1. Gina Marciano, a 44-year-old mother of eight children, visited her physician complaining of a “bearing down” sensation in her pelvis, low backache, and urinary incontinence. A vaginal examination showed that the external os of her cervix was just inside the vaginal orifice and her perineum exhibited large keloids (masses of scar tissue). Her history revealed that she was a member of a commune located in the nearby mountains that shunned hospital births (if at all possible). What do you think Gina’s problem is and what caused it? (Be anatomically specific). (4 points) Answer: Gina has a prolapsed uterus, caused by the stress on the pelvic floor muscles during her many pregnancies. Because of the keloids, I can assume that the central tendon to which those muscles attach has been severely damaged and many vaginal tears have occurred (pg.1044 in Marieb).
2. Harry, a sexually active adolescent appeared in the emergency room complaining of a penile “drip” and pain during urination. An account of his recent sexual behavior was requested and recorded. (a) What do you think Harry’s problem is? (b) What is the causative agent of this disorder? (c) How is the condition treated, and what may happen if it isn’t treated? (4 points) Answer: I believe Harry has a gonorrhea infection. The causative agent of gonorrhea is Neisseria gonorrhoeae. Gonorrhea is treated with penicillin and other antibiotics. If left untreated, it can cause urethral constriction and inflammation of the entire male duct system (pg. 1058 in Marieb).
3. A 36 year old mother of four is considering tubal ligation as a means of ensuring that her family gets no larger. She asks the physician if she will become “menopausal” after the surgery. (a) How would you answer her question and explain away her concerns? (b) Explain what a tubal ligation is. (4 points) Answer: (A). I will say, “No, you will not be menopausal because your ovaries will not be affected, don’t worry, they will continue to produce hormones. (B). Tubal ligation is the cutting, or cauterizing of the uterine tubes (pg. 1096 in Marieb).
4. Mr. Scanlon, 76-year-old gentlemen is interested in a much younger woman and is concerned because of his age. He asks his urologist if he will be able to father a child. What questions would a physician ask this man, and what diagnostic tests would be ordered? (4 points) Answer: The physician will ask questions about any history of medical or sexual factors that might affect fertility. The physician would order a physical exam, a post-ejaculatory urine sample, a semen analysis, a blood test, an ultrasound to determine the size of the testes, and possibly a genetic test (University of Maryland Medical Center (2011). Infertility in Men-Diagnosis. Retrieved from
http://www.umm.edu/patiented/articles/what_causes_of_male_infertility_000067_4.htm, on February 23, 2012).
5. Lucy had both her left ovary and her right uterine tube removed surgically at age 17 because of a cyst and a tumor in these organs. Now at age 32, she remains healthy and is expecting her second child. How could Lucy conceive a child with just one ovary and one uterine tube, widely separated on opposite sides of the pelvis like this? (4 points) Answer: This occurs due to migration of the ovum. Once the ovum is released from the right ovary and is not picked up by the right uterine tube, currents created by the fimbriae and ciliated distal end of the uterine tube helps to move the ovulated ovum into the left uterine tube (pg. 1067 in Marieb).
Critical Thinking Questions: 1, 3, 4, 5, 6, pg. 1100 in Marieb
1. Jennie, a freshman in your dormitory tells you she just discovered that she is three months pregnant. She recently bragged that since she came to college that she has been drinking alcohol heavily and experimenting with every kind of recreational drug she could find. From the following, select the advice that you would give her, and explain why it is the best choice. (a) She must stop taking drugs, but they must not have affected her fetus during the first few months of her pregnancy (b) Harmful substances usually cannot pass from the mother to the embryo, so she can keep on using the drugs and visit a doctor as soon as possible (c) There could be defects in the fetus, so she should stop using drugs and visit a doctor as soon as possible. (d) If she has not taken and drugs in the last week, she is okay. (4 Points) Answer: I would select answer (c) as the advice to give her, because the first 3 months (the embryonic period) of pregnancy are the crucial months. And her excessive alcohol and drug use could have caused major problems with her unborn fetus, because the alcohol and drugs can cross placental barriers and enter the fetal blood (pg. 1071 in Marieb).
3. A woman in substantial pain called her doctor and explained (between sobs) that she was about to have her baby “right here”. The doctor calmed her and asked how she had come to that conclusion. She said that her water had broken and there her husband could see the baby’s head. (a) Was she right? If so, what stage of labor is she in? (b) Do you think that she had time to make it to the hospital 60 miles away? Why or why not? (4 points) Answer: Yes, she is very much right because she is crowing, and she is in the expulsion stage, the 2nd stage of labor. I don’t think that she will make it to a hospital 60 miles away. The entire expulsion stage may last 2 hours from full dilation to delivery, 50 minutes for the first baby, and 20 minutes for the second baby. So, depending on how many kids she already has, if she is crowning, that means the baby is out and she is about to deliver (pg. 1091 in Marieb).
4. Mary is a heavy smoker and has ignored a friend’s advice to stop smoking during her pregnancy. On the basis of what you know about the effects of smoking on physiology, describe how Mary’s smoking might affect her fetus? (4 points) Answer: I think Mary’s smoking might cause her baby to be born underweight, addicted to nicotine, suffer from severe congenital abnormalities, or it may even cause fetal death (pg. 1085 in Marieb).
5. While Mortimer was cramming for his Anatomy test, he read that some parts of the mesoderm become segmented. He suddenly realized that he could not remember what segmentation is. Define segmentation, and give two examples of segmented structures in the embryo. (4 points). Answer: Segmentation is defined as the process of dividing into many segments; the formation of many cells from a single cell (Merriam-Webster (2012). Segmentation. Retrieved from
http://mw1.merriam-webster.com/dictionary/segmentation, on February 23, 2012). Examples of segmented structures in the embryo are the vertebral column and neural tubes (pg. 1084 in Marieb).
6. Assume a sperm has penetrated a polar body and their nuclei fuse. Why would it be unlikely for the resulting cell to develop into a healthy embryo? (4 points) Answer: It would be unlikely for the cell to develop into a healthy embryo because only the ovum is a functional gamete, and polar bodies are nonfunctional and degenerate (pg. 1049 in Marieb).
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