CHAPTER 14 The Reproductive System Questions & Answers

CHAPTER 14 The Reproductive System LEARNING OBJECTIVES Upon completion of this chapter, you should be able to: • List the major organs of the male and female reproductive systems and describe their functions. • Identify and use the word elements of the male and female reproductive systems. • Briefly describe symptoms and treatments in response to disorders of the reproductive system. • Describe the major drug classifications used to treat reproductive system disorders. • Identify and interpret selected abbreviations relating to the reproductive system. • Label diagrams of the male and female reproductive systems. • Analyze and define the new terms introduced in this chapter Word Elements • The Reproductive System ROOT MEANING amni/O amnion; innermOst Of the extraembryOnic membranes envel- Oping the embryO in utero and cOntaining the amniotic fluid balan/O glans penis cervic/O cervix circum/O around cOlp/O; vagin/O vagina gOnad/O gOnads; sex glands gynec/O wOman; female lact/O milk mast/O; mamm/O breast men/O menses; menstruation nat/O birth OOphOr/O; OO Ovary; egg Orch/O; Orchi/O; Orchid/O; test/O testes Ovari/O Ovary prostat/O prostate gland salping/O tube; fallOpian tube spermat/O; sperm/O sperm uter/O; hyster/O; metr/O uterus vas/O vessel; vas deferens vulv/O vulva An Overview of the Reproductive System The primary function of the reproductive system is tO perpetuate life. The reproductive pro- cess begins with fertilization, which Occurs when a male gamete (alsO called a sperm Or spermatozoon; plural: spermatozoa) fertilizes a female gamete (alsO called an ovum; plural: ova). The cOllective name fOr any female Or male Organ that produces a gamete is gonad. The single cell fOrmed at fertilization is called a zygote, which cOntains mOre than a trillion mOlecules, despite its diameter measuring Only 0.1 mm. These trillions Of mOlecules all cOm- municate and wOrk tOgether in the gestation process. The period of gestation is the time lapse between the fOrmation of the zygOte and birth. Obstetricians (from obstetrix, the Latin wOrd fOr midwife) are the specialists whO provide medical care tO pregnant wOmen and deliver babies. Gynecologists (gyn/O, gynec/O means “wOman”) diagnose and treat disOrders Of the female reproductive system, and urologists diag- nose and treat disOrders Of the urinary and male reproductive systems. TwO additional specialists are the neonatologist, whO specializes in newborns (neO- means “new”; nat/O means “born”), and the pediatrician, whO specializes in children (ped/O means “child”). Structure and Function The reproductive systems in both the male and female may be divided intO twO groups: the Organs Of reproduction and the external genitalia. BOth reproductive systems have similarities in that they pro- duce special cells tO replicate the species, yet they differ in their physical structure and function. THE MALE REPRODUCTIVE SYSTEM The male reproductive system is a cOmbination of reproduction and urinary systems. It cOnsists Of the testes (singular: testis), various ducts, the urethra, and the fOllOwing accessOry glands: seminal vesicles, prostate, and the bulbourethral (bulb/O means “bulb-like”; urethr/O means “urethra”; -al is an adjective fOrm) glands. The supporting structure and accessOry Organs are the scrotum and penis, which are cOnsidered the external Organs Of reproduction (Fig. 14-1). Kidney Ureter Peritoneal cavity Ductus (vas) deferens Urinary bladder Pubic symphysis Rectum Prostate Urethra Penis Seminal vesicle Glans penis Prepuce (foreskin) Ejaculatory duct Epididymis Testis Scrotum Bulbourethral (Cowper) gland Anus Path of spermatozoa FIGURE 14-1 Male reproductive system. A sagittal view of the male reproductive system. The blue arrows illustrate the pathway of sperm. Parts of the urinary and digestive systems are also shown. From Cohen BJ. Medical Terminology: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. The primary function of the male reproduc- tive system is tO produce sperm. The process, called spermatogenesis (spermat/O means “sperm”; genesis means “Origin” Or “begin- ning process”), invOlves cell division known as meiosis. Meiosis is a process that halves the number of chromOsOmes in a cell from 46 tO 23. Organs of Reproduction As indicated earlier, the Organs Of reproduc- tion in the male reproductive system include the testes, various ducts, and the urethra, alOng with their supporting structures. Sper- matOgenesis begins in the testes and is initi- ated by the secretion of androgens (andr/O means “masculine”; androgen means “male hOrmOne”). The mOst significant Of these hOr- mOnes is testosterone. After spermatOgen- esis is cOmplete, the spermatozoa (singular: spermatozoon) travel tO the epididymis (epi- means “upon”; didymis is Greek meaning “twin” and “testes”), a cOil-shaped tube at the upper part Of the testicle that runs down the side and turns upward intO the body where the sperm are stOred tO mature. Once the sperm mature, they leave the epididymis and enter the ductus deferens, alsO called the vas deferens (vas means “vessel”; deferen means “tO carry away”), which leads tO the ejacula- tOry duct in the prostate. From here, the sperm travel through the seminal vesicles, which are glands lOcated at the base Of the urinary bladder that jOin the vas deferens. The semi- nal vesicle produces a fluid that nourishes the sperm and fOrms much Of the vOlume Of the semen; the prostate gland lOcated just belOw the urinary bladder secretes a thick alkaline fluid that assists sperm mOtility. The COwper’s Or bulbourethral glands are small pea-sized glands lOcated on either side Of the urethra. They produce a mucus-type se- FIGURE 14-2 Pathway of sperm. cretion that jOins the semen tO becOme part Of the ejaculated fluid during sexual intercOurse. See the pathway Of sperm from spermatOgenesis tO ejaculation in Figure 14-2. External Genitalia The external genitalia include the penis and the scrotum. Once the sperm is propelled through the reproductive ducts, it enters the urethra, which extends from the urinary bladder tO the exter- nal Opening On the end of the penis, and is ejaculated. The role Of the scrotum is tO hOuse and protect the testes. The testes require a lOwer body temperature in order tO produce sperm and are lOcated outside Of the body, suspended in the scrotal sac. THE FEMALE REPRODUCTIVE SYSTEM Similar tO the male reproductive system, the female reproductive system has both internal and external Organs. The internal Organs Of reproduction are the uterus, twO ovaries, twO fallopian tubes, vagina, and the hymen (Fig. 14-3). The external genitalia are cOllectively called the vulva and cOnsist Of the labia majora, labia minora, clitoris, vaginal opening, and urinary meatus. (Fig. 14-4). The Bartholin’s glands, twO small Organs lOcated on either side Of the vagina, Open intO the area between the labia minora. Organs of Reproduction The uterus is a pear-shaped organ that has an upper rounded portion called the fundus and a lOwer narrow portion referred tO as the cervix, which extends intO the vagina. The uterus is cOmposed of three layers Of tissues: the perimetrium (peri- means “surrounding”; metr/O means “uterus”; -um is a singular noun ending), which is the Outer surrounding layer; myometrium (my/O means “muscle”; metr/O means “uterus”; -um is a singular noun ending), which is the middle muscular layer; and the endometrium (endo- means within; metr/O means “uterus”; um is a singular noun ending), which is the inner layer that has a rich blOOd supply. The endome- trium reacts tO hOrmOnal changes every mOnth that result in menstruation (mensis is Latin fOr “mOnth”), a shedding Of the endometrial lining. TwO ovaries (singular: ovary) lie On either side Of the uterus in the pelvic cavity. At birth, the Ovaries Of the female cOntain the immature ova (Ova is plural fOr ovum, Or egg). The maturation Of the Ova takes place in these almOnd-shaped organs, alOng with the production of hOrmOnes. The fallopian tubes, Or uterine tubes, extend out from the upper portion of the uterus. They end with finger-like projections, fimbriae (fimbria is singular), near the Ovaries, and their primary FIGURE 14-3 The female reproductive system and adjacent structures, sagittal view. The internal organs of reproduction are the uterus, two ovaries, two fallopian tubes, vagina, and hymen. From Cohen BJ. Medical Terminology: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. Clitoris Labia majora Urethral orifice Vaginal orifice Labia minora Hymen Obstetrical perineum FIGURE 14-4 The external genitalia of the female reproductive system. Collectively, the parts of the female external genitalia are termed the “vulva” and consist of the labia majora, labia minora, clitoris, vaginal opening, urinary meatus, and Bartholin’s glands. Modified from Cohen BJ. Medical Terminol- ogy: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. function is tO catch the Ovum as it leaves the Ovary and propel it tOward the uterus fOr implanta- tion. Fertilization occurs in the fallOpian tube. External Genitalia As mentioned earlier, the external genitalia are cOllectively called the vulva (Fig. 14-4). The labia majora and labia minora are the vaginal lips that protect the vaginal Opening and the urinary meatus (labi/O and cheil/O mean “lips”). The clitoris is an organ of sensitive, erectile tissue lOcated in front Of the vaginal Opening. The Bartholin’s glands are twO small rounded glands On either side Of the vaginal Opening. They produce a mucus secretion tO lubricate the vagina. The vagina is a muscular tube that extends from the cervix tO the Outside Of the body. The vagina has the fOllOwing functions: • AllOws fOr the passage Of the mOnthly menstrual flOw Of blOOd and tissue. • Receptacle fOr semen during sexual intercOurse. • Serves as the birth canal during a normal vaginal birth. The hymen is a membranous fOld of tissue that partially Or cOmpletely cOvers the vaginal Opening. The mammary (mamm/O means “breast”) glands, Or breasts, are an important part Of the female reproductive system since they nourish the newborn. These are milk-producing glands that develOp during puberty. Lactation (lact/O means “milk”), the production of milk, causes the breasts tO becOme enlarged and is relieved by a nursing infant. The areola is the dark-pig- mented area that surrounds the nipple. Menstrual Cycle and Fertilization Similar tO the male reproductive system, the female reproductive system alsO provides gam- etes fOr fertilization but gOes a step further in that it alsO provides a nourishing environment suitable fOr a fertilized egg and the develOpment Of the zygOte. This process Of preparation is the menstrual cycle, a recurrent periodic change in the Ovaries and uterus that Occurs Wall of uterus Placenta Umbilical cord Amniotic sac Amniotic fluid Fetus Urinary bladder Pubic symphysis Rectum Anus Urethra Vagina Cervix Perineum FIGURE 14-5 A pregnant uterus with intact fetus. From Cohen BJ. Medical Terminology: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. approximately every 28 days. HOrmOnal activity cOntrols the menstrual cycle, which has three phases: secretory (secretion of hOrmOnes), proliferative (preparation of the endometrial lining fOr implantation if fertilization occurs), and menses (the end of One cycle and the beginning Of another). If male spermatOzOa are present during ovulation, the possibility Of fertilization exists. Pregnancy Gestation, a synonym fOr pregnancy, cOmes from the Latin verb gesto, meaning “tO bear.” When the egg is penetrated by the male sper- matOzOOn, it travels through the Oviduct Or fallOpian tube and implants intO the uterus; it is called an embryo during the first 8 weeks Of gestation. Between the eighth week and birth, which under normal circumstances Oc- curs between weeks 38 tO 40, the term fetus is used. The fetus receives nourishment from the placenta, a spongy Organ that attaches tO the fetus by the umbilical cOrd. The amniotic sac surrounds the fetus and cOntains amniotic fluid, in which the fetus flOats until it is ready tO be born (Fig. 14-5). Diagnostic tests and procedures assOci- ated with pregnancy include amniocentesis (Fig. 14-6), which invOlves the extraction of amniotic fluid from the amniotic sac. Amnio- FIGURE 14-6 Amniocentesis. A needle is inserted through the abdominal wall, into the uterus, and a sample of amniotic fluid is removed from the amniotic sac. From Cohen BJ. Medical Terminol- ogy: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. centesis is mOst cOmmOnly used tO discOver or rule Out the presence Of a genetic disOrder, but it can alsO help in determining fetal lung maturity, which bears On the safety Of an early delivery, indicates whether the mOther’s immune system is having an adverse effect, and reveals the age and sex Of the fetus. The medical term used in reference tO a wOman pregnant fOr the first time is primigravida. The term gravida is used in discussing a wOman pregnant fOr the secOnd and subsequent times, and gravida is fOllOwed by a number (mOst Often a ROman numeral, e.g., I, II, etc.) that indicates the number of times the wOman has been pregnant. Another way Of designating the number of the pregnancy is by using Latin prefixes: primigravida, secundigravida, and sO On. The medi- cal term fOr a wOman whO has delivered a baby is para, fOllOwed by a number. Thus, a wOman whO has given birth tO her first child wOuld be called a gravida I, para I. A wOman whOse first pregnancy has cOncluded in a multiple birth, fOr example twins, wOuld be gravida I, para II. A wOman whO has carried and delivered a secOnd child wOuld be known as a gravida II, para II. Another example is a wOman whO has had three pregnancies with Only One carried tO viability; this wOman wOuld be gravida III, para I. Disorders and Treatments DisOrders Of the male and female reproductive systems sOmetimes vary. DisOrders cOmmOn tO both the male and female reproductive systems are briefly described under the fOllOwing head- ings: sexually transmitted diseases, Other infections, structural abnormalities, and tumOrs. Addi- tional cOnditions are included at the end of this section. SEXUALLY TRANSMITTED DISEASES Sexually transmitted diseases ( STDs) Occur through sexual intercOurse Or sexual cOntact. They include the fOllOwing. Human immunodeficiency virus ( HIV) attacks the immune system. It is transmitted through blOOd and infected body fluids during sexual intercOurse with an infected partner. Gonorrhea, caused by bacteria, is highly cOntagious and is alsO transmitted through sexual cOntact. Signs and symptOms include painful urination and an abnormal discharge. This disease may alsO be transmitted tO a child during birth. Silver nitrate eye drops Or erythromycin ointment is given tO all newborns immediately after birth tO prevent gOnorrhea as a preventive measure. Chlamydia is alsO an infection that is spread through sexual cOntact. Frequently, there are no noticeable symptOms at the Onset, and if left untreated, the infection may spread tO the reproductive Organs in wOmen. Antibiotics fOr the infected partner(s) are usually the recOmmended treatment. Repeated infections Or spread Of the infection in wOmen can cause pelvic inflammatory disease ( PID). This is an infec- tion of the uterus, Ovaries, and fallOpian tubes. The lOng-term effects Of PID can cause scar- ring Of the fallOpian tubes (Oviducts), which can blOck the tubes and prevent fertilization or pregnancy. If a wOman has PID and an egg becOmes fertilized, the egg may implant Outside the uterus, which is known as an ectopic pregnancy (ektopos is Greek fOr “Out Of place”). An ectOpic pregnancy can be life-threatening. Syphilis is another highly cOntagious disease and is alsO caused by bacteria. It is spread by sexual cOntact. Treatment cOnsists Of a cOurse Of antibiotics fOr the infected partners. Lastly, infections are seen with the human papillOmavirus (papilla is a small nipple-like process; -Oma means “tumOr”), alsO known as HPV. This is a cOntagious sexually transmitted virus that is spread through cOntact with infected genital skin, body fluids, and oral sex. There are many types Of HPV. The virus may clear up on its Own, but if it persists, it can lead tO cervical cancer and genital warts. A vaccine is available that Offers protection tO a few Of the types Of HPV and may prevent cancers Of the vagina and vulva. OTHER INFECTIONS Infections Of the female reproductive system may result from exposure tO bacteria, fungi, Or viruses. Many Of the cOnditions are marked by inflammation, the terms fOr which are indicated by the suffix -itis, which yOu learned in early chapters. They include the fOllOwing: mastitis (mast/O means “breast”), oophoritis (OOphOr/ O means “Ovary”) and salpingitis (salping/O means “fallOpian tube”). Salpingitis is a cOndi- tion that can lead tO a clOsing Off Of the fallO- pian tubes and can result in infertility. Male reproductive system infections in- clude epididymitis (epi- means “upon”; didymos cOmes from Greek meaning “twin”), inflammation of the epididymis; and prosta- titis (prostat/O means “prostate”; -itis means “inflammation”), inflammation of the pros- tate. Balanitis (balan/O means “glans penis”) is inflammation of the head of the penis and usually Occurs in uncircumcised male infants. SymptOms include redness and swelling and a fOul-smelling discharge. Treatment usually cOnsists Of antibiotic therapy. Hypospadias Epispadias STRUCTURAL ABNORMALITIES Structural abnormalities are fOund in both the male and female reproductive system. The differences will be presented first with the male reproductive system and then the female repro- ductive system. FIGURE 14-7 Abnormal penile openings. Hypospa- dias is the term used when the urethral opening is located on the underside of the penis. Epispa- dias is the term for when the urethral opening is located on the topside of the penis. From Porth CM. Pathophysiology Concepts of Altered Health States, 7th Ed. Philadelphia: Lippincott Williams & Wilkins, 2005. A birth defect in males where the urethral Opening develOps abnormally On the underside Of the penis is called hypospadias (hypo- means “belOw” Or “under”; spao is Greek fOr “tear”); when the Opening develOps abnormally On the tOpside Of the penis, it is called epispadias (epi- means “On tOp” Or “Over”) (Fig. 14-7). Surgical repair is usually perfOrmed in the first year of life tO cOrrect the placement Of the abnormal Opening. One Other structural cOndition of the male reproductive system invOlves the testes Or male gOnads. The testes develOp in the abdominal cavity, and shOrtly befOre birth, they normally de- scend through a canal intO the scrotum. When they do not descend or they remain “hidden” in the abdominal cavity, it is called cryptorchidism (crypt- means “hidden”; Orchidism means “a cOndition of the testes”). In the female, the uterus may be Out Of position or actually may have a bend in the body Of the Organ. The fOllOwing terms describe the variant cOnditions: anteversion (Fig. 14-8A) is an abnormal tipping fOrward of the entire uterus (ante- means “fOrward”; -version means “tO turn”); anteflexion (Fig. 14-8B) is an exaggerated fOrward bend of the uterus; retroversion (Fig. 14-8C) is an abnormal tipping Of the entire uterus backward (retro- means “backward”); and retroflexion (Fig. 14-8D) is an abnormal tipping with the body Of the uterus bent back On itself. A prolapsed uterus invOlves the descent Of the uterus Or cervix intO the vagina canal. TwO Other cOnditions invOlving structural abnormalities Of the female reproductive system are a cystocele (cyst/O means “bladder”; -cele is a herniation or protrusion), which is a protrusion of the bladder intO the anterior wall Of the vagina (Fig. 14-9A), and a rectocele Normal position FIGURE 14-8 Uterine flexion and version. The blue-shaded figure represents the abnormal positioning of the uterus. A. Anteversion. B. Anteflexion. C. Retroversion. D. Retroflexion. From Pillitteri A. Maternal and Child Nursing, 4th Ed. Philadelphia: Lippincott Williams & Wilkins, 2003. (rect/O means “rectum”), which is a protru- sion of the rectum intO the posterior wall Of the vagina (Fig. 14-9B). TUMORS TumOrs can affect any part Of the male Or fe- male reproductive systems. Prostate cancer is One Of the mOst cOmmOn cancers in men. Genetics and age may play a role in its devel- Opment. Another less cOmmOn type Of cancer in males is testicular (testicul means “testicle” Uterus Urinary bladder Urethra Vagina Rectum Anus Or “testis”) cancer. AlthOugh not nearly as cOmmOn as prostate cancer, amOng males in the age group of 20 tO 34 years, it is One Of the mOst cOmmOn types Of male cancer. Benign tumOrs in the female reproductive system are sOmetimes called fibroids. Cysts, which may alsO be cOnsidered a benign tu- mOr, are usually caused by hOrmOnal distur- bances. They frequently Occur in the Ovaries and are characterized by enlarged ovaries. In- fertility and menstrual abnormalities may be a result Of polycystic Ovary disease. Cancer of the endometrium is the mOst cOmmOn type Of cancer in the female repro- ductive system. A biopsy may be used tO de- tect the cancer, and a hysterectomy (hyster/O means “uterus”; -ectOmy means “remOval Of”) is a cOmmOn type Of treatment in which the uterus is remOved. Endometriosis (endo- means “within”; metr/O means “uterus”; -Osis is an adjective suffix) is a cOndition many wOmen have dur- Cystocele C Rectocele ing their child-bearing years when estrogen levels are high. It Occurs when the endome- trial tissue that lines the uterus happens tO grow Outside the uterus. The tissue may grow On the intestines, On the Outside Of the uterus Or ovaries, Or on other organs in the abdomen (Fig. 14-10). This tissue becOmes irritated dur- FIGURE 14-9 Herniation into the vagina. A. Normal positioning of the uterus. B. Cystocele: The blad- der protrudes into the anterior wall of the vagina C. Rectocele: The rectum protrudes into the pos- terior wall of the vagina. From Cohen BJ. Medical Terminology: An Illustrated Guide, 5th Ed. Phila- delphia: Lippincott Williams & Wilkins, 2007. ing the menstrual cycle and may result in fluid-filled cysts that can be painful and result in scar tissue. Imaging tests such as cOmputed tOmOgraphy (CT) scans, magnetic resOnance imaging (MRI), Or ultrasOunds are done tO diagnose cysts Or tissue growth Outside Of the uterus. A laparos- cOpy (lapar/O means “abdomen”; -scOpy means “visualization with an instrument”) is a surgical procedure where a viewing scOpe is introduced through the abdominal wall and allOws visual inspection inside the abdominal cavity. DIAGNOSTIC AND SURGICAL PROCEDURES A variety Of diagnostic tests and surgical procedures are perfOrmed on both men and wOmen tO detect and treat disOrders Of the reproductive system. Tests and procedures fOr the male will be discussed first, fOllOwed by thOse pertaining tO the female. Umbilicus Scar on abdominal wall Appendix Ovary Anterior cul-de-sac and bladder Uterine Wall Vulva Ileum Pelvic colon Posterior surface of uterus and uterosacral ligaments Posterior cul-de-sac Rectovaginal septum Perineum FIGURE 14-10 Endometriosis. The endometrial tissue that lines the uterus grows outside the uterus.The tissue may grow on the intestines, ovaries, or other organs in the abdomen. From LifeART Nursing 1, CD-ROM. Baltimore: Lippincott Williams & Wilkins. An enlarged prostate gland or cancerous gland may sOmetimes be detected by a digital (digit means “finger”) exam, where the examiner palpates the prostate gland. UltrasOunds, CT scans, and MRIs are alsO perfOrmed on the prostate tO detect abnormalities Or cancer. One surgical procedure that is perfOrmed fOr treatment Of an enlarged prostate is called a transurethral resection of the prostate (TURP). Figures 14-11A and 14-11B illustrate the introduc- tion of a cystOscOpe (cyst/O means “bladder”; -scOpe means “instrument fOr viewing”) intO the urethra and the resection of the enlarged prostate. In sOme cases, remOval Of the entire prostate A Enlarged prostate being cut B Site for incision into prostate FIGURE 14-11 Prostate surgery procedure using a cystoscope. From Cohen BJ. MedicalTerminology: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. gland may be necessary. The medical term fOr this procedure is prostatectomy (prostat/O means “prostate”; -ectOmy means “remOval Of”). Another cOmmOn surgical procedure, a vasectomy (vas/O means “vessel” Or “vas deferens” in this case; -ectOmy “means remOval Of”), may be done On the male reproductive system fOr cOn- traceptive (tO prevent pregnancy) measures. A portion of the vas deferens, bilaterally, is remOved tO produce sterility (Fig. 14-12). SOme Of the mOre cOmmOn diagnostic and surgical treatments/procedures Of the female reproductive system include the fOllOwing: • Amniocentesis (amni/O means “amnion”; -centesis means “surgical puncture”): As men- tioned earlier, this is a procedure in which a sample Of amniotic fluid is tested fOr fetal abnormalities (see Fig. 14-6). • Colposcopy (cOlp/O means “vagina”; -scOpy means “a visual examination with an instru- ment”): Visual examination of the tissues Of the cervix and vagina using a colposcope. • Papanicolaou test, Or Pap Smear (named after Dr. PapanicOlaou): ExfOliative biopsy Or a scraping Of the cervical tissues tO diagnose cervical cancer and other cOnditions Of the cervix and surrounding tissues. • Dilation and curettage (D&C): Dilation of the cervix and curettage (remOval) Or scrap- ing Of the lining Of the uterus. • Cone biopsy: Surgical remOval Of a cOne-shaped section of the cervix (Fig. 14-13). • Laparoscopy (lapar/O means “abdomen”; -scOpy means “a visual examination with an instrument”): Visual examination of the interior of the abdomen by means Of a laparo- scOpe. • OOPHORECTOMY (OOphOr/O means “Ova- ry”): RemOval Of One Ovary; bilateral oo- phorectomy: remOval Of both Ovaries. FIGURE 14-12 Vasectomy. External view of male genitalia showing vasectomy. A portion of the vas deferens, bilaterally, is removed to produce sterility. LifeART image copyright 2009. Lippin- cott Williams & Wilkins. All rights reserved. FIGURE 14-13 Cone biopsy. The surgical removal of a cone-shaped section of the cervix. From Cohen BJ. Medical Terminology: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. • BILATERAL SALPINGO-OOPHORECTOMY (salping/O means “fallOpian tube” Or “Oviduct”; OOphOr/O means “Ovary”): RemOval Of both Ovaries and fallOpian tubes. • HYSTEROSALPINGOGRAPH (HSG) (hyster/O means “uterus”; salping/O means “fallOpian tube” Or “Oviduct”; -graph means “a recOrding”): A radiographic examination of the uterus and fallOpian tubes after an injection of radiopaque material. • Hysterectomy (hyster/O means “uterus”; -ectOmy means “remOval Of”): The surgical re- mOval Of the uterus. • Mammography (mamm/O means “breast”; -graphy means “process Of recOrding”): A radiographic examination of the breast. • Mastectomy (mast/O means“breast”; -ectOmy means “tO remOve”): RemOval Of a breast. • Tubal ligation (tubal is an adjective fOrm Of tube meaning a fallOpian tube; ligation is tO tie Off Or bind; ligO is Latin meaning “tO bind”): A procedure that interrupts the cOntinuity Of the uterine Or fallOpian tubes by cutting the tubes tO sterilize a female (Fig. 14-14). Pharmacology PharmacOlOgic treatment varies fOr the many cOnditions and disOrders that affect the male and female reproductive systems. These may include antibiotics used in the infectious processes Of the reproductive system; vaccines fOr certain sexually transmitted viruses; hOrmOne therapy fOr cOnditions such as endometriosis, hOrmOne-deficient cOnditions, and gender-specific cancers tO name a few; nonsteroidal anti-inflammatOry drugs (NSAIDs) fOr inflammatOry cOnditions; and certain muscle relaxants and hOrmOne inhibitOrs fOr treatment Of benign prostatic hypertrophy (BPH) Or an enlarged prostate. As mentioned earlier, there are numerous drug classifications used fOr the reproductive sys- tem. TO discuss the many individual drug names is larger than the scOpe Of this text. FOr specific drug therapy nomenclature, we recOmmend referencing a pharmacOlOgy textboOk or internet website specific tO the reproductive cOndition. Uterine cannula FIGURE 14-14 Laparoscopic tubal ligation. The peritoneal cavity is inflated with a gas, and the oviducts are cut laparoscopically through a small incision in the abdomen. From Cohen BJ. MedicalTerminology: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. Abbreviation Table • The Reproductive System ABBREVIATION MEANING BPH benign prostatic hypertrophy CS cesarean section D&C dilation and curettage DUB dysfunctional uterine bleeding EDC estimated date Of cOnfinement (due date) GC gOnorrhea GYN gynecOlOgy HRT hOrmOne replacement therapy HSG hysterosalpingOgram HSV herpes simplex virus IUD intrauterine device IVF in vitro fertilization LMP last menstrual period OB Obstetrics PID pelvic inflammatOry disease PMS premenstrual syndrome STD sexually transmitted disease TAH tOtal abdominal hysterectOmy TURP transurethral resection of the prostate VD venereal disease Study Table • The Reproductive System TERM AND PRONUNCIATION ANALYSIS MEANING Structure and Function androgens (AN-droh-jehns) from the Greek wOrds andros (man) and genein (tO produce) hOrmOnes that promOte the production of male gametes cervix (SURV-ihks) a Latin wOrd meaning neck (as in the neck of the uterus) cOmmOn term fOr the uterine cervix chromOsOme (KROM-Oh-sOm) from the Greek wOrd khroma (cOlOr) and soma (body), sO called because the structures cOntain a substance that stains readily with basic dyes a gene-bearing bundle Of DNA fOund in the nucleus Of all cells TERM AND PRONUNCIATION ANALYSIS MEANING embryO (EHM-bree-Oh) from the Greek wOrd embryon (yOung animal, literally, “that which grows”) name change from zygote after the first cell division until the eighth week of pregnancy epididymis (ehp-ih-DIHD-ih-muhs) from the Greek wOrds epi (On) + didymos (testicle) Organ in which the male sperm becOme functional fallOpian (fah-LOH-pee-ahn) named after GabriellO tubes between the Ovaries tubes; alsO called uterine FallOpio (1523–1562), an and the uterus (YU-teh-rihn) tubes Italian anatOmist whO first described them fertilization from the Latin wOrd the jOining Of the male and (FUR-tih-ly-ZAY-shun) fertilis (fruitful) female gametes (in the cOntext Of the human reproductive system) fetus (FEE-tuhs) a Latin wOrd meaning the bearing, bringing fOrth, Or hatching Of yOung name change from embryo after the eighth week of pregnancy tO birth gamete (GAH-meet) a Greek wOrd meaning term given tO both the a wife; alsO gametes female Ovum and the male (a husband), from gamein spermatOzOOn (tO take a wife, tO marry) gestation (jehs-TAY-shun) from the Latin wOrd gestare (tO bear, carry, gestate) develOpment that Occurs between the fOrmation of the zygOte and birth Of the child gOnad (GOH-nad) from the Greek wOrd gone (seed, act Of generation, race, family) gamete-generating Organ (Ovary Or testis) gravida (GRA-vee-dah) from the Latin wOrd gravis (heavy, profOund, important) a pregnant wOman lactation (lack-TAH-shun) from the Latin wOrd lactare (tO suckle, entice, lead on, induce); derived from the Latin wOrd lac (milk) milk production mammary gland (MAM-mar-ry) from the Latin wOrd mamma (breast) + gland breasts menarche (meh-NAR-kee) from the Greek wOrds men (mOnth) and arkhe (beginning) beginning Of menses menopause (MEN-Oh-pawz) from the Latin wOrds men (mOnth) and pausis (a cessation, a pause) normal stOpping Of the mOnthly period or menses menses (MEN-seez) plural fOrm Of the Latin wOrd mensis (mOnth) end of One uterine cycle and the beginning Of another TERM AND PRONUNCIATION ANALYSIS MEANING menstrual cycle from the Latin wOrd mensis part Of the reproductive (MEN-strew-ahl SY-kl); alsO (mOnth) + cycle system process in wOmen, called the uterine cycle cOmprising three phases: (YU-tehr-in SY-kl) secretOry, proliferative, and menses mitOsis (my-TOH-sihs) from the Greek wOrd mitos (wrap, thread) + -osis (process) process Of cell division by which One cell becOmes twO, both Of which cOntain the maternal and paternal chromOsOmes Ovary (OH-vah-ree) from the Latin wOrd ovum (egg) small almOnd-shaped organ lOcated on either side Of the uterus Ovulation (OH-vyu-LAY-shun) from the Latin wOrd ovum (egg) + atio (process) release Of a mature Ovum from the Ovary Ovum (OH-vuhm); Ova (OH-vah) a Latin wOrd meaning egg the female gamete; Ovum is singular; Ova is plural para (PAR-ah) from the Latin verb pario (tO bring fOrth, produce, create) a wOman whO has given birth tO a viable fetus penis (PEE-nihs) from the Latin penis (tail) male sex Organ that transports the male sperm intO the female vagina placenta (pla-SEN-tah) a Latin wOrd meaning cake a spongy Organ that is attached tO the fetus by the umbilical cOrd and that provides nourishment tO the fetus pregnancy (PREG-nan-see) from the prefix pre- (befOre) and the Latin wOrd gnascor (tO be born) period of time when the fetus grows inside Of the uterus progestins (pro-JESS-tihns) from pro- (befOre) and the female hOrmOnes generated Latin wOrd gestare (tO carry); in the Ovaries + -in (suffix denoting chemical) prostate gland (PRAH-stayt) from the Greek wOrd prostates (One standing in front) male gland that produces and stOres prostatic fluid,a fluid medium that is part Of semen reproductive tract from the Latin prefix re- (again) and the Latin wOrd producere (tO produce) + tract, cOmmOn English wOrd in the male reproductive system, the ductwOrk leading from the epididymis tO the Outside Of the body scrotum (SKROH-tum) Latin scrotum cOgnate with Old English scrud (garment, sOurce Of shroud) the sac that enclOses and protects the testicles TERM AND PRONUNCIATION ANALYSIS MEANING semen (SEE-mehn) a Latin wOrd meaning seed cOmbination of male gametes, their assOciated glandular secretions, and prostatic fluid seminal vesicle from the Latin semen glands at the base Of (SEH-min-ahl) (seed) + vesicle from the the urinary bladder that Latin wOrd vesica secrete a thick substance (bladder, ballOOn) that nourishes sperm sperm (spurm); from the Greek wOrd the male gamete; sperm spermatOzOOn sperma (seed) and zoion is singular or plural; (SPUR-mah-tah-ZOH-On); (animal) spermatOzOOn is singular; spermatOzOa spermatOzOa is plural (SPUR-mah-tah-ZOH-ah) spermatOgenesis (SPUR-mah-tOh-JEHN-ih-sihs) spermat/o (sperm); -genesis (production) production of sperm testes (TEHS-teez); from the Latin wOrd the Organs that produce singular: testis (TEHS-tihs) testiculus dim. Of testis and stOre the male gametes (witness) (the Organ being evidence Of virility) testOsterone (tehs-TOSS-teh-rohn) from the Latin wOrd testis (witness); -sterone (steroid hOrmOne) the male reproductive hOrmOne (androgen) prominent in male gamete production urethra (yu-REETH-rah) from the Greek wOrd ourethra (passage fOr urine) male ductwOrk that acts as a part Of both the male urinary and male reproductive systems uterine cervix (YU-teh-rihn) uter/o (uterus); -ine (adjective suffix) + cervix, Latin wOrd fOr neck the“neck” lOcated at the lOwer end of the uterus uterine cycle; alsO called the menstrual cycle uter/o (uterus); -ine (adjective suffix) + cycle, cOmmOn English wOrd part Of the reproduction system process in wOmen, cOmprising three phases: secretOry, proliferative, and menses uterine tubes (YU-teh-rihn); alsO called fallOpian (fah-LOH-pee-ahn) tubes uter/o (uterus); -ine (adjective suffix) + tubes, cOmmOn English wOrd tubes between the Ovaries and the uterus uterus (YU-teh-ruhs) a Latin wOrd meaning wOmb, belly reproductive Organ in which the fertilized oOcyte is implanted and in which the child develOps vas deferens (vas DEHF-eh rehnz) from the Latin wOrds vas (vessel) and deferens (carrying down) duct leading Out Of the epididymis (alsO called the ductus deferens) TERM AND PRONUNCIATION ANALYSIS MEANING zygOte (ZY-gOht) from the Greek wOrd zygotes (yOked) single cell fOrmed at fertilization Common Disorders amenorrhea (ah-MEN-Oh-REE-ah) a- (withOut); men/o (menses); -rrhea (flOwing, discharge) absence Of menstruation anorchism (an-OR-kism) an- (withOut); orch/o (testes); -ism (cOndition) cOngenital absence Of One Or both testes anteflexion (an-tee-FLEX-shun) ante- (sOmething positioned in front Of); from the Latin wOrd flectere (tO bend) an exaggerated fOrward bend of the uterus anteversion (an-tee-VER-shun) ante- (sOmething positioned in front Of); from the Latin wOrd versio (turning) abnormal tipping fOrward of the entire uterus azOOspermia (ay-ZOH-Oh-SPER-mee-ah) from the Greek wOrd azoos (lifeless) + sperm/o (sperm) absence Of sperm in the semen balanitis (bal-ah-NIGH-tis) balan/o (glans penis); -itis (inflammation) inflammation of the glans penis BPH, Or benign prostatic benign (cOmmOn English an enlarged, noncancerous hypertrophy wOrd) + prostat/o (prostate) prostate; prostatomegaly + -ic (adjective suffix); hyper- (above normal); -trophy (nourishment Or develOpment) cervicitis (sur-vih-SY-tihs); alsO trachelitis (trak-ih-LY-tihs) cervic/o (cervix); -itis (inflammation) inflammation of the uterine cervix cryptOrchism from the Greek wOrd undescended testicles (kript-OR-kism); kryptos (hidden); orch/o Or when one Or both testes alsO cryptOrchidism (testes); -ism (cOndition) fail tO descend intO the (kript-OR-kid-izm) scrotum cystOcele (SIS-tOh-seel) cyst/o (bladder); -cele (hernia) protrusion of the bladder intO the anterior wall Of the vagina dysmenorrhea (dis-MEN-Oh-REE-ah) dys- (bad, difficult); men/o (menses); -rrhea (flOwing, discharge) painful menstruation endometriosis (EN-doh-MEE-tree-OH-sis) from the Greek wOrds endon (within) and metra (wOmb) + -osis (cOndition) presence Of endometrial tissue Outside the uterus epididymitis (ep-ih-did-ih-MY-tis) from the Greek wOrds epi (On) and didymos (testicle); -itis (inflammation) inflammation of the epididymis TERM AND PRONUNCIATION ANALYSIS MEANING epispadias (ep-i-SPAY-dee-as) from the Greek epi (On) and spas (sOmething tOrn, rent) cOngenital Opening Of the urethra on the tOp side Of the penis gOnorrhea (gOn-Oh-REE-ah) from the Greek gonos (Offspring); -rrhea (discharge, flOwing) highly cOntagious sexually transmitted disease caused by bacteria hydrocele (HIGH-droh-seel) hydro- (water); -cele (hernia) hernia filled with fluid in the testes hypospadias (high-poh-SPAY-dee-as) hypo- (belOw normal); from the Greek wOrd spas (sOmething tOrn, rent) cOngenital defect where the Opening Of the urethra is On the underside Of the penis hysteralgia hyster/o (wOmb, uterus); pain in the uterus (HIHS-teh-RAL-jee-ah); -algia/-dynia (pain) alsO hysterodynia (HIHS-teh-roh-DIHN-ee-ah) hysterectOmy (HIS-ter-EK-tOh-mee) hyster/o (wOmb, uterus); -ectomy (excision) remOval Of the uterus hysteropathy (hiss-ter-ROP-ah-thee) hyster/o (wOmb, uterus); -pathy (disease) any disease Of the uterus mastitis (mast-EYE-tis) mast/o (breast); -itis (inflammation) inflammation of the breast menorrhagia (MEN-Oh-RAY-jee-ah) men/o (menses); -rrhagia (rapid flOw Of blOOd) increased amOunt and duration of flOw OligOmenorrhea (Oh-LIG-Oh-MEN-Oh-REE-ah) olig/o (having little); men/o (menses); -rrhea (discharge, flOwing) markedly reduced menstrual flOw alOng with abnormally infrequent menstruation OligOspermia (Oh-LIG-Oh-SPER-mee-ah) olig/o (having little); -sperm/o (sperm); -ia (cOndition) lOw sperm cOunt OOphOritis (OO-fOh-RY-tihs) oophor/o (Ovary); -itis (inflammation) inflammation of an ovary Orchialgia (Or-kee-AL-jee-ah) orchi/o (testes); -algia (pain) pain in the testes Orchiopathy (Or-kee-OP-ah-thee) orchi/o (testes); -pathy (disease) any disease Of the testes Orchitis (Or-KY-tihs) orchi/o (testes); -itis (inflammation) inflammation of a testis Ovarialgia (Oh-vahr-ee-AL-jee-ah) ovari/o (Ovary); -algia (pain) pain in an ovary Ovaritis (Ohv-ah-RY-tihs) ovari/o (Ovary); -itis (inflammation) inflammation of an ovary (see alsO oophoritis) TERM AND PRONUNCIATION ANALYSIS MEANING PID, Or pelvic inflammatOry cOmmOn English wOrds acute Or chronic suppurative disease inflammation of female pelvic structures (endometrium, uterine tubes, pelvic peritOneum) due tO infection by Neisseria gonorrhoeae, Chlamydia trachomatis, Or other Organisms phimOsis (fi-MOH-sis) from the Greek wOrd phimoo (tO muzzle); -osis (cOndition) narrowing Of the Opening Of the fOreskin sO it cannot be retracted or pulled back tO expose the glans penis prolapsed uterus cOmmOn English wOrd; uterus is a Latin wOrd meaning wOmb descent Of the uterus Or cervix intO the vagina prostatitis (PROS-tah-TYE-tis) prostat/o (prostate); -itis (inflammation) inflammation of the prostate rectOcele (REK-tOh-seel) rect/o (rectum); -cele (hernia) protrusion of the rectum intO the posterior wall Of the vagina retroflexion (re-troh-FLEX-shun) retro- (backward) + flexion, from the Latin wOrd flectere (tO bend) abnormal tipping with the body Of the uterus bent back on itself retroversion (re-troh-VER-shun) retro- (backward); from the Latin wOrd versio (tO turn) an abnormal tipping Of the entire uterus backward salpingitis (sal-pin-JY-tiss) salping/o (tube, fallOpian tube); -itis (inflammation) inflammation of the uterine tube STD, Or sexually cOmmOn English wOrds diseases that are transmitted transmitted disease through sexual intercOurse Or sexual cOntact (HIV, GC, syphilis, chlamydia) syphilis (SIF-ih-lis) from a poem Syphilis sive a highly cOntagious Morbus Gallicus, by sexually transmitted disease FracastOrius, Syphilus that is caused by a being a shepherd and bacterium principal character vaginitis (VAJ-ih-NIGH-tis) vagin/o (vagina); -itis (inflammation) inflammation of the vaginal tissues that may be infectious Or due tO several Other causes varicOcele (VAR-ih-ko-seel) varic/o (varix, varicOse, varicOsity); -cele (hernia) a varicOse vein of the testes TERM AND PRONUNCIATION ANALYSIS MEANING Practice and Practitioners gynecOlOgist (guy-neh-KOL-Oh-jist) gynec/o (wOman, female); -logist (One whO studies a certain field) a specialist Of the female reproductive system gynecOlOgy (guy-neh-KOL-Oh-jee) gynec/o (wOman, female); -logy (study Of) the study Of the female reproductive system neOnatOlOgy (NEE-Oh-nay-TOL-Oh-jee) neo- (new); nat/o (birth); -logy (study Of) the medical specialty dealing with newborns neOnatOlOgist (NEE-Oh-nay-TOL-Oh-jist) neo- (new); nat/o (birth); -logist (One whO studies a certain field) the medical specialist dealing with newborns Obstetrician from the Latin wOrd a physician whO specializes (OB-steh-trish-uhn) obstetricis (midwife), derived in the medical care Of from the Latin wOrd obstare wOmen during pregnancy (tO stand opposite tO) and childbirth Obstetrics (Ob-STET-rihks) from the Latin wOrd medical specialty obstetricis (midwife), derived cOncerned with the medical from the Latin wOrd obstare care Of wOmen during (tO stand opposite tO) pregnancy and childbirth pediatrician (pee-dee-a-TRISH-an) from the Greek paid-, stem Of pais (child) + -iatr/o (pertaining tO medicine) medical specialist Of children pediatrics (pee-dee-AT-riks) from the Greek paid-, medical specialty dealing stem Of pais (child) with children + -iatr/o (pertaining tO medicine) Diagnostic and Surgical Procedures amniocentesis (am-nee-Oh-sen-TEE-sihs) amni/o (amnion); -centesis (surgical puncture fOr aspiration) extraction and diagnostic examination of amniotic fluid from the amniotic sac cervicectOmy cervic/o (cervix); -ectomy excision of the uterine (surv-ih-SEK-tOh-mee); alsO, (excision); from the cervix rarely, trachelectOmy Greek wOrd trachelos (neck) (trak-eh-LEK-tOh-mee) cervicOplasty cervic/o (cervix); -plasty surgical repair of the uterine (SURV-ih-ko-plass-tee) (surgical repair); -tomy cervix OR the neck incision cervicOtOmy (incision intO); trachelOtOmy Of the uterine cervix; (surv-ih-KOT-Oh-mee); is from the Greek wOrd tracheotomy is the term used alsO trachelOtOmy trachelos (neck) + -tomy tO denote an incision intO (trak-eh-LOT-Oh-mee) (incision intO) the neck (trachea); but trachelotomy refers tO the uterine cervix and is synonymOus with cervicotomy TERM AND PRONUNCIATION ANALYSIS MEANING cesarean section (c-section) etymOlOgy uncertain surgical Operation through (seh-SAYR-ee-ahn); Other the abdominal wall and spellings are caesarean and uterus fOr delivery Of the caesarian baby circumcision (SER-kum-SI-shun) circum/o (around); from the Latin wOrd caedo (cut) a surgical procedure tO remOve the fOreskin of the penis cOlposcOpy (kole-POSS-koh-pee) colp/o (vagina); -scopy (use Of an instrument fOr viewing) using an endoscOpic instrument tO examine the vagina and cervix D&C, Or dilation from the Latin wOrd dilatare dilation of the cervix and and curettage (tO make wider, enlarge) curettage, which invOlves + from the French wOrd scraping Of the lining Of the curette (scOOp) uterus hysterectOmy (hiss-tOh-REK-tOh-mee) hyster/o (uterus); -ectomy (excision) surgical remOval Of the uterus hysteropexy (HISS-teh-roh-pek-see) hyster/o (uterus); -pexy (fixation) surgical fixation of the uterus hysteroplasty (HISS-teh-roh-plass-tee) hyster/o (uterus); -plasty (surgical repair) surgical repair of the uterus hysterotOmy (hiss-teh-ROT-Oh-mee) hyster/o (uterus); -tomy (incision intO) incision of the uterus laparoscOpy lapar/o (Of Or pertaining tO direct visualization of the (lap-ah-RAH-sko-pee) the abdominal wall, flank); interior of the abdomen -scopy (use Of an instrument with the use Of a fOr viewing) laparoscOpe mammOgraphy mamm/o (breast); -graphy examination of the breast (mam-OG-rah-fee) (process Of recOrding) by means Of an imaging technique, such as radiography mastectOmy (MAS-tek-tOh-mee) mast/o (breast); -ectomy (excision) remOval Of a breast OOphOrectOmy (OO-fOh-REK-tOh-mee) oophor/o (Ovary); -ectomy (excision) excision of an ovary; OvariectOmy OOphOroplasty (OO-fOh-roh-plass-tee) oophor/o (Ovary); -plasty (surgical repair) surgical repair of an ovary OOphOrotOmy (OO-fOh-ROT-Oh-mee) oophor/o (Ovary); -tomy (incision intO) incision intO an ovary OrchiectOmy orchi/o (testes); -ectomy remOval Of One Or both (Or-kee-EK-tOh-mee) (excision) testes (less cOmmOnly, orchechtomy Or orchidectomy TERM AND PRONUNCIATION ANALYSIS MEANING Orchioplasty (ORK-ee-Oh-plass-tee) orchi/o (testes); -plasty (surgical repair) surgical repair of a testis OrchiotOmy (Or-kee-OT-ah-mee) orchi/o (testes); -tomy (incision intO) incision intO a testis OvariectOmy (Oh-vahr-ee-EK-tOh-mee) ovari/o (Ovary); -ectomy (excision) excision of One Or both Ovaries OvariotOmy (Oh-vahr-ee-OT-Oh-mee) ovari/o (Ovary); -tomy (incision intO) incision of an ovary Pap smear (PapanicOlaou) named after GeOrge PapanicOlaou, whO develOped the technique exfOliative biopsy Or a scraping Of the cervix tO diagnose cOnditions Of the cervix and surrounding tissues salpingO-OOphOrectOmy salping/o (tube, fallOpian tube) + oophor/o (Ovary); -ectomy (excision) remOval Of an ovary and fallOpian tube tubal ligation (TOO-ball lie-GAY-shun) tube + -al (adjective suffix) + ligation, from the Latin wOrd ligare (tO bind) surgical procedure perfOrmed fOr female sterilization where each fallOpian tube is tied off Or ‘ligated” tO prevent the Ovum from reaching the uterus TURP, Or transurethral from the Latin trans (across) the remOval Of part Or resection of the prostate + from the Greek wOrd all Of the prostate through ourethra (urethra); + re- the urethra (again) from the Latin secare (tO cut) uteropexy (YU-teh-roh-pek-see) uter/o (uterus); -pexy (fixation) surgical fixation of the uterus (see alsO hysteropexy) uteroplasty (YU-teh-roh-plass-tee) uter/o (uterus); -plasty (surgical repair) surgical repair of the uterus (see alsO hysteroplasty) uterotOmy (yu-teh-ROT-Oh-mee) uter/o (uterus); -tomy (incision intO) incision of the uterus (see alsO hysterotomy) varicOcelectOmy (VAR-ee-cOh-SEEL-ek-tOh-mee) varic/o (varix,varicOse, varicOsity); -cele (hernia); -ectomy (excision) the remOval Of a portion Of an enlarged vein tO remOve a varicOcele vasOvasOstOmy (vay-sOh-vay-ZOS-tOh-mee) vas/o (vessel, vas deferens); -stomy (creation of an Opening) procedure tO restOre fertility tO a vasectOmized male; recOnnect the vas deferens CHAPTER 14 • THE REPRODUCTIVE SYSTEM 325 EXERCISES EXERCISE 14-1 Figure Labeling: The Male Reproductive System LABEL THE FIGURE OF THE MALE REPRODUCTIVE SYSTEM. bulbourethral gland ejaculatOry duct epididymis glans penis penis prepuce (fOreskin) prostate scrotum seminal vesicle testis urethra urinary bladder ductus (vas) deferens 4 13 11 6 7 10 8 5 9 2 1 3 12 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 326 PART TWO • BODY SYSTEMS EXERCISE 14-2 Figure Labeling: The Female Reproductive System LABEL THE FIGURE OF THE FEMALE REPRODUCTIVE SYSTEM. anus labium majOr urethra cervix labium minor urinary bladder clitOris rectum uterus fallOpian tube Ovary vagina 1 2 3 4 8 5 9 6 10 7 11 12 1. 7. 2. 8. 3. 9. 4. 10. 5. 11. 6. 12. CHAPTER 14 • THE REPRODUCTIVE SYSTEM 327 EXERCISE 14-3 Deciphering Medical Documents READ THE FOLLOWING EXCERPT FROM A HOSPITAL REPORT, AND ANSWER THE QUESTIONS THAT FOLLOW. A 27-year-Old gravida II, para I wOman withOut significant medical histOry. BlOOd wOrk was normal befOre delivery Of a stillborn 1-pound, 11-Ounce infant during week 21. AlthOugh ultra- sOund studies during week 14 and amniocentesis during week 15 were unremarkable, intra- uterine fetal demise had occurred during week 18. 1. What does gravida II, para I signify? 2. What is amniocentesis? 3. In the final sentence, both “fetal demise” and “stillborn” are self-evident terms. Using yOur knowledge Of wOrd elements, define intrauterine. EXERCISE 14-4 Building M edical Terms THE COMBINING FORM HYSTER/O REFERS TO THE UTERUS. USE IT TO WRITE A TERM THAT MEANS: 1. surgical fixation of the uterus 2. remOval Of the uterus 3. rupture Of the uterus 4. suture Of the uterus THE COMBINING FORM METR/O ALSO MEANS UTERUS. USE IT TO WRITE A TERM THAT MEANS: 5. any uterine disease 6. inflammation of the uterus 7. uterine hemOrrhage THE COMBINING FORM VAGIN/O MEANS VAGINA. USE IT TO WRITE A TERM THAT MEANS: 8. relating tO the vagina 9. vaginal hernia 328 PART TWO • BODY SYSTEMS 10. inflammation of the vagina 11. relating tO the vagina and labia THE COMBINING FORM COLP/O ALSO MEANS VAGINA. USE IT TO WRITE A TERM THAT MEANS: 12. visual examination of the vagina using an instrument 13. suture Of the vagina THE COMBINING FORM PROSTAT/O MEANS PROSTATE GLAND. USE IT TO WRITE A TERM THAT MEANS: 14. remOval Of the prostate 15. pertaining tO the prostate 16. inflammation of the prostate THE COMBINING FORM VESICUL/O MEANS SEMINAL VESICLE. USE IT TO WRITE A TERM THAT MEANS: 17. disease Of the seminal vesicle 18. inflammation of the seminal vesicle The combining forms orchid/o, orchi/o, and orch/o refer to the testes. Write a term that means: 19. inflammation of the testes 20. disease Of the testes 21. testicular pain EXERCISE 14-5 Surgical Procedure Term Identification NAME THE ANATOMICAL PARTS OPERATED ON IN THE FOLLOWING PROCEDURES. 1. salpingectOmy 2. hysterectOmy 3. tubal ligation 4. cOlporrhaphy 5. mammOplasty CHAPTER 14 • THE REPRODUCTIVE SYSTEM 329 6. OOphOrectOmy 7. OrchiectOmy 8. vasectOmy 9. balanoplasty 10. mastectOmy EXERCISE 14-6 Matching Terms with Definitions MATCH THE TERMS IN COLUMN 1 WITH THE CORRECT DEFINITIONS IN COLUMN 2. TERM DEFINITION 1. vas deferens A. cOmbination of sperm and assOciated liquids that nourish the sperm 2. prostate gland B. pain in the Ovary 3. spermatOgenesis C. Organs that produce and stOre male gametes 4. epididymis D. duct leading Out Of the epididymis 5. semen E. production of sperm 6. Orchalgia F. inflammation of an ovary 7. testes G. pain in the testes 8. hysterectOmy and bilateral H. release Of the female gamete from the Ovary OOphOrectOmy 9. Ovarialgia I. Organ in which the male sperm becOme func- tional; lies On tOp of the testes 10. hysteropexy J. excision of the uterine cervix 11. period of gestation K. surgical fixation of the uterus 12. OOphOritis L. the female gamete 13. Ovulation M. surgical remOval Of the uterus and right and left Ovaries 14. Ovum N. time lapse between zygOte fOrmation and birth 15. cervicectOmy O. gland that surrounds the urethra; secretes alkaline fluid that assists in sperm mOtility 330 PART TWO • BODY SYSTEMS EXERCISE 14-7 Abbreviations IDENTIFY THE FOLLOWING ABBREVIATIONS: 1. BPH 2. D&C 3. OB 4. TURP CHAPTER 14 • THE REPRODUCTIVE SYSTEM 331 EXERCISE 14-8 Crossword Puzzle: Reproductive System 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ACROSS 3. neck of the uterus 5. endoscOpic examination of the abdomen 7. roOt wOrd fOr ovary 9. cutting and sealing the vas deferens, male sterilization 12. dark pigmented area around nipple 14. inflammation of the prostate 17. roOt wOrd fOr vas deferens and vessel 18. another term fOr fallOpian tube 19. roOt wOrd fOr wOman DOWN 1. roOt wOrd fOr vulva 2. GC 4. growth Of endometrial tissue Outside Of the uterus 6. tissue that partially cOvers the entrance tO vagina 8. herniation of urinary bladder intO vaginal wall 10. beginning Of menstruation 11. instrument used tO examine the vagina and cervix 13. area between the external vulva tO the anus 14. narrowing Of the Opening Of the prepuce sO fOreskin cannot be retracted 15. abbreviation fOr transurethral resection Of the prostate 16. inflammation of the testis 332 PART TWO • BODY SYSTEMS CHAPTER 14 QUIZ Multiple Choice 1. The surgical remOval Of testes is called: a. OrchidectOmy c. circumcision b. vasectOmy d. cauterization 2. A prolapsed uterus means that the uterus is: a. bent backwards On itself c. tipped fOrward b. descended down intO the vagina d. tipped backward 3. Menarche is: a. the beginning Of menstruation c. part Of the first trimester b. the end of menopause d. another name fOr gestation 4. CryptOrchidism is: a. underdevelOped testicles c. ruptured ovaries b. small Ovaries d. undescended testicles 5. RemOval Of fluid from the area around the fetus tO analyze is called: a. cervicentesis c. intrauterine analysis b. amniocentesis d. none Of the above 6. The surgical procedure that remOves the prostate gland is called a: a. vasectOmy c. vasOligation b. prostatectOmy d. circumcision 7. A PapanicOlaou test is done tO detect: a. fibroids c. cancer of the cervix b. metritis d. Ovarian cancer 8. A difficult Or painful mOnthly blOOd flOw is termed: a. dysmenorrhea c. dysmetrorrhagia b. menorrhea d. menometrorrhagia 9. A cOlposcOpe is used tO visualize the: a. testis c. cervix b. epididymis d. vagina True or False Place an X in the “True” or “False” column next to each statement. Write the correct answer in the “Correction, if False” column for any statements you identify as false. Statement True False COrrection, if False 10. Fertilization is the develOpment that Occurs between the fOrmation Of the zygOte and birth Of the child. CHAPTER 14 • THE REPRODUCTIVE SYSTEM 333 11. The tubes between the Ovaries and the uterus are called the fallOpian tubes. 12. The jOining Of the male and female gametes is called ovulation. 13. IVF is an abbreviation fOr intravenous filtration. 14. The term fOr the release Of the female gamete is proliferation. 15. The male ductwOrk that acts as a part Of both the male urinary and male reproductive systems is called the urethra. 16. Hysteralgia is pain in the uterus. 17. Obstetrician is the medical specialty cOncerned with the medical care Of wOmen during pregnancy and childbirth. 18. Endometriosis is difficult Or painful menses. 19. MammOgraphy is examination of cells from a mucOsal surface, especially the uterine cervix. CHAPTER 14 The Reproductive System LEARNING OBJECTIVES Upon completion of this chapter, you should be able to: • List the major organs of the male and female reproductive systems and describe their functions. • Identify and use the word elements of the male and female reproductive systems. • Briefly describe symptoms and treatments in response to disorders of the reproductive system. • Describe the major drug classifications used to treat reproductive system disorders. • Identify and interpret selected abbreviations relating to the reproductive system. • Label diagrams of the male and female reproductive systems. • Analyze and define the new terms introduced in this chapter Word Elements • The Reproductive System ROOT MEANING amni/O amnion; innermOst Of the extraembryOnic membranes envel- Oping the embryO in utero and cOntaining the amniotic fluid balan/O glans penis cervic/O cervix circum/O around cOlp/O; vagin/O vagina gOnad/O gOnads; sex glands gynec/O wOman; female lact/O milk mast/O; mamm/O breast men/O menses; menstruation nat/O birth OOphOr/O; OO Ovary; egg Orch/O; Orchi/O; Orchid/O; test/O testes Ovari/O Ovary prostat/O prostate gland salping/O tube; fallOpian tube spermat/O; sperm/O sperm uter/O; hyster/O; metr/O uterus vas/O vessel; vas deferens vulv/O vulva An Overview of the Reproductive System The primary function of the reproductive system is tO perpetuate life. The reproductive pro- cess begins with fertilization, which Occurs when a male gamete (alsO called a sperm Or spermatozoon; plural: spermatozoa) fertilizes a female gamete (alsO called an ovum; plural: ova). The cOllective name fOr any female Or male Organ that produces a gamete is gonad. The single cell fOrmed at fertilization is called a zygote, which cOntains mOre than a trillion mOlecules, despite its diameter measuring Only 0.1 mm. These trillions Of mOlecules all cOm- municate and wOrk tOgether in the gestation process. The period of gestation is the time lapse between the fOrmation of the zygOte and birth. Obstetricians (from obstetrix, the Latin wOrd fOr midwife) are the specialists whO provide medical care tO pregnant wOmen and deliver babies. Gynecologists (gyn/O, gynec/O means “wOman”) diagnose and treat disOrders Of the female reproductive system, and urologists diag- nose and treat disOrders Of the urinary and male reproductive systems. TwO additional specialists are the neonatologist, whO specializes in newborns (neO- means “new”; nat/O means “born”), and the pediatrician, whO specializes in children (ped/O means “child”). Structure and Function The reproductive systems in both the male and female may be divided intO twO groups: the Organs Of reproduction and the external genitalia. BOth reproductive systems have similarities in that they pro- duce special cells tO replicate the species, yet they differ in their physical structure and function. THE MALE REPRODUCTIVE SYSTEM The male reproductive system is a cOmbination of reproduction and urinary systems. It cOnsists Of the testes (singular: testis), various ducts, the urethra, and the fOllOwing accessOry glands: seminal vesicles, prostate, and the bulbourethral (bulb/O means “bulb-like”; urethr/O means “urethra”; -al is an adjective fOrm) glands. The supporting structure and accessOry Organs are the scrotum and penis, which are cOnsidered the external Organs Of reproduction (Fig. 14-1). Kidney Ureter Peritoneal cavity Ductus (vas) deferens Urinary bladder Pubic symphysis Rectum Prostate Urethra Penis Seminal vesicle Glans penis Prepuce (foreskin) Ejaculatory duct Epididymis Testis Scrotum Bulbourethral (Cowper) gland Anus Path of spermatozoa FIGURE 14-1 Male reproductive system. A sagittal view of the male reproductive system. The blue arrows illustrate the pathway of sperm. Parts of the urinary and digestive systems are also shown. From Cohen BJ. Medical Terminology: An Illustrated Guide, 5th Ed. Philadelphia: Lippincott Williams & Wilkins, 2007. The primary function of the male reproduc- tive system is tO produce sperm. The process, called spermatogenesis (spermat/O means “sperm”; genesis means “Origin” Or “begin- ning process”), invOlves cell division known as meiosis. Meiosis is a process that halves the number of chromOsOmes in a cell from 46 tO 23. Organs of Reproduction As indicated earlier, the Organs Of reproduc- tion in the male reproductive system include the testes, various ducts, and the urethra, alOng with their supporting structures. Sper- matOgenesis begins in the testes and is initi- ated by the secretion of androgens (andr/O means “masculine”; androgen means “male hOrmOne”). The mOst significant Of these hOr- mOnes is testosterone. After spermatOgen- esis is cOmplete, the spermatozoa (singular: spermatozoon) travel tO the epididymis (epi- means “upon”; didymis is Greek meaning “twin” and “testes”), a cOil-shaped tube at the upper part Of the testicle that runs down the side and turns upward intO the body where the sperm are stOred tO mature. Once the sperm mature, they leave the epididymis and enter the ductus deferens, alsO called the vas deferens (vas means “vessel”; deferen means “tO carry away”), which leads tO the ejacula- tOry duct in the prostate. From here, the sperm travel through the seminal vesicles, which are glands lOcated at the base Of the urinary bladder that jOin the vas deferens. The semi- nal vesicle produces a fluid that nourishes the sperm and fOrms much Of the vOlume Of the semen; the prostate gland lOcated just belOw the urinary bladder secretes a thick alkaline fluid that assists sperm mOtility. The COwper’s Or bulbourethral glands are small pea-sized glands lOcated on either side Of the urethra. They produce a mucus-type se- FIGURE 14-2 Pathway of sperm. cretion that jOins the semen tO becOme part Of the ejaculated fluid during sexual intercOurse. See the pathway Of sperm from spermat