a human, and i...
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Chapt23 pregnancy & growth

  1. 1. South Arkansas Community College Edited by B. Holmes MSN/Ed, RN Associate Professor Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Chapter 23 Pregnancy, Growth & Development
  2. 2. Hole’s Human Anatomy and Physiology Twelfth Edition Shier  Butler  Lewis Chapter 23 Pregnancy, Growth, And Development Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
  3. 3. 23.1: Introduction <ul><li>A sperm and a secondary oocyte unite, forming a zygote, and the journey of prenatal development begins </li></ul><ul><li>After 38 weeks of cell division, growth and specialization into distinctive tissues and organs, a new human being enters the world </li></ul><ul><li>Humans grow, develop and age </li></ul><ul><ul><li>Growth is an increase in size </li></ul></ul><ul><ul><li>Development, which includes growth, is the continuous process by which an individual changes from one life phase to another </li></ul></ul><ul><ul><ul><li>Prenatal period is from fertilization to birth </li></ul></ul></ul><ul><ul><ul><li>Postnatal period is from birth to death </li></ul></ul></ul>
  4. 4. 23.2: Pregnancy <ul><li>Pregnancy is the presence of a developing offspring in the uterus </li></ul><ul><li>It consists of three periods, or trimesters, each three months long </li></ul>
  5. 5. Transport of Sex Cells <ul><li>Before fertilization can occur, a secondary oocyte must be ovulated and enter a uterine tube </li></ul><ul><li>Only 200 of between 200 to 600 million sperm reach a secondary oocyte </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Infundibulum Egg cell Path of egg cell Sperm cells Cervix Body of uterus Ovary Semen deposited in vagina during sexual intercourse Path of Sperm cells Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. From M. Tegner and D. Epel. 16 February 1973. &quot;Sea Urchin Sperm.&quot; Science, 179:685-688. © 1973 American Association for the Advancement of Science Vagina
  6. 6. 23.1 From Science to Technology Assisted Reproductive Technologies
  7. 7. Fertilization <ul><li>Fertilization is the union of an egg cell (secondary oocyte) and a sperm cell </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. First polar body Corona radiata Zona pellucidav 1 3 2 4 5 Second meiotic spindle Cell membrane of secondary oocyte Cytoplasm of secondary oocyte Acrosome containing enzymes Nucleus containing chromosomes
  8. 8. 23.3: Prenatal Period <ul><li>The prenatal period usually lasts 38 weeks from conception </li></ul><ul><li>It can be divided into: </li></ul><ul><ul><li>A period of cleavage </li></ul></ul><ul><ul><li>An embryonic stage </li></ul></ul><ul><ul><li>A fetal stage </li></ul></ul>
  9. 9. Period of Cleavage <ul><li>The rapid cell division and distribution of the zygote’s cytoplasm into progressively smaller cells is cleavage </li></ul><ul><li>The cells produced during cleavage are called blastomeres </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a) (b) (c) a: © A. Tsiara/Photo Researchers, Inc.; b: © Omikron/Photo Researchers, Inc.; c: © Petit Format/Nestle/Photo Researchers, Inc.
  10. 10. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Zona pellucida Zygote Day 0 Ovulation Uterus Endometrium Stem cells Cleavages (first cleavage completed about 30 hours after fertilization) Stem cells Sperm nucleus Egg nucleus Polar bodies Day 4 Late morula Day 3 Early morula Day 2 4-cell stage Day 1 2-cell stage Pronucleus formation begins First cleavage division Fertilization occurs about 12-24 hours after ovulation Day 6-7 Blastocyst implantation
  11. 11. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display Blastocyst (a) Trophoblast Inner cell mass Uterine wall (b) Invading trophoblast c: Courtesy of Ronan O'Rahilly, M.D. Carnegie Institute of Washington (c) Inner cell mass Endometrium Trophoblast Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Courtesy of Ronan O'Rahilly, M.D. Carnegie Institute of Washington Lumen Endometrium
  12. 12. 23.2 From Science to Technology Preimplantation Genetic Diagnosis
  13. 13. Hormonal Changes During Pregnancy <ul><li>Secretion of hCG maintains the corpus luteum </li></ul><ul><li>The corpus luteum secretes estrogens and progesterone </li></ul><ul><li>The placenta secretes large amounts of estrogens and progesterone </li></ul><ul><li>Estrogens and progesterone stimulate and maintain the uterine lining, inhibit FSH and LH, inhibit uterine contractions, and enlarge the reproductive organs </li></ul><ul><li>Relaxin from the corpus luteum inhibits uterine contractions and relaxes the pelvic ligaments </li></ul><ul><li>Placental lactogen stimulates breast development </li></ul><ul><li>Aldosterone promotes sodium retention </li></ul><ul><li>PTH maintains calcium concentrations in the blood </li></ul>
  14. 14. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Trophoblast cells secrete hCG hCG maintains corpus luteum Corpus luteum continues to secrete estrogens and progesterone Estrogens and progesterone promote growth, development, and maintenance of uterine wall
  15. 15. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 0 2 4 Months of pregnancy 1 3 5 7 9 6 8 Increasing hormone concentration Estrogens Progesterone Human chorionic gonadotropin
  16. 16.
  17. 17. Other Changes During Pregnancy <ul><li>Growth of the uterus can displace abdominal organs and disrupt meals, including the development of heartburn and increased urinary frequency </li></ul><ul><li>More oxygen is needed and more waste is excreted causing increases in blood volume, cardiac output, breathing rate, and urine production </li></ul><ul><li>To obtain adequate nutrition, intake must be sufficient to supply needed vitamins, minerals and proteins </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (a) (b) (c) a: © A. Tsiara/Photo Researchers, Inc.; b: © Omikron/Photo Researchers, Inc.; c: © Petit Format/Nestle/Photo Researchers, Inc.
  18. 18. Embryonic Stage <ul><li>The embryonic stage extends from the beginning of the second week through the eighth week, when the placenta forms, the main internal organs develop, and the major external body structures appear </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chorion Extraembryonic cavity Ectoderm Mesoderm Endoderm Chorionic villi Connecting stalk Amniotic cavity Endometrium Amnion Lumen of uterus Yolk sac of embryo Germ layers of embryonic disc
  19. 19.
  20. 20. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Yolk sac Ectoderm Mesoderm Connecting stalk Skin Brain Chorion Heart Amnion Neural tube (Spinal cord) Amniotic fluid Digestive tract Chorionic villi Tail end Allantois Endoderm
  21. 21. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. a,b: © 2007 Landrum B. Shettles; c: © Petit Format/Nestle/Photo Researchers, Inc. (a) (b) (c)
  22. 22. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. b: © Carroll Weiss/Camera M.D. Studios (b) Actual length 4 weeks 5 weeks 6 weeks 7 weeks (a) Actual length Actual length Actual length
  23. 23. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. – (e) 49 ± 1 day (28–30 mm) Developing ear External ear Forebrain Elbow Handplate Lens Midbrain Ear Eyelid Heart prominence Hindlimb External ear Digital rays Pigmented eye Paddle-shaped foot plate Notches between toe rays Webbed fingers Mandibular process Paddle-shaped forelimb External acoustic meatus Fingers separated Toes separated Fan-shaped webbed toes (c) 40 ± 1 day (16–21 mm) (a) 35 ± 1 day (10–12 mm) (b) 37 ± 1 day (12.5–15.75 mm) (d) 45 ± 1 day (22–24 mm) (g) 56 ± 1 day (34–40 mm) (f) 52 ± 1 day (32–34 mm) Maxillary process Developing eye Toe rays Wrist
  24. 24. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chorion Endometrium Amniotic cavity Amnion Allantois Umbilical cord Maternal blood vessels Developing placenta Extraembryonic cavity Yolk sac <ul><li>As the amnion develops, it surrounds the embryo, and the umbilical cord begins to form from structures in the connecting stalk </li></ul>
  25. 25. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Artery Chorion Chorionic villi Connective tissue Section of villus Lacuna filled with maternal blood Placental membrane Wall of villus Maternal blood Embryonic capillaries Vein Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Umbilical cord Umbilical arteries Umbilical vein Placenta Endometrium Lacuna Chorion Myometrium Decidua basalis (maternal portion of placenta) Maternal blood vessels Embryonic blood vessels Villi (embryonic portion of placenta)
  26. 26. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chorion Placenta Umbilical cord Amniochorionic membrane Endometrium Myometrium Amniotic fluid
  27. 27. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. © Donald Yaeger/Camera M.D. Studios Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 0 Accutane 1 2 3 4 5 6 7 8 9 Month (b) When different teratogens disrupt development 0 1 2 3 4 5 6 7 8 9 Eyes Ears Heart Month (a) When physical structures develop Reproductive system Upper and lower limbs Central nervous system Diethylstilbestrol Thalidomide
  28. 28. Fetal Stage <ul><li>The fetal stage begins at the end of the eighth week of prenatal development </li></ul><ul><li>Here growth is rapid, and body portions change considerably </li></ul><ul><li>At the beginning of this stage, the head is disproportionately large, and the lower limbs are relatively short </li></ul>
  29. 29. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 13 years 2 month embryo 3 month fetus 22 years Newborn 2 years 5 years
  30. 30. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Genital tubercle Urogenital folds Labioscrotal folds Fused urogenital folds Perineum Anus Urethral groove (a) Urogenital fold Developing penis (c) (e) (d) (f) Glans penis Scrotum Genital tubercle Glans Urogenital fold Labioscrotal fold (b) Developing clitoris Embryonic tail Urethral groove Glans clitoris Hymen Labia minora Labia majora Perineum Anus Urethral orifice Prepuce Male Female Vaginal orifice
  31. 31. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Umbilical cord Placenta Uterine wall Cervix Amniochorionic membrane Amniotic fluid
  32. 32.
  33. 33. 23.1 Clinical Application Some Causes of Birth Defects
  34. 34. Fetal Blood and Circulation Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Placenta Fetal capillaries Umbilical vein Umbilical arteries Uterine wall Maternal blood in lacuna Diffusion Oxygen and nutrients into fetal blood Diffusion W aste substances into maternal blood Chorionic villus Blood flow from fetus, branch of umbilical artery Blood flow to fetus, branch of umbilical vein
  35. 35. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Aortic arch Superior vena cava Inferior vena cava Hepatic portal vein Pulmonary artery Left atrium Pulmonary veins Abdominal aorta Pulmonary trunk Left ventricle Left renal artery Common iliac artery Internal iliac artery Umbilical vein Umbilical arteries Placenta Foramen ovale (becomes fossa ovalis) Ductus venosus (becomes ligamentum venosum) Umbilical vein (becomes ligamentum teres) Umbilical arteries (become medial umbilical ligaments) Ductus arteriosus (becomes ligamentum arteriosum) Decreasing blood oxygen level
  36. 36. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Placenta Liver Lungs Ductus venosus Right atrium Right ventricle Foramen ovale Left atrium Left ventricle Aortic arch Aorta Umbilical vein (oxygen, nutrients) Superior vena cava Inferior vena cava Heart, brain, upper limbs Ductus arteriosus (most of the blood) Pulmonary trunk Trunk and lower limbs Umbilical artery (carbon dioxide, wastes) Umbilical artery (carbon dioxide, wastes) Internal iliac arteries Decreasing blood oxygen level
  37. 37.
  38. 38. 23.2 Clinical Application Joined For Life
  39. 39. Birth Process <ul><li>Pregnancy terminates with the birth process called parturition </li></ul><ul><li>The process is complex as noted in Table 23.5 </li></ul>
  40. 40. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Fetal head is forced toward cervix Cervix is stretched Stretch receptors are stimulated Fetus is moved downward Reflex is elicited that causes stronger uterine contractions
  41. 41. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Placenta Urethra V agina Cervix Rectum Amniotic sac (b) (a) (c) (d) Placenta Placenta Uterus Symphysis pubis Urinary bladder Ruptured amniotic sac Umbilical cord
  42. 42. Milk Production and Secretion
  43. 43. © Biophoto Associates/Photo Researchers, Inc. (a) (b) Glandular tissue with secretions Glandular tissue Connective tissue Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
  44. 44. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Release Duct Lumen Myoepithelial cells Secretion Milk Nipple or areola of breast is stimulated Nerve impulses travel to hypothalamus Hypothalamus signals posterior lobe of pituitary gland to release oxytocin Oxytocin causes myoepithelial cells surrounding alveolar glands to contract Milk is released from ductile system through nipple Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
  45. 45.
  46. 46. 23.3 Clinical Application Human Milk – The Perfect Food for Human Babies
  47. 47. 23.4: Postnatal Period <ul><li>Following birth, both mother and newborn experience physiological and structural changes </li></ul><ul><li>The postnatal period lasts from birth until death </li></ul><ul><li>It can be divided into: </li></ul><ul><ul><li>The neonatal period </li></ul></ul><ul><ul><li>Infancy </li></ul></ul><ul><ul><li>Childhood </li></ul></ul><ul><ul><li>Adolescence </li></ul></ul><ul><ul><li>Adulthood </li></ul></ul><ul><ul><li>Senescence (including dying) </li></ul></ul>
  48. 48. Neonatal Period <ul><li>Neonatal period </li></ul><ul><ul><li>From birth to the end of the 4 th week </li></ul></ul><ul><ul><li>The newborn begins to carry on respiration, obtain nutrients, digest nutrients, excrete wastes, regulate body temperature, and make cardiovascular adjustments </li></ul></ul>
  49. 49.
  50. 50. Infancy <ul><li>Infancy </li></ul><ul><ul><li>From the end of the 4 th week to one year </li></ul></ul><ul><ul><li>The growth rate is high </li></ul></ul><ul><ul><li>The teeth begin to erupt </li></ul></ul><ul><ul><li>The muscular and nervous systems mature </li></ul></ul><ul><ul><li>Communication begins </li></ul></ul>
  51. 51. Childhood <ul><li>Childhood </li></ul><ul><ul><li>From one year to puberty </li></ul></ul><ul><ul><li>The growth rate is high </li></ul></ul><ul><ul><li>Permanent teeth appear </li></ul></ul><ul><ul><li>Muscular control is achieved </li></ul></ul><ul><ul><li>Bladder and bowel controls are established </li></ul></ul><ul><ul><li>Intellectual abilities mature </li></ul></ul>
  52. 52. Adolescence <ul><li>Adolescence </li></ul><ul><ul><li>From puberty to adulthood </li></ul></ul><ul><ul><li>The person becomes reproductively functional and emotionally more mature </li></ul></ul><ul><ul><li>Growth spurts occur </li></ul></ul><ul><ul><li>Motor skills continue to develop </li></ul></ul><ul><ul><li>Intellectual abilities continue to mature </li></ul></ul>
  53. 53. Adulthood <ul><li>Adulthood </li></ul><ul><ul><li>Adolescence to old age </li></ul></ul><ul><ul><li>The person remains relatively unchanged anatomically and physiologically </li></ul></ul><ul><ul><li>Degenerative changes begin </li></ul></ul>
  54. 54. Senescence <ul><li>Senescence </li></ul><ul><ul><li>Old age to death </li></ul></ul><ul><ul><li>Degenerative changes continue </li></ul></ul><ul><ul><li>The body becomes less able to cope with the demands placed on it </li></ul></ul><ul><ul><li>Death results from various conditions and diseases </li></ul></ul>
  55. 55.
  56. 56.
  57. 57. 23.4 Clinical Application Living To 100 – And Beyond
  58. 58. The End of Life <ul><li>Nearing the end of life is a personal process, influenced by belief as well as circumstance </li></ul><ul><li>A person who has been chronically ill may show signs of impending death, often in a sequence </li></ul><ul><li>Two stages of the dying process include: </li></ul><ul><ul><li>Preactive dying which may take up to three months </li></ul></ul><ul><ul><li>Active dying with a distinct set of signs </li></ul></ul>
  59. 59. 23.5: Aging <ul><li>The aging process is difficult to analyze </li></ul><ul><li>The medical field of gerontology examines the biological changes of aging at the molecular, cellular, organismal, and population levels </li></ul><ul><li>Aging is both active and passive </li></ul>
  60. 60. Passive Aging <ul><li>Aging as a passive process is a breakdown of structures and slowing of functions </li></ul><ul><ul><li>Molecularly a degeneration of elastin and collagen proteins </li></ul></ul><ul><ul><li>Biochemically lipids breakdown </li></ul></ul><ul><ul><li>Cellular degradation is associated with free radicals </li></ul></ul>
  61. 61. Active Aging <ul><li>Aging also entails new activities or the appearance of new substances </li></ul><ul><ul><li>Lipofuscin granules from the breakdown of lipids </li></ul></ul><ul><ul><li>Autoimmunity </li></ul></ul><ul><ul><li>Apoptosis: the process of programmed cell death </li></ul></ul>
  62. 62. The Human Life Span <ul><li>The human life span is approximately 120 years </li></ul><ul><li>Life expectancy is a realistic projection of how long an individual will live </li></ul><ul><li>The current U.S. life expectancy is 75.4 years for men and 83.2 years for women </li></ul><ul><li>Medical advances contribute to improved life expectancy </li></ul>
  63. 63.
  64. 64. Important Points in Chapter 23: Outcomes to be Assessed <ul><li>23.1: Introduction </li></ul><ul><li>Distinguish between growth and development. </li></ul><ul><li>Distinguish between prenatal and postnatal. </li></ul><ul><li>23.2: Pregnancy </li></ul><ul><li>Describe fertilization. </li></ul><ul><li>23.3: Prenatal Period </li></ul><ul><li>List and provide details of the major events of cleavage. </li></ul><ul><li>Describe implantation. </li></ul><ul><li>Discuss the hormonal and other changes in the maternal body during pregnancy. </li></ul>
  65. 65. Important Points in Chapter 23: Outcomes to be Assessed <ul><li>Explain how the primary germ layers originate and list the structures each layer produces. </li></ul><ul><li>Describe the major events of the embryonic stage of development. </li></ul><ul><li>Describe the formation and function of the placenta. </li></ul><ul><li>Define fetus, and describe the major events that occur during the fetal stage of development. </li></ul><ul><li>Trace the path of blood through the fetal cardiovascular system. </li></ul><ul><li>Explain the role of hormones in the birth process and milk production. </li></ul><ul><li>23.4: Postnatal Period </li></ul><ul><li>Describe the major cardiovascular and physiological adjustments that occur in a newborn. </li></ul>
  66. 66. Important Points in Chapter 23: Outcomes to be Assessed <ul><li>Name the postnatal stages of development of a human, and indicate the general characteristics of each stage. </li></ul><ul><li>23.5: Aging </li></ul><ul><li>Distinguish between active and passive aging. </li></ul><ul><li>Contrast lifespan and life expectancy. </li></ul>
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