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Human Sexuality > Human Sexuality Exam > Flashcards

Human Sexuality Exam Flashcards

1
Q

common diseases associated with sexual dysfunction

A 
depression
cardiovascular disease
chronic respiratory disease
musculoskeletal disorders
cancer
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2
Q

When should nitroglycerin not be taken for sexual dysfunction?

A

patients on sildenafil

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3
Q

What antidepressant negatively affect all aspects of sexual function?

A

venlafaxine

mirtazapine

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4
Q

What is required for an orgasm?

A

intact sympathetic NS

muscle tone

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5
Q

What is Erotophilia and Erotophobia referring to?

A

Positive or negative emotional responses to sexuality

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6
Q

Outercourse

A

Any form of sexual intimacy that does not involve intercourse

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7
Q

FROTTEURISM

A

Touching or rubbing a non-consenting person in a sexual manner or the recurrent urge to do so (like bus sexual assult)

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8
Q

VOYEURISM

A

peeping tom

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9
Q

dyspareunia

A

painful intercourse

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10
Q

sexual arousal disorder

A

Persistent or recurring absence of sexual fantasy

Lack of receptivity to sexual activity

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11
Q

sexual aversion disorder

A

fear and disgust of sex

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12
Q

categories of orgasmic disorders

A

primary: never had one

secondary

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13
Q

What conducts orgasms?

A

CNS (Spinal cord)

ACCUMBENS NUCLEUS: reward center

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14
Q

Vaginismus

A

Involuntary contraction of muscles around vaginal opening

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15
Q

Exam procedure for dyspareunia

A

monomanual exam

then bimanual and speculum

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16
Q

siladenafil

A

vasodilator for sexual dysfunction

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17
Q

intersexuality

A

individuals who do not conform to traditional male or female classification

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18
Q

pseudohermaphrodite

A

two testes or two ovaries but with ambiguous genital appearance

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19
Q

Woffian

A

male

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20
Q

Mullerian

A

female

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21
Q

hypospadius

A

opening of penis on underside

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22
Q

What is MIF and what is it produced by?

A 
inhibits mullerian (female) development
By Sertoli cells
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23
Q

Tumescence

A

Parasympathetic NS

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24
Q

path of male external genitalia differentiation

A

SRY –> TDF –> GONADS (Sertoli: MIH; Leydig: Testosterone) –> DHT (converted from testosterone) –> differentiation

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25
Q

What hormone are Sertoli cells affected by

A

FSH

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26
Q

What hormone affects Leydig cells?

A

LH

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27
Q

What cells influence Mullerian formation?

A

Sertoli

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28
Q

What does the genital tubercle develop into?

A

male or female glans

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29
Q

XX virilized

A

too much androgen; ovaries present

internally female, externally ambiguous

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30
Q

What can XX virilized be caused by?

A

congenital adrenal hyperplasia

from mom: adrenal tumor or excessive androgens

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31
Q

What is congenital adrenal hyperplasia caused by

A 
male outside (phenotype), female inside
enzyme block --> deficient cortisol production--> pituitary secretes high levels of precursors (that also leads to other hormones like testosterone)
aka adrenal genital syndrome
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32
Q

What is the precursor of all steroid hormones?

A

cholesterol

need it to produce androgens, cortisol, aldosterone

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33
Q

What are the two forms of congenital adrenal hyperplasia

A

21-hydroxylase deficiency: 90%; low mineralcorticoid; MASSIVE androgens
11-hydroxylase deficiency: high mineralcorticoid and androgens

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34
Q

What does 21-hydroxylase deficiency cause?

A

high androgens, low testosterone and aldosterone

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35
Q

XY undervirilized

A

defect in testicular differentiation

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36
Q

5-alpha-reductase deficiency

A

cant convert testosterone to DHT –> minimally virilized male –> massive virilization at puberty
(think end organ failure)

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37
Q

XY androgen insensitivity syndrome

A 
female outside, male inside
testicular feminization syndrome
testosterone receptor defect
abdominal testes, no uterus, phenotypically female
(think end organ failure)
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38
Q

XO chromosome (most common chromosomal abnormality)

A

turner’s syndrome

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39
Q

XXY

A

klinefelter’s syndrome

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40
Q

XXX

A

Triple X syndrome
premature ovarian failure
poor pregnancy congenital malformation

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41
Q

XXY

A

tall
severe acne
hyperactive
“super psycho male”

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42
Q

XO/XY

A

Mixed gonadal dysgenesis

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43
Q

XX/XY

A

Hermaphrodite

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44
Q

Classic symptoms of turner’s syndrome

A

short stature, abnormal facies, webbed neck
ovarian failure before birth, infertility
disruption of mitosis –> impaired growth
“knuckle, knuckle, dimple, knuckle”

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45
Q

Gender dysphoria

A

transexualism
cross gender identification
NO physical intersex

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46
Q

90% cause of Klinefelter’s and symptoms

A

older pregnancies
externally male
hypogonadism (no secondary secual characteristics)
XXY
eventual infertility
small penis, diminished hair, enlarged breast tissue
undetected in a lot

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47
Q

juvenile gender dysphoria

A

four or more of the following:
desire to be other sex
preference for cross-sex roles in play/dress
persistent fantasies about being the other sex
intense desire to participate in stereotypic games of opposite sex
strong prefer. for playmates of opposite sex

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48
Q

what age is transexuality fixed by?

A

12-18 months

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49
Q

difference between CAH and F to M trans

A

CAH: internally female, excessive androgen, look male, raised as male, male puberty
Trans: trapped in wrong body, all else female

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50
Q

Site of sperm production

A

SEMINIFEROUS TUBULES (10% semen)

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51
Q

Function of Sertoli cells

A

protect and nourish sperm

blood-testis barrier

52
Q

What take places at the epididymis?

A

sperm maturation

store sperm at epididymis tail

53
Q

Where does testicular artery come from?

A

off aorta in abdomen by kidney (bc testis originate in abdomen)

54
Q

risks of retained abdominal testes

A

high temp so impaired sperm production

high risk of cancer

55
Q

seminal vesicle

A

60% of semen

56
Q

what is ejaculatory duct from?

A

vas deferens and seminal vesicle

57
Q

What structures are combined in the prostate?

A

ejaculatory duct and urethra

58
Q

what does prostate gland do?

A

30% volume of semen (fructose for sperm flagella ATP)

59
Q

WHAT ARE THE THREE SECTIONS OF URETHRA

A

Prostatic, Membranous, & Penile (spongy)

60
Q

BULBOURETHRAL GLAND (Cowper’s gland)

A

at base of penis

pre-ejaculate fluid: sterilized urethra before ejaculation

61
Q

corpora cavernosa (two of them)

A

engorged with blood –> erection

62
Q

corpus spongiosum

A

protect and guard urethra during engorgement

wrap around urethra

63
Q

What physiological change needs to occur to produce erection?

A

needs vascular and neural
1. increase arterial blood to corpora cavernosa
2. decrease venous outflow (close off)
blood in and not out

64
Q

what is tumescence mediated by?

A

nitric oxide

65
Q

how does nitric oxide

A

released by Parasympathetic postganglionic cell

cause arterial inflow and block venous outflow

66
Q

what is a common initial vascular disease presentation in males?

A

erectile dysfunction (if see this symptom, check other vascular dysfunction)

67
Q

What does internal pudendal artery supply and where does it come from?

A

dorsal penile artery down to cavernous artery

from internal iliac a.

68
Q

venous sinusoid

A

cavities in cavernosa –> can expand with erection and collapse when flaccid

69
Q

what does the tunica albuginea do?

A

stretch during tumescence and pinch of venous outflow

70
Q

action of PNS v. SNS in tumescence

A

Parasympathetic: initiate tumescence, nitric oxide, muscle relaxation (arterial dilation)
Sympathetic: ejaculation and resolution, smooth muscle contraction (arterial constriction)

71
Q

bulbocavernosus muscle

A

muscle surrounding urethra –> clears urethra

72
Q

ischiocavernosus muscle

A

contract during sexual excitation and ejaculation to close off vein

73
Q

Nerve route of Somatic Input of tumescence

A

dorsal nerve –> internal pudendal n. –> bulbocavernosus and ischiocavernosus muscles

74
Q

afferent stimulation v psychogenic impulse during tumescence

A

afferent: from touch
psychogenic: no touch

75
Q

what is involved in somatic input of tumescence

A

afferent stimulation
psychogenic impulse
motor input

76
Q

How can pts with spinal cord injury have tumescence?

A

reflex arc from direct touch stimulation

77
Q

what are the stages of tumescence and what nerve system involved?

A

excitement: efferent parasymp
orgasm - emission: efferent symp
organsm - expulsion: efferent symp/somatic
resolution: efferent symp

78
Q

Masters and Johnson: 2 principle physio changed

A
  1. vasocongestion

2. myotonia

79
Q

4 phases of human sexual response cycle (M+J)

A

excitement
plateau
orgasm
resolution

80
Q

what happens to testis during tumescence?

A

testis elevation and enlargement

81
Q

What are the two stages of male orgasm?

A

stage 1: sense of ejaculatory inevitability bc fluid in urethra
2: ejaculation, muscle contraction
BP and pulse rises

82
Q

Helen Singer-Kaplan’s triphasic model

A

sexual desire: psych

excitement: vascular
orgasm: muscle

83
Q

Difference between MJ and Singer-Kaplan’s model***

A

HSK considered DESIRE***

84
Q

causes of erectile disorders***

A

vascular: 40%
diabetes: 35%
medication: anti-HTN, anti-depressants
injury: eg prostate

85
Q

most common sexual dysfunction in young men***

A

premature ejaculation***

86
Q

priapism

A

failure of detumescence (>4hrs)
extremely painful erection
can lead to proprial fibrosis

87
Q

What drug classes contribute to ED?***

A 
Anti-HTN: beta blockers, diuretics
Anti-cholinergic
Anti-depressant
Anti-psychotics
Sedatives/drug abuse
88
Q

Types of testosterone in blood

A

tightly bounded to SHBG
loosely bound to albumin (68%)
free

89
Q

ED diagnostic test

A

measure free testosterone

90
Q

What does viagra (Sildanefil) do?

A

prolong vasodilation (PDE5 inhibitor)

91
Q

Paramesonephric duct v Mesonephric

A 
Para = Mullerian, female
Mesonephric = Wolfian, male
92
Q

Kallmann’s Syndrome

A 
hypogonadotropic hypogonadism
deficient hypothalamic GnRH
infertility
abnormal pubertal maturation
usually in males
93
Q

adrenarche

A

increase in adrenal androgen; ~age 6

secondary sex characteristics (hair, sebaceous glands)

94
Q

Pubarche

A

appearance of pubic hair

95
Q

Gonadarche

A

FSH and LH activation of gonads

male: testicular enlargement
female: ovulation from LH surge

96
Q

Thelarche

A

breast development (breast buds)

97
Q

Spermarche

A

first ejaculation

98
Q

premature thelarche

A

<2 yo: self limiting

>2 yo: can have uterine bleeding

99
Q

precocious puberty

A

development of secondary sexual characteristics before 8yo –> reduce adult height

100
Q

what does bone age tell you?

A

pubertal age

101
Q

When is menarche?

A

one year after growth spurt

102
Q

FIRST SIGN OF GROWTH SPURT IN GIRLS***

A

Breast buds! (sometimes pubic or axillary hair)

103
Q

Female Tanner Stages (SMR)***

A

1: nipple elevation (preadolescence)
2: breast bud; elevation of breast and nipple as small mound
3: elevation of breast and areola (no separation of contour)
4: secondary mount from areola and nipple projection
5: mature stage; only nipple projection (areola recedes)

104
Q

First sign of male puberty***

A

testicular enlargement

105
Q

First ejaculation stage

A

SMR3

106
Q

Male Tanner Stages***

A

1: no hair
2: testicular enlargement; some downy hair
3: pub hair coarse and curly at base
4: adult quality hair, NOT on thighs
5: adult quality and QUANT ON thighs

107
Q

Gynecomastia

A

breast enlargement in boys (40-65%); resolves itself within 3yrs

108
Q

Sexual orientation

A

ID of physical/emotional attraction to others

109
Q

cisgender

A

someone not transgender

110
Q

gender nonconforming

A

gender fluid (not quite at transgender level)

111
Q

nonbinary

A

gender nonconforming individual identifies as neither male or female

112
Q

transmasculine/transfeminine

A

directionality of gender identity of gender nonconforming individual

113
Q

gender affirmation

A

recognizing, accepting and expressing one’s gender identity

114
Q

Feminizing hormone therapy

A

estrogen (17-beta-estradiol)
+ androgen blocker (sprinolactone)
+/- progestagen ()

115
Q

Biggest adverse effect of androgen blockers***

A

hyperkalemia

116
Q

masculinizing hormone therapy

A

testosterone

side effect: acne

117
Q

5 P’s of sexual history

A 
Partners
Practices
Past History of STI’s
Protection from STI’s
Pregnancy Plans/Prevention
118
Q

Screening for adolescent issues: HEEADSSS

A 
Home environment
Education, employment
Eating
Activities (peer-related), affect, ambitions, anger
Drugs
Sexuality
Suicide/depression
Safety from injury and violence
119
Q

celibacy

A

refraining from intercourse bc not married (doesnt have to be virgin)

120
Q

chastity

A

refraining from intercourse and other activities (and thoughts) bc moral purity or virtuousness

121
Q

paraphilia

A

OVERDEPENDENCE ON CULTURALLY UNACCEPTABLE/ UNUSUAL STIMULUS FOR SEXUAL AROUSAL/ SATISFACTION

122
Q

transvestic fetish

A

arousal from dressing like opposite sex

123
Q

treatment for variant sexual behavior

A

DECREASING VARIANT SEXUAL AROUSAL:
AVERSIVE CONDITIONING
COVERT SENSITIZATION

INCREASE NONVARIANT SEXUAL AROUSAL:
MASTURBATORY CONDITIONING
EXPOSURE
SYSTEMATIC DESENSITIZATION

124
Q

Raptophilia***

A

Sexual gratification from rape

125
Q

Coprophilia***

A

Sexual gratification from defecation

Human Sexuality (1 decks)

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