Human Sexuality

Human Sexuality

1. Concepts
1. A person’s sexuality encompasses the complex behaviors, attitudes emotions and preferences that are related to sexual self and eroticism.
2. Sex – basic and dynamic aspect of life
3. During reproductive years, the nurse performs as resource person on human sexuality.
2. Definitions related to sexuality:

Gender identity – sense of femininity or masculinity

2-4 yrs/3 yrs gender identity develops.

Role identity – attitudes, behaviors and attributes that differentiate roles

Sex – biologic male or female status. Sometimes referred to a specific sexual behavior such as sexual intercourse.

Sexuality - behavior of being boy or girl, male or female man/ woman. Entity life long dynamic change.

- developed at the moment of conception.

II. Sexual Anatomy and Physiology

        A. Female Reproductive System

        1. External value or pretender

a. Mons pubis/veneris -  a pad of fatty tissues that lies over the symphysis pubis covered by skin and at puberty covered by pubic hair that serves as cushion or protection to the symphysis pubis.

Stages of Pubic Hair Development

Tannerscale tool - used to determine sexual maturity rating.

                                        Stage 1 – Pre-adolescence. No pubic hair. Fine body hair only

Stage 2 – Occurs between ages 11 and 12 – sparse, long, slightly pigmented & curly hair at pubis symphysis

                                        Stage 3 occurs between ages 12 and 13 – darker & curlier at labia

Stage 4 – occurs between ages 13 and 14, hair assumes the normal appearance of an adult but is not so thick and does no  appear to the inner aspect of the upper thigh.

                                        Stage 5 sexual maturity- normal adult- appear inner aspect of upper thigh .

        b. Labia Majora - large lips longitudinal fold, extends symphisis pubis to perineum

        c. Labia Minora – 2 sensitive structures

 clitoris- anterior, pea shaped erectile tissue with lots sensitive nerve endings sight of sexual arousal (Greek-key)

fourchette- Posterior, tapers posteriorly of the labia minora- sensitive to manipulation, torn during delivery.

Site – episiotomy.

        d. Vestibule – an almond shaped area that contains the hymen, vaginal orifice and bartholene’s glands.

1.       Urinary Meatus – small opening of urethra, serves for urination

2.       Skenes glands/or paraurethral gland – mucus secreting subs for lubrication

3.       hymen – covers vaginal orifice, membranous  tissue

4.       vaginal orifice – external opening of vagina

5.       bartholene’s glands- paravaginal gland or vulvo vaginal gland -2 small mucus secreting subs – secrets alkaline subs.

Alkaline – neutralizes acidity of vagina

Ph of vagina - acidic

                                Doderleins bacillus – responsible for acidity of vagina

                                Carumculae mystiformes-healing of torn hymen

                e. Perineum – muscular structure – loc – lower vagina & anus

Internal:

                A. vagina – female organ of copulation, passageway of mens & fetus, 3 – 4inches or 8 – 10 cm long, dilated canal

Rugae – permits stretching without tearing

B.  uterus- Organ of mens is a hollow, thick walled muscular organ. It varies in size, shape and weights.

                                Size- 1x2x3

                                Shape: nonpregnant pear shaped / pregnant - ovoid

                                Weight - nonpregnant – 50 -60 kg- pregnant – 1,000g

                                Pregnant/ Involution of uterus:

                                4^th stage of labor                                - 1000g

                                2 weeks after delivery                         - 500g

                                3 weeks after delivery                         - 300 g

                                5-6 weeks after delivery     - returns to original, state 50 – 60

Three parts of the uterus

1.       fundus                   - upper cylindrical layer

2.       corpus/body         - upper triangular layer

3.       cervix                     - lower cylindrical layer

* Isthmus lower uterine segment during pregnancy

                                          Cornua-junction between fundus & interstitial

Muscular compositions: there are three main muscle layers which make expansion possible in every direction.

1. Endometrium- inside uterus, lines the nonpregnant uterus. Muscle layer for menstruation. Sloughs during menstruation.

Decidua- thick layer.

Endometriosis-proliferation of endometrial lining outside uterus. Common site: ovary.

                S/sx: dysmennorhea, low back pain.

                Dx: biopsy, laparoscopy

                Meds: 1. Danazole (Danocrene) a. to stop mens b. inhibit ovulation

                           2. Lupreulide (Lupron) –inhibit FSH/LH production

2. Myometrium – largest part of the uterus, muscle layer for delivery process
• Its smooth muscles are considered to be the living ligature of the body.

- Power of labor, resp- contraction of the uterus

3. Perimetrium – protects entire uterus

C. ovaries – 2 female sex glands, almond shaped. Ext- vestibule int – ovaries

Function:               1. ovulation

                                                2. Production of  hormones

d. Fallopian tubes – 2-3 inches long that serves as a passageway of the sperm from the uterus to the ampulla or the passageway of the mature ovum or fertilized ovum from the ampulla to the uterus.

4 significant segments

1. Infundibulum – distal part of FT, trumpet or funnel shaped, swollen at ovulation

2. Ampulla – outer 3^rd or 2^nd half, site of fertilization

3. Isthmus – site of sterilization – bilateral tubal ligation

4. Interstitial – site of ectopic pregnancy – most dangerous

B. Male Reproductive System

1. External

penis – the male organ of copulation and urination. It contains of a body of a shaft consisting of 3 cylindrical layers and erectile tissues. At its tip is the most sensitive area comparable to that of the clitoris in the female – the glands penis.

3 Cylindrical Layers

2 corpora cavernosa

1 corpus spongiosum

Scrotum – a pouch hanging below the pendulous penis, with a medial septum dividing into two sacs, each of which contains a testes.

-          cooling mechanism of testes

-      < 2 degrees C than body temp.

-      Leydig cell – release testosterone

2. Internal

The Process of Spermatogenesis – maturation of sperm

                        

Male and Female homologues

Male                                      Female

Penile glans                           Clitoral glans

Penile shaft                            Clitorial shaft

Testes                                     ovaries

Prostate                                  Skene’s gands

Cowper’s Glands                   Bartholin's glands

                                                    Scrotum                                 Labia Majora