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

Question 1

5Ps of sexual history

Answer 1

Partners
Practices
Protection
Past hx of STI
Pregnancy intention

Question 2

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

Answer 2

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

Question 3

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

Answer 3

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

Question 4

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

Answer 4

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

Question 5

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

Answer 5

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

Question 6

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

Answer 6

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

Question 7

the glans penis continuous with the corpus […]

Answer 7

spongiosum

Question 8

the urethra is housed in the corpus […]

Answer 8

spongiosum

Question 9

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

Answer 9

common penile a. (via internal pudendal)

Question 10

artery that perfuses the glans penis

Answer 10

dorsal penile artery

Question 11

artery that allows corporal filling during erection

Answer 11

deep penile (cavernosal) a.

Question 12

artery that allows the corpus spongiosum to fill during erection

Answer 12

bulbaourethral artery

Question 13

erection is a [sympathetic/parasympathetic] function

Answer 13

parasympathetic

Question 14

detumescence is a [sympathetic/parasympathetic] function

Answer 14

sympathetic

Question 15

emission is a [sympathetic/parasympathetic] function

Answer 15

sympathetic

Question 16

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

Answer 16

pelvic splanchnics

(S2, S3, S4)

Question 17

nerves surrounding the prostate that can be damaged during prostate surgeries

Answer 17

cavernous nerves

Question 18

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

Answer 18

hypogastric

Question 19

innervates the ischiocavernosus muscle for the rigid erection phase

Answer 19

internal pudendal n.

Question 20

innervates the bulbospongiosus muscle for ejaculation

Answer 20

internal pudendal n.

Question 21

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

Answer 21

cerebral cortex

Question 22

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

Answer 22

amygdala

(larger in men, greater emphasis on visual stimuli)

Question 23

what part of the brain is responsible for arousal?

Answer 23

hypothalamus (MPOA)

Question 24

what neurotransmitter facilitates sexual behavior?

Answer 24

dopamine

(serotonin opposite effect)

Question 25

refractory period where another erection can't be achieved increases with [...]

Answer 25

age

Question 26

useful to determine psychogenic ED from physiologic ED

Answer 26

presence of nocturnal erection

Question 27

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

Answer 27

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

Question 28

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

Answer 28

sinusoids

Question 29

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

Answer 29

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

Question 30

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

Answer 30

emission

Question 31

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

Answer 31

expulsion

Question 32

[...] promotes emission/ejaculation | neurotransmitter

Answer 32

dopamine

Question 33

[...] inhibits emission/ejaculation

Answer 33

serotonin

Question 34

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

Answer 34

bulbospongiosus

Question 35

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

Answer 35

ischiocavernosus muscle

Question 36

low serotonin can play a role in what ejaculation disorder?

Answer 36

premature ejaculation (SSRIs can help)

Question 37

alpha blockers can cause what ejaculation disorder?

Answer 37

retrograde ejaculation (they relax the bladder neck, tamsulosin)

Question 38

medications that can cause male sexual dysfunction

Answer 38

anti-psychotics beta blockers anti-depressants narcotics

Question 39

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

Answer 39

vaginismus

Question 40

golden standard of care for vaginismus

Answer 40

PT psych MD

Question 41

high pelvic floor strength is related to [...] orgasms

Answer 41

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)

Question 42

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

Answer 42

the uterus contracts during orgasm

Question 43

what hormone stimulates orgasm and inspires attachment?

Answer 43

oxytocin

Question 44

parts of the woman's erectile network

Answer 44

clitoris perineal sponge urethral sponge vestibular bulbs

Question 45

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

Answer 45

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

Question 46

what aspects of sexual behavior of influenced by body image?

Answer 46

number of partners orgasmic response level of arousal

Question 47

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

Answer 47

sildenafil (switch to tadalafil)

Question 48

how does chronic opioid use affect male sexual function?

Answer 48

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

Question 49

which PDE 5i medication has the quickest onset?

Answer 49

avanafil (15 min)

Question 50

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

Answer 50

sildenafil vardenafil

Question 51

which PDE 5i medication has the longest onset?

Answer 51

tadalafil

Question 52

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

Answer 52

tadalafil

Question 53

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

Answer 53

avanafil