NCLEX Review Guide: Maternal Newborn Health - Reproductive System Structures and Functions

External Structures (Vulva)

• The mons pubis is the fatty tissue covering the pubic bone that provides protection during intercourse and childbirth.
• The labia majora and minora are protective folds that surround the vaginal and urethral openings, with the majora containing sebaceous glands.
• The clitoris contains erectile tissue and numerous nerve endings, serving as the primary organ for sexual arousal.
• The vestibule contains the urethral meatus, vaginal opening, and Bartholin's glands that provide lubrication.

Internal Structures

• The vagina is a muscular tube approximately 8-10 cm long that serves as the birth canal and menstrual flow pathway.
• The cervix is the lower portion of the uterus with an internal and external os that dilates during labor.
• The uterus consists of three layers: endometrium (inner lining), myometrium (muscle layer), and perimetrium (outer covering).
• The fallopian tubes are approximately 10 cm long with fimbriae that capture the ovum during ovulation.
• The ovaries produce ova and hormones (estrogen and progesterone) in a cyclic pattern.

Hormonal Regulation

• FSH (Follicle Stimulating Hormone) stimulates follicle development and estrogen production in the first half of the cycle.
• LH (Luteinizing Hormone) triggers ovulation around day 14 and maintains the corpus luteum.
• Estrogen peaks just before ovulation, causing cervical mucus to become thin and stretchy (spinnbarkeit).
• Progesterone dominates the luteal phase, preparing the endometrium for implantation and raising basal body temperature.

Conception Process

1. Sperm capacitation occurs in the female reproductive tract over 4-6 hours
2. Fertilization typically occurs in the ampulla (widest part) of the fallopian tube
3. The zygote begins mitotic division while traveling toward the uterus over 3-4 days
4. Implantation occurs 6-10 days after fertilization in the upper uterine fundus

Self-Assessment Checklist

• ☐ Can identify all external and internal reproductive structures
• ☐ Understand the four phases of the menstrual cycle
• ☐ Know the difference between gravida and para
• ☐ Can calculate GTPAL from client scenarios
• ☐ Understand when fertilization and implantation occur