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Gastro intestinal, Reproductive, Urinary


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Gastro intestinal, Reproductive, Urinary

  1. 1. <ul><li>The digestive system </li></ul>
  2. 2. The DIGESTIVE SYSTEM <ul><li>Alimentary tract composed of organs, the primary function of which is the ingestion, digestion and absorption of nutrients </li></ul>
  3. 3. The DIGESTIVE SYSTEM <ul><li>Consists of the tube extending from the mouth to the anus together with the associated organs- salivary glands, liver, pancreas, gallbladder </li></ul>
  4. 5. The GIT <ul><li>The tract is long, fibromuscular tube lined internally by specialized epithelium for secretion and absorption </li></ul>
  5. 6. The GIT <ul><li>The wall is divided into </li></ul><ul><li>Mucosa </li></ul><ul><li>Submucosa </li></ul><ul><li>Muscularis layer (inner circular and outer longitudinal) </li></ul><ul><li>and Serosa/adventitia </li></ul>
  6. 7. Fig. 16.2
  7. 8. GENERAL FUNCTIONS <ul><li>Ingestion of food into the mouth </li></ul><ul><li>Moves food along the digestive tract </li></ul><ul><li>Mechanically digests the food into small particles </li></ul>
  8. 9. GENERAL FUNCTIONS <ul><li>Chemically digests the food into simple molecules </li></ul><ul><li>Absorbs nutrients into the portal and lymphatic circulation </li></ul>
  9. 10. The MOUTH <ul><li>Extends from the lips to the orophaynx </li></ul><ul><li>Initial digestion of carbohydrates occurs here </li></ul><ul><li>Contains the teeth, tongue, palate, salivary glands and tonsils </li></ul>
  10. 11. Salivary glands <ul><li>1. Parotid= secretes purely serous, Stensen’s duct </li></ul><ul><li>2.Submandibular/submaxillay= secretes mixed saliva, with Wharton’s duct </li></ul><ul><li>3. Sublingual= secretes mixed saliva, with two ducts- duct of Rivinus and duct of Bartholin </li></ul>
  11. 13. The Pharynx <ul><li>Oropharynx is a passageway of both food and air </li></ul>
  12. 14. The Esophagus <ul><li>Muscular tube extending from the pharynx to the stomach </li></ul><ul><li>With upper esophageal sphincter and lower esophageal sphincter </li></ul>
  13. 15. The Esophagus <ul><li>Function: to propel food to the stomach </li></ul>
  14. 16. The Stomach <ul><li>J-shaped dilatable part of the GIT </li></ul><ul><li>Located on the epigastric area and right upper quadrant </li></ul><ul><li>With 3 parts: </li></ul><ul><ul><li>1. Fundus </li></ul></ul><ul><ul><li>2. Body </li></ul></ul><ul><ul><li>3. Pylorus </li></ul></ul>
  15. 17. Cells in the stomach <ul><li>1. Mucus cells </li></ul><ul><li>2. Chief cells/principal cells/Zymogenic cells </li></ul><ul><li>3. Parietal Cells </li></ul><ul><li>4. Argentaffin cells </li></ul>
  16. 18. Cells in the stomach <ul><li>1. Mucus cells- secrete mucus for protection of the mucosa </li></ul>
  17. 19. Cells in the stomach <ul><li>2. Chief cells/principal cells/Zymogenic cells </li></ul><ul><li> secrete Pepsinogen needed for protein digestion </li></ul>
  18. 20. Cells in the stomach <ul><li>3. Parietal cells/Oxyntic cells- secrete Hydrochloric acid to activate pepsinogen and Intrinsic factor needed to absorb Vitamin B12 </li></ul>
  19. 21. Cells in the stomach <ul><li>4. Argentaffin cells- secrete Serotonin </li></ul>
  20. 22. Small intestine <ul><li>Characteristics: </li></ul><ul><li>Provided with mesentery </li></ul><ul><li>Presence of villi </li></ul><ul><li>Presence of plicae circularis </li></ul><ul><li>Lined by simple columnar </li></ul>
  21. 23. Fig. 16.14
  22. 24. Parts of Small Intestine <ul><li>1. DUODENUM- shortest part </li></ul><ul><li>2. Jejunum </li></ul><ul><li>3. Ileum- longest part </li></ul>
  23. 25. Parts of Small Intestine
  24. 26. Large intestine <ul><li>Characteristics </li></ul><ul><li>Presence of haustra </li></ul><ul><li>Presence of taenia coli </li></ul><ul><li>Presence of appendices epiploicae </li></ul>
  25. 27. Large intestine <ul><li>Characteristics </li></ul><ul><li>No villi </li></ul><ul><li>With mesocolon on the appendix, transverse colon and sigmoid colon </li></ul>
  26. 28. Parts of the large intestine <ul><li>Cecum </li></ul><ul><li>Appendix </li></ul><ul><li>Ascending colon </li></ul><ul><li>Transverse colon </li></ul><ul><li>Descending colon </li></ul><ul><li>Sigmoid colon </li></ul><ul><li>rectum </li></ul>
  27. 30. Anus <ul><li>The anal canal is the last portion of the tract, surrounded by an internal and external anal sphincter </li></ul>
  28. 31. The Peritoneum <ul><li>Serous membrane lining the abdominal cavity </li></ul><ul><li>Parietal peritoneum- abdominal wall </li></ul><ul><li>Visceral peritoneum- visceral organs </li></ul>
  29. 32. Fig. 16.3
  30. 33. The Peritoneum <ul><li>Retroperitoneal organs are found posterior to the peritoneum- kidney, pancreas, duodenum, ascending and descending colon, rectum </li></ul>
  31. 34. Mesentery <ul><li>This is a peritoneum folded upon itself extending from the organ to the abdominal wall </li></ul>
  32. 35. Blood supply of the GIT <ul><li>Branches of the celiac trunk </li></ul><ul><li>Left gastric artery </li></ul><ul><li>Hepatic artery </li></ul><ul><li>Superior mesenteric artery </li></ul>
  33. 36. Accessory organs <ul><li>Pancreas </li></ul><ul><li>A pistol-shaped organ both an endocrine and exocrine gland </li></ul><ul><li>Parts: head, body and tail </li></ul><ul><li>Ducts: major is Wirsung, minor is Santorini </li></ul>
  34. 38. Accessory organ <ul><li>Liver </li></ul><ul><li>Largest internal organ </li></ul><ul><li>Located on the right upper quadrant </li></ul><ul><li>With right and left lobes </li></ul><ul><li>Functions to secrete bile </li></ul>
  35. 39. Liver physiology and Pathophysiology = Gynecomastia, testes atrophy 8. Metabolizes estrogen =Deficiencies of Vit and min 7. Stores Vitamims and minerals =Hyper-ammonemia 6. Converts ammonia to urea = Jaundice and pruritus 5. Secreting bile = Bleeding tendencies 4. Synthesizes Clotting factors =Decreased Antibody formation  risk for INFECTION 3. Synthesizes globulins = Hypo-proteinemia 2. Synthesizes proteins = Hypoglycemia 1. Stores glycogen Abnormality in function Normal Function
  36. 41. Accessory organ <ul><li>Gallbladder </li></ul><ul><li>Pear-shaped organ on the right upper quadrant below the liver </li></ul><ul><li>Parts: fundus, body and neck </li></ul><ul><li>Functions to store and concentrate bile </li></ul>
  37. 43. <ul><li>PHYSIOLOGY OF THE GIT </li></ul>
  38. 44. Movement <ul><li>Mouth </li></ul><ul><li>Chewing or mastication </li></ul>
  39. 45. Secretions <ul><li>Mouth </li></ul><ul><li>Salivary secretions- salivary amylase or ptyalin begins the digestion of carbohydrates </li></ul>
  40. 46. Movements <ul><li>Mouth and esophagus: Deglutition </li></ul><ul><li>1. Voluntary phase- food bolus is pushed by tongue to the pharynx </li></ul><ul><li>2. Pharyngeal phase- reflex action </li></ul><ul><li>3. Esophageal phase- peristaltic waves moves the food towards the stomach </li></ul>
  41. 47. Stomach movement <ul><li>Mixing waves </li></ul><ul><li>Peristaltic movements </li></ul>
  42. 48. Fig. 16.12
  43. 49. Secretions <ul><li>Stomach </li></ul><ul><li>1. Mucus- by the mucus cells for mucosal protection </li></ul><ul><li>2. HCL from parietal cells </li></ul><ul><li>3. Pepsinogen from chief cells </li></ul><ul><li>4. Intrinsic factor from parietal cells </li></ul><ul><li>5. Gastrin =a hormone from the antral G cells </li></ul>
  44. 50. Secretions <ul><li>Stomach </li></ul><ul><li>Digestion for lipids: </li></ul><ul><ul><li>Gastric lipase </li></ul></ul><ul><li>Digestion for proteins: </li></ul><ul><ul><li>Pepsin </li></ul></ul><ul><li>No enyme for carbohydrates </li></ul>
  45. 51. Regulation of stomach secretions <ul><li>1. Cephalic phase- stomach secretions are initiated by the sight, smell, thought and taste of food </li></ul>
  46. 52. Regulation of stomach secretions <ul><li>2. Gastric phase- secretions are produced upon stomach distention </li></ul>
  47. 53. Regulation of stomach secretions <ul><li>3. Intestinal phase- acidic chyme from the stomach passes into the duodenum causing inhibition of gastric secretions </li></ul>
  48. 54. Small intestine: movement <ul><li>1. Segmental contraction mixes food occurring over short distance </li></ul><ul><li>2. Peristalsis propels food all throughout the entire intestine </li></ul>
  49. 55. Fig. 16.9
  50. 56. Small intestine: secretions <ul><li>1. Intestinal lipase for lipids </li></ul><ul><li>2. Dissacharidases from the intestinal cells that complete the digestion of carbohydrates </li></ul><ul><li>3. Peptidases from the intestinal cells complete the digestion of proteins </li></ul>
  51. 57. Fig. 16.22
  52. 59. Large Intestine: secretion and movement <ul><li>Mucus for mucosal protection </li></ul><ul><li>Mass movement- short peristaltic movement </li></ul>
  53. 60. Large Intestine: secretion and movement <ul><li>Defecation reflex- moves the feces to the internal anal sphincter, mediated by the parasympathetic nerves </li></ul><ul><li>Distention causes the reflex </li></ul>
  54. 61. Liver secretion <ul><li>Bile- aids in emulsifying the fats </li></ul>
  55. 62. Pancreatic secretions <ul><li>1. Bicarbonate- to neutralize the acidic chyme from the stomach </li></ul><ul><li>2. Pancreatic amylase- for carbohydrate digestion </li></ul>
  56. 63. Pancreatic secretions <ul><li>3. Pancreatic lipase- for fat digestion </li></ul><ul><li>4. Trypsin and chymotrypsin- for protein digestion </li></ul>
  57. 64. <ul><li>End of GIT </li></ul>
  58. 65. THE URINARY SYTEM <ul><li>The excretory system consisting of the kidney, ureters, urinary bladder and urethra </li></ul>
  59. 67. Major functions <ul><li>Eliminates wastes </li></ul><ul><li>Controls blood and fluid volume </li></ul><ul><li>Regulates acid-base balance </li></ul><ul><li>Regulates RBC production by erythropoietin </li></ul>
  60. 68. The Kidney <ul><li>Retroperitoneal organ surrounded by capsule and fats </li></ul><ul><li>Right is lower than the left </li></ul><ul><li>The substance is composed of renal cortex ( where nephrons are located) and renal medulla ( where collecting ducts are found) </li></ul>
  61. 70. The Nephron <ul><li>Functional unit of the kidney that produces urine by filtration </li></ul><ul><li>Composed of </li></ul><ul><ul><li>Efferent arteriole </li></ul></ul><ul><ul><li>Glomerulus </li></ul></ul><ul><ul><li>Afferent arteriole </li></ul></ul><ul><ul><li>Bowman’s capsule </li></ul></ul><ul><ul><li>Convoluted tubules- proximal, loop of Henle and distal </li></ul></ul>
  62. 72. Special cells in the nephron <ul><li>Juxtaglomerular cells- secrete renin and erythropoietin </li></ul><ul><li>Podocytes </li></ul>
  63. 73. Blood supply of the kidney <ul><li>Renal artery- branch of the abdominal aorta </li></ul><ul><li>Renal vein- drains into the inferior venal cava </li></ul>
  64. 74. Renal pelvis <ul><li>Funnel-shaped expanded portion of the ureter </li></ul><ul><li>Formed by the calyces </li></ul><ul><li>Collects urine from the kidney </li></ul>
  65. 75. The Ureter <ul><li>Left and right </li></ul><ul><li>A long slender tube that propels urine from the kidney to the urinary bladder </li></ul><ul><li>With smooth muscles and transitional epithelium </li></ul><ul><li>With innervations from the sympathetic and parasympathetic </li></ul>
  66. 77. The urinary bladder <ul><li>Hollow pyramid shaped organ located in the pelvis </li></ul><ul><li>Lined with transitional epithelium </li></ul><ul><li>With thick detrusor muscles </li></ul><ul><li>Micturition reflex resulting from the distension of the organ </li></ul><ul><li>Impulses are transmitted to the sacral parasympathetic segments to initiate urination </li></ul>
  67. 78. Fig. 18.17
  68. 79. Urethra <ul><li>Tube extending from the urinary bladder to the external urethral orifice </li></ul><ul><ul><li>1 ½ inches in females </li></ul></ul><ul><li>3 parts in Males </li></ul><ul><ul><li>1. Prostatic urethra- most dilatable </li></ul></ul><ul><ul><li>2. Membranous urethra- least dilatable and shortest </li></ul></ul><ul><ul><li>3. Penile urethra- longest </li></ul></ul>
  69. 81. Renal Physiology <ul><li>Urine formation </li></ul><ul><li>1. Urinary blood flow </li></ul><ul><li>2. Glomerular filtration </li></ul><ul><li>3. Tubular reabsorption </li></ul><ul><li>4. tubular secretion </li></ul>
  70. 85. Fig. 18.12
  71. 86. Fig. 18.13
  72. 87. Fig. 18.14
  73. 88. <ul><li>End of renal </li></ul>
  74. 89. The MALE Reproductive system <ul><li>Made up of organs, ducts and glands whose function is to produce spermatozoa and androgens </li></ul>
  75. 90. Internal Male reproductive organs <ul><li>1. Testes </li></ul><ul><li>2. Ducts- epididymis, vas deferens and ejacularoty duct </li></ul><ul><li>3. Glands- prostate and Cowper’s </li></ul><ul><li>4. Seminal vesicle </li></ul>
  76. 91. The testes <ul><li>Male gonad housed in the scrotum </li></ul><ul><li>Divided into lobules containing tubules and cells </li></ul><ul><li>Sperm cells are produced in the seminiferous tubules </li></ul><ul><li>Leydig cells secrete testosterone </li></ul>
  77. 92. Spermatogenesis <ul><li>Begins during puberty </li></ul><ul><li>Occurs in the seminiferous tubules </li></ul><ul><li>Spermatogonia divides by MITOSIS into primary spermatocytes </li></ul><ul><li>Primary spermatocytes divide by MEOSIS to produce secondary spermatocytes </li></ul>
  78. 94. Spermiogenesis <ul><li>Maturation of sperm cells </li></ul><ul><li>Secondary spermatocytes become spermatids and go to the epididymis for maturation into spermatozoa </li></ul>
  79. 95. Ducts <ul><li>1. Epididymis- coiled tube </li></ul><ul><li>2. Vas deferens- long tube from the epididymis to the seminal vesicle </li></ul><ul><li>3. Ejaculatory duct- formed by the union of the vas deferens and the duct of the seminal vesicle </li></ul>
  80. 96. Glands <ul><li>1. Prostate gland- glandular and muscular tissue produces likely, slightly acidic fluid and contributes 20% of the semen </li></ul><ul><li>2. Seminal Vesicle- convoluted pouch, secretes alkaline fluid and fructose contributing to the bulk of the semen </li></ul><ul><li>3. Cowper’s glands- secrete mucus for lubrication </li></ul>
  81. 97. Fig. 19.5a
  82. 98. External genitalia <ul><li>1. Scrotum- two chambered sac contains the testes </li></ul><ul><li>2. Penis- erectile tissue consists of two corpora cavernosa and one corpora spongiosa </li></ul><ul><ul><li>With 3 parts- bulb, shaft and glans </li></ul></ul>
  83. 99. The semen <ul><li>Mixture of glandular secretions from the prostate and seminal vesicle and spermatozoa from the testes </li></ul><ul><li>Volume: 2.5-5 ml </li></ul><ul><li>Sperm count- 50-150 million per ml </li></ul>
  84. 100. <ul><li>SEMEN: </li></ul><ul><ul><li>Is a thick whitish fluid ejaculated by the male during orgasm, contains spermatozoa and fructose-rich nutrients. </li></ul></ul><ul><ul><li>During ejaculation, semen receives contributions of fluid from </li></ul></ul><ul><ul><ul><li>Prostate gland </li></ul></ul></ul><ul><ul><ul><li>Seminal vesicle </li></ul></ul></ul><ul><ul><ul><li>Epididymis </li></ul></ul></ul><ul><ul><ul><li>Bulbourethral gland </li></ul></ul></ul><ul><ul><li>Average pH = 7.5 </li></ul></ul><ul><ul><li>The average amount of semen released during ejaculation is 2.5 -5 ml. It can live with in the female genital tract for about 24 to 72 hours. </li></ul></ul><ul><ul><li>(60-200 million/ml of ejaculation ave. of 400 million/ ejaculation ) </li></ul></ul><ul><ul><li>90 seconds- cervix </li></ul></ul><ul><ul><li>5 minutes.- end of fallopian tube </li></ul></ul>
  85. 101. THE FEMALE reproductive system <ul><li>Group of organs with the function of production of ovum and sex hormones </li></ul>
  86. 102. Parts of the reproductive system <ul><li>EXTERNAL (vulva) </li></ul><ul><li>1. Mons pubis </li></ul><ul><li>2. Labia majora </li></ul><ul><li>3. Labia majora </li></ul><ul><li>4. Clitoris </li></ul><ul><li>5. Hymen </li></ul><ul><li>6. Vestibule </li></ul><ul><li>7. Pudendal cleft </li></ul><ul><li>INTERNAL </li></ul><ul><li>1. Ovary </li></ul><ul><li>2. Fallopian tubes </li></ul><ul><li>3. Uterus </li></ul><ul><li>4. Vaginal canal </li></ul>
  87. 103. The Internal organs <ul><li>OVARY </li></ul><ul><ul><li>Firm almond shaped organ covered by the peritoneum </li></ul></ul><ul><ul><li>Two parts: cortex and medulla </li></ul></ul><ul><ul><li>CORTEX- follicles are found </li></ul></ul><ul><ul><li>Medulla- connective tissue </li></ul></ul>
  88. 104. The internal organs <ul><li>Fallopian tubes </li></ul><ul><li>Bilateral ducts extends laterally from the uterus </li></ul><ul><li>4 parts </li></ul><ul><li>1. Infundibulum- funnel shape, with fimbriae </li></ul><ul><li>2. Ampulla- widest part; usual site of FERTILIZATION </li></ul><ul><li>3. Isthmus- narrowest part </li></ul><ul><li>4. Interstitial or Intramural- embedded in the uterine wall </li></ul><ul><li>FUNCTION: Transport of ovum </li></ul>
  89. 105. Fig. 20.2
  90. 107. The Uterus <ul><li>Pear-shaped organ with a cavity </li></ul><ul><li>3 main parts </li></ul><ul><li>1. Fundus- upper dome-shape part </li></ul><ul><li>2. Corpus or Body- broad part </li></ul><ul><li>3. Cervix- narrow lower part </li></ul><ul><ul><li>Isthmus- junction between the body and the cervix </li></ul></ul><ul><li>POSITION: Anteverted and Anteflexed </li></ul>
  91. 109. The Uterus <ul><li>The uterine wall is made up of three layers </li></ul><ul><li>1. Epimetrium- superficial part surrounded by the perimetrium </li></ul><ul><li>2. Myometrium- thickest muscular part </li></ul><ul><li>3. Endometrium- inner layer </li></ul><ul><li>FUNCTION: Fetal development in pregnancy </li></ul>
  92. 110. The endometrium <ul><li>3 layers of the endometrium </li></ul><ul><li>1. Stratum Functionale </li></ul><ul><ul><ul><li>Stratum compactum </li></ul></ul></ul><ul><ul><ul><li>Stratum spongiosum </li></ul></ul></ul><ul><li>2. Stratum basale or germinativum </li></ul>
  93. 111. Uterine ligaments <ul><li>Broad ligament </li></ul><ul><li>Round ligament </li></ul><ul><li>Cardinal ligament </li></ul><ul><li>Utero-sacral ligament </li></ul>
  94. 112. Fig. 19.8
  95. 113. Vaginal canal <ul><li>Connects the cervix to the vestibule </li></ul><ul><li>Fibromuscular canal lined with mucus and covered with hymen </li></ul><ul><li>The remnant of hymen is called CARUNCULAE MYRTIFORMIS </li></ul><ul><li>Function: organ of copulation and passageway of baby </li></ul>
  96. 115. External genitalia <ul><li>1. Vestibule- space between the labia minora </li></ul><ul><li>2. Pudendal cleft- space between the labia majora </li></ul><ul><li>3. Clitoris- erectile tissue, homologue of penis </li></ul>
  97. 116. External genitalia <ul><li>4. Labia majora- thick fold of skin, homologue of scrotum </li></ul><ul><li>5. Labia Minora- thin fold of skin devoid of hairs </li></ul><ul><li>6. Mons pubis/veneris- elevated area above the labia </li></ul>
  98. 117. Mammary gland <ul><li>Modified sweat gland </li></ul><ul><li>Consists of glandular and adipose tissue </li></ul><ul><li>Estrogen  for breast development </li></ul><ul><li>Progesterone  for lobular development </li></ul><ul><li>Prolactin  for milk production </li></ul><ul><li>Oxytocin  for milk “let down” </li></ul>
  99. 119. PHYSIOLOGY of female reproduction <ul><li>1. Puberty </li></ul><ul><li>2. Menstruation </li></ul><ul><li>3. Menopause </li></ul>
  100. 120. Puberty <ul><li>Begins with the onset of the first menstruation= MENARCHE </li></ul><ul><li>GnRH (from hypothalamus) Gonadotrophins (LH and FSH from the ant pit) levels are increased </li></ul><ul><li>Tanner- states that the initial sign of puberty in girls is breast development </li></ul>
  101. 121. Fig. 19.11
  102. 122. Menstrual cycle <ul><li>Cyclical changes in the uterus controlled by hormones </li></ul><ul><li>Duration: 24-35 days </li></ul><ul><li>Changes in the 3 systems/organs: </li></ul><ul><li>1. Uterus  uterine cycle </li></ul><ul><li>2. Ovary  ovarian cycle </li></ul><ul><li>3. Hormone  hormonal cycle </li></ul>
  103. 123. <ul><li>MENSTRUATION: </li></ul><ul><li>Menstrual cycle/ female reproductive cycle- monthly discharge of blood from the uterus occurring form puberty to menopause wherein about 30-80 cc (60 cc ave.) of blood, epithelial cells and mucus are being discharged </li></ul>
  104. 124. <ul><li>Maturation of Oocytes: </li></ul><ul><ul><li>first formed in utero - 5 to7 million; </li></ul></ul><ul><ul><li>first 5 months in utero - 2 million immature oocytes per ovary </li></ul></ul><ul><ul><li>at birth - 2 million in BOTH ovaries </li></ul></ul><ul><ul><li>7 yrs of age only - 500,000/ovary </li></ul></ul><ul><ul><li>22y/o only - 300,000/ovary </li></ul></ul><ul><ul><li>Reproductive age only - 300–400 oocytes </li></ul></ul><ul><ul><li>Menopause - none </li></ul></ul>
  105. 126. Fig. 19.14
  106. 127. The uterine cycle <ul><li>Consists of 3 phases </li></ul><ul><li>Menstrual phase </li></ul><ul><li>Proliferative phase </li></ul><ul><li>Secretory phase </li></ul>
  107. 128. OVARIAN cycle Consists of three phases 1. Pre-ovulatory : follicular phase 2. Ovulatory phase 3. Post-ovulatory : Luteal phase
  108. 130. Uterine Cycle: Menstrual phase <ul><li>Day 1- day 5 </li></ul><ul><li>First day of bleeding is the first day of cycle </li></ul><ul><li>Stratum functionale (compactum and spongiosum) is shed </li></ul><ul><li>Around 60 ml average! </li></ul>
  109. 131. Uterine cycle: proliferative Phase <ul><li>Day 5- day 14 </li></ul><ul><li>Epithelial cells of functionale multiply and form glands </li></ul><ul><li>Due to the influence of estrogen </li></ul>
  110. 132. Uterine cycle: Secretory phase <ul><li>Day 15- day 28 </li></ul><ul><li>Endometrium becomes thicker and glands secrete nutrients </li></ul><ul><li>Uterus is prepared for implantation </li></ul><ul><li>Due to progesterone </li></ul><ul><li>If no fertilization  constriction vessels  menstruation </li></ul>
  111. 133. OVARIAN cycle <ul><li>Consists of three phases </li></ul><ul><li>1. Pre-ovulatory : follicular phase </li></ul><ul><li>2. Ovulatory phase </li></ul><ul><li>3. Post-ovulatory : Luteal phase </li></ul>
  112. 134. Ovarian Cycle; preovulatory/follicular <ul><li>Variable in length: day 6- day 13 </li></ul><ul><li>Dominant follicle matures and becomes graafian follicle with primary oocyte </li></ul><ul><li>FSH increases initially then decreases because of estrogen increase </li></ul>
  113. 135. Ovarian cycle: Ovulatory phase <ul><li>Day 14 </li></ul><ul><li>Rupture of the graafian follicle releasing the secondary oocyte </li></ul><ul><li>Due to the LH surge </li></ul><ul><li>MITTELSCHMERZ- pain during rupture of follicle </li></ul>
  114. 136. OVARIAN cycle: Post-ovulatory: luteal phase <ul><li>Day 15- day 28 </li></ul><ul><li>MOST CONSTANT 14 days after ovulation </li></ul><ul><li>Corpus luteum secretes Progesterone </li></ul><ul><li>If no fertilization, corpus luteum will become corpus albicans then degenerate </li></ul><ul><li>Decreased estrogen and progesterone </li></ul>
  115. 137. Hormonal cycle <ul><li>1. Menstrual phase </li></ul><ul><ul><li>Decreased Estrogen, decreased progesterone, decreased FSH and decreased LH </li></ul></ul><ul><li>2. Proliferative/ Pre-ovulatory phase </li></ul><ul><ul><li>Increased FSH and Estrogen in small amounts </li></ul></ul>
  116. 138. Hormonal cycle <ul><li>3. Ovulatory phase </li></ul><ul><ul><li>Increased FSH, Increased LH (surge) Increased Estrogen </li></ul></ul><ul><li>4. Post ovulatory/luteal Phase </li></ul><ul><ul><li>Increased Estrogen, increased progesterone, decreased FSH and LH </li></ul></ul>
  117. 140. MENOPAUSE <ul><li>Cessation of menstruation for at least one year occurring at the age of 45-52 </li></ul><ul><li>Decreased estrogen and progesterone </li></ul><ul><li>Increased FSH </li></ul>
  118. 141. <ul><li>End of reproductive </li></ul>