female reproductive organ, gross anatomy of uterus, its parts,position, internal structure, its attachments, supports of uterus, blood supply and lymphatic drainage.
The female reproductive system is made up of the internal and external sex organs that function in reproduction of new offspring. In humans, the female reproductive system is immature at birth and develops to maturity at puberty to be able to produce gametes, and to carry a fetes to full term.
female reproductive organ, gross anatomy of uterus, its parts,position, internal structure, its attachments, supports of uterus, blood supply and lymphatic drainage.
The female reproductive system is made up of the internal and external sex organs that function in reproduction of new offspring. In humans, the female reproductive system is immature at birth and develops to maturity at puberty to be able to produce gametes, and to carry a fetes to full term.
ovaries, fallopian tube, component of internal genitalia, location of ovarie, boundaries of ovaries,external features of ovaries,ligaments of ovaries, support of ovaries, broad ligament, mesovarium, mesosalpinx, mesometrium, round ligament of uterus, blood supply and lymphatics of ovaries, prts of fallopian tube, blood supply of fallopian tube, ectopic pregnancy, polycystic ovaries,
PHYSIOLOGY OF MENSTRUATION
Introduction :
Typically, a woman of childbearing age should menstruate every 28 days or so unless she's pregnant or moving into menopause. But numerous things can wrong with the normal menstrual cycle.
Definition:
Menstruation means cyclic uterine bleeding caused by shedding of progestational endometrium it occurs between menarche and menopause
Menstruation (also called menstrual bleeding, menses, or a period)
Characteristics of normal menstruation
1-Menarche: 10-16 years. average 13 years.
2-Duration: 2-7 days (<2days>7 days is menorrhagia
3-Amount: 30-80 ml., uses 3 napkins per day, >80 ml. is menorrhagia and < 30 ml. is hypomenorrhea.
4-Normally menstrual blood doesn’t coagulate as a result of secretion of fibrinolysin enzyme (plasmin) secreted by the endometrium.
5-Menstrual molimina refers to mild symptoms of 7-10 days before menstruation relieved once menstruation occurs exaggerated condition called (premenstrual syndrome).
The hypothalamic-pituitary-ovarian axis:
There are two main components of the menstrual cycle,
1. the changes that happen in the ovaries in response to pituitary hormones (the ovarian cycle)
2. and the variations that take place in the uterus,
but it is important to remember that both cycles work together simultaneously to produce the menstrual cycle.
Changes in cervical mucus also take place during the course of the menstrual cycle.
Introduction to anatomy and physiology of the female reproductive systemKaramo Sanneh
Female reproductive system (summary of the external and internal structures). A reference lecture note for nursing students and graduate nurses in clinical practice.
ovaries, fallopian tube, component of internal genitalia, location of ovarie, boundaries of ovaries,external features of ovaries,ligaments of ovaries, support of ovaries, broad ligament, mesovarium, mesosalpinx, mesometrium, round ligament of uterus, blood supply and lymphatics of ovaries, prts of fallopian tube, blood supply of fallopian tube, ectopic pregnancy, polycystic ovaries,
PHYSIOLOGY OF MENSTRUATION
Introduction :
Typically, a woman of childbearing age should menstruate every 28 days or so unless she's pregnant or moving into menopause. But numerous things can wrong with the normal menstrual cycle.
Definition:
Menstruation means cyclic uterine bleeding caused by shedding of progestational endometrium it occurs between menarche and menopause
Menstruation (also called menstrual bleeding, menses, or a period)
Characteristics of normal menstruation
1-Menarche: 10-16 years. average 13 years.
2-Duration: 2-7 days (<2days>7 days is menorrhagia
3-Amount: 30-80 ml., uses 3 napkins per day, >80 ml. is menorrhagia and < 30 ml. is hypomenorrhea.
4-Normally menstrual blood doesn’t coagulate as a result of secretion of fibrinolysin enzyme (plasmin) secreted by the endometrium.
5-Menstrual molimina refers to mild symptoms of 7-10 days before menstruation relieved once menstruation occurs exaggerated condition called (premenstrual syndrome).
The hypothalamic-pituitary-ovarian axis:
There are two main components of the menstrual cycle,
1. the changes that happen in the ovaries in response to pituitary hormones (the ovarian cycle)
2. and the variations that take place in the uterus,
but it is important to remember that both cycles work together simultaneously to produce the menstrual cycle.
Changes in cervical mucus also take place during the course of the menstrual cycle.
Introduction to anatomy and physiology of the female reproductive systemKaramo Sanneh
Female reproductive system (summary of the external and internal structures). A reference lecture note for nursing students and graduate nurses in clinical practice.
Maternal Physiology & Related Conditions refers to the physiological changes that occur in a woman's body during pregnancy, childbirth, and the postpartum period. These changes include hormonal fluctuations, cardiovascular and metabolic changes, and structural changes in the reproductive system. Maternal physiology also encompasses the study of any potential complications that may arise during this time, such as gestational diabetes or preeclampsia.
Maternal physiological changes in pregnancy are the adaptations during pregnancy that a woman's body undergoes to accommodate the growing embryo or fetus. ... The pregnant woman and the placenta also produce many other hormones that have a broad range of effects during the pregnancy.
Physiological changes during pregnancyDeepa Mishra
PHYSIOLOGICAL CHANGES DURING PREGNANCY
Deepa Mishra
Assistant Professor (OBG)
Pregnancy
Pregnancy usually occurs during 15-44 yrs of a woman.
Duration of pregnancy from LMP is 280 days or 40 weeks or 9 months and 7 days
Three trimester-
1st Trimester -0 -12 weeks
2nd trimester – 13-28 weeks
3rd trimester -29-40 weeks s
Physiological changes
Reproductive system
Hematological and Cardiovascular changes
Respiratory, Acid base balance, electrolyte changes
Urinary changes
GI changes
Metabolic changes
Skeletal and neurological changes
Skin changes
Endocrinal changes
Psychological changes
physiological changes during pregnancy
effect of pregnancy on physiological functions during pregnancy
cardiovascular, respiratory and hormonal changes
Shifa Riaz
gynecology
obstetrics
females
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. Genital changes
• The body of the uterus
- Height and weight (hyperplasia)
the height increases from 7.5 cm to 35cm
the weight increases from 50g to 1000g at term
- Uterine ligaments
show hypertrophy
- Dextro-rotation
the uterus is tilted and twisted to the right in 80% of cases
- Lower uterine segment (LUS)
the LUS is formed from the isthmus
formed from the 4th
month to reach 10 cm at full term
3. Genital changes
• The cervix
- edema and congestion, and becomes soft
- mucus plug (operculum): cervical mucus closing the cervical
canal
- increased secretion from its glands
• The vulva
shows increased vascularity and varicosities
4. Genital changes
• The vagina
- shows increased vascularity soft, moist and bluish
- distention of vagina at birth
• The ovary
shows increased vascularity and size
one ovary contains the corpus luteum
• Pelvic ligaments
- relaxation of the ligaments
- relaxation of the pelvic joints
- the pelvis become more mobile and increases in capacity
5. Breast changes
• Increased size and vascularity
warm, tense and tender
• Increased pigmentation of the nipple and areola
• Secondary areola appear
(light pigmentation around the 1ry areola)
• Montgomery tubercules appear on the areola
(dilated sebaceous glands)
• Colostrum like fluid is expressed at the end of the 3rd
month
6. Skin changes
• Pigmentation
due to increased melanocyte stimulating hormone:
- linea nigra: pigmentation of the linea alba, more marked below
the umbilicus
- chloasma gravidarum: Butterfly pigmentation of the face (mask
of pregnancy)
• Striae gravidarum
- stretch of the abdominal wall
rupture of the subcutaneous elastic fibers
pink lines in flanks
- become white after labor
7. Weight increase
• There is an increase weight of approximately 12.5 Kg at term
• The main increase occurs in the 2nd
half of the pregnancy, 0.5
Kg/week
• Causes:
growth of the conceptus
enlargement of the maternal organs
maternal storage of fat
increase in maternal blood and interstitial fluid
8. Skeletal changes
• Increased lumbar lordosis
• Relaxation of pelvic joints and ligaments
due to progesterone and relaxin
9. Urinary changes
• Kidneys
- increase in size
- hydronephrosis
- effective renal plasma flow is increased
• Dilatation of the ureters
- Atony of the ureteric muscles caused by progesterone and relaxin
hydro-ureter
- vesico-ureteric reflux increased - pressure of the uterus on the ureter
affects more the right ureter due to the dextro-rotation of the uterus
Changes in the ureter in pregnancy leads to urinary stasis and pyelitis
10. Urinary changes
• Frequency of micturation
causes: 1st
trimester: pressure of the uterus on the bladder
late in pregnancy: engagement of the head
• Urinary output
- diminished on a normal fluid intake
- increase in tubular reabsorption
- 100 extra liters of fluid pass into the renal tubules each day
- extracellular water is increased by 6 to 7 liters during pregnancy
- this is due to increased amounts of
aldosterone progesterone and oestrogen
11. Gastro-intestinal changes
• Increased salivation (ptyalism)
• Taste is often altered very early in pregnancy
• Increase appetite & thirst frequent small snacks
• Heart burn (reflux oesophagitis)
relaxation of the cardiac sphincter due to progesterone and relaxin
• Emesis gravidarum, morning sickness in 50 %
• Decreased gastric acidity, which interfere with iron absorption
• Constipation
reduced gut motility due to progesterone
increased water and salt absorption
12. Gastro-intestinal changes
• Liver
- Hepatic synthesis of albumin, plasma globulin and fibrinogen
increases
- Total hepatic synthesis of globulin increases stimulated by
estrogen
- Hormone-binding globulins rise
- gall bladder increases in size and empties more slowly
- relaxation of gall bladder increases the tendency of stone
formation
- cholestasis is almost physiological
- secretion of bile is unchanged
13. Cardiovascular changes
• Fall in total peripheral resistance by 6 weeks gestation to a nadir ~
40% by mid gestation
• Circulatory underfilling
activation of renin-angiotensin- aldosterone system
necessary expansion of the plasma volume
the bigger the expansion, the bigger the baby birthweight
• Total extracellular volume 16% by term
• Plasma osmolality by 10mOsm/Kg as water is retained
14. Cardiovascular changes
• The heart
- the heart rate rises synchronously by 10-15 b.p.m.
from 70 to 85 b.p.m.
- stroke volume rises
- cardiac output begins to rise by 35-40% in a first pregnancy
and ~ 50% in later pregnancies
15. Cardiovascular changes
• The blood pressure
- Korotkoff 5 used with auscultatory techniques
- slight drop in the 2nd
trimester
small fall in systolic, greater fall in diastolic B.P.
opening of arterio-venous shunts at the placenta
increased pulse pressure
- supine hypotension syndrome in 8% of the women
2nd
half of the pregnancy:
maternal hypotension occurs in the supine position due to pressure of
the uterus on the inferior vena cava
decreased venous return and cardiac output
16. Cardiovascular changes
• Noradrenaline
- pressor response to angiotensin II reduced in normal
pregnancy, unchanged to noradrenaline
- plasma noradrenaline is not increased in normal pregnancy
• Pulmonary circulation
- able to absorb high rate of flow without an increase in pressure
- pressure in right ventricle, pulmonary arteries and capillaries
does not change
- pulmonary resistance falls in early pregnancy
- progressive venodilatation + rises in venous distensibility +
capacitance throughout a normal pregnancy
17. Respiratory changes
• Tidal volume rises by 30% in early pregnancy
40-50% by term
• Fall in expiratory reserve and residual volume
decrease the threshold
increase the sensitivity of medulla oblongata to CO2
• Respiratory rate does not change
the minute ventilation rises by a similar amount
from 7.25L to 10.5L
• Elevation of the diaphragm in late pregnancy
dyspnea
Driven by
progesterone
18. Respiratory changes
• Carbon dioxide production rises sharply during the 3rd
trimester
as fetal metabolism increases
• The fall in maternal P CO2
- allows more efficient placental transfer of CO2 from the fetus
- results in a fall in plasma bicarbonate concentration
( from 24-28 mmol/L to 18-22 mmol/L)
fall in plasma osmolality
venous pH rises slightly ( from 7.35 to 7.38)
19. Respiratory changes
• The increased alveolar ventilation small rise in PCO2
(from 96.7 to 101.8 mmHg)
• Rightward shift of the maternal oxyhaemoglobin dissociation curve
( due to an increase in 2,3-DPG in erythrocytes)
oxygen unloading to the fetus which has:
- lower PCO2 (25-30 mmHg, 3.3-4 KPa)
- marked leftward shift of the oxyhaemoglobin dissociation curve,
(due to lower sensitivity of fetal haemoglobin to 2,3-DPG)
20. Respiratory changes
• Increase of 16% in oxygen consumption by term
• Fall in arterio-venous oxygen difference
• Pregnancy places greater demands on the cardiovascular than the
respiratory system
21. Haematological changes
• Circulating red cell mass increases by 20-30%
( rises more in multiple pregnancies and iron supplement)
• Serum iron concentration falls
absorption from gut and iron-binding capacity rise
• Plasma folate concentration halves by term ( renal clearance)
red cell folate concentration falls less
• Mild maternal anaemia associated with
increased placental/birthweight ratio
decreased birthweight
22. Haematological changes
• Erythropoietin rises especially if iron supplement not taken
• Human placental lactogen may stimulate haematopoiesis
• Fall in packed cell volume from 36% in early pregnancy to 32% in the 3rd
trimester ( normal plasma volume expansion)
• WBC count rises ( increase in polymorphonuclear leucocytes)
• Neutrophil number rises with oestrogen
peak at 33 weeks
stabilizing after that
until labour and the puerperium, when they rise sharply
23. Haematological changes
• T and B lymphocyte counts do not change but their function is
suppressed
( women become more susceptible to viral infections, malaria and
leprosy)
• Platelet count and platelet volume are largely unchanged
24. Haematological changes
• Coagulation
- factors VII, VIII and X rise
- absolute plasma fibrinogen doubles
- antithrombin III falls
- erythrocyte sedimentation rates increase
- Protein C unchanged
- Protein S concentrations, co-factor of protein C, fall in 1st
& 2nd
trimesters
- plasma fibrinolytic activity decreases during pregnancy & labour
returns to normal values within an hour of delivery of placenta
25.
26. Endocrinal changes
• Pituitary
- anterior pituitary increases in size and activity
- posterior pituitary releases oxytocin on the onset of labor
• Thyroid
- increases in size and activity: physiological goiter
- most pregnant women are euthyroid
- thyroid binding globulin concentrations double (not other thyroid
binding proteins)
- total T3, T4 are increased (not the free T3 ,T4)
• Parathyroid
increases in size and activity to regulate calcium metabolism
27. Endocrinal changes
• Adrenals
- increases in size and activity
- total cortisol is increased (free cortisol unchanged)
• Placental hormones
Progesterone
- produced by the corpus luteum
- levels rise steadily during pregnancy, output reaches 250mg/day
- actions:
colon activity reduced, nausea, constipation
reduced bladder and ureteric tone
diastolic pressure reduced, venous dilatation
raises temperature
28. Endocrinal changes
• Placental hormones
Oestrogens
- source:
ovary in early pregnancy
later, oestrone and oestradiol produced by the placenta
increased a hundredfold
oestriol produced by the placenta and fetal adrenals
increased thousandfold
- levels: output of oestrogens reaches a maximum of at least 30-40mg/day
oestriol accounts 85%
levels increase up to term
29. Endocrinal changes
• Placental hormones
Oestrogens
- possible actions:
1- induce growth of uterus and control its function
2- responsible for the development of breasts ( with progesterone)
3- alter chemical constitution of connective tissue, become more pliable
4- cause water retention
5- reduce sodium excretion
30.
31. Metabolic changes
• Carbohydrate metabolism
- pregnancy is hyperlipidaemic and glucosuric
- after mid-pregnancy, resistance of insulin develops
- plasma glucose concentrations rise, maintained between 4.5-5.5 mmol/L
- glucose crosses the placenta, the fetus uses glucose as primary energy
substrate, transport occurs by carrier mediated mechanism
- the insulin resistance is endocrine-driven, via increase in cortisol and hPL
- concentrations of glucagons and the catecholamines are unaltered
32. Metabolic changes
• Carbohydrate metabolism
- carbohydrate deposited in the liver as glycogen
- some escapes to general circulation
- portion metabolised by the tissues:
converted to depot fat
stored as muscle glycogen
- first noticeable change occurs in blood sugar
- tested by giving a load of oral glucose (glucose tolerance test)
- the blood sugar, after meal, remains high facilitating placental
transfer
33. Metabolic changes
• Carbohydrate metabolism
- with increased placental production of steroid, less glycogen
deposited in liver and muscles
- the effect of fasting is pronounced in pregnancy
overnight fast of 12hrs
hypoglycaemia, production of ketone bodies
34. Metabolic changes
• Protein metabolism
- positive nitrogen balance
- on average 500 g of protein retained by the end of pregnancy
- blood and urine urea are reduced
• Fat metabolism
- by 30 weeks, 4Kg are stored in form of
depot fat in the abdominal wall, back and thights
modest amount in breasts