Sexual Wellbeing Flashcards
What are the four phases of sexual response (defined by Masters and Johnson, 1966)?
- Excitement
- Plateau
- Orgasm
- Resolution
What are the anatomical components of the clitoris?
Corpus spongiosum
Corpus cavernosa
What supplies the smooth muscle and coropora cavernosa of the clitoris?
Cavernous nerves (uterovaginal plexus, from the inferior hypogastric plexus)
What is the sensory nerve supply to the clitoris?
Dorsal nerve, arising from the pudendal nerve
What is the arterial supply to the clitoris?
Dorsal artery of clitoris, a terminal brach of the internal pudendal artery
What is the function of the clitoris?
The receptor of sexual stimuli, as part of the sensory arm of the female orgasmic reflex
Why is the lower third of the vagina ‘tighter’ and ‘less capacious’ than the upper third?
The levator ani and perineal muscles
What is responsible for the ‘female ejaculate’?
The urethra is surrounded laterally and anteriorly by some erectile tissue - is is the response of the erectile tissue that causes the secretion of clear fluid from the urethra
Why is the lower vagina, clitoris and introitus more sensitive?
Supplied by the pelvic plexus of nerves (whereas the upper vagina, derived from Mullerian ducts, which have a poor sensory supply)
What is the most sensitive part of the vagina?
Anterior vaginal wall - high concentration of nerve plexuses and ganglia, especially along the mid-line
What are the two sensory arms of the female orgasmic reflex?
- Clitoris
- Anterior vagina
What are the different ways arousal can be mediated?
- Local genital areas - esp. clitoris and vagina, but also other sites e.g. the nipples
- Centrally
A. The nervous system - e.g. visual and olfactory stimuli are potent arousal senses (contributing psychological and environmental factors) - vasocongestion followed by myotonia fits with parasympathetic followed by sympathetic activity
B. Hormones = may act directly on genitalia to induce vasocongestion similar to a state of sexual arousal, and may increase sexual attractiveness by secretion of pheromones
What happens during the excitement phase of the sexual response?
- Initiated by psychological or physical stimuli, or both
- Vasocongestion of external genitalia occurs within 30 secs - clitoris and labia (and uterus) become engorged
- Labia majora, appears to flatten out
- Rapid development of transudate (production dependant on blood flow)
- Vasodilation leading to erection of nipples, flushing of skin etc.
What is the function of the transudate produced in the excitement phase?
- Reduction in friction
- Increases partial pressure of oxygen in the vaginal epithelium, providing more energy for sperm actvitity
What happens during the plateau phase of the sexual response?
- Continued lengthening of the vagina, with elevation of the uterus , with expansion of the proximal end of the vagina - ‘tenting’ or ‘ballooning’ (allowing complete filling of the ant or post fornix with the penis during SI)
- ‘Turgid cuff’ of the distal vagina continues (dilatation of the venous plexuses in vagina and vestibule)
- Retraction of the clitoris
What happens during the orgasm phase of the sexual response?
- Release of vasocongestion, brief contraction of the turgid cuff at the distal vagina (approx. 5), uterus and occasionally the anal sphincter
- Voluntary and involuntary contraction elsewhere - Can cause stress incontinence
- Transient hypertension, tachycardia, hyperventilation