Coition Flashcards

1
Q

What is the EPOR model for human sexual responses?

A
  1. Excitement
  2. Plateau
  3. Orgasm
  4. Resolution
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2
Q

What is excitement?

A

In response to psychogenic or somatogenic stimuli

Increasing sexual arousal or tension

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3
Q

What is plateau?

A

Arousal is maintained and intensified

Increased pelvic haemodynamics

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4
Q

What is orgasm?

A

A few seconds of involuntary climax

Tension relieved by wave of intense pleasure

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5
Q

What is resolution?

A

Arousal dissipated

Pelvic haemodynamics resolve

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6
Q

What causes penile erection?

A

Changes in blood flow in erectile tissue

Increased pressure in corpora cavernosa

Pressure in corpus spongiosum remains low to prevent compression of urethra and allow ejaculation

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7
Q

How is flaccidity maintained?

A

Arterial input to corpora cavernosa blocked by smooth muscle mounds

Keeps pressure in corpora lower than in artery

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8
Q

What is tumescence?

A

Stimulation of pelvic nerve causes increased blood flow through penis

After 20-30 seconds, increased pressure in corpus cavernosum leading to engorgement

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9
Q

How is erection maintained?

A

Relaxation of smooth muscle mounds at arterial input allows full arterial input and high pressure but reduced blood flow

Reduced venous drainage due to occlusion by flaps of smooth muscle keeps pressure high

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10
Q

What is detumescence?

A

Contraction of smooth muscle causes arterial flow to decrease and increases venous outflow

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11
Q

Which autonomic system regulates erection?

A

Parasympathetic

Pelvic nerve - S2, 3, 4

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12
Q

Which autonomic system regulates detumescence?

A

Sympathetic

T12 - L3 via hypogastric nerves

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13
Q

What causes smooth muscle relaxation?

A

Prostacyclin
VIP
NO

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14
Q

How does viagra work?

A

PDE5 inhibitor

Maintains level of cGMP

Causes smooth muscle relaxation

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15
Q

What is the bulbospongiosus reflex?

A

Ischiocavernosus muscle contracts and compresses proximal part of corpus cavernosum to increase penile rigidity

Triggered by pressing on glans penis

Mediated by pudendal nerve S2, 3, 4

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16
Q

What are the organic causes of erectile dysfunction?

A
  1. Neurogenic
  2. Arteriogenic
  3. Drugs
  4. Endocrine
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17
Q

What is the treatment for erectile dysfunction?

A
  1. Sex therapy
  2. Hormone replacement
  3. Injection of smooth muscle relaxants
  4. Viagra
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18
Q

How does sperm travel through vasa efferentia?

A

Passively in bulk flow

Sperm are non-fertile and immotile

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19
Q

How does sperm travel through vas deferens?

A

Muscular contractions move sperm along

90% fluid reabsorbed

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20
Q

What are the vasa efferentia?

A

Connect seminiferous tubules to epididymis

21
Q

What occurs in the epididymis?

A

Sperm maturation

  1. Nuclear condensation and acrosome remodelling complete
  2. Loss of cytoplasmic droplet
  3. Rise in cAMP in tail allows movement
  4. Membrane lipid composition becomes more fluid
  5. Surface coated with stabilising glycoproteins
  6. Sialic acid levels rise
22
Q

What causes seminal emission?

A

Contraction of smooth muscle in prostate, vas deferens and seminal vesicle

Controlled by sympathetics from lumbar splanchnics via α-adrenergic fibres

23
Q

What provides nutrition in sperm?

A

Fructose

24
Q

What is the role of prostaglandins?

A

Muscle stimulants

25
Q

Which antioxidants are present in semen?

A
  1. Ascorbic acid

2. Hypotaurine

26
Q

What causes ejaculation?

A

Rhythmic contractions of urethra and bulbospongiosus and ischiocavernosus at orgasm

Controlled by pudendal nerve

27
Q

What prevents retrograde ejaculation?

A

Urethral sphincter at neck of bladder

28
Q

Where do the ejaculate contributions come from?

A

Early - prostate - 30%
Mid - vas deferens - 10%
Late - seminal vesicle - 60%

29
Q

What are Cowper’s glands?

A

Produce lubricant in ejaculate and pre-ejaculate

30
Q

What do corpora cavernosa do in the female?

A

Enlargement of clitoris

31
Q

What do corpora spongiosa do in the female?

A

Enlargement and eversion of labia

32
Q

What lubricates the vaginal orifice?

A

Greater vestibular glands

Bartholin’s duct

Cervical secretions

33
Q

What is transudation?

A

Lubrication of vagina and vestibule through vascular engorgement of walls

34
Q

What is the tenting effect?

A

Dilatation of upper part of vagina caused by increased stimulation

35
Q

What is uterine elevation?

A

Uterine and vaginal contractions at orgasm

36
Q

What are the characteristics of the cervix during oestrogen dominance?

A

Watery secretion

Os open

Good for sperm

37
Q

What are the characteristics of the cervix during progesterone dominance?

A

Thick secretion

Os closed

38
Q

What is spinnbarkeit?

A

Elasticity of cervical secretion

39
Q

How does the cervix act as a filter?

A
  1. Prevents pathogens ascending female tract during non-receptive phase of cycle
  2. Filters out abnormal sperm
  3. Separates sperm from seminal fluid
40
Q

How many sperm are inseminated?

A

~350,000

41
Q

How quickly do first sperm arrive at oviduct?

A

5 mins

42
Q

What is sperm capacitation?

A

Acquisition of capacity to fertilise eggs

  1. Loss of membrane cholesterol to albumin in uterine fluid
  2. Loss of glycoproteins by glycosidase enzymes in uterine fluid
  3. Increases fusogenicity with oocyte
  4. Influx of calcium causes increase in cAMP and PKA
43
Q

Where does capacitation occur?

A

In uterus during passage to oviduct

44
Q

How can sperm capacitation be reversed?

A

By seminal fluid

45
Q

How is the oocyte transported?

A
  1. Ovulated oocyte and cumulus cells picked up by fimbriae

2. Cilia beat in direction from ovary to uterus

46
Q

What is Mittelschermz pain?

A

Bleeding into peritoneal cavity from ovulation

47
Q

Which hormone stimulates cilia to beat?

A

Oestrogen

48
Q

Where does fertilisation occur?

A

Ampulla of oviduct