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NURS 611Assign 12.1Becki EwyChapter 24: Structure and Function of the Reproductive SystemsConcept 1: Puberty (Q# 1, Study Guide, p. 118): Puberty is the onset of sexual maturation and differs from adolescence. Adolescence is the stage of human development between childhood and adulthood and includes social, psychologic, and biologic changes. In girls, puberty begins atabout ages 8-9 years with thelarche (breast development). In boys, it begins later-at about age 11years-but occurs earlier with increased weight and body mass index. Genetic, environment, ethnicity, general health, and nutrition can influence the timing of puberty.Concept 2: Thelarche (Q#4, Study Guide, p. 118): Breast development, or thelarche, is usually the first sign of puberty in the female. Full differentiation and maturation of breast tissue occur over approximately 4 years and are mediated by the level of a variety of hormones, including estrogen progesterone, prolactin, growth hormone, thyroid and parathyroid hormones, insulin, and cortisol. Estrogen promotes the increase in size of the breast by the formation of a mass tissue under the areola, increases the size and pigmentation of areola, and promotes development of the lobular ducts. The breast cells of parous women are different than those of women who never become pregnant as expansion of acini only occurs with pregnancy when the mammary gland prepare for lactation. During menopause the lobules of the parous breast involute to pre-pregnancy composition and become identical to the nulliparous breast.
Concept 3: Menopause (Q# 26, Study Guide, p. 120): Natural menopause is the cessation of ovulation and menses caused by ovarian failure. It is a normal developmental event marking the end of reproduction. Menopause is universally experienced by midlife women at the average ageof 50.5-51.5 years in North America with variability between 40-60 years old. A number of factors are thought to influence the age of menopause, including genetics, socioeconomic status, race, parity, oral contraceptive use, and lifestyle such as smoking or weight. It can occur 2 years sooner on average for smokers; thinner women also tend to experience menopause at a slightly younger age. Concept 4: Progesterone (Q# 22, Study Guide, p. 120): Progesterone is sometimes called the hormone of pregnancy. Progesterone’s effects in pregnancy include: (1) maintaining the thickened endometrium; (2) relaxing smooth muscle in the myometrium, which prevents premature contractions and helps the uterus expand; (3) thickening (hypertrophy) of the myometrium, which prepares it for the muscular work of labor; (4) promoting growth of lobules and alveoli in the breast in preparation for lactation but prevents lactation until the fetus is born; (5) preventing additional maturation of ova by way of FSH and LH, thereby stopping the menstrual cycle; (6) providing immune modulation allowing tolerance against fetal antigens (the mother’s immune system does not attack the fetus); and preventing preterm birth.