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Psychology 353: Human Sexuality > Chapter 10: Conception, Pregnancy, and Childbirth R7-12 > Flashcards

Chapter 10: Conception, Pregnancy, and Childbirth R7-12 Flashcards

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1
Q

Conception

A

union of a sperm cell and an ovum

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2
Q

Y chromosomes

A

Creates a boy

-faster swimming sperm than X (why more boys than girls)

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3
Q

Male fetuses are more likely to be lost in spontaneous _____

A

abortions

-which often occur in the first month

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4
Q

Upon ejaculation, ___ to ___ million sperm are released and only ___ in ___ get in the vicinity of an ovum

A

200-400 million

1 in 1000

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5
Q

Sperm cells are apparently attracted by

A

Sperm cells are apparently attracted by

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6
Q

zona pellucida

A

A gelatinous layer that surrounds an ovum

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7
Q

hyaluronidase

A

An enzyme that briefly thins the zona pellucida, enabling one sperm to penetrate

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8
Q

Physicians often recommend that couples try to conceive on their own for ___ months before seeking medical assistance

A

six

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9
Q

Infertility

A

Inability to conceive a child

-failed to conceive for over a year

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10
Q

In vitro fertilization can cost up to

A

$15 000

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11
Q

About __% of infertility lies in men, while ___% lies in both partners

A

40% men

20% both

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12
Q

Motility

A

Self-propulsions. Motility is a measure of the viability of sperm cells

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13
Q

Autoimmune responses

A

The production of antibodies that attack naturally occuring substances that are (incorrectly) recognized as foreign or harmful

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14
Q

Problems in producing normal, abundant sperm may be caused by:

A

genetic factors, advanced age, hormonal problems, diabetes, injuries to the testes, varicose veins in the scrotum, drugs (alcohol, narcotics, marijuana, and/or tobacco), antihypertensive medications, environmental toxins, excess heat, and emotional stress

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15
Q

Low sperm count (or the absence of sperm)

A

the most common problem

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16
Q

To be considered normal, sperm must be able to:

A
  • To be considered normal

- sperm must be able to

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17
Q

artificial insemination

A

The introduction of sperm into the reproductive tract through means other than sexual intercourse

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18
Q

Women encounter the following major fertility problems:

A

Irregular ovulation, including failure to ovulate (MOST COMMON)

Obstructions or malfunctions of the reproductive tract, often caused by infections or diseases involving the reproductive tract

Endometriosis

Declining hormone levels of estrogen and progesterone that occur with aging and may prevent the ovum from becoming fertilized or remaining implanted in the uterus

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19
Q

The following fertility problems are found in men:

A

Low sperm counts

Irregularly shaped sperm (e.g., malformed heads or tails)

Low sperm motility

Chronic diseases such as diabetes

Infections such as sexually transmitted infections

Injuries to the testes

Autoimmune responses, in which the man produces antibodies that deactivate his sperm

A pituitary imbalance and/or thyroid disease

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20
Q

Ovulation can often be induced by fertility drugs such as

A
  • clomiphene (sold as Clomid), which stimulates the pituitary gland to secrete FSH and LH, which in turn stimulate the maturation of ova.
  • Pergonal, contains a high concentration of FSH, which directly stimulates maturation of ovarian follicles
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21
Q

Endometriosis (1 in 6 cases)

A

A condition caused by the growth of endometrial tissue in the abdominal cavity, or elsewhere outside the uterus, and characterized by menstrual pain

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22
Q

Laparoscopy

A

A medical procedure in which a long, narrow tube (a laparoscope) is inserted through an incision in the naval, permitting visual inspection or organs in the pelvic cavity

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23
Q

In Vitro Fertilization (IVF)

A

A method of conception in which mature ova are surgically removed from an ovary and placed in a laboratory dish with sperm

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24
Q

gamete intrafallopian transfer GIFT

A

sperm and ova are inserted together into a fallopian tube for fertilization. Conception occurs in a fallopian tube, rather than in a laboratory dish.

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25
Q

Zygote intrafallopian transfer (ZIFT)

A

involves a combination of IVF and GIFT. Sperm and ova are combined in a laboratory dish. After fertilization, the zygote is placed in the mother’s fallopian tube, to begin its journey to the uterus for implantation.

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26
Q

ZIFT’s advantage over GIFT

A

the fertility specialists can ascertain that fertilization has occurred before insertion is performed.

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27
Q

Donor IVF

A

Ovum is taken from one women, fertilized, and injected into the uterus or fallopian tube of another women

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28
Q

Embryonic transfer

A

Female volunteer is artificially inseminated by the male partner of the intended mother, than the embryo is removed from the volunteer and inserted intot he uterus intended mother

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29
Q

Intracytoplasmic sperm injection (ICSI)

A

A single sperm is injected directly into an ovum
-may lead to: increase in birth defects, including heart, stomach, kidney, and bladder problems, cleft palates, hernias, and malformation of the penis.

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30
Q

surrogate mother

A

artificially inseminated by the partner of an infertile woman or by one of two men who are a couple. She carries the baby to term and then turns the baby over to the father and his partner

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31
Q

Surrogate mother in Canada

A

Legal

  • must be no contract
  • can not pay women
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32
Q

The main provisions of the Assisted Human Reproduction Act include:

A

A ban on human cloning

A ban on selection of a baby’s sex for non-medical purposes

A ban on payment to a surrogate mother

A ban on payment to a sperm donor

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33
Q

For many women, the first sign of pregnancy is (most common)

A

a missed period.

-Missing a period is therefore not a fully reliable indicator, as stress can delay periods

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34
Q

human chorionic gonadotropin (hCG)

A

-Found as early as 10 days after conception
Hormone produced by women shortly after conception. hCG stimulates the corpus luteum to continue producing progesterone. The presence of hCH in a women’s urine indicates that she is pregnant

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35
Q

human chorionic gonadotropin (hCG)

A

refers to the nausea, food aversions, and vomiting a woman may experience during pregnancy
-subsides by about the 12th week of pregnancy.

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36
Q

Miscarriage

A

A spontaneous abortion

  • specific cause is not identified
  • prevalent among older mothers
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37
Q

The normal gestation period ____ days is from the onset of the last menstrual cycle before conception

A

280

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38
Q

The normal gestation period is ___ days when we measure from the date at which fertilization is assumed to have taken place, which normally corresponds to two weeks after the beginning of a woman’s last menstrual cycle

A

266

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39
Q

Naegele’s rule to calculate the delivery date:

A

1) Write down the date of the first day of the last menstrual period.
2) Add seven days.
3) Subtract three months.
4) Add one year.

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40
Q

The Germinal Stage

A
  • Within 36 hours of conception, the zygote divides into two cells (dividing rapidly, becomes 32 cells in another 36 hours)
  • Takes zygote three or four days to reach the uterus
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41
Q

Germinal Stage definition (aka period of the ovum)

A

The period of prenatal development before implantation in the uterus

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42
Q

Blastocyst

A

Embryo that consists of a sphere of cells surrounding a cavity of fluid
-Occurs at the germinal stage of embryonic development

Jenny;s baby is in day 9… it is called a blastocyst

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43
Q

Embryonic Stage

A

Lasts from implantation through the eighth week

-characterized by the differentiation of major organ systems

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44
Q

amniotic sac

A

A sac containing the fetus

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45
Q

amniotic sac

A

Fluid within the amniotic sac

-suspends and protects the fetus

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46
Q

placenta (after birth)

A

An organ connected to the fetus by the umbilical cord. The placenta serves as a relay station between the mother and the fetus, allowing the exchange of nutrients and wastes

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47
Q

umbilical cord

A

A tube that connects the fetus to the placenta

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48
Q

The Fetal Stage

A
  • begins by the ninth week and continues until birth
  • By about the ninth or tenth week, the fetus begins to respond to the outside world by turning in the direction of external stimulation
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49
Q

By the end of the first trimester

A

The major organ systems, fingers, toes, and external genitals are formed, the gender can be visually determined, and the eyes are clearly distinguishable.

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50
Q

By the end of the first trimester,

A 
Maternal Diet
Maternal Diseases and Disorders
Critical Periods of Vulnerability
Rubella (German Measles)
Syphilis
HIV and AIDS
Pregnancy-Induced Hypertension
Ectopic Pregnancy
Rh Incompatibility
Maternal (and Paternal) Drug Use
Vitamins
Narcotics
Marijuana
Alcohol
Cigarette Smoking
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51
Q

Teratogens

A

Environmental influences or agents that can damage an embryo or fetus
-They include alcohol, aspirin, the metals lead and mercury, radiation, and disease-causing organisms such as viruses and bacteria

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52
Q

critical periods of vulnerability

A

A period when an embryo or fetus is vulnerable to the effect of a teratogen

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53
Q

Rubella (aka German measles)

A

Viral infection that can cause deafness, intellectual disabilities, and heart disease in an embryo

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54
Q

Syphilis

A

Sexually transmitted disease caused by a bacterial infection

55
Q

Stillbirth

A

Birth of a dead fetus

3000 stillbirths a year (8 for every 1000)

56
Q

Acquired immunodeficiency syndrome (AIDS)

A

A condition cause by HIV that destroys white bloods cells in the immune system, leaving the body vulnerable to various ‘opportunistic’ diseases

57
Q

Pregnancy-induced hypertension (aka pre-eclampsia)

A

A life-threatening condition characterized by high blood pressure

58
Q

ectopic pregnancy

A

A pregnancy in which the fertilized ovum implants outside the uterus, usually in the fallopian tube

59
Q

Rh incompatibility

A

A condition in which antibodies produced by a pregnant women are transmitted to the fetus, where they may cause brain damage or death

60
Q

fetal alcohol syndrome (FAS)

A

A cluster of symptoms in the infant caused by maternal alcohol consumption during pregnancy. These symptoms are typified by developmental lags, characterized facial features, and a smaller-than-average body and brain

61
Q

Dropping or lightening

A

Early in the ninth month of pregnancy, the fetus’s head settles in the pelvis

62
Q

Labour begins

A

with the onset of regular uterine contractions.

63
Q

Braxton Hicks contractions

A

So-called fake labour contractions, which are relatively painless
-they don’t widen the cervix or advance the baby through the birth canal

64
Q

Childbirth has ____ stages

A

3

65
Q

First stage of childbirth

A
  • uterine contractions efface and dilate the cervix to about 10 centimetres in diameter, so the baby can pass
  • THE LONGEST STAGE
66
Q

efface

A

Cause to become thin

67
Q

Dilate

A

Open or widen

68
Q

___ to ___ hours of labour is considered about average for a first pregnancy

A

12-24

69
Q

Transition

A

Process during which the cervix becomes almost fully dilated and the infant’s head begins to move into the birth canal

70
Q

The second stage of childbirth

A
  • begins after transition, when the cervix is fully dilated and the baby begins to move into the birth canal (vagina)
  • fetal membrane rupture and amniotic fluid gushes out
  • Umbilical cord cut after breathing starts
71
Q

Crowning

A

When the baby’s head becomes visible at vaginal opening

-full emergence ends the second stage

72
Q

begins after transition,

A

Surgical incision in the perineum that widens the birth canal, preventing random tearing during childbirth

73
Q

The third, or placental, stage of childbirth (after birth)

A
  • a few minutes to an hour or more

- the placenta is expelled and the uterus begins the process of contracting

74
Q

Methods of Childbirth

A

Methods of Childbirth
Prepared Childbirth (The Lamaze Method)
Caesarean Section

75
Q

Lamaze method

A

Women lears how to relax and breath in patterns that conserve energy and lessen pain, with the help of a coach who’s present during childbirth

76
Q

Caesarean Section (C section)

A

Method of childbirth in which the fetus is delivered through a surgical incision in the abdomen
-could be due to cord, position, distress, length of labour

77
Q

transverse position

A

A crosswise birth position

78
Q

midwife

A

A health professional who provides primary care to w omen and her baby during pregnancy, labour, birth, and the postpartum period

79
Q

Birth Problems

A

Preterm and Low-Birth-Weight Children

Stillbirth

80
Q

Premature / preterm

A

Born before 37 weeks of gestation

81
Q

The normal period of gestation is ___ weeks

A

40

82
Q

Postpartum period

A

the weeks following birth (Baby blues)

-caused by hormone changes (last for about 10 days)

83
Q

Postpartum depression (PPD)

A
  • begins within four weeks after delivery and may linger for weeks or months
  • symptomized by serious sadness, feelings of hopelessness and helplessness, feelings of worthlessness, difficulty concentrating, and major changes in appetite (usually loss of appetite) and sleep patterns (often insomnia)
84
Q

Breastfeeding

A
85
Q

Negatives to breastfeeding

A

HIV can be transmitted to infants via breast milk

-may undernourished the mother by feeding the baby

86
Q

Prolactin

A

Pituitary hormone that stimulates milk production

87
Q

Loctation

A

Production of milk by the mammary glands

88
Q

Does Breastfeeding Affect Sexual Behaviour?

A

women who breastfeed are more likely than those who bottle-feed to experience decreased sexual desire, decreased frequency of sexual intercourse, and painful intercourse due to lack of vaginal lubrication

89
Q

lochia

A

A reddish vaginal discharge that may persists for a month after childbirth

90
Q

Sex / intercourse after birth

A

Obstetricians usually advise a six-week waiting period, for safety and comfort

91
Q

Why are women giving birth later in life? There are a number of reasons:

A

Improved access to safe, effective contraception allows women to choose whether and when they’ll have children, how many they’ll have, and how far apart they’ll space them.

More women are completing postsecondary education during their childbearing years and are therefore delaying motherhood.

Increasing numbers of women choose to limit the number of children they have, so they can continue working full time.

Financial constraints lead some women to limit the number of children they decide to have.

It’s becoming more and more socially acceptable in Western society to choose not to have children.

92
Q

How long does it take to get pregnant?

A

Around 5.3 months to get pregnant

- around 21% chance of pregnancy with single act of penile-vaginal intercourse

93
Q

Journey of the sperm

A

300-55 million sperm ejaculated

  • 2000 get to fallopian tube with the ovum
  • 50 get to the ovum

-Sperm moves against the flow by the cilia, at 1-2cm/hr

94
Q

Conception usually occurs within ___ hours after ovulation

A

24

95
Q

Sperm typically last ___ hours but can last as long as ___ days

A

48

5

96
Q

Once fertilization occurs, the walls of the ovum become _____, if more than one sperm enters typically a spontaneous _____ will occur

A

impervious (prevent excess genetic material from entering the egg as too much can cause issues)

spontaneous abortion

97
Q

Other than pregnancy, what else can stop period / mensruation?

A

Vigorous exercise
Body fat (low body fat)
illness
emotions

98
Q

In about ___% of women they have spotting (spot bleeding) after implantation

A

20

99
Q

Physical signs of early pregnancy

A

Breasts swelling and tenderness, frequent urination, irregular bowel movement, increased vaginal discretions

100
Q

Morning sickness

A

Queasy sensation upon awaking (6-8 weeks)
-aversion to food or odours of certain food
1 in 200 experience extreme morning sickness with hospitalization required

101
Q

Chadwick’s sign

A

Purplish vagina and cervix

102
Q

Hegar’s sign

A

By week 6 of pregnancy

-soft area between cervix and uterus by month after missing period

103
Q

False pregnancy

A

Associated with Women intensely desirous of having a child

- physical symptoms, including morning sickness, breast tenderness, fullness in pelvis, sensation of fetal movements

104
Q

Blood test

A

picks up Early Pregnancy Factor (EPF) in blood

-time consuming and expensive

105
Q

Immunological reaction to human chorionic gonadotropin (hCG)

A

Either in blood or urine

  • only found after implantation
  • near perfect accuracy in 7 days
106
Q

First response home kits

A

Detect hCG in urine

  • as early as 7 days
  • 3% false pregnancy, 20% missed pregnancy
107
Q

Pregnancy tests providing inaccurate results

A
  • Absolute confirmation as early as 9 weeks through fetal heartbeat
  • Fetal skeleton via ultrasound after 4th month (16 weeks)
  • Fetal movements by end of 4th month
108
Q

False labour

A

Sporadic contractions of the uterus

109
Q

True labour

A

Regular and rhythmic uterine contractions (dilates cervix)

  • Delivery of baby, placenta, and fetal membranes
  • fetus trigger labour (not mother)
110
Q

How the baby triggers labour

A

Fetus’s adrenal gland producing hormones that make the placenta and uterus increase secretion of prostaglandins - this leads to mother’s contractions

111
Q

Oxytocin

A

Released in the late stages of labour by mother’s posterior pituitary gland - stimulates more powerful contractions

112
Q

C-Sections in Canada

A

Most common inpatient surgical procedure performed in canadian hospitals

  • 28.2% of hospital births in 2017 were C-sections
  • Age 35+ are more likely to receive
113
Q

Reading 7 (Davis) (r7)

A

The purpose: to investigate the variability in young heterosexual men’s perceptions of the advantages and disadvantages of condom use in their casual sexual relationships.
-Used focus groups
Findings: participants reported that condoms may affect the likelihood and quality of sex, one’s physical sensation during intercourse, and risk of STIs and unwanted pregnancy.

DID NOT USE PHYSICAL AGGRESSION

114
Q

Positive decisional balance

A

(i.e., perceiving more pros than cons) is associated with increased engagement in a behavior

115
Q

After birth, the postpartum period begins, which causes physiological changes

A

Estrogen and progesterone levels drop

-lactation hormones produced

116
Q

Mild form of depression and crying after birth of child (baby blues)

A

50-80% for 24-48 hours

Sadness, crying, mood swings

117
Q

Moderate form of postpartum depression

A

Depressed mood, insomnia, tearfulness, feelings of inadequacy, fatigue, irritability, inability to cope

118
Q

Most severe of postpartum depression

A

Psychosis (0.01%)

119
Q

One cause of infertility: man can not ejaculate deep in vagina

A

can include erectile dysfunction (ED)
Hypospadias (opening of urethra in not in tip but lower in shaft)
Low sperm count (or poor quality sperm)

120
Q

If you have viable sperm but low sperm count

A

Use artificial insemination

concentrate the sperm and inject into vagina

121
Q

Another cause of infertility (male)

A 
Infectious diseases (mumps or prostate)
Direct damage to testes (trauma, radiation)

Hypothyroidism and diabetes

Blockage of the duct system (sperm can’t get through channel - microsurgery needed)

122
Q

Women fertility

A

Failure to ovulate
-due to hormonal deficiencies (pituitary, thyroid, adrenal)

Vitamin deficiencies, drug abuse, anemia, malnutrition, psychological stress

Blockage of reproductive system (fallopian tubes)

Infections of vagfina, cervix, uterus, fallopian tubes, ovaries

Tumors that obstruct

123
Q

Drugs used for inducing ovulation

A

Clomiphene, human menopausal gonadotropin (HMG)

-drugs result in multiple births

124
Q

__ to ___% of couples involuntarily childless

A

10 to 15 %

125
Q

psychological impacts of infertility

A

Issues of self-definition

  • especially if women believe their purpose is to become a mother (women)
  • for men (lineage / continue on the blood line)

Adds stress to relationships creating friction or intensifying problems

Loss of sexual pleasure (getting pregnant becomes a task)

Greif, anger, guilt

126
Q

Reading 8 Wright R8

A 
Centerfold images (i.e., still-shot depictions of lone, provocatively posed, scantily clad
women) are one of the most enduring, pervasive, and popular forms of sexual media.

Measured: young women’s attitude toward the male gaze following exposure
to centerfolds of varying explicitness

Findings: Women exposed to more explicit centerfolds expressed greater acceptance of
the male gaze than women exposed to less explicit centerfolds immediately after exposure
and at a 48 hour follow-up (the 2 days after was the difference between their study and prior)

The more sexualized media expose women’s bodies, the stronger they communicate the acceptability of the male gaze.

127
Q

Reading 9 Crawford (R9)

A

What it looked for: Existence of sexual double standards: different standards of sexual permissiveness for women and men.

Measured: This review discusses methodological issues, including the strengths and limitations of quantitative and qualitative approaches. It also discusses implications for women’s high-risk sexual
behavior and sexual identity)” and suggests directions for future research.

Findings: Studies show thaI sexual double standards are influenced by situational and interpersonal factors
(e.g., the target’s age, level of relationship commitment, and number of partners), and that double standards are local constructions, differing across ethnic and cultural groups

Reiss classified attitudes toward premarital
sexual activity into Four general categories: abstinence (premarital intercourse considered wrong for both sexes), double standard (males considered to have greater right to premarital intercourse), permissiveness without affection (premarital intercourse considered right for both sexes regardless of emotional involvement), and permissiveness with
affection (premarital intercourse considered right for both sexes if pan of a committed relationship)
Findings from Reiss: Overall. 42% of the
student samples endorsed abstinence from premarital
intercourse, with a sizeable minority endorsing permissiveness wi th (19%) and without (7%) affection

Men’s endorsement of a double standard was
strongest at the first date but also existed for intermediate dating stages.

Evidence of double standards exists if women are evaluated differently than men for engaging in comparable levels of sex ual activity under the smne conditions.

Finally. there is a notable gap in research on sexual double standards in the area of attention to racial and ethnic
diversity

128
Q

Reading 10 Blumberg (R10)

A

Findings: Highly sexual women reported that their lives have been strongly affected by their sexuality

Methods: Demographic questionnaire prior to interview, and then a 60 question interview

3 negative themes: Constant struggle to find and maintain a sexually satisfying relationship, difficulties in relationship with other women, and a general sense of being at best misunderstood and at worst being painfully rejected

3 positive themes: satisfaction with becoming a unique individual apart from judgments, physical satisfaction, generall satisfying nonsexual relationships with men and women.

Would not change permanently

Culture nor biology alone is sufficient to completely understand human sexual behaviour

Addiction or compulsion is not applicable (addicts lose control)

Culture nor society provides the answer

Partners didn’t like them masturbating

Highly sexual due to be sexualized at an early age, but not always true. Most are not raped or molested at a young age

129
Q

Reading 12 de graaf (R12)

A

Dimensions of general parenting that have been studied rather extensively: support, control, and knowledge (of parents of their child’s whereabouts)

The results show that, in general, higher scores on support, control, and knowledge relate to a delay of first sexual intercourse, safer sexual practices, and higher sexual competence.

Sex before age 14 is due to coercion and unprotected among older adolescents

Higher levels of parental support correlate with a delay of first sexual intercourse.

Furthermore, parental support correlates with higher levels of contraceptive and condom use among sexually active adolescents, more positive feelings regarding sexuality, and higher levels of competence in sexual interactions.

Both too much control and a lack of control can be disadvantageous (authoritative and authoritarian)

Clear and fair demands seem to correlate with a delay of firstsexual intercourse and less unwanted sexual experiences.

130
Q

Reading 11 Simon r11

A

What is was: . A thematic and critical literature review was conducted to determine what is known about adolescents’ experiences with online sex education

What they found: Four major themes could be dis-cerned from the literature, revealing that:
(a) adolescents report engaging with sex information online;
(b) adolescents are interested in a number of topics, including sexually transmitted infections and pregnancy;
(c) the quality of adolescent-targeted sex information online can belacking, but adolescents can evaluate these sources; and
(d) Internet-based interventions can increase adolescents’ sexual health knowledge
Together, these findings suggest that online sex education plays a role in adolescents’ lives, though their process of applying online information offline is gener-ally unknown.

How they are different: this is the first review todate that exclusively examines adolescents’ use of the Internet as a sex education resource.

unclear whether online sex education replaces or supplements traditional sources of sex education, like SBSE

Use online sex ed want to learn about sexual experiences, not just sexual health

Internet 5 A’s: Availability, acceptability, affordability, anonymity, and aloneness

131
Q

Sperm counts of ___ million to 150 million sperm per millilitre of semen are considered normal.

A count of less than 20 million is generally regarded as low.

A

40

132
Q

Sewell reading 1 r1

A

Searched for: This study examined how people define having sex utilizing a new approach to this area of
research.

Results: for both sexes, some behaviors (e.g.,
penile-vaginal intercourse) were far more confidently rated (i.e., ‘‘definitely sex’’) than were others (e.g., oral-genital stimulation)

Qualitative results, paired with quantitative findings, suggest that individuals consider a variety of contextual factors when making these definitional decisions.

among men ages 18 to 96, the oldest and youngest groups were less likely than others to label some behaviors as sex

ambiguous sexual encounter as ‘‘having sex’’ seemed to be influenced by their perception of the consequences of labeling it as such (e.g., negative self-evaluation)

People are more
likely to call a behavior sex if at least one person has
an orgasm during the act

Multivariate procedures (e.g., MANOVA), such
as those utilized in the present study

Limitations: no study in this area has
asked participants for qualitative explanations for their
decisions about whether intimate behaviors count as
having sex

The measures used comprised three parts: a page of
demographics and two sets of study questions

‘‘69’’ position added

Limitation: age range was limited

133
Q

Abbey reading r3

A

Objective: To provide evidence regarding the construct validity of a sexual aggression proxy in
which male participants go on multiple virtual dates with a woman.

Method: Focus groups and surveys and cognitive interviews

Psychology 353: Human Sexuality (8 decks)

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