Coition Flashcards
What is the EPOR model for human sexual responses?
- Excitement
- Plateau
- Orgasm
- Resolution
What is excitement?
In response to psychogenic or somatogenic stimuli
Increasing sexual arousal or tension
What is plateau?
Arousal is maintained and intensified
Increased pelvic haemodynamics
What is orgasm?
A few seconds of involuntary climax
Tension relieved by wave of intense pleasure
What is resolution?
Arousal dissipated
Pelvic haemodynamics resolve
What causes penile erection?
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
How is flaccidity maintained?
Arterial input to corpora cavernosa blocked by smooth muscle mounds
Keeps pressure in corpora lower than in artery
What is tumescence?
Stimulation of pelvic nerve causes increased blood flow through penis
After 20-30 seconds, increased pressure in corpus cavernosum leading to engorgement
How is erection maintained?
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
What is detumescence?
Contraction of smooth muscle causes arterial flow to decrease and increases venous outflow
Which autonomic system regulates erection?
Parasympathetic
Pelvic nerve - S2, 3, 4
Which autonomic system regulates detumescence?
Sympathetic
T12 - L3 via hypogastric nerves
What causes smooth muscle relaxation?
Prostacyclin
VIP
NO
How does viagra work?
PDE5 inhibitor
Maintains level of cGMP
Causes smooth muscle relaxation
What is the bulbospongiosus reflex?
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
What are the organic causes of erectile dysfunction?
- Neurogenic
- Arteriogenic
- Drugs
- Endocrine
What is the treatment for erectile dysfunction?
- Sex therapy
- Hormone replacement
- Injection of smooth muscle relaxants
- Viagra
How does sperm travel through vasa efferentia?
Passively in bulk flow
Sperm are non-fertile and immotile
How does sperm travel through vas deferens?
Muscular contractions move sperm along
90% fluid reabsorbed