Female Reproductive System

Question 1

sexual dimorphism

Answer 1

differences in male vs female traits, morphologically and behaviourally

Question 2

name 4 general primary sex characteristics of female reproductive system

Answer 2

ovaries
vagina
uterus
vulva (external genitalia)

Question 3

name 4 general primary sex characteristics of the male reproductive system

Answer 3

testes
penis
scrotum
prostate gland

Question 4

primary sex characteristics

Answer 4

traits that are necessary for reproduction

Question 5

secondary sex characteristics

Answer 5

traits that are unique to each sex but not necessary for reproduction

Question 6

name 3 secondary sex characteristics in females

Answer 6

breasts
distribution of hair
fat deposits

Question 7

name 3 secondary sex characteristics in males

Answer 7

muscular development
broadening of shoulders
changes in voice

Question 8

what did the human breast evolve from?

Answer 8

the sweat glands

Question 9

what muscles do the breasts rest on?

Answer 9

the mammary glands (breasts) rest on the upper chest wall on a muscle called the pectoralis major. beneath this is the pectoralis minor, which lies on the chest wall made up of the ribs and intercostal muscles

Question 10

what surrounds and supports breast tissue?

Answer 10

the pectoral fat pad. it is covered in skin with the nipple sticking out from the middle for milk to come from

Question 11

describe the nipple

Answer 11

surrounded by brown pigmented area called the areola which contains smooth muscle, and may be surrounded by hair.

Question 12

what are fibrous and connective tissues and what’s the difference?

Answer 12

they’re both connective tissue.

fibrous tissue provides strength and support to the body. it is composed of fibroblasts (cells that produce collagen and other fibres). collagen provides strength and elastin. Found in tendons, ligaments, cartilage, and fibrous capsules around organs

connective tissue is a more general term, refers to cells and extracellular matrix that fills space between tissues and organs in body. subtypes include adipose, blood, bone, cartilage. structural support, insulation, and communication between cells.

Question 13

name the 3 key features of the breast

Answer 13

lobules
ducts
connective tissue

Question 14

describe the lobules

Answer 14

the glands that produce milk

Question 15

describe the ducts

Answer 15

small tubes that transport milk from the lobules to the nipple

Question 16

what does connective tissue do in the breast

Answer 16

connective tissue supports and protects the breast tissue (lobules, ducts)

Question 17

how do mammary glands change before and during pregnancy

Answer 17

picture on slide 14 shows deeply stained epithelial elements (cells that line the ducts and lobules). these are the intralobular ducts.
intralobular ducts are surrounded by fine intralobular tissue. between them, lies interlobular connective tissue that contains dense collagen and adipose cells.
lobular epithelial cells line the lobules of the breast, and are responsible for milk production. organized in small groups called alveoli, which are small sacs that produce and store milk.
during pregnancy the lobules grow significantly, and the lobular epithelial cells are mostly responsible for this. they also play a role in the structural integrity of the lobules and production of milk.

Question 18

which two hormones are most important for breast development during pregnancy

Answer 18

estrogen and progesterone

Question 19

describe estrogen in pregnancy

Answer 19

a steroid hormone produced mainly in the ovaries. plays a key role in growth and development of ductual and lobular tissue of the breast.
estrogen levels rise during pregnancy and stimulate growth of ductal system, formation of new lobules, and the development of milk producing cells within lobules. estrogen also increases blood flow to breasts, which helps wth lactation

Question 20

describe progesterone in pregnancy

Answer 20

steroid hormone produced by ovaries and placenta
key role in preparing the breast for lactation by stimulating growth of alveolar cells within the lobules, which produce milk.
progesterone causes ducts to enlarge and swell, which is why breasts feel fuller and heavier during pregnancy
progesterone inhibits contraction of myoepithelial cells that surround alveoli and ducts, which maintain the milk inside the ducts and alveoli

Question 21

describe the placenta’s role in pregnancy

Answer 21

fetus needs it to grow and develop, supply nutrients and oxygen
waste exchange between fetus and placenta
fetus is connected to placenta which is connected to umbilical cord (tube with 2 arteries and a vein)
blood from fetus enters placenta through umbilical arteries, exchanges gasses and other substances with parent’s blood, then travels back to fetus via umbilical vein
placenta also produces hormones like human chorionic gonadotropin (hCG) and estriol. it functions as an endocrine gland and produces hormones that are necessary to maintain a healthy pregnancy. can also help protect the fetus from certain infections, by producing placental protein that can neutralize microorganisms and toxins

Question 22

what are the main constituents of human milk

Answer 22

water
lactose (sugar)
fat
proteins
amino acids
vitamins
energy content is 19cal/ounce

Question 23

how does the breast change during pregnancy

Answer 23

result of progesterone
areolas begin to swell, then breasts rapidly swell. most people feel soreness down sides of breasts and nipple tingling

Question 24

describe cancer

Answer 24

can start anywhere in body
cells usually grow and divide, and die when they get old or damaged. Cancer breaks this process down, and as cells become more abnormal or damaged they don’t die, meaning new cells form where they are not needed. cancer of blood (leukaemia) dont form solid tumours

Question 25

what is a malignant cancer tumour? a benign tumour?

Answer 25

a malignant tumour that can spread to/invade nearby tissues. sometimes tumours can break off and travel to distant places in the body through the blood or lymph system to form new tumours a benign tumour do not invade nearby tissues, but they can be quite large. when removed they usually dont grow back. can be life threatening in the brain.

Question 26

what causes cancer genetically?

Answer 26

genes that control how cells grow and divide are altered, or they can be inherited. can arise as result of errors that occur during cell division or damage to DNA from exposures. (ex. smoke, radiation, UV rays from the sun)

Question 27

what is the leading cause of death in ontario?

Answer 27

cancer. 1in 2 expect to be diagnosed, 1 in 4 expect to die. mortality rate decreased since the 80s, stable since 2000s

Question 28

what are most common cancers in men?

Answer 28

prostate lung colorectal

Question 29

what are most common cancers in women?

Answer 29

breast lung colorectal

Question 30

which cancer is most dangerous, prostate or breast?

Answer 30

breast, has higher death % and is more common

Question 31

what is the difference between a diagnostic and screening procedure?

Answer 31

diagnostic: if a symptom needs to be investigated, such as a lump in the breast screening: this type of mammogram looks for signs that breast cancer may be developing

Question 32

describe how a mammogram works

Answer 32

screening: breast is placed between compression plates, squeezed while x rays are taken. X ray is taken with low dose of radiation. picture made is called a mammogram. can help find tumours diagnostic: spot compression done on suspicious area with spot compression plate. gives closer view of one area of breast.

Question 33

when should you have a mammogram?

Answer 33

every 2 years for women/afab 50-74 years old. this has reduced deaths by 1/3 in this age range whether mammograms are beneficial to those outside this age range is inconclusive

Question 34

when should you have an early mammogram?

Answer 34

women/afab aged 30-69 can be screened through the high risk ontario breast screening program if they have a referral, no acute breast symptoms and fall into one of these categories: - have a mutation in a known BC causing gene - are first degree relatives with someone who has a gene mutation - have been assessed by genetics clinic as having 25% or more lifetime risk of getting BC - have had radiation therapy to chest to treat another cancer or condition before age 30 and at least 8 years ago - personal history of breast or ovarian cancer

Question 35

describe a mammogram

Answer 35

x ray imaging test to detect abnormalities in the breast tissue. detects changes in density and structure, lumps or masses, which can indicate presence of cancer microcalcifications are tiny mineral deposits, can appear as white spots in the mammogram. can be early sign of BC. mammogram does not directly detect cancer cells, but abnormalities in the breast tissue can be indicative of BC. biopsy needed to confirm

Question 36

what are dense breasts?

Answer 36

some ppl have more fibrous tissue in their breasts than fatty tissue. may be diagnosed with dense breasts. dense breasts mean higher BC risk, higher than a family history of BC. mammograms miss about 50% of BC in dense breasts, since there is low contrast.

Question 37

what is a biopsy?

Answer 37

a test that removes some tissue or fluid from a sus area. the removed cells are examined under a microscope and further tested to check for the presence of BC. only diagnostic procedure to definitively determine what the sus area is

Question 38

explain the hormone receptor status test

Answer 38

BC cells taken out during biopsy to check for estrogen and progesterone receptors. cancer is hormone receptor positive or negative depending on if they have these receptors. important in deciding on treatment options

Question 39

what is an ER+ breast cancer? PR+?

Answer 39

ER+: have estrogen receptors PR+: have progesterone receptors

Question 40

what is a hormone receptor positive cancer?

Answer 40

a cancer with either ER or PR receptors tends to grow slower than hormone receptor negative cancers tend to have better outlook short term, but these cancers can sometimes come back many years after treatment

Question 41

what is a hormone receptor negative cancer?

Answer 41

hormone receptor negative breast cancers have neither estrogen or progesterone receptors hormone therapy drugs are not helpful with these these cancers tend to grow faster than hormone receptor positive cancers. if they come back after treatment, it’s often in the first few years are more common in those who have not yet gone through menopause

Question 42

what is HER2 and what does it mean to be HER2+?

Answer 42

HER2: human epidermal growth factor 2 this receptor is part of a family of receptors that play a role in controlling cell growth and division HER2 is a protein that helps breast cancer cells grow fast if BC has higher than normal levels of HER2, it is HER2+ these cancers spread faster than HER2- , but are more likely to respond to treatment

Question 43

what is a triple negative breast cancer?

Answer 43

don’t have estrogen receptors or progesterone receptors more common in women under 40, black women, or women with mutated BRCA1 triple - spread and grow faster than other types of BC hormone therapy is not helpful in treating these cancers. they dont have much HER2, so drugs that target HER2 don’t help either

Question 44

surgery for cancer

Answer 44

surgical removal of the tumour or affected tissues often the first line treatment of solid tumors that are localized and haven’t spread

Question 45

chemotherapy for cancer

Answer 45

use of drugs to kill or inhibit the growth of cancer cells may be used as main treatment or in combination with other therapies. effective for cancers that have spread or are difficult to treat with surgery alone

Question 46

radiation therapy for cancer

Answer 46

use of high dose of radiation to kill cancer cells often used after surgery to eliminate any remaining cancer cells, or as a primary treatment if surgery is not possible

Question 47

hormone therapy for cancer

Answer 47

interferes with the activity of hormones that promote the growth of hormone sensitive cancers common for breast and prostate cancers that are hormone receptor positive

Question 48

what are main risk factors for breast cancer?

Answer 48

age race family history personal health history early menstruation late menopause (After 55)

Question 49

what is invasive cancer?

Answer 49

a type of cancer that has spread beyond the original site where it began and has invaded nearby tissue

Question 50

which background has the highest rate of breast cancer diagnosis?

Answer 50

white/caucasian women

Question 51

what hormonal factors (menstruation, birth) can add breast cancer risk

Answer 51

early menstruation (before 12) and late menopause (after 55) having a first child at an older age never having given birth

Question 52

what are the genes that are scrutinized for breast cancer risk

Answer 52

BRCA1 BRCA2

Question 53

which lifestyle factors put people at risk for breast cancer?

Answer 53

sedentary lifestyle alcohol consumption combined hormone replacement therapy

Question 54

explain how alcohol consumption and cancer are linked

Answer 54

alcohol is a carcinogen that causes at least 7 types of cancer. mainly breast and colon, along with rectum, mouth and throat cancer. many carcinogenic contaminants are introduced during fermentation and production. like phenols and hydrocarbons ethanol metabolizes into acetaldehyde, which is a toxic chemical and a probable human carcinogen. acetaldehyde can damage DNA and proteins, generated reactive oxygen species that can also damage DNA, proteins, and lipids via oxidation

Question 55

what is the BRCA gene test

Answer 55

a blood test to detect mutations in the two breast cancer genes: BRCA1 and BRCA2. if +, physician works with patient to determine risk level if there is no mutation the result is - . there could be gene variants doctors dont know about. these are called variants of uncertain significance (VUS)

Question 56

what are BRCA1 and BRCA2?

Answer 56

BReast CAncer genes 1 and 2 everyone has a copy, they have been found to impact a person’s chances of developing breast cancer. these genes produce proteins that help repair damaged DNA. when functioning properly they repair DNA, keep other genes healthy and prevent cancerous changes. If someone has a harmful variant, they tend to develop cancer at younger ages than people who do not have such a variant. 0.25% of the population carries mutated BRCA genes. 55-65% of women with the BRCA1 mutation will develop BC before 70 45% of women with BRCA2 mutation will develop BC by 70

Question 57

what is a VUS?

Answer 57

variant of uncertain significance is when an abnormal form of a BRCA gene is found, but it is unknown if it is harmful or not. its significance to the development or progression of disease is unknown. it is hard to predict clinical relevance of such variants

Question 58

what cancers are BRCA gene mutations responsible for?

Answer 58

5-10% of breast cancers 15% of ovarian cancers both men and women are prone to cancers if their BRCA is mutated

Question 59

true or false: you need a physician referral and sign off to get genetic testing for BRCA

Answer 59

true. a physician or NP needs to refer you

Question 60

what is an invasive ductal carcinoma?

Answer 60

of men who develop breast cancer, they are mostly IDCs. cells in/around the ducts begin to invade surrounding tissue. most common type of BC, making up 70-80% of all diagnoses. less than 1% of BC are in males, and of this 1%, 80% are IDC.

Question 61

describe the female external genital area

Answer 61

the vulva vulva is a collective term to describe the external genitalia, including the mons veneris, labia majora/minora, clitoris and vaginal opening. structures allow for sexual reproduction by providing means for sperm to enter the body and fertilize an egg

Question 62

the mons veneris

Answer 62

aka. mons fatty tissue covered with skin and pubic hair. acts as a cushion during sex, while pubic hair helps to vaporize odours

Question 63

labia majora

Answer 63

aka. outer lips two folds of skin that extend down from the mons on either side of the vulva. like the mons, they are padded with fatty tissue and hair

Question 64

labia minora

Answer 64

aka, inner lips thin folds of hairless skin between the two labia majora. they meet at the front to form the clitoral hood and enclose the vestibule space. amply supplied with glands, blood vessels and nerve endings and are erotically sensitive

Question 65

what are the 3 main components of the vestibule

Answer 65

clitoris urethral opening vaginal opening

Question 66

introitus

Answer 66

refers to the opening of a body canal or passage in the female reproductive system, the vaginal introitus refers to the opening of the vagina, which connects the vaginal canal to the outside of the body

Question 67

draw some anatomy out! the muscles and the structures of the external female genitalia

Answer 67

ok bestie

Question 68

pubic symphysis

Answer 68

the line of fusion between the left and right pubic bones

Question 69

glans of clitoris

Answer 69

a small highly sensitive knob of tissue positioned at the front of the vestibule the clit

Question 70

clitoris

Answer 70

the clit, esp the glans is richly innervated with sensory nerve fibres whose function is to produce sexual arousal. the only function of the clit is sexual pleasure its stimulation is the most reliable way for afab ppl to get orgasm erection of clit is physiological sign of sexual arousal. during erection, the shaft of the clit becomes firmer but the glans remains soft. the reason for this is that the shaft is surrounded by a layer of tough connective tissue that restricts its expansion whereas the glans is free to expand

Question 71

what are the two internal extensions of the clitoris

Answer 71

crura vestibular bulbs

Question 72

the crura

Answer 72

diverge backward and down clitoral shaft. partially enwrap the urethra

Question 73

vestibular bulbs

Answer 73

are closely associated with the clitoris. they are curved masses of erectile tissue that surround the vestibule and underlie the labia minora. erection of vestibular bulbs during sexual arousal helps stiffen and lengthen the vagina

Question 74

what are the 2 muscles associated with the clitoris

Answer 74

the ischiocavernosus muscle the bulbospongiosus muscle

Question 75

the ischiocavernosis muscle

Answer 75

surrounds each crus of the clitoris. contract during sexual arousal

Question 76

the bulbospongiosus muscle

Answer 76

runs down and surrounds the vaginal opening. contractions of this muscle tighten the vaginal opening, increases clitoral erection and may help increase erotic sensations of vaginal penetration by transferring mechanical stim to the clit

Question 77

the pubococcygeus muscles

Answer 77

muscles of the pelvic floor, one of the muscles targeted by kegel exercises the steady contraction of these muscles stiffens the walls of the vagina during sex. that actually increases the sexual sensations for both individuals during penetrative sex these muscles will contract more strongly during orgasm, increase pleasure, prevent urinary and fecal leakage. and possibly help keep sperm in the vagina

Question 78

what is female circumcision

Answer 78

aka female genital cutting or female genital mutilation involves partial or complete removal of external female genitalia for non medical reasons typically done to girls in infancy to 15, common in Africa, Middle East and SE asia considered a human rights violation and is illegal in many countries. serious health consequences, like infections, complications during childbirth, and death

Question 79

clitoridectomy

Answer 79

90% of female genital mutilation removal of entire external portion of the clitoris

Question 80

infibulation

Answer 80

10% of all female genital mutilation clitoridectomy + sewing together labia majora over vestibule

Question 81

describe the hymen

Answer 81

the hymen is a thin membrane located at the entrance of the vagina. not a necessary organ and has no known function not a solid barrier, a ring of tissue that can vary in shape, size, thickness some hymens are barely visible, while others are more prominent not a reliable indicator of virginity, as it can be stretched or torn for various reasons, or left unscathed

Question 82

why is the hymen not a good indicator of virginity?

Answer 82

some people are born without a hymen, or it is not visible the hymen can be stretched or torn without causing pain or bleeding

Question 83

annular hymen

Answer 83

forms in a ring around vaginal opening

Question 84

septate hymen

Answer 84

forms two holes in vaginal opening, sort of a pig’s snout appearance

Question 85

cribiform hymen

Answer 85

the membrane has many holes, very tryptophobia-triggering

Question 86

the wonder down under book

Answer 86

virginity fraud sexual education about the hymen and debunks myths around female virginity and the hymen advocate against virginity testing

Question 87

look at the reproductive tract diagram for anatomy!!

Answer 87

ok!!!

Question 88

Bartholin’s glands

Answer 88

greater vestibular glands, located on either side of vaginal opening produce small amount of mucus to help lubricate vagina during sexual activity

Question 89

what is the G spot? does it exist?

Answer 89

the Graenberg-spot (G spot) is thought to be an area of increased sexual sensitivity if it exists, the best candidate is the paraurethral glands, located in root of the anterior wall of the vagina and next to urethra in 2008 Italian researchers reported that the region containing paraurethral glands are larger in those who get orgasm from vaginal stimulation than those who do not maybe the orgasm is just from stimulation of nerve fibres in wall of vagina? or urethra? or erectile tissue?

Question 90

3 layers of vaginal wall

Answer 90

thin cellular lining/mucosa intermediate muscle layer outermost fibro-elastic layer outer third of the vagina near the opening has a different developmental origin. it is tighter and richly innervated. most sensation during sex derives from outer portion of vagina

Question 91

describe vaginal bacteria and fungi

Answer 91

vagina is inhabited by many microorganisms lactobacilli are type of bacteria that are naturally present. considered probiotics, and are beneficial bacteria for overall health they maintain vaginal pH, which helps prevent growth of harmful bacteria and yeast healthy bacteria produce lactic acid, lowering the pH and creating an acidic environment also produce hydrogen peroxide that protects vagina from infection. helps to keep balance of good bacteria.

Question 92

main vaginal microorganisms

Answer 92

lactobacilli (95%) candida albicans (fungal yeast)

Question 93

what is candidiasis

Answer 93

a yeast infection overgrowth of fungi inflammation of vaginal walls, itching and white discharge treatment: antifungal medication

Question 94

what is normal pH of a healthy vagina?

Answer 94

slightly acidic, at 3.8-4.5 this protects vagina from infection by creating environment that is inhospitable to harmful bacteria and other pathogens. the acidity is maintained by healthy bacteria like lactobacilli which makes lactic acid pH can fluctuate throughout menstrual cycle, during sexual activity or pregnancy, or with use of certain medications. as long as the pH isn’t consistently higher, there will not be a condition like bacterial vaginosis or a yeast infection

Question 95

what can disrupt vaginal pH>

Answer 95

antibiotics: not only target harmful bacteria but also beneficial vaginal bacteria, leading to imbalance douching: disturb natural pH and wash away good bacteria hormonal changes: fluctuations in hormone levels like those in menstruation/pregnancy or menopause can affect balance of vaginal bacteria sexual activity: can influence vaginal microbiome by disrupting it certain hygiene products: harsh soaps or perfumed products can disrupt natural balance tight clothing: creates warm and moist environment which promotes growth of harmful bacteria stress: high levels of stress can impact immune system and potentially contribute to imbalance in vaginal microbiome immunosuppression: conditions or medications that weaken the immune system can make vagina susceptible to infection

Question 96

cervix

Answer 96

narrow part of uterus

Question 97

the os

Answer 97

the external os connects the vagina to a short canal through the cervix

Question 98

describe the uterus’s functions and layers

Answer 98

functions: - pregnancy - menstrual cycle layers: - endometrium (inner lining) - myometrium (muscular wall) - perimetrium (outer covering)

Question 99

TNM staging system for cancer

Answer 99

T: tumour describes main tumor, and if it has grown to other parts or tissues. T ranges from 1-4, with higher number meaning larger tumor, or that it has grown deeper into tissues N: lymph nodes whether cancer has spread to lymph nodes around organ N0- no spread N1,N2,N3 means cancer has spread to lymph nodes, higher number means more lymph nodes and their size/location M:metastasis if the cancer has spread to other parts of the body via blood or lymphatic system M0- no spread M1- spread

Question 100

what demographic sees the most cancer deaths?

Answer 100

black/african american