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    By F. Shakyor. Georgia Southwestern State University.

    Just as the hormones produced by the granulosa and theca cells of the ovary “drive” the follicular and luteal phases of the ovarian cycle buy super p-force 160mg without prescription, they also control the three distinct phases of the menstrual cycle buy discount super p-force 160 mg line. Menses Phase The menses phase of the menstrual cycle is the phase during which the lining is shed; that is, the days that the woman menstruates. Recall that progesterone concentrations decline as a result of the degradation of the corpus luteum, marking the end of the luteal phase. Proliferative Phase Once menstrual flow ceases, the endometrium begins to proliferate again, marking the beginning of the proliferative phase of the menstrual cycle (see Figure 27. It occurs when the granulosa and theca cells of the tertiary follicles begin to produce increased amounts of estrogen. High estrogen levels also slightly decrease the acidity of the vagina, making it more hospitable to sperm. In the ovary, the luteinization of the granulosa cells of the collapsed follicle forms the progesterone- producing corpus luteum, marking the beginning of the luteal phase of the ovarian cycle. In the uterus, progesterone from the corpus luteum begins the secretory phase of the menstrual cycle, in which the endometrial lining prepares for implantation (see Figure 27. If fertilization has occurred, this fluid will nourish the ball of cells now developing from the zygote. If no pregnancy occurs within approximately 10 to 12 days, the corpus luteum will degrade into the corpus albicans. Prostaglandins will be secreted that cause constriction of the spiral arteries, reducing oxygen supply. In all cases, the virus enters body cells and uses its own genetic material to take over the host cell’s metabolic machinery and produce more virus particles. These women ranged in age from 14 to 59 years and differed in race, ethnicity, and number of sexual partners. If pre-cancerous cells are detected, there are several highly effective techniques that are currently in use to remove them before they pose a danger. Unfortunately, the high cost of manufacturing the vaccine is currently limiting access to many women worldwide. The Breasts Whereas the breasts are located far from the other female reproductive organs, they are considered accessory organs of the female reproductive system. The areolar region is characterized by small, raised areolar glands that secrete lubricating fluid during lactation to protect the nipple from chafing. The milk itself exits the breast through the nipple via 15 to 20 lactiferous ducts that open on the surface of the nipple. These lactiferous ducts each extend to a lactiferous sinus that connects to a glandular lobe within the breast itself that contains groups of milk-secreting cells in clusters called alveoli (see Figure 27. Once milk is made in the alveoli, stimulated myoepithelial cells that surround the alveoli contract to push the milk to the lactiferous sinuses. The lobes themselves are surrounded by fat tissue, which determines the size of the breast; breast size differs between individuals and does not affect the amount of milk produced. Supporting the breasts are multiple bands of connective tissue called suspensory ligaments that connect the breast tissue to the dermis of the overlying skin. During the normal hormonal fluctuations in the menstrual cycle, breast tissue responds to changing levels of estrogen and progesterone, which can lead to swelling and breast tenderness in some individuals, especially during the secretory phase. If pregnancy occurs, the increase in hormones leads to further development of the mammary tissue and enlargement of the breasts. Hormonal Birth Control Birth control pills take advantage of the negative feedback system that regulates the ovarian and menstrual cycles to stop This OpenStax book is available for free at http://cnx. Although the estrogen in birth control pills does stimulate some thickening of the endometrial wall, it is reduced compared with a normal cycle and is less likely to support implantation. Some birth control pills contain 21 active pills containing hormones, and 7 inactive pills (placebos). The decline in hormones during the week that the woman takes the placebo pills triggers menses, although it is typically lighter than a normal menstrual flow because of the reduced endometrial thickening. Newer types of birth control pills have been developed that deliver low-dose estrogens and progesterone for the entire cycle (these are meant to be taken 365 days a year), and menses never occurs.

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    Hormonal changes that occur adolescence with the initiation of risky use of 6 during adolescence also pose a biological risk addictive substances best 160 mg super p-force, but the onset of risky use for substance use in this age group quality super p-force 160mg. The surge in and addiction can occur at any point in the the female hormone estrogen and the male lifespan. Common * 7 behavioral symptoms include defiance, spitefulness, of substance use and its consequences, but signs of risk sometimes can be observed much negativity, hostility and verbal aggression. In addition to the overall risks enormous difficulty following rules and behaving in a associated with substance use, children and socially-acceptable manner. These children may adolescents with heightened risk of engaging in bully others, start fights, show aggression toward substance use, of experiencing the adverse animals, steal or engage in sexually inappropriate consequences of risky use and of developing behavior. The lack of fully developed decision-  Coping with the stresses of child rearing, making and impulse-control skills combined balancing a career with family and 23 with the hormonal changes of puberty managing a household; compromise an adolescent’s ability to assess risks and make them uniquely vulnerable to  Facing divorce, caring for an adult family 16 substance use. In recent years, researchers have begun to recognize the developmental stage of young Middle aged and older adults who engage in adulthood--often referred to as emerging risky use may be even more vulnerable to the adulthood--as a period of life that is strongly health consequences of such use since physical 18 associated with risky use. Young adults facing tolerance for alcohol and other drugs declines heightened risk include: with age: the ways in which addictive substances are absorbed, distributed, *  College students-- --while approximately metabolized and eliminated in the body change two-thirds of college students who engage in 27 as people get older. With regard to alcohol, substance use began to smoke, drink or use several biological factors account for reduced other drugs in high school or earlier, the tolerance. The amount of lean body mass culture on many college campuses permits (muscle and bone) and water in older adults’ and promotes risky use rather than curtailing bodies decreases as the amount of fat increases, 19 it. Reduced liver and kidney function slows down the  Young adults facing work-related stress or metabolism and the elimination of alcohol from instability in living arrangements, social the body, including the brain. Young adults may turn to addictive substances to The increasing susceptibility to substance- relieve these forms of stress and self- induced neurotoxicity with age is a growing medicate their anxiety and emotional concern as the “Boomer” generation, a 21 29 troubles. The interaction of prescribed and other drugs Middle and Later Adulthood with alcohol also is of great concern for the physical and mental health of middle and older Major life events and transitions increase the adults who are likelier than younger people to chances that an individual will engage in risky use prescription and over-the-counter 22 30 use of addictive substances. Therefore, any signs and symptoms of risk and seeking attempt to identify risky use of addictive professional help at the first sign of trouble. Being informed of a Screening, a staple of public health practice that 34 patient’s health conditions that might be caused dates back to the 1930s, serves to identify early or exacerbated by substance use or that might signs of risk for or evidence of a disease or other cause or exacerbate the patient’s addiction will health condition and distinguish between help medical professionals determine individuals who require minimal intervention appropriate interventions and provide effective and those who may need more extended 32 35 care. It is an effective method of patients with medical conditions that frequently preventive care in many medical specialties, and co-occur with risky use and addiction--such as risky use of addictive substances is no hypertension, gastritis and injuries--should be exception. Screening for risky use of addictive prompted to screen for risky use of addictive substances is comparable to offering regularly substances that may cause or aggravate these scheduled pap smears or colonoscopies to 36 conditions. Patient Education and Motivation Educating patients and motivating them to reduce their risky use of addictive substances is 33 a critical component of preventive care. As part of routine medical practice, medical and other health professionals should educate their patients (and parents of young patients) about:  The adverse consequences of risky use and the nature of addiction--that it is a disease that can be prevented and treated † Despite the distinction between screening and effectively; assessment tools, the term screening often is used to subsume the concept of assessment or  The risk factors for substance use, tailoring interchangeably with the term in the clinical and the information to the patient’s age, gender, research literatures. Depending on the Prevention and Control patient’s age, positive responses to these Centers for Disease Control and Prevention items would be followed by more in-depth questions assessing the level of the patient’s Screening tools typically are brief and easy to risk and the provision of appropriate brief 40 administer and are to be implemented with a interventions. Screening tools typically screening test to identify other drug use in a include written or oral questionnaires and, less diverse sample of adult primary care patients frequently, clinical and laboratory tests. However, most instruments focus on specific In recent years, attempts have been made to substances rather than the range of addictive develop and validate more simple screening substances that pose a risk for addiction. The instrument use has been validated on adult populations 37 actually contains four separate screens and asks for use in research protocols but also can be used clinically to determine if a patient is patients about the frequency of their past-year a current smoker. At Response options for each, on a five-point scale, the same time, looking for biological markers is range from never to daily or almost daily. Used more objective than using a patient’s self- 51 online, the screening tool tallies the responses to reports, as it is not subject to patients’ or generate a score indicating the patient’s level of examiners’ biases. It also Unlike tests for other diseases such as diabetes provides additional resources to help and hypertension which can be diagnosed using 43 practitioners intervene appropriately. It would help reduce billions of ‡ exceptions, laboratory tests for nicotine, alcohol dollars annually in lost productivity, injury and and other drugs generally inform health care social costs associated with risky behaviors. It § providers of whether patients recently have would also encourage those with chronic been using these substances rather than being conditions to get the treatment they need. The question is, when will society Individuals, groups and organizations may be 44 hesitant to agree to laboratory tests for substance demand this change?

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    Exocrine Glands Exocrine glands release their contents through a duct that leads to the epithelial surface super p-force 160mg low price. Secretions into the lumen of the gastrointestinal tract super p-force 160mg otc, technically outside of the body, are of the exocrine category. The unicellular glands are scattered single cells, such as goblet cells, found in the mucous membranes of the small and large intestine. The multicellular exocrine glands known as serous glands develop from simple epithelium to form a secretory surface that secretes directly into an inner cavity. These glands line the internal cavities of the abdomen and chest and release their secretions directly into the cavities. The duct is single in a simple gland but in compound glands is divided into one or more branches (Figure 4. In tubular glands, the ducts can be straight or coiled, whereas tubes that form pockets are alveolar (acinar), such as the exocrine portion of the pancreas. Methods and Types of Secretion Exocrine glands can be classified by their mode of secretion and the nature of the substances released, as well as by the structure of the glands and shape of ducts (Figure 4. The secretions are enclosed in vesicles that move to the apical surface of the cell where the contents are released by exocytosis. For example, watery mucous containing the glycoprotein mucin, a lubricant that offers some pathogen protection is a merocrine secretion. Apocrine sweat glands in the axillary and genital areas release fatty secretions that local bacteria break down; this causes body odor. Both merocrine and apocrine glands continue to produce and secrete their contents with little damage caused to the cell because the nucleus and golgi regions remain intact after secretion. In contrast, the process of holocrine secretion involves the rupture and destruction of the entire gland cell. New gland cells differentiate from cells in the surrounding tissue to replace those lost by secretion. The serous gland produces watery, blood-plasma-like secretions rich in enzymes such as alpha amylase, whereas the mucous gland releases watery to viscous products rich in the glycoprotein mucin. Unlike epithelial tissue, which is composed of cells closely packed with little or no extracellular space in between, connective tissue cells are dispersed in a matrix. The matrix usually includes a large amount of extracellular material produced by the connective tissue cells that are embedded within it. Connective tissues come in a vast variety of forms, yet they typically have in common three characteristic components: cells, large amounts of amorphous ground substance, and protein fibers. The amount and structure of each component correlates with the function of the tissue, from the rigid ground substance in bones supporting the body to the inclusion of specialized cells; for example, a phagocytic cell that engulfs pathogens and also rids tissue of cellular debris. Functions of Connective Tissues Connective tissues perform many functions in the body, but most importantly, they support and connect other tissues; from the connective tissue sheath that surrounds muscle cells, to the tendons that attach muscles to bones, and to the skeleton that supports the positions of the body. Protection is another major function of connective tissue, in the form of fibrous capsules and bones that protect delicate organs and, of course, the skeletal system. Transport of fluid, nutrients, waste, and chemical messengers is ensured by specialized fluid connective tissues, such as blood and lymph. Adipose cells store surplus energy in the form of fat and contribute to the thermal insulation of the body. The first connective tissue to develop in the embryo is mesenchyme, the stem cell line from which all connective tissues are later derived. Clusters of mesenchymal cells are scattered throughout adult tissue and supply the cells needed for replacement and repair after a connective tissue injury. A second type of embryonic connective tissue forms in the umbilical cord, called mucous connective tissue or Wharton’s jelly. This tissue is no longer present after birth, leaving only scattered mesenchymal cells throughout the body. Classification of Connective Tissues The three broad categories of connective tissue are classified according to the characteristics of their ground substance and the types of fibers found within the matrix (Table 4. Dense connective tissue is reinforced by bundles of fibers that provide tensile strength, elasticity, and protection. Supportive connective tissue—bone and cartilage—provide structure and strength to the body and protect soft tissues. In fluid connective tissue, in other words, lymph and blood, various specialized cells circulate in a watery fluid containing salts, nutrients, and dissolved proteins. Connective Tissue Examples Connective tissue proper Supportive connective tissue Fluid connective tissue Loose connective tissue Cartilage Areolar Hyaline Adipose Fibrocartilage Blood Reticular Elastic Dense connective tissue Bones Regular elastic Compact bone Lymph Irregular elastic Cancellous bone Table 4.

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