NURSING 507 FINAL EXAM STUDY GUIDE REPRODUCTION

FINAL EXAM STUDY GUIDE Reproductive Endometrial cycle and the occurrence of ovulation -menstrual cyclestarts with menarche (first menstruation) ends with menopause (cessation of menstrual flow for 1 year) -Cycles -anovulatory at first may vary in length from 10 to 60 days or more. -As adolescence proceeds into adulthood, regular patterns of menstruation and ovulation are established at intervals ranging from 21 to 45 days. -Menstruation continues to recur in a recognizable and characteristic pattern during adulthood, with the length of the menstrual cycle varying considerably among women. - commonly accepted cycle average is 28 (27 to 30) days, with rhythmic intervals of 21 to 35 days considered normal. -Approximately 2 to 8 years before menopause, cycles begin to lengthen again with variation related to changing hormone levels -2 phases: 1) follicular/proliferative phase (postmenstrual) -lasts until about day 14. - endometrium grows to form a lush lining inside of the uterus. 2) luteal/secretory phase (premenstrual) - this is where the body secretes the hormones estrogen and progesterone. -These hormones work together to prepare the lining of the uterus for implantation. -lasts for 12 days -During menstruation (menses), the functional layer of the endometrium disintegrates and is discharged through the vagina.  The estrogen and progesterone start to decline and the endometrial lining begins to shed. This lasts for 3-5 days and the process restarts. Menstruation is followed by the follicular/proliferative phase. 1 NURSING 507 FINAL EXAM STUDY GUIDE REPRODUCTION -Ovulation is the release of an ovum from a mature follicle and marks the beginning of the luteal/secretory phase of the menstrual cycle. The ovarian follicle begins its transformation into a corpus luteum hence the name luteal phase.  Pulsatile secretion of the LH from the anterior pituitary stimulates the corpus luteum to secrete progesterone. -This will initiate the secretory phase of endometrial development.  Glands and blood vessels in the endometrium branch and curl through a functional layer, and the glands begin to secrete a thin glycogen-containing fluid= the secretory phase. *If conception occurs the nutrientladen endometrium is ready for implantation. Uterine prolapse -descent of the cervix or entire uterus into the vaginal canal -In severe cases the uterus falls completely through the vagina and protrudes from the introitus. -Symptoms of other pelvic floor disorders also may be present. -due to weakness of the pelvic musculature, ligaments, and fascia or obstetric trauma and lacerations sustained during labor and delivery. - Pregnancy, obesity, prolonged standing, and chronic constipation are associated with stretching of the fascia and prolapse over time. - Women with connective tissue disorders are also at risk, so there is a strong genetic/familial component. In addition, risk of prolapse increases with age because of cumulative effects of stress on the pelvic floor. -Because estrogen improves vascularity of the pelvic area, postmenopausal women are at risk since their fascia and pelvis musculature lose resilience with diminished estrogen levels - Treatment is often progressive with less aggressive treatments tried first. 2