Lecture 38: Coitus, Fertilisation and Contraception Flashcards

1
Q

what is coitus?

A
  • sexual intercourse/copulation
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2
Q

what happens in coitus?

A
  • erect penis introduced into vagina (intromission)
  • semen released into upper part of vagina (insemination) so that sperm can travel to appropriate site for fertilisation (ampulla of uterine tube)
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3
Q

what are the stages of the male sexual act?

A
  • erection of the penis (parasympathetic)
  • mucus secretion into urethra
  • ejaculation (2 phases: emission and expulsion - sympathetic)
  • resolution
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4
Q

what are fascia?

A

the erectile tissues are surrounded by different layers of fascia

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5
Q

how do the clitoris and penis compare?

A
  • structure of the clitoris and penis share developmental origins
  • tissues of clitoris are erectile as in the penis
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6
Q

what are the branches of the abdominal aorta involved in supplying the penis?

A
  • abdominal aorta
  • common iliac artery
  • internal iliac artery
  • internal pudendal artery
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7
Q

what does the internal pudendal artery do?

A

internal pudendal artery feed perineum and external genitalia, including penis

the branches to the penis:
- artery to bulb
- urethral artery
- dorsal artery
- deep (cavernosal) artery

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8
Q
A
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9
Q
A
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10
Q

how is the blood supply to the penis during an erection?

A
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11
Q

what regulates the genital sexual reflexes?

A
  • coordination of sympathetic, parasympathetic and somatic divisions of the nervous system
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12
Q

what is the nerve supply of the penis?

A
  • penis is richly innervated by sensory and motor nerves
  • includes sensory fibres responsive to touch, pressure and temperature
  • pudendal nerve supplies sensory and somatic motor innervation to perineum and external genitalia, including penis (dorsal nerve)
  • autonomic innervation to penis derives to pelvic plexus (parasympathetic and sympathetic)
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13
Q

what is the parasympathetic nervous system involved in? how?

A

erection
- stimulates production of nitric oxide by deep arteries of penis
- deep arteries dilate and fill lacunae in corpora cavernosa

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14
Q

what is the sympathetic nervous system involved in? how?

A
  • stimulates contraction of smooth muscle
  • reproductive ducts
  • accessory glands
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15
Q

what is the somatic motor division involved in? how?

A
  • stimulates contraction of skeletal muscles around bulb of penis
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16
Q

what happens in the erection phase of the male sexual act?

A
  • parasympathetic response to stimuli
  • deep artery in the penis dilate
  • trabecular muscle of erectile tissue relaxes
  • erectile tissues become engorged with blood
  • bulbourethral gland secrete bulbourethral fluid
  • erect penis can be inserted into vagina
17
Q

what happens in the emission phase of the male sexual act?

A
  • sympathetic response
  • smooth muscle of ductus deferens contracts to move sperm into the ampulla (peristalsis)
  • smooth muscle of ampulla, seminal vesicles and prostate gland contract and move sperm and seminal fluid into urethra
18
Q

what happens in the expulsion phase of the male sexual act?

A
  • semen in the urethra activates somatic and sympathetic reflexes

accessory glands:
- additional secretion from prostate gland and seminal fluid
- internal urethral sphincter contracts (urine remains in bladder)

bulbospongiosus muscle:
- contracts and rhythmically compresses root/bulb of penis, which compresses urethra

  • semen ejected
19
Q

what happens in the resolution phase of the male sexual act?

A
  • the internal pudendal artery constricts and reduces blood flow to penis
  • trabecular muscle contract and squeeze blood from erectile tissues
  • penis becomes flaccid
20
Q

what are the stages of the female sexual response?

A
  • similar sequence of reflex responses as the male
  • engorgement of clitoris, labia and vagina is response to autonomic stimulation
  • lubricating fluid secreted through vaginal wall; secretion of mucus into vestibule (greater vestibular glands)
  • increased width and length of vagina. uterus elevates upwards
  • rhythmic contraction of vaginal, uterine and perineal muscles
21
Q

what happens to sperm after ejaculation?

A
  • semen released into the upper part of the vagina (insemination)
  • sperm travels to uterine tube for fertilisation (ampulla)
  • sperm fuses with secondary oocyte
  • oocyte complete meiosis 2
  • fertilised oocyte/ovum known as zygote
  • zygote initiates cleavage (takes about 7 days) and travels towards the uterus for implantation
22
Q

what is contraception? what types?

A

any method used to prevent pregnancy and regulate when and how many pregnancies

  • natural methods
  • artificial methods: barrier, hormonal contraception, intrauterine devices, sterilisation
23
Q

what are the natural methods of contraception?

A
  • rely on timing of coitus or behaviour during coitus
  • high failure rate
  • rhythm method (periodic abstinence)
  • withdrawal method (coitus interruptus)
  • lactational infertility
24
Q

what are the types of barrier methods?

A
  • caps, diaphragms
  • condoms
25
Q

what are caps/diaphragms?

A
  • imperfect barrier so should be used with foams/jellies/creams/sponges
  • needs to remain at least 6 hours after intercourse
  • not commonly used anymore as there are more convenient and effective methods now
26
Q

what are condoms?

A
  • cheap
  • readily available
  • easy to use
  • reduce risk of STIs
27
Q

what are the types of steroidal contraceptive for females?

A
  • combined oral contraceptive pills
  • progestin-only contraception
  • subdermal implant/injectable progestins
28
Q

what is the combined oral contraceptive pill?

A
  • contains estrogen and progestin
  • suppresses ovulation by affecting the feedback loops to hypothalamus and pituitary
  • affects mucus produced by cervix to prevent sperm penetration
29
Q

what is the progestin-only contraception?

A
  • progesterone only pill
  • low doses of progestin
  • effect on servical mucus
30
Q

what is subdermal implant/injectable progestins?

A
  • long acting (over years)
  • act primarily by disrupting follicular growth and ovulation
31
Q

what are the types of intrauterine devices (IUD)?

A
  • copper IUD
  • hormonal IUD
32
Q

what is the copper IUD?

A
  • causes low grade inflammation
  • reduces sperm transport
  • toxic for oocyte and zygote
  • impairs implantation
33
Q

what is the hormonal IUD?

A
  • contains progestins
  • affects cervical mucus, reducing sperm transport
  • local effects on endometrium
  • may prevent ovulation
34
Q

what sterilisation can be done on females?

A

tubal ligation
- cut uterine tubes

35
Q

what sterilisation can be done on males?

A

vasectomy
- cut ductus deferens