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1
Copyright © 2019 Pearson Education, Inc.
Processes, Systems, and Information, 3e (McKinney/Kroenke)
Chapter 7 Supporting Processes with ERP Systems
1) With information silos, the data needed by one process are stored in an information system
designed and used in another process.
Answer: TRUE
Difficulty: Easy
AACSB: Information Technology
Chapter LO: 1: What problem does an ERP system solve?
Course LO: Discuss the role of information systems in supporting business processes
2) Information silos create islands of automation that increase the performance of processes and
make process integration easy.
Answer: FALSE
Difficulty: Easy
3) An ERP system tackles the silo problem by bringing data together in a big database to help a
company improve its processes.
Answer: TRUE
Difficulty: Easy
Course LO: Describe the uses of enterprise systems and enterprise resource planning
4) An ERP system use a centralized database.
Answer: TRUE
Difficulty: Easy
5) By consolidating data, a company can avoid the problem of having multiple versions of the
same thing.
Answer: TRUE
Difficulty: Easy
6) The challenges now involve updates and expansions, not the initial implementation.
Answer: TRUE
Difficulty: Easy

2
7) ERP system can improve a single process, but it interferes with the processes in an entire
organization.
Answer: FALSE
Difficulty: Easy
8) Businesses have been using information systems to support their processes well before the
Internet was invented.
Answer: TRUE
Difficulty: Easy
Chapter LO: 2: What are the elements of an ERP system?
9) Material requirements planning provided financial tracking capabilities and the opportunity to
schedule equipment and facilities.
Answer: FALSE
Difficulty: Easy
10) To execute a just in time delivery, unimpeded flows of data are essential between the
supplier and manufacturer.
Answer: TRUE
Difficulty: Easy
11) The progress of information systems and business processes impact one another.
Answer: TRUE
Difficulty: Moderate
12) For a product to be considered a true enterprise resource planning product, it must include
applications that integrate processes in supply chain management, manufacturing, customer
relationship management, human resources, and accounting.
Answer: TRUE
Difficulty: Easy

3
13) An enterprise resource planning solution cannot be partially implemented.
Answer: FALSE
Difficulty: Easy
14) Writing new code to supplement an enterprise resource planning system is called
customization.
Answer: TRUE
Difficulty: Easy
15) If a new enterprise resource planning customer has requirements that cannot be met via
configuration, then the customer must stay with its current systems.
Answer: FALSE
Difficulty: Easy
16) Application code can be added to any enterprise resource planning implementation using
specific application languages such as Java.
Answer: TRUE
Difficulty: Easy
17) An enterprise resource planning solution does not contain a company's actual operational
data, but operational data can be entered during development and use.
Answer: TRUE
Difficulty: Easy
18) Enterprise resource planning (ERP) systems rely on a DBMS to process and administer the
ERP database.
Answer: TRUE
Difficulty: Easy

4
Course LO: Discuss best practices for using and managing databases
19) Transactional data are data related to events such as a purchase or a student enrollment.
Answer: TRUE
Difficulty: Easy
Course LO: Discuss best practices for using and managing databases
20) Master data, used in an enterprise resource planning system, changes with every transaction.
Answer: FALSE
Difficulty: Easy
21) Transactional data, also called reference data, includes supplier names and addresses, item
names and units of measure, and employee data.
Answer: FALSE
Difficulty: Easy
22) A procedure is a set of instructions for a person to follow when operating an information
system.
Answer: TRUE
Difficulty: Easy
23) In the context of an enterprise resource planning (ERP) system, a systems analyst works for
the ERP vendor or a third party, and helps budget, plan, train, configure, and implement the
system.
Answer: FALSE
Difficulty: Easy
24) Users are the employees of the firm implementing the system.
Answer: TRUE
Difficulty: Easy

5
25) Training an organization's users to become in-house trainers for enterprise resource planning
systems reduces the total expenses.
Answer: TRUE
Difficulty: Easy
26) Organizations implementing an enterprise resource planning system are restricted from
designing new business processes.
Answer: FALSE
Difficulty: Easy
27) A gap analysis highlights the differences between the business requirements that emerge
from strategic planning and the capabilities of the enterprise resource planning system.
Answer: TRUE
Difficulty: Easy
28) One of the shortcomings of using an enterprise resource planning product is that data sharing
does not occur in real time.
Answer: FALSE
Difficulty: Easy
Chapter LO: 3: What are the benefits of an ERP system?
29) A benefit of an ERP system for the organization is converting its processes to the
well-integrated, inherent, best-practice processes of the ERP vendor.
Answer: TRUE
Difficulty: Easy
30) Customers and suppliers want to do business with an organization that does not use an ERP
system.
Answer: FALSE
Difficulty: Easy

6
31) To help managers spot trends and changes, enterprise resource planning systems can provide
managers with dashboards.
Answer: TRUE
Difficulty: Easy
32) Selecting the right ERP vendor is one of them most challenging decisions for an
organization.
Answer: TRUE
Difficulty: Easy
Chapter LO: 4: What are the challenges of implementing an ERP system?
33) A long list of “likes” will lead to a long list of gaps and a difficult implementation.
Answer: TRUE
Difficulty: Easy
34) The configuration decisions that implementation teams must make include decisions about
item identifiers, order size, and bill of material.
Answer: TRUE
Difficulty: Easy
35) Data issues are rarely a decision implementation challenge.
Answer: FALSE
Difficulty: Easy
36) The actions and attitudes of the people in the client organization can make implementation
even more challenging.
Answer: TRUE
Difficulty: Easy

7
37) Management’s failure to anticipate cultural resistance may negatively impact self-efficacy.
Answer: TRUE
Difficulty: Easy
38) Most companies have not survived an initial implementation and have not learned how to
cope with many of the problems of an ERP implementation.
Answer: FALSE
Difficulty: Easy
39) When a firm customizes the ERP software, it is always compatible with new ERP software
versions.
Answer: FALSE
Difficulty: Easy
40) Among companies of varied sizes, the availability of skilled business and IT analysts is an
important difference that has a major impact on enterprise resource planning.
Answer: TRUE
Difficulty: Easy
Chapter LO: 5: What types of organizations use ERP?
41) Small organizations expand IT from one person to a small staff, but frequently this staff is
isolated from senior-level management.
Answer: FALSE
Difficulty: Easy
42) Midsize organizations have a full IT staff that is headed by the chief information officer.
Answer: FALSE
Difficulty: Easy

8
43) International enterprise resource planning solutions are designed to work with multiple
currencies.
Answer: TRUE
Difficulty: Easy
44) International organizations can maintain multiple instances of enterprise resource planning
implementation for each country, business unit, or region.
Answer: TRUE
Difficulty: Easy
45) Intel has the largest market share in the enterprise resource planning industry.
Answer: FALSE
Difficulty: Easy
Chapter LO: 6: Who are the major ERP vendors?
46) A Microsoft Dynamics implementation is larger in scale and functionality compared to
Oracle and SAP.
Answer: FALSE
Difficulty: Easy
47) All the enterprise resource planning products of Microsoft Dynamics are well integrated with
Microsoft Office and Microsoft's development languages.
Answer: FALSE
Difficulty: Easy
48) Oracle is the gold standard of enterprise resource planning (ERP) products and offers the
most extensive line of ERP products.
Answer: FALSE
Difficulty: Easy

9
49) SAP produces and sells cost-specific platforms to speed up the configuration process.
Answer: FALSE
Chapter LO: 7: What makes SAP different from other ERP products?
50) A configuration is a distinct and logical grouping of processes.
Answer: FALSE
51) The SAP Business Suite runs on an application platform called NetSuite.
Answer: FALSE
Difficulty: Easy
52) With ________, the data needed by one process are stored in an information system designed
and used in another process.
A) information silos
B) automation
C) encapsulation
D) data warehousing
Answer: A
Difficulty: Easy
53) Which of the following statements is true about ERP systems?
A) It utilizes a centralized database.
B) It provides users with access to metadata files that describe the location of an organization's
data.
C) It appears to be an integrated database to the user.
D) It prohibits information silos from communicating with each other and sharing data.
Answer: A

10
54) In an organization, data from a new sale is immediately sent to the database and that new
data updates the pace of production and the procurement of supplies. This is an example of
enterprise resource planning process ________.
A) customization
B) duplication
C) integration
D) decentralization
Answer: C
55) By the 1970s, manufacturing companies began to use software called ________ to efficiently
manage inventory, production, and labor.
A) enterprise application integration
B) enterprise resource planning
C) business performance management
D) material requirements planning
Answer: D
Difficulty: Easy
56) ________ integrates manufacturing and supply where manufacturing occurs just as raw
materials arrive.
A) Just in case manufacturing
B) Just in time delivery
C) Material requirements planning
D) Economic order quantity
Answer: B
Difficulty: Easy
57) Which of the following federal laws required companies to exercise greater control over their
financial processes?
A) the Gramm–Leach–Bliley Act
B) the Volstead Act
C) the Tower Amendment
D) the Sarbanes-Oxley Act
Answer: D
Difficulty: Easy

11
58) Which of the following activities is included in supply chain management?
A) sales prospecting
B) bill of materials
C) inventory management
D) customer management
Answer: C
Difficulty: Easy
Course LO: Discuss the role of information systems in supply chain management and
performance
59) Which of the following activities is included in customer relationship management?
A) procurement
B) marketing
C) bill of materials
D) payroll
Answer: B
Difficulty: Easy
Course LO: Describe the functions of customer relationship management (CRM) systems
60) Which of the following activities is included in human resources?
A) capacity planning
B) call center support
C) benefits administration
D) cash management
Answer: C
Difficulty: Easy
61) The customization of enterprise resource planning software to meet different customer
requirements without changing the program code is called ________.
A) modularity
B) configuration
C) automation
D) process blueprinting
Answer: B
Difficulty: Easy

12
62) Writing new code to supplement an enterprise resource planning system is called ________.
A) automation
B) customization
C) integration
D) centralization
Answer: B
Difficulty: Easy
63) Which of the following technological advances has enabled the use of off-premises
enterprise resource planning systems?
A) cloud computing
B) computer card reader
C) punch card
D) legacy system
Answer: A
Difficulty: Easy
64) A ________ is a set of instructions for a person to follow when operating an information
system.
A) procedure
B) metadata
C) process
D) database
Answer: A
Difficulty: Easy
65) A ________ works for an enterprise resource planning (ERP) vendor or a third party and
helps budget, plan, train, configure, and implement an ERP system.
A) developer
B) consultant
C) systems analyst
D) business analyst
Answer: B
Difficulty: Easy

13
66) A ________ understands the technical aspects of enterprise resource planning (ERP) and
helps plan, configure, and implement an ERP system for company use.
A) trainer
B) project manager
C) business analyst
D) developer
Answer: C
Difficulty: Easy
67) ________ write additional code where necessary for implementing enterprise resource
planning systems.
A) Consultants
B) Business analysts
C) Architects
D) Developers
Answer: D
Difficulty: Easy
68) The inherent processes defined in an enterprise resource planning system are also known as
________.
A) inbound processes
B) stored procedures
C) transaction logs
D) process blueprints
Answer: D
Difficulty: Easy
69) Which of the following is an organizational benefit of using an enterprise resource planning
system?
A) It maintains individual databases for each department.
B) It facilitates data sharing in real time.
C) It minimizes the use of dashboards.
D) It promotes the duplication of data.
Answer: B

14
70) Organizations conduct ________ to identify the differences between the business
requirements that emerge from strategic planning and the capabilities of the chosen enterprise
resource planning system.
A) access controls
B) inherent processes
C) gap analysis
D) dashboards
Answer: C
71) The ________ is used to specify the raw materials, quantities, and subassemblies needed to
create a final product.
A) bill of material
B) bill of lading
C) item identifier
D) dashboard
Answer: A
Difficulty: Easy
72) Which of the following challenges of implementing an enterprise resource planning (ERP)
system is people-related?
A) the structure of the bill of material
B) the order size
C) the data in the ERP system
D) the inability to collaborate
Answer: D
73) When organizations upgrade existing enterprise resource planning systems, they can be
challenged by the version lock problem because of ________.
A) employee self-efficacy
B) heavy customization
C) organizational culture
D) minimal configuration
Answer: B

15
74) Which of the following statements is true of small organizations?
A) They expand IT from one person to a small staff, but frequently this staff is isolated from
senior-level management.
B) They employ only one or two IT analysts who not only manage the enterprise resource
planning system, but also the entire IS department.
C) They employ several IT analysts to manage the enterprise resource planning system.
D) They have a full IT staff that is headed by the chief information officer.
Answer: B
75) When international firms consolidate all their operations within a large enterprise resource
planning implementation, it is referred to as a(n) ________.
A) single instance
B) multiple instance
C) inherent process
D) configuration decision
Answer: A
Difficulty: Easy
76) The ________ is a business and IT professional who heads the IT staff in large
organizations, sits on the executive board, and is an active participant in organizational strategic
planning.
A) chief executive officer
B) chief information officer
C) chief operating officer
D) chief financial officer
Answer: B
Difficulty: Easy
77) Which of the following companies has the largest market share in the enterprise resource
planning industry?
A) Epicor
B) SAP
C) Oracle
D) Microsoft
Answer: B

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Processes Systems and Information An Introduction to MIS 3rd Edition Mckinney Test Bank

CHAPTER I
ANATOMY
The study of obstetrics is an investigation of the passage, the
passenger, and the driving powers of labor, as well as of the various
complications and anomalies that may attend the process of
reproduction.
The passage is composed of a bony canal, called the pelvis, and the
soft tissues which line and almost close its outlet.
The pelvis is made up of four bones; the sacrum, the coccyx, and
two other large structures of irregular shape, called the hip, or
innominate bones. Joined by cartilage and held in place by
ligaments, they form a cavity or basin which, in the male is deep,
narrow, small and funnel-shaped, while in the female, slighter bones,
expanded openings and wider arches make a broad, shallow channel,
through which the child is born.
The bony pelvis is divided for description into two parts, the upper
or false pelvis, and the lower or true pelvis. The upper pelvis is
formed by the wings of the innominate bones and has but two
functions of importance to child-bearing. It acts as a guide to direct
the child into the true passage, and when measured by the
pelvimeter, it gives information as to the shape and size of the inlet
to the true pelvis. The true pelvis is of most concern to the
obstetrician, because anomalies in its size or shape may impede the
progress of labor or render it impossible. The pelvis is divided
conveniently into three parts: the brim, the outlet, and the cavity.
The brim, inlet, or upper pelvic strait, is the boundary line
between the false and true pelvis. It is traced from the upper border
of the symphysis along the iliopectineal line on both sides to the
promontory of the sacrum. The shape and size of this opening varies

much in different races and individuals, both normally and through
disease; and when pathologically altered, both shape and size may
exercise a marked influence on the course of labor. In American
women, the outline of the brim is roughly heart-shaped, like an ovoid
with an indentation where the promontory of the sacrum impinges
upon the opening.
Fig. 1.—The normal female pelvis. (Eden.) The
lines ab and cd divide the pelvis into the right
and left anterior and the right and left posterior
quadrants. ab indicates the anteroposterior
diameter of the brim, cd shows the transverse
diameter while gh and ef represent, respectively,
the right and left oblique diameters.
The brim or inlet has four important diameters to be remembered;
important because the hard, round head of the child must pass
through them by accommodating its diameters as favorably as
possible to those of this opening. These diameters are named
respectively the anteroposterior or conjugate diameter, the
transverse, and the right and left oblique diameters. The two oblique
diameters attain their greatest importance when the pelvis is
irregularly distorted, but the others are essential in every case where
labor impends. It is to secure an estimate of these latter diameters
that the bony prominences are measured. This upper opening lies
not horizontally, but in oblique relation to the body in standing

position, and the weight of the abdominal viscera rests largely upon
the bones and in consequence does not crowd into the inlet unless
forced in by corsets or faulty habits.
Fig. 2.—The planes of (a) the brim, (b) the cavity
and (c) the outlet. (Eden.)
Passing through the brim, a cavity is found below it, midway
between the inlet and outlet, which is nearly round in shape. This is
the “excavation,” or the true pelvis. Then comes the outlet, bounded
in front by the pubic arch and soft parts, and behind by the coccyx
pushed back as far as it can go. It is ovoid in shape, but the long axis
of this ovoid lies at right angles with the axis of the ovoid inlet.
We find, therefore, a succession of three geometric figures or
planes through which the head must pass by means of a spiral
motion called rotation. These figures are inclined to one another so
markedly in front that a line drawn through the center of each will
curve forward at both ends, one end passing out near the umbilicus,
the other through the vulva. This is known as the axis of the pelvis or
the curve of Carus.

Fig. 3.—Visceral
relations. (Redrawn
from Gray.)

THE SOFT PARTS
Inside the pelvis are the organs of generation with their accessory
structures and supporting tissues.
Of first importance are the ovaries, tubes and uterus, together with
the vagina. These special structures are the true genital organs. They
are bounded in front by the bladder, behind by the rectum, above by
the abdominal viscera, and surrounded everywhere by muscular,
mucous and fatty tissues, which support them and aid their function.
The Vagina.—The vagina is a hollow organ, about four inches
long, attached to the cervix above and the vulva below. It is an elastic
sheath bounded in front by the bladder and behind by the rectum.
Under normal conditions, this tube easily admits one or two fingers,
but during labor it dilates enormously to allow the head to pass. The
vagina is lined with a thick mucous membrane, ridged and
roughened by folds, which are called rugæ. Thus a continuous
channel connects the ovary with the outside and through it pass, at
appropriate times, the ovule, the menstrual blood, the uterine
secretions, the child, the placenta, and the lochia.
The Uterus.—The uterus (womb) is a pear-shaped organ,
flattened from before backward, and composed of unstriped or
involuntary muscle cells and connective tissue. Normally the virgin
uterus measures from two and one-half to three inches in length, and
weighs about two ounces. It is suspended in the middle of the pelvis
by strong ligaments, so that the fundus inclines gently forward
against the bladder. When the bladder fills, the uterus is pushed
backward. Most of the organ is internal, but a small part of the lower
pole is grasped by the vagina, in which the lower end with its
invaluable aperture, the os, dips and swings. The part above the
vagina is called the body or fundus, and is covered with the serous
membrane (peritoneum) that lines the abdominal cavity. Below the
fundus is the cervix or neck, which lies partly above and partly within
the vagina. The cavity of the uterus is usually closed by the
apposition of the walls. The inner surface is covered with a peculiar
kind of membrane called the endometrium, which is highly vascular.

The uterine cavity opens into the vagina through the os, which is
small and round in the nulliparous woman, and slit-shaped or gaping
in the woman who has borne a child.
Fig. 4.—Uterus and appendages. On either side of
the uterus will be seen the ovary, the fimbriated
extremity of the tube, the tube, and the round
ligament. The vagina lies open below. (Lenoir and
Tarnier.)
Fallopian Tubes.—On either side of the upper end of the uterus
are the orifices of the Fallopian tubes, through which the egg,
escaping from the ovary, finds access to the uterine cavity. These
tubes extend outward from the uterus about four inches, and
terminate in a bell-shaped opening with long, ragged fingers which
hang loosely down toward the ovary. The tubes are lined by epithelial
cells having hair-like projections, (ciliæ) which wave automatically
toward the uterus. Thus impelled by a gentle current, the egg moves
definitely along the tube toward the uterus and against this current
the spermatozoa force their way to meet and fertilize the egg.
The Ovaries.—On either side of the pelvis, close to the fringed
end of the Fallopian tube and attached to it, lies a small, hard,
almond-shaped organ, called the ovary. This is the intrinsic sexual
gland of the female. It contains the small cells which are to ripen and
become eggs. Each ovary is said to contain about thirty-six thousand
eggs, or ovules.

The Bladder.—The bladder lies between the pubic bone and the
uterus. It is a reservoir for urine, filled by means of two little tubes
called ureters, that run down from the kidneys. It drains through the
urethra which opens just below the pubic bone in front of, and just
above, the vaginal opening. The bladder should be emptied
frequently during labor.
The Anus.—The large bowel (colon) terminates in an opening
near the middle of the genital crease. This opening is called the anus.
It is closed by a contracting muscle, the sphincter, which acts like a
puckering string. Just inside of the opening is a group of large veins
which may become enlarged, inflamed, and bleed during pregnancy.
They are then called hæmorrhoids.
The Rectum.—Upward from the anus and to the left of the uterus
extends the rectum. This is the end of the intestinal canal and is
supplied with an abundance of nerves. When the head presses upon
it, it gives the sensation of a bowel movement, and warns the
observer of the low position of the head. The anus pouts as the head
comes down and the anterior walls become visible. In severe cases of
labor, the sphincter is sometimes torn. The bowels should be
emptied by an enema as early as possible in the first stage of labor.
The Peritoneum.—The peritoneum is a thin, glistening, serous
membrane, which lines the abdominal cavity and drops down from
above over the uprising tops of the bladder and uterus. Folding
together at the sides and extending to the walls of the pelvis, it
encloses the tubes and round ligaments in deep, flat masses, called
the broad ligaments. This is the structure that becomes so perilously
inflamed (peritonitis) when infected by germs that find entrance
through the genital passage.

Fig. 5.—Normal position of pelvic organs, seen
from above and in front. They are enveloped in
peritoneum. (Bougery and Jacob, in American
Text Book.)

THE EXTERNAL GENITALS
The external genitals form the vulva. Under this name are included
the mons veneris, the labia majora, the labia minora, the clitoris, the
vestibule, the hymen and the glands of Bartholin.
The entire groove from the mons veneris to a point well up on the
sacrum forms a deep fold or crevice, which is known as the genital
crease. That part of the genital crease lying between the anus and
vulva is technically known as the perineum (q.v.)
Fig. 6.—The external
genitals. (Redrawn from
Gray.)
The Mons Veneris.—The mons veneris is a gently rounded pad
of fat lying just above the junction of the pubic bones (the
symphysis). The overlying integument is filled with sebaceous glands
and covered with hair at puberty.
The Labia Majora.—The labia majora are the large lips of the
vulva. They are loose, double folds of skin extending downward from
the mons veneris to the anterior boundary of the perineum and
covered externally with hair. Normally they lie in apposition and
conceal the vaginal opening. They correspond to the male scrotum.
The Labia Minora.—The labia minora, or nymphæ, are two
small folds of skin and mucous membrane, that extend from the
clitoris obliquely downward and outward for an inch and a half on

each side of the entrance to the vagina. On the upper side, where
they meet and invest the clitoris, the fold is called the prepuce, but
on the under side they constitute the frænum.
The labia minora are sometimes enormously enlarged in the black
races and are then called the Hottentot apron.
The Clitoris.—The clitoris is an erectile structure analogous to
the erectile tissue of the penis. The free extremity is a small,
rounded, extremely sensitive tubercle, called the glans of the clitoris.
About the clitoris there forms a whitish substance called smegma.
This is a good culture medium for germs and must be carefully
sponged away when the vulva is prepared for delivery.
The Vestibule.—The vestibule is bounded by the clitoris above,
the labia minora on the sides, and the vaginal orifice below. It
contains the opening of the urethra, which is called the meatus
urinarius.
The Hymen.—The hymen is a thin fold of membrane which
closes the vaginal opening to a greater or lesser extent in virgins. It
varies much in shape and consistency. It is sometimes absent, or it
may persist after copulation, hence its presence or absence can not
be considered a test of virginity. When torn, the edges shrink up and
form little irregularities called carunculæ myrtiformes.
Fig. 7 A.—Varieties of
hymen. (American Text
Book.)

Bartholin Glands.—Bartholin glands are located on each side of
the commencement of the vagina. Each gland discharges by a small
duct just external to the hymen. They are often the seat of a chronic
gonorrhœal inflammation and must be watched carefully, lest
infection extend to the mother after labor, or to the eyes of the child
in passing.
Fig. 7 B.—Varieties of
hymen. (American Text
Book.)
The Perineum.—The perineum is a body of muscle, fascia,
connective tissue, and skin, situated between the vagina and the
rectum. The vagina bends forward and the rectum backward, so a
triangular area is left between them which is filled by the perineal
body. It is about two inches long from before backward, and becomes
progressively thinner the deeper it extends.

Fig. 8 A.—The excreting ducts of the mammary
gland. (Lenoir and Tarnier.)
Fig. 8 B.—Lobules and
duct of the mammary
gland. (Lenoir and
Tarnier.)
The perineal body is flattened out and compressed by the passage
of the head and in many cases torn. (Thirty per cent of primiparas
and ten to fifteen per cent of multiparas.) It should be repaired
immediately.

The Mammary Glands.—The mammary glands are secondary
but highly important parts of the genital system. They are formed by
a dipping down of skin glands and they perform the special function
of secreting milk.
The breast is made up of fifteen or twenty lobes, each of which, like
a bunch of grapes, clusters about and discharges into a single tube
which, in turn, leads to the nipple. The area between the lobes is
filled with fat and connective tissue.
Fig. 9.—Nipple, areola,
and the glands of
Montgomery. (Eden.)
The nipple is pink or darkly pigmented. It is composed of erectile
tissue and under stimulation, it rises from the surface of the gland so
that it is easily taken into the mouth.

Fig. 10.—Supernumerary milk glands in the
axillæ. They may be found also below the breasts.
(Witkowski.)
Fig. 11.—The three ages of the breast—virginity,
maturity, and senescence. (Witkowski.)
Surrounding the nipple is a darkly pigmented area from one inch
to four inches in diameter that is called the areola. It contains hard,
shot-like nodules, the glands, or tubercles, of Montgomery. These
often secrete milk and sometimes become infected. It occasionally
happens that more than two breasts may be found on the human
female, and not infrequently pieces of mammary tissue may be
discovered in the axilla or on the chest or back.

The mammary gland is undeveloped at birth, but, nevertheless it
may fill with milk (witches’ milk). At puberty, after marriage, and
during pregnancy, the gland reaches maturity. It is only after
delivery, however, that the functional climax is attained.

CHAPTER II
PHYSIOLOGY
Ovulation.—Ovulation is the process whereby the eggs are
discharged from the Graafian follicle which matures and protects
them in the ovary. The egg is a true cell with one, and sometimes
more than one, nucleus.
The ripening of the eggs, as well as their discharge, is attended
with much general disturbance and great physical changes. This
phenomenon begins from the twelfth to the fifteenth year, depending
on race, climate, occupation and temperament, and marks the
transition of the individual from childhood into maturity.
This period is called puberty. At this time the breasts enlarge, the
hips round out, the vagina, uterus and external genitals increase in
size. Hair appears upon the vulva, the emotions become more
evident, and modesty develops through a consciousness of sexual
difference and attraction.
Simultaneously a new function appears—
Menstruation.—Menstruation may be defined as a process
wherein a bloody fluid is discharged from the uterus at regularly
recurring periods between puberty and the menopause, except
during pregnancy and lactation. It is a hæmorrhage which in some
way is closely associated with ovulation, but it is not known
positively which is the precedent of the other, or whether one causes
the other.
Menstruation is not essential to pregnancy, for pregnancy may
occur when the flow is normally absent, as before puberty, after the
menopause, or during lactation. Nevertheless, regularity of
menstruation is the rule in fertile women and clinicians agree that

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