Sexuality and Men's Health Flashcards by SABRINA HALILI

Phases of sexual function by masters & johnsons

Excitement
plateau
orgasm
resolution

How well did you know this?

Not at all

Perfectly

excitement phase

pelvic vasocongestion & neuromuscular tension
tumescence
vaginal lubrication and accommodation; lengthening and uterine lifting
HR and RR increase
sweating

How well did you know this?

Not at all

Perfectly

plateau

pre-orgasmic phase

maximal erection and rigidity, ejaculatory inevitability

outer third of vagina forms a thickening

How well did you know this?

Not at all

Perfectly

orgasmic phase

pleasant experience recognized in genital area, brain, and body

accompanied by rhythmic contractions of pelvic floor muscles

smooth muscle contractions in internal sexual organs and structures

maximal HR< BP, RR

EJACULATION

How well did you know this?

Not at all

Perfectly

resolution phase

reversal of tumescence, pelvic vasocongestion, neuromuscular tension, CV parameters

men have additional physiologic refractory period

women have extended, repeated orgasms
women have higher endurance

How well did you know this?

Not at all

Perfectly

hypoactive or hyperactive more common

hypoactive

How well did you know this?

Not at all

Perfectly

Kluver-bucy syndrome

disorder resultion from lesions on (B) temporal lobe including amygdaloid nucleus

HYPERsexuality

How well did you know this?

Not at all

Perfectly

medications for PD patients which act as a replacement of dopamine results to what kind of changes in sexual desire

increase or hyperactive sexual desire

How well did you know this?

Not at all

Perfectly

arousal disorders

disorders of male penile erection

How well did you know this?

Not at all

Perfectly

ejaculatory dysfunction

problems with anterograde sminal fluid expulsion

How well did you know this?

Not at all

Perfectly

orgasmic disorders

inability to reach orgasm

How well did you know this?

Not at all

Perfectly

problems with arousal, ejaculation, and orgasm include

fertility issues & dyspareunia

How well did you know this?

Not at all

Perfectly

dyspareunia

pain in genitals that occurs before, during, and after sexual intercourse

also happens with decreased lubrication of the genitals

How well did you know this?

Not at all

Perfectly

function of somatic nerves

transmits signals activated by tactile inputs

How well did you know this?

Not at all

Perfectly

autonomic nerves function

receptor organ for stretch and lack of oxygen stimuli

sexual activity is not only triggered by tactile inputs but also by stretch & lack of oxygen

How well did you know this?

Not at all

Perfectly

process of sexual arousal

signals transmitted to brain, signals are perceived and received by cerebrum with limbic system, hypothalamus, and midbrain —-> once there is stimulus that triggers sexual activity, brain perceives it as sexual sensation & signals are passed to brainstem and spinal tracts (at this level signals are modulated by mood, hormones, emotions, and physical factors like stress) —-> signals from brainstem and spinal tract will be passed to the sacral parasympathetic nerves then to pelvic floor muscles —-> can also go to the thoracolumbar sympathetic via the hypogastric n. & the lumbar sympathetic chains —-> may also go to the somatic pathway through bilat pudendal n. —-> as an effect of the descending pathways, there is sexual arousal primarily in the PFM

How well did you know this?

Not at all

Perfectly

in women, lubrication depends on

intact innervation and normal estrogen levels

How well did you know this?

Not at all

Perfectly

in men, internal accessory organ functioning and erection are dependent on

adequate testosterone levels

How well did you know this?

Not at all

Perfectly

reflexogenic arousal

triggered by direct stimulation of genitals

afferent: pudendal nerve –> s2-s4 spinal segments —> influence from descending pathway –> sacral parasympathetic center –> pelvic nerve –> genitalia

How well did you know this?

Not at all

Perfectly

dominant in SCI pt

reflexogenic

How well did you know this?

Not at all

Perfectly

psychogenic stimulation

supraspinal origin (auditory, imaginative, visual, etc)

medial preoptic nucleus —> paraventricular nucleus of hypothalamus –> reticular activating system —> thoracolumbar sympathetic & sacral parasympathetic centers

In lumbosacral SCI, there is loss of this

How well did you know this?

Not at all

Perfectly

arousal is primarily —- in function

parasympathetic

How well did you know this?

Not at all

Perfectly

ejaculation is predominantly

sympathetic BUT still has a factor of parasympathetic

How well did you know this?

Not at all

Perfectly

ejaculation pathway

s1 & s2 nerves –> hypogastric nerves –> activation of vans deferens, seminal vesicles, & prostate –> smooth muscle contractions

preganglionic fibers from L1-L2 segments of sc

How well did you know this?

Not at all

Perfectly

phases of ejaculation

seminal emission expulsion

process of seminal emission

(sympathetic T10-L2) transport of semen into prostatic urethra via ejaculatory duct in the prostate hypogastric nerve (L1,2) closes the neck of the bladder to prevent retrograde ejaculation

process of expulsion

parasympathetic s2-s4 & sympathetic propulsion of semen distally or out of the urethral meatus or the opening of the urethra

---- levels rise during arousal & orgasm

oxytocin

----- levels remain elevated even after orgasm

prolactin

low --- levels make orgasm more difficult in men and women

androgen

disability can affect sexual function through 4 basic mechanisms

direct effects of vascular, neurologic, hormonal, anatomical, damage to any area functionally connected to sex response indirect effect of medical/psychological condition Iatrogenic effects of tx: radiation, surgery, meds, chemo contextual factors

excitatory medications

levodopa

inhibitory medications

serotonin antidepressants (serotonin reuptake inhibitors) DA blockers sympathomimetic drugs

excitatory hormones

dopamine and noradrenaline

inhibitory hormones

serotonin

effect of aging on sexual function in females

Post menopausal women experience less vaginal lubrications, ↓ muscle spasm during orgasm, dyspareunia

effect of aging on sexual function in men

2-3x as long to achieve erection erection not as rigid orgasm delay decreased ejaculatory fluid volume penile detumescence occur rapidly longer refractory period

METS for sexual intercourse for couples with long standing relationships

METS for sexual intercourse for extramarital

9 METs

measure used to determine risk of ischemia or safe return to sexual activities

6 METS

Sci in men reduces

sperm motility & semen count in men

SCI in women causes

pregnancy increases risk of: UTI changes in bladder mx skin breakdown difficulty in transfers risk for DVT delayed bowel emptying pedal edema vaginal spotting fatigue thrombophlebitis

Complete SCI above the LS spinal cord center (above t10)

(+) reflexogenic arousal (-) psychogenic

complete lesions interrupting sacral reflexogenic pathways

reliance on psychogenic arousal

men with sacral sci reliant on

psychogenic arousal unwanted seminal emission & penile detumescence are triggered

SCI with preserved sensation in the T11-L2 level

capable of psychogenic arousal

presence of (+) bulbocavernosus reflex

intact reflexogenic arousal capacity

ejaculatory disorder in men with sci

premature ejaculation

men c incomplete conus medullaris or cauda equina lesion

natural ejaculation most likely to occur

men with complete supraconal lesions

natural ejaculation LEAST likely to occur, vs assisted ejaculation more reliable

Diabetes mellitus effect on sexual function

ED is correlated with score glycemic control, onset of retrograde ejaculation, impaired genital sensation (reflexogenic) Type 1 DM: sexual dysfunction correlated with depression

CRF effect on sexual funciton

Comorbidities from CRF responsible for ED, menstrual abnormalities in women, & ↓ libido & infertility in both sexes Hyperprolactinemia: ↓ libido, frequency of sexual intercourse, orgasmic difficulties

sexual rehabilitation framework: sexual interest

biological urge combined with motivation and/or wish to be sexual

sexual rehabilitation framework: sexual response

mental and genital arousal ejaculation in men ability to attain orgasm and orgasmic quality

sexual rehabilitation framework: changes to genital sensation or other erogenous zones

loss of erotic zone sensitivity or hypersensitivity in specific areas

sexual rehabilitation framework: changes to motor function

hand function, balance, ability to transfer to a bed, hold a partner, etc

sexual rehabilitation framework: bladder & bowel issues

mx strategies, concerns with continence during social & sexual activities, & social implications

sexual rehabilitation framework: factors associated with the condition

medication effects, alteration in hormone status, pain, fatigue, AD, anemia, etc.

sexual rehabilitation framework

sexual interest sexual response changes to genital sensation or other erogenous zones changes to motor function bladder & bowel issues factors associated with the condition practical use of contraception, concerns about fertility, pregnancy, delivery parenting issues specific to disability or illness relationship & partnership issues sexual self-esteem & self-view issues

kluver-bucy syndrome symptoms

amnesia hypersexuality docility