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Endocrine > Erectile Dysfunction > Flashcards

Erectile Dysfunction Flashcards

1
Q

Which muscles contract to increase vascular pressure in the penis?
Innervation.

A

Bulbocavernosus and ischocavernosus muscles

Innervated by pudendal nerve (somatic).

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2
Q

Spinal cord levels for sympathetics

A

T10-12

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3
Q

Spinal cord levels for parasympathetics

A

S2,3,4 keep the penis off the floor

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4
Q

Which nerve does the dorsal nerve of the penis join?

Which SC levels does this nerve enter?

A

Joins pudendal nerve, which enters S2-4 spinal roots (Onuf’s nucleus)

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5
Q

Onuf’s nucleus

A

Center of somatomotor penile innervation in S2-4 spinal cord

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6
Q

Messenger molecules for erection

A
  • NO is the primary messenger. cGMP / cAMP are the secondary messengers.
  • NO → guanylyl cyclase → conversion of GTP to cGMP → decrease in Ca → relaxation allowing for increased blood flow.
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7
Q

Characteristics of psychogenic ED

Mechanism

A
  • Younger pxs
  • Nocturnal erections are maintained
  • Sudden onset
  • Mechanism – inhibition of spinal erection center as exaggeration of normal suprasacral inhibition and sympathetic outflow. May also involve elevated catecholamines preventing relaxation of penile smooth muscle.
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8
Q

Testosterone threshold for erections

A

200 ng/dL

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9
Q

At what testosterone level should you suspect hyperprolactinemia?

A

Less than 150 ng/dL

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10
Q

Effects of hyper / hypothyroidism on sexual function

A

•Hyperthyroidism decreases libido. •Hypothyroidism → low testosterone secretion and elevated prolactin.

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11
Q

Risk factors for arteriogenic ED (6)

A

Same risk factors as heart disease: HTN, hyperlipidemia, smoking, DM, trauma, irradiation.

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12
Q

Treating venogenic ED

What does not work?

A

Treat w/ therapies to increase flow (PDE5 inhibitors, injection) or decrease outflow (constriction bands).
Surgery to occlude veins does not work.

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13
Q

Substance abuse causing ED (3)

A

Cigarettes, alcohol, marijuana

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14
Q

Meds causing ED (8)

A
  • Anti-hypertensive: Thiazides, B-blockers
  • CNS: Sedatives, anti-depressants, analgesics
  • Histamine receptor blockers
  • Long-lasting LHRH-agonists, estrogen
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15
Q

Lifestyle changes to treat ED (5)

A

•Reduce fat / cholesterol in diet, decrease alcohol, eliminate tobacco / substance abuse, weight loss, regular exercise

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16
Q

4 PDE5 inhibitors

Mechanism

A
  • Sildenafil (Viagra), Vardenafil (Levitra), Tadalafil (Cialis), Avanafil
  • Mechanism -increased cGMP, which promotes and sustains smooth muscle relaxation.

Endocrine (24 decks)

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