Health and Social Care Anatomy and physiology

•Heart – to pump deoxygenated blood to the lungs where it is oxygenated  

•Vascular system – to ensure oxygenated blood is transported to where it is needed.

•Arteries – transport blood away from the heart

•Veins – transport blood towards the heart  

•Capillaries – exchange surface for gases and nutrients

  •Artery

 •Arteriole (small artery)

 •Vein

 •Venule (small vein)

 •Capillary

•Direction of blood flow (towards/away)

•Pressure (high/low)

•Valves (presence/absence)

•Oxygenation of blood (oxygenated/deoxygenated)

•Pulse (yes/no)

•Thickness of walls (thick/thinner)

•Transports gase

 •Transports nutrients

 •Removes wastes

 •Fights infection

 •Maintains body temperature

 •Maintains homeostasis

•Fluid – plasma

  •Cells

–Red blood cells (erythrocytes)

 –White blood cells

 –platelets

•Contain haemoglobin which binds to oxygen in the lungs

•Transports oxygen around the body and releases it to the tissues.

•Tiny disc shaped cells  

•Prevent excessive bleeding  

•By forming clots

•Defend the body against bacteria, viruses and fungi.  

•3 main types, monocytes, granulocytes and lymphocytes.

Defend the body against  BACTERIAL infections

•Fight bacterial and fungal infections

•rapidly increase in number

•Engulf and destroy bacteria

•Die forming pus

•ingested by monocytes

•2 types called T cells and B cells.

•T cells kill virus infected cells and cancer cells.

•B cells make antibodies.

•Antibodies bind to pathogens and prevent them from doing damage to the body

The heart consists of 4 chambers: right atrium, right ventricle, left atrium, left ventricle

• Right atrium receives blood from superior and inferior vena cava
• Blood flows from right atrium, across tricuspid valve, into right ventricle
• Muscle of right ventricle is not as thick as left ventricle
• Blood enters pulmonary artery from right ventricle.
• Blood returns to heart from lungs via 4 pulmonary veins that enter left atrium
• Blood flows from left atrium, across mitral valve, into left ventricle
• Blood from left ventricle is ejected, across aortic valve, into aorta

• Atria receive blood from veins and store it prior to each heart beat
• Right atrium receives blood from main body veins called "vena cava"

• Superior vena cava SVC carries blood from head, upper chest and arms
• Inferior vena cava IVC carries blood from lower chest, abdomen and legs

• Left atrium receives blood from lungs via 4 separate pulmonary veins
• Systole refers to a period of contraction by heart muscle
• Diastole refers to a period of relaxation by heart muscle

• Both atria contract and push stored blood across AV valves into ventricles, to help fill them
• Atrioventricular (AV) valves include

• Mitral valve located between left atrium and left ventricle
• and tricuspid valve which separates right atrium from right ventricle

• Reduces the volume of atria and increases pressure

• After atria contracts, ventricles begin to contract
• Pressure in ventricles increases, blood is forced against AV valves
• Valves close to prevent backflow → first heart sound
• Volume is reduced
• Blood is ejected into arteries through aortic and pulmonary valves

• End of cardiac cycle, all chambers relax
• Aortic and pulmonary valves close (second heart sound) / prevents backflow into heart
• Atria begin to fill up again to start next cycle
• Volume increases and pressure decreases

• Sinus node is located at the top right atrium

• Electrical signal rapidly spreads from the Sinus node across the right atrium and left atrium

• Only one area where atria and ventricles are electrically connected

• Atrioventricular node or AV node deep in center of heart
• All electrical signals from atrium must pass through AV node in order to get to ventricles
• AV node is connected to the Bundle of His
• Branches into a right bundle (to right ventricle) and left bundle (to left ventricle)

• Fibers that branch out to distant ventricular tissues are called Purkinje Fibers

•P wave – contraction of the atria  

•QRS waves - contraction of ventricles  

•T wave – relaxation of the ventricles

•Diagnosing heart attack

•Monitoring treatment for CAD

•Identifying rhythm problems

•Thickening of heart muscle due to hypertension

•Plaques form in the walls of arteries

•The plaques split open

•Causes blood to clot (a thrombus)

•Thrombus blocks the artery

•Poor diet

•Alcohol and smoking

•Stress and lack of exercise

•hypertension

•Hereditary conditions

age – you are more likely to have a stroke if you are over 65 years old, although about a quarter of strokes happen in younger people

• family history – if a close relative (parent, grandparent, brother or sister) has had a stroke, your risk is likely to be higher
• ethnicity – if you are south Asian, African or Caribbean, your risk of stroke is higher, partly because rates of diabetes and high blood pressure are higher in these groups
• your medical history – if you have previously had a stroke, TIA or heart attack, your risk of stroke is higher
• Ischaemic strokes, the most common type of stroke, occur when blood clots block the flow of blood to the brain
• Haemorrhagic strokes usually occur when a blood vessel in the brain bursts and bleeds into the brain

·   smoking – sticky blood and less elastic

• high blood pressure (hypertension)
• obesity
• high cholesterol levels (often caused by a high-fat diet, but can result from inherited factors)
• a family history of heart disease or diabetes
• excessive alcohol intake
• atrial fibrillation, blood not moved around the body so it them becomes a clot (move around the body to the brain)

The main cause of haemorrhagic stroke is high blood pressure (hypertension), which can weaken the arteries in the brain and make them prone to split or rupture.

Things that increase the risk of high blood pressure include:

being overweight or obese

• drinking excessive amounts of alcohol
• smoking
• a lack of exercise
• stress, which may cause a temporary rise in blood pressure

Physical symptoms

Blood tests –cholesterol

Blood pressure

ECG

Ct and MRI scans

Swallow test

Heart and blood vessel tests (ultrasound (carotid Dopplers) and an echocardiogram)

Thrombolysis (within 4 hours) –aspirin (anti platelet medication)

Anticoagulants – aspirin

Surgery to remove blood from brain

High blood pressure medicines – Anti hypertensive medication –

Cholesterol- STATINS, Simvastatin

Physiotherapy, OT, Speech and language specialist

FAST: Face-Arms-Speech-Time.

• Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped
• Arms – the person with suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
• Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake. Loss of speech – Aphasia
• Time – it is time to dial 999 immediately if you see any of these signs or symptoms

mastication (chewing) "mechanical digestion"

chemical digestion, food mixes with saliva and an enzyme called Amylase breakes down carbohydrates

saliva moistens food so it is able to form into a bolbus

• Takes food into the stomach by peristalsis
• production of mucus to lubricate food
• carries vomit back into the mouth

• stores food (chyme)
• mechanical digestion- churning food by muscualr contraction
• produces mucus to protect the stomach lining

• where most of the digestion takes places
• The production of some digestive enzymes
• absorbs the nutrients through villi

• stores glycogen for balancing blood sugar levels
• produces bule
• detoxification

• stores bile
• it contracts to release bile into the small intestine when acid and fatty foods enter

• produces insulin to maintain blood glucose levels
• produces digestive enzymes - protease/trypsin= proteins

- lipase=fats

- pancreatic amylase=carbohydrates

• neutralises the small intestine

• absorbs water
• transportation of waste
• produces some vitamins

• Stores feces
• produces mucus

Causes- an autoimmune condition where the immune system mistakenly attacks healthy tissue

Coeliac disease isn't an allergy or intolerance to gluten

The immune system mistakes substances found inside gluten as a threat to the body and attacks them

This damages the surface of the small intestines (Villi), disrupting the body’s ability to absorb nutrients from food.

Exactly what causes the immune system to act in this way is still not entirely clear, although a combination of a person's genetic make-up and the environment appear to play a part.

• mild abdominal (stomach) pain
• bloating
• occasional changes in bowel habit, such as episodes of mild diarrhea or constipation
• anemia (tiredness, breathlessness and an irregular heartbeat, caused by a lack of iron in the blood)
• loss of appetite
• Villi flattened= Mal-absorption =weight loss
• Depression b vitamins
• Risk of osteoporosis and cancer later in life

Screening for coeliac disease involves a two stage process:

• Blood tests – If coeliac disease antibodies are found in your blood, your GP will refer you for a biopsy of your gut.
• A (endoscopy) biopsy – A biopsy can help confirm a diagnosis of coeliac disease. The gastroenterologist will pass a tiny biopsy tool through the endoscope to take samples of the lining of your small intestine. The sample will then be examined under a microscope for signs of coeliac disease. The endoscopy can show the villi and see if there damaged

There is no cure for coeliac disease, but switching to a gluten-free diet should help control symptoms and prevent long term consequences of the disease.

-          Vaccinations (e.g. Flu) and supplements (vitamins and minerals) can also be used if a person has a low immune system

•Support

•Movement

•protection

  •Muscles

•Bones (skeleton)

•Voluntary muscles  

•Attached to bones of the skeleton  

•Muscles can contract and relax  

•Bring about movement of the skeleton

•Synovial membrane - secretes synovial fluid

•Synovial fluid – lubricates the joint

•Cartilage – smooth surface to end of bones and cushions joints

•Tendons – joint muscles to bones

•Ligaments – join bone to bone

•Ball and socket - hips and shoulders

•Hinge – elbow and knee

•Pivot – head at the top of the spine

•Gliding/sliding – wrist and ankles

•Fixed – skull

Its overall functions are to collect information about the body's external/internal states and transfer this information to the brain to analyse this information, and to send impulses out to initiate appropriate motor responses to meet the body's needs. 

The system is composed of specialized cells, termed nerve cells or neurons, that communicate with each other and with other cells in the body.

•The cell body, containing the nucleus

•The dendrites, hair-like structures surrounding the cell body, which conduct incoming signals.

•The axon (or nerve fiber), which conduct outgoing signals emitted by the neuron. Axons are encased in a fat-like sheath, called myelin sheath, which acts like an insulator and, along with the Nodes of Ranvier, speeds impulse transmission.

The nerves of the body are organized into two major systems:

•the central nervous system (CNS), consisting of of the brain and spinal cord,

•the peripheral nervous system (PNS), the vast network of spinal and cranial nerves linking the body to the brain and spinal cord. The PNS is subdivided into: –the autonomic nervous system (involuntary control of internal organs, blood vessels, smooth and cardiac muscles), consisting of the sympathetic NS and  parasympathetic NS –the somatic nervous system (voluntary control of skin, bones, joints, and skeletal muscle).

–the autonomic nervous system (involuntary control of internal organs, blood vessels, smooth and cardiac muscles), consisting of the sympathetic NS and  parasympathetic NS –the somatic nervous system (voluntary control of skin, bones, joints, and skeletal muscle).

The central nervous system is divided into two parts: the brain and the spinal cord.

•The somatic nervous system consists of peripheral nerve fibres that send sensory information to the central nervous system AND motor nerve fibres that project to skeletal muscle.

•The autonomic nervous system is divided into three parts: the sympathetic nervous system, the parasympathetic nervous system and the enteric nervous system. The autonomic nervous system controls smooth muscle of the viscera (internal organs) and glands.

•In the peripheral nervous system, neurons can be functionally divided in three ways:

•Sensory (afferent) - carry information INTO the central nervous system from sense organs or motor (efferent) - carry information away from the central nervous system (for muscle control).

•Cranial - connects the brain with the periphery or spinal - connects the spinal cord with the periphery.

•Somatic - connects the skin or muscle with the central nervous system or visceral - connects the internal organs with the central nervous system.

•Thought

•Voluntary movement

•Language

•Reasoning

•Perception

•The right and left sides of the cerebral cortex are connected by a thick band of nerve fibres called the "corpus callosum."

The word "cerebellum" comes from the Latin word for "little brain." The cerebellum is located behind the brain stem. In some ways, the cerebellum is similar to the cerebral cortex: the cerebellum is divided into hemispheres and has a cortex that surrounds these hemispheres.

•Functions: •Movement

•Balance

•Posture

The brain stem is a general term for the area of the brain between the thalamus and spinal cord. Structures within the brain stem include the medulla and  pon

Some of these areas are responsible for the most basic functions of life such as breathing, heart rate and blood pressure.

•Functions:

•Breathing, Heart Rate, Blood Pressure

•Functions:

•Body Temperature

•Emotions – moods and motivation

•Hunger

•Thirst

•Sexual maturation

•Hormonal body processes

•Functions:

•Hormonal body processes

•Physical maturation

•Growth (height and form)

•Sexual maturation

•Sexual functioning

•Sequential Analysis: systematic, logical interpretation of information.

•Interpretation and production of symbolic information: language, mathematics, abstraction and reasoning.

•Memory stored in a language format

•Holistic Functioning: processing multi-sensory input simultaneously to provide "holistic" picture of one's environment.

•Visual spatial skills.

•Holistic functions such as dancing and gymnastics are coordinated by the right hemisphere.

•Memory is stored in auditory, visual and spatial modalities.

•Four distinct lobes make up the cerebrum: the frontal lobe, the parietal lobe, the occipital lobe, and the temporal lobe. Each of these parts of the brain has different functions. Some of these functions may overlap: for instance, the frontal and temporal lobes are both important for language and speech.

The frontal lobe is responsible for speech, movement, planning, organising, problem solving, selective attention, personality and a variety of "higher cognitive functions" including behaviour and emotions.

controls memory, personality, and language. 

also allows us to distinguish smells and sounds. 

help in sorting new information and are believed to be responsible for short-term memory.

•Right Lobe - Mainly involved in visual memory (i.e., memory for pictures and faces).

•Left Lobe - Mainly involved in verbal memory (i.e., memory for words and names)

pain, pressure, and other physical sensations.

the area of the brain that allows us to identify objects.

processes visual stimuli and allows the brain to process light and objects. 

also contains association areas that help in the visual recognition of shapes and colors.

Damage to this lobe can cause visual deficits

•Larynx – voice box

•Trachea – windpipe

•Bronchi – left and right to each lobe of lung

•Bronchioles – smaller tubes leading to:

•Alveoli – small air sacs – site of gas exchange.

•Pleural membranes – cover and protect lungs.

•Diaphragm – dome shaped muscle separates chest from abdomen.

•Intercostal muscles – contract and relax to expand the chest volume.

•Pulmonary arteries and veins – move blood through the lungs.

•Inspiration/expiration (breathing!)  

•Gaseous exchange of oxygen and carbon dioxide

•A large surface area for exchange of gases.

•A short distance for the gases to diffuse.

•Concentration gradients for the gases.

Numerous (large surface area)

Thin walled (short distance)

Surrounded by many tiny capillaries (keeps a concentration gradient)

to speed up diffusion!

•Oxygen binds to haemoglobin to form oxyhaemoglobin.

•Carbon dioxide is dissolved in the blood plasma.

•Airways become inflamed and narrow

•Tightness in the chest

•Difficulty in breathing (out)

•Wheezing and breathlessness

•distress

•Anxiety (sweating, rapid heart beat)

•Cyanosis of lips and face

Inherited

overweight

Exercise

Low Temperatures

Chemical Foods

Smoking

House dust

Aerosols

Household Cleaners

Car Fumes

•Peak flow meter

•spirometry

•Diagnostic imaging techniques

•Blood tests

•Measures maximum volume of air that can be blown during the 1st second of expiration (FEV1)

•Score based on age and height

•Best of 3 attempts

•Check during time of no symptoms

•Monitor decrease during asthma attack

•Helps to identify triggers.

•Identifies best medicines for each individual.

•Decrease during attack indicates symptoms worsening – change medication?

•Stable value during attack indicates medication working.

•Chest X ray to show change in structure of lungs or infection

•CT/MRI scan to assess the condition of the lungs

•Arterial blood gas can show low levels of oxygen in the blood (hypoxia) or high levels of carbon dioxide (respiratory acidosis).

•Used to identify infections

•Used to identify allergies by looking at antibody levels.

•Preventers e.g. steroids

•Relievers e.g. Ventolin

•Antibiotics

•Avoidance of triggers

 •Reduce inflammation

•Reduce mucus production

•Reduce swelling and narrowing of airways

•Help reliever medicines to work better.

•Relax muscles that constrict airways

•Help the flow of respiratory gases

•Balance the levels of oxygen and carbon dioxide

•Use as an inhaler

•Wheezing

•Coughing

•Shortness of breath

•Chest infections

•not understanding the overall causes

•Not understanding the disease process and its effects

•Not understanding the links between the causes and effects on themselves

•effects on work

•effects on education

•bullying

•fear  or anxiety of condition / treatments

•low self esteem / self worth / self concept

•frustration due to constraints on lifestyle

•Emotional effects on family

•lack of empowerment

•social stigma

•unable to have a normal social (sporting) life style

•unable to participate fully in education or working activities

25 – 30 cm long and 4-5mm in diameter. Transport urine from kidneys to bladder.  Enter the bladder at an angle to prevent reflux of urine.

hollow muscular organ which can expand. Urinary sphincter keeps the urethra closed and prevents reflux of urine.

Only found in men!

•Surrounds the top of the urethra.

•Provides the fluid for semen.

•May get larger in older men and block the flow of urine.

cortex- outer layer

medulla- middle layer

Renal Pelvis- connects the kidney to the upper end of the ureter

calyx- 2-3 major calyces diveded into 8-14 minor calyces. collection area for urine

•Made from a filter (glomerulus)

•Bowman’s capsule

•Proximal tubule

•Loop of Henle

•Collecting duct

•Glomerulus – network of capillaries. Site of ultrafiltration. Fluid filtered out under pressure.  

•Bowman’s capsule – a double walled chamber containing the glomerulus.

•Proximal tubule – coiled tube, reabsorbs glucose

•Loop of Henle – reabsorbs water

•Distal tubule – coiled tube, reabsorbs electrolytes

•Collecting duct – site of osmoregulation and leads to the calyx.

•Urine production

AND

•osmoregulation

•High pressure in glomerulus forces fluid into the Bowman’s capsule = ultrafiltration.

•Small molecules such as water, glucose, electrolytes and urea (a poisonous substance made in the liver from unwanted amino acids), are filtered out of the blood and collect in the fluid in the Bowman’s capsule.

•All of the glucose in the proximal tubule

•Most of the water in the loop of Henle

•Most of the electrolytes in the distal tubule  

•Urea is not reabsorbed.

•Maintaining the correct water and electrolyte content of the body and its fluids.

•Takes place in the collecting duct by changing their ability to reabsorb water from the fluid.

•Controlled by a hormone made in the brain.

•A syndrome is a collection of signs and symptoms that occur together that indicate that the nephron is not working properly.

•Auto-immune disease.

•Thought to be triggered by a throat infection.

•Immune system attacks the glomerulus/Bowman’s capsule, damaging basement membrane (filter).

•Allows leakage of proteins.

•Protein in the urine

•Abnormal blood and urine values

•Fluid retention/oedema/swelling

•“Moon face”

•Increased blood clotting times

•Reduced immunity

•Leads to renal failure

•Little or no glomerular filtration

•Little urine produced (50-250ml/day)

•Oedema due to salt and water retention

•Increased levels of urea and potassium in the blood

•Acidosis (inability to excrete acid substances)

•Cardiac arrest

•Fever/high temperature

•Nausea, vomiting, loss of appetite and hiccups caused by uraemia.

•High blood pressure

•Yellow/brown skin discoloration

•Neuropathy twitching

•Lack of concentration

•effects on mobility

•decreased immunity

•See previous slides for alternative physical effects

•not understanding the overall causes

•Not understanding the disease process and its effects

•Not understanding the links between the causes and effects on themselves

•effects on work

•effects on education

•bullying

•fear of condition / treatments

•low self esteem / self worth / self concept

•frustration due to constraints on lifestyle

•reassesses own life and its effects on those close to them

•lack of empowerment

•social stigma

•unable to have a normal social life style.

•unable to attend education or working activities without feeling inadequate

•Urine tests using dipsticks for :

•Blood, glucose, protein  

•Blood tests:

•U and E’s (urea and electrolytes)

•eGFR

•Protein in the blood

•Plain X rays

•X rays using contrast injections (urography or IVU)

•CAT scans to get a detailed “slice”

•MRI scans to get a detailed 3D picture. (Uses magnets, not x rays).

•uroscopy/urethroscopy using a fibre optic instrument passed into the urethra.

 Steroids - reduce inflammation

•Immunosuppressant drugs - suppress immune response

•Diuretics - increase urine production

•Coping with the side effects of these drugs e.g. change in appearance, disruption of routines

•Haemodialysis  

•Peritoneal dialysis

•in a patient suffering from temporary or permanent kidney failure, cleansing of the blood can be done with an artificial kidney machine; this is known as haemodialysis.

•two plastic tubes, one connected to anarteryand one to avein, are implanted in the patient's arm.

•Dialysis takes 3-5 hrs per treatment, 3 days a week. •blood enters the machine from the artery and comes into contact with a thin membrane.

•wastes from the blood pass through the membrane into the dialysis fluid on the other side of the membrane.

•Efficient

•Patient feels better immediately

•Less restricted food intake

•No need to wear a bag

•No need to worry about a transplant

•No medical equipment at home

•Expensive

•Time consuming

•Restricted movement

•Shunt required

•Infection risk

•Clotting risk

•Air embolus risk

•The patient's peritoneum (lining of the abdominal cavity) is used as the dialysis membrane

•a sterile plastic catheter (tube) is passed into the abdominal cavity

•Dialysis fluid is periodically injected into and withdrawn from the cavity.

•The fluid comes into contact with capillaries in the peritoneum.  

•Wastes from the blood diffuse through the membrane of the peritoneal wall due to the differences in concentration of molecules between the blood and fluid.

•The dialysis liquid is periodically withdrawn and replaced with a fresh solution.

•Cheaper

•Used where haemodialysis machine unavailable.

•Patient can move around.

•Can be done at home.

•Uncomfortable

•Slow (several hours)

•Draining fluid can be difficult and time consuming.

• embarrassing to have bags attached.

•Operation takes 4 hours

•General anaesthetic can be risky

•Remove tissue matched kidney from donor

•Insert in recipient above pelvic brim

•Attach new kidney to iliac blood vessels

•Attach ureter to new kidney

•Do not remove damaged kidneys unless required.

Start anti rejection drugs immediately

tiredness,increasing need to urinate, especially at night, 

itchy skin, nausea,

erectile dysfunction, 

shortness of breath, 

swollen ankles, feet or hands (due to water retention), and 

blood and/or protein in the urine.

If kidney failure has been caused by a sudden injury, these symptoms can appear rapidly, and may progress quickly to seizures, coma and potentially death.

•Ovary – produces ovum, stores ovum, secretes hormones (oestrogen and progesterone)

•Ovum (ova) – an egg. One is released each month to be fertilised by a sperm

•Fallopian tubes – transfer the ovum from the ovary to the uterus. Site of fertilisation.

•Uterus – accepts fertilised ovum, site where foetus develops, expands during pregnancy, contracts during birth

•Cervix – circular ring of muscle at the entrance to the uterus, dialates when giving birth

•Vagina – path for menstrual blood to leave body, route for baby to leave uterus, produces lubrication during sexual activity

•Controlled by changing the levels of the female hormones.

•Uterus lining thickens, then an ovum is released.

•If ovum is fertilised it implants in the uterus.

•If it is not fertilised, the lining of the uterus breaks down (menstruation).

FSH (follicle stimulating hormone) made by the pituitary gland in the brain.

•Oestrogen made by the ovaries

•LH (luteinising hormone) made by the pituitary gland.

•Progesterone made by the ovaries

•(FOLP = order of secretion)

•Days 1-6  (menstrual phase)  

•Days 7-14 (follicular phase)  

•Days 15 – 28 (secretory phase)  

•= roughly 28 days

•Lining (endometrium) of uterus is shed

•First day of bleeding is day 1

•Can be painful

•Can be unusually heavy in some women

•An ovum grows and matures. Controlled by FSH (follicle stimulating hormone) produced by the pituitary gland.

•The uterus lining thickens. Controlled by oestrogen produced by the ovary.

•A mature ovum is released from the ovary (ovulation).

•Controlled by LH (luteinising hormone) produced by the pituitary gland.

•The ovum travels down the fallopian tube towards the uterus.

•Fertilisation takes place in the fallopian tube.

•LH also causes the empty follicle to turn into a corpus luteum.

•The corpus luteum secretes progesterone.

•Progesterone keeps the uterus lining thick and spongy, ready to receive a fertilised ovum.

•A newly fertilised ovum is called a zygote.

•Zygote travels down the fallopian tube and implants into the uterus lining

•Now called an embryo

•Embryo develops into a foetus

•Once implanted, the embryo produces a hormone to stimulate the placenta to grow.  

•The hormone is called hCG (human chorionic gonadotropin) and is the hormone detected by pregnancy tests.

•Urethra

•Penis

•Testicle

•Seminal vesicle Prostate

•Vas deferens (sperm duct) epididymis

•Urethra – structure through which urine  passes from the bladder

•Penis – for intercourse or urination

•Seminal vesicle – produces a solution to neutralise acids

•Prostate – produces a nutrient fluid for sperm

•Testicle – produces sperm

•Epididymis = matures sperm and stores them for up to one month

•Vas deferens (sperm duct) – moves sperm from the epididymis to the urethra

•Sperm production is temperature related.

•The temperature of the testicle must be a few degrees lower than body temperature (370C)…

•…for optimum sperm production.

•Testes can also be moved nearer to the body in cold weather.

1.Problems with ovulation

2.Problems with the  fallopian tubes

3.Problems with the uterus  

4.Other causes (e.g. medicines/drugs/lifestyle/age)

•Premature ovarian failure

•Polycystic ovary syndrome (PCOS)

•Thyroid problems

•Chronic conditions e.g. anorexia, excessive exercise, cancer

•STI’s including chlamydia

•Previous ectopic pregnancy

•Previous sterilisation  (not always reversible!)

•Pelvic surgery

•Surgery to the cervix

•Fibroids

•Endometriosis

•Hostile mucus

•Long term NSAID  (nurofen) use

•Illegal drugs particularly cannabis and cocaine

•Age (declines rapidly after mid 30’s) /menopause

•chemotherapy

1.Problems with semen (sperm)

2.Problems with testicles

3.Problems with ***********

4.Other  causes e.g. medicines and drugs

•Decreased number (sperm count)

•Decreased motility

•Abnormal sperm

•Decrease in number or quality of sperm  

•Infection

•Testicular cancer

•Surgery

•injury

•Retrograde ***********

•Blocked vas deferens

•impotence

Anabolic steroids

chemotherapy

•Weight

•STI’s

•Smoking

•Stress

•Environmental factors (e.g. pesticides, solvents)

•Poor diet

•Clinical observation

•Ultrasound

•Blood tests

•salpingogram

•laparoscopy

•Weight

•Abdominal tenderness or swelling

•General health

•Radiographer

•Full bladder

•Lubricating skin gel

•Probe moved over skin

•Sound waves detected by computer and displayed as an image.

•FSH – high levels indicate premature menopause, low levels indicate hormone imbalance

•LH – high levels may indicate PCOS

•Prolactin – high levels caused by stress can prevent release of FSH and LH

•Diagnoses whether the fallopian tubes are clear (patent).

•Uses speculum to observe cervix

•Dye placed into uterus

•“Fill and spill” of dye. Dye spills through fallopian tubes into abdomen.

•Cut made in belly button

•Gas introduced into abdomen

•Doctor introduces microscope (laparoscope) to find blockages

•Dye may be injected or other instruments inserted

•Afterwards, gas allowed to escape

•Cuts closed with stitches

•Correcting unbalanced hormones

•Surgery to remove blockages

•IVF

•Sperm donation

•Treating erection problems

•Lifestyle changes

 Correct oestrogen and progesterone

•Clomid given to stimulate ovulation

•Laparoscopy to clear blocked fallopian tubes

•Laparoscopy to remove ectopic pregnancy

•Surgery to remove fibroids in uterus

•Remove blockages in the epididymis in men

•Preparation before IVF

•Egg retrieval

•Fertilisation

•Embryo formation

•Implantation

•pregnancy

 •Fertility drugs (clomid) given to stimulate the ovary to produce lots of eggs.

•Blood tests and ultrasound used to see if eggs are developing.

•Outpatient clinic

•Local anaesthetic used

•Needle inserted into ovary

•Eggs removed

•Man produces a semen sample

•Eggs examined and counted

•Sperm added to dish to fertilise eggs

•Special fluid added to nourish eggs and sperm

•Check 18 hours later to see if an embryo is forming.

•Incubate for 2-3 days until embryo is large enough to be implanted in uterus.

•Pass a catheter through the cervix into the uterus

•Transfer up to 2 embryos into the uterus

•Patient rests for a short time in bed to allow embryo to implant

  •Hormones given for 2 weeks to help embryo to remain implanted.

Positive pregnancy test=worked

•AID (artificial insemination by donor)

•AIH (artificial insemination by husband)

•Sperm usually placed in the vagina or can be placed in the fallopian tubes in GIFT – gamete intra-fallopian transfer

•General values – non invasive, relatively painless, instant images, relatively low cost, quick, good pictures of soft tissue, real time images.

•Diagnostic values – date foetus, identify abnormalities, identify gender, monitor growth.

•Surface probe – the probe moves over the surface of the skin. A lubricating gel helps to conduct the sound waves into the body.

•vaginal probe – used to gain a better image of tissues inside the body.

•High frequency sound waves are generated by a hand-held probe.

•The sound waves can pass through liquids and soft tissues.

•Sound is reflected back off solid objects and the time of travel is calculated and turned into an image by the receiver.

•Images are constantly updated so the scan can show movement.

•Structures can be viewed from different angles.

•Measurements can be made of the foetus.

•Still pictures can be printed out or saved on computer for comparison.