B8-069 Sexual Dysfunction & B8-079 Female Sexual Response Flashcards

1
Q

5Ps of sexual history

A

Partners
Practices
Protection
Past hx of STI
Pregnancy intention

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2
Q

the genital tubercle becomes the […] in males, and […] in females

A

the genital tubercle becomes the [glans penis] in males, and [glans clitoris] in females

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3
Q

the urogenital groove becomes the […] in males, and […] in females

A

the urogenital groove becomes the [urethral opening] in males, and [urethral +vaginal opening] in females

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4
Q

the urogenital folds becomes the […] in males, and […] in females

A

the urogenital folds becomes the [urethra] in males, and [labia minora] in females

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5
Q

the lateral tubercle becomes the […] in males, and […] in females

A

the lateral tubercle becomes the [penile shaft] in males, and [clitoral shaft] in females

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6
Q

the genital swelling becomes the […] in males, and […] in females

A

the genital swelling becomes the [scrotum] in males, and [labia majora] in females

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7
Q

the glans penis continuous with the corpus […]

A

spongiosum

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8
Q

the urethra is housed in the corpus […]

A

spongiosum

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9
Q

gives rise to both the dorsal penile a. and deep penile a.

A

common penile a. (via internal pudendal)

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10
Q

artery that perfuses the glans penis

A

dorsal penile artery

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11
Q

artery that allows corporal filling during erection

A

deep penile (cavernosal) a.

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12
Q

artery that allows the corpus spongiosum to fill during erection

A

bulbaourethral artery

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13
Q

erection is a [sympathetic/parasympathetic] function

A

parasympathetic

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14
Q

detumescence is a [sympathetic/parasympathetic] function

A

sympathetic

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15
Q

emission is a [sympathetic/parasympathetic] function

A

sympathetic

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16
Q

parasympathetic function of the […] nerve is responsible for erections

A

pelvic splanchnics

(S2, S3, S4)

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17
Q

nerves surrounding the prostate that can be damaged during prostate surgeries

A

cavernous nerves

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18
Q

sympathetic function of the […] nerves are responsible for emission/detumescence

A

hypogastric

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19
Q

innervates the ischiocavernosus muscle for the rigid erection phase

A

internal pudendal n.

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20
Q

innervates the bulbospongiosus muscle for ejaculation

A

internal pudendal n.

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21
Q

what part of the brain is responsible for how we perceive sex?

A

cerebral cortex

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22
Q

what part of the brain is responsible for how we feel about sex?

A

amygdala

(larger in men, greater emphasis on visual stimuli)

23
Q

what part of the brain is responsible for arousal?

A

hypothalamus (MPOA)

24
Q

what neurotransmitter facilitates sexual behavior?

A

dopamine

(serotonin opposite effect)

25
Q

refractory period where another erection can’t be achieved increases with […]

A

age

26
Q

useful to determine psychogenic ED from physiologic ED

A

presence of nocturnal erection

27
Q

increased sinusoidal pressure during erection leads to decreased […] outflow

A

venous

(this + stretched tunica albuginea =venous compression of emissary veins)

28
Q

during erection, arterioles dilate allowing for increased blood flow to the

A

sinusoids

29
Q

release of […] by the parasympathetic cavernosal nerves allows for smooth muscle relaxation –> erection

A

NO

(can also release ACh to stimulate epithelial cells to produce NO)

30
Q

secretion of seminal components by seminal vesicles, prostate, ampulla of vas is the […] phase of ejaculation

A

emission

31
Q

forceful propulsion of semen out of the urethra is the […] phase of ejaculation

A

expulsion

32
Q

[…] promotes emission/ejaculation

neurotransmitter

A

dopamine

33
Q

[…] inhibits emission/ejaculation

A

serotonin

34
Q

muscle of the penis important for expulsion of fluid from posterior urethra

A

bulbospongiosus

35
Q

muscle of the penis important for pushing all of the blood into the penis for the rigid erection phase just before ejaculation

A

ischiocavernosus muscle

36
Q

low serotonin can play a role in what ejaculation disorder?

A

premature ejaculation

(SSRIs can help)

37
Q

alpha blockers can cause what ejaculation disorder?

A

retrograde ejaculation

(they relax the bladder neck, tamsulosin)

38
Q

medications that can cause male sexual dysfunction

A

anti-psychotics
beta blockers
anti-depressants
narcotics

39
Q

involuntary muscle spasms around the vagina that can make penetration nearly impossible

A

vaginismus

40
Q

golden standard of care for vaginismus

A

PT
psych
MD

41
Q

high pelvic floor strength is related to […] orgasms

A

vaginal

(women with medium vaginal floor strength were only able to experience clitoral orgasms so clitoral orgasm are associated with both medium and high muscle tone)

42
Q

what about the female sexual response is a consideration prior to hysterectomy?

A

the uterus contracts during orgasm

43
Q

what hormone stimulates orgasm and inspires attachment?

A

oxytocin

44
Q

parts of the woman’s erectile network

A

clitoris
perineal sponge
urethral sponge
vestibular bulbs

45
Q

[…]% of women will be anorgasmic throughout their lives

A

10

(lack of information or understanding about anatomy/arousal are contributors)

46
Q

what aspects of sexual behavior of influenced by body image?

A

number of partners
orgasmic response
level of arousal

47
Q

ED medication that can cause vision changes due to cross-reactivity of PDE-6 in the retina

A

sildenafil

(switch to tadalafil)

48
Q

how does chronic opioid use affect male sexual function?

A

GnRH suppression –> low T and FSH –> low sperm counts

49
Q

which PDE 5i medication has the quickest onset?

A

avanafil (15 min)

50
Q

high fat meal decreases the efficacy of what PDE 5i medications? [2]

A

sildenafil
vardenafil

51
Q

which PDE 5i medication has the longest onset?

A

tadalafil

52
Q

which PDE 5i medication has the longest duration of action?

A

tadalafil

53
Q

which PDE 5i medication has the shortest duration of action?

A

avanafil