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SpeCon > Sexuality and Men's Health > Flashcards

Sexuality and Men's Health Flashcards

1
Q

Phases of sexual function by masters & johnsons

A

Excitement
plateau
orgasm
resolution

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2
Q

excitement phase

A

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

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3
Q

plateau

A

pre-orgasmic phase

maximal erection and rigidity, ejaculatory inevitability

outer third of vagina forms a thickening

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4
Q

orgasmic phase

A

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

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5
Q

resolution phase

A

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

men have additional physiologic refractory period

women have extended, repeated orgasms
women have higher endurance

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6
Q

hypoactive or hyperactive more common

A

hypoactive

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7
Q

Kluver-bucy syndrome

A

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

HYPERsexuality

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8
Q

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

A

increase or hyperactive sexual desire

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9
Q

arousal disorders

A

disorders of male penile erection

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10
Q

ejaculatory dysfunction

A

problems with anterograde sminal fluid expulsion

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11
Q

orgasmic disorders

A

inability to reach orgasm

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12
Q

problems with arousal, ejaculation, and orgasm include

A

fertility issues & dyspareunia

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13
Q

dyspareunia

A

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

also happens with decreased lubrication of the genitals

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14
Q

function of somatic nerves

A

transmits signals activated by tactile inputs

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15
Q

autonomic nerves function

A

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

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16
Q

process of sexual arousal

A

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

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17
Q

in women, lubrication depends on

A

intact innervation and normal estrogen levels

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18
Q

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

A

adequate testosterone levels

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19
Q

reflexogenic arousal

A

triggered by direct stimulation of genitals

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

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20
Q

dominant in SCI pt

A

reflexogenic

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21
Q

psychogenic stimulation

A

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

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22
Q

arousal is primarily —- in function

A

parasympathetic

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23
Q

ejaculation is predominantly

A

sympathetic BUT still has a factor of parasympathetic

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24
Q

ejaculation pathway

A

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

preganglionic fibers from L1-L2 segments of sc

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25
Q

phases of ejaculation

A

seminal emission
expulsion

26
Q

process of seminal emission

A

(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

27
Q

process of expulsion

A

parasympathetic s2-s4 & sympathetic

propulsion of semen distally or out of the urethral meatus or the opening of the urethra

28
Q

—- levels rise during arousal & orgasm

A

oxytocin

29
Q

—– levels remain elevated even after orgasm

A

prolactin

30
Q

low — levels make orgasm more difficult in men and women

A

androgen

31
Q

disability can affect sexual function through 4 basic mechanisms

A

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

32
Q

excitatory medications

A

levodopa

33
Q

inhibitory medications

A

serotonin
antidepressants (serotonin reuptake inhibitors)
DA blockers
sympathomimetic drugs

34
Q

excitatory hormones

A

dopamine and noradrenaline

35
Q

inhibitory hormones

A

serotonin

36
Q

effect of aging on sexual function in females

A

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

37
Q

effect of aging on sexual function in men

A

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

38
Q

METS for sexual intercourse for couples with long standing relationships

A

6

39
Q

METS for sexual intercourse for extramarital

A

9 METs

40
Q

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

A

6 METS

41
Q

Sci in men reduces

A

sperm motility & semen count in men

42
Q

SCI in women causes

A

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

43
Q

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

A

(+) reflexogenic arousal
(-) psychogenic

44
Q

complete lesions interrupting sacral reflexogenic pathways

A

reliance on psychogenic arousal

45
Q

men with sacral sci reliant on

A

psychogenic arousal

unwanted seminal emission & penile detumescence are triggered

46
Q

SCI with preserved sensation in the T11-L2 level

A

capable of psychogenic arousal

47
Q

presence of (+) bulbocavernosus reflex

A

intact reflexogenic arousal capacity

48
Q

ejaculatory disorder in men with sci

A

premature ejaculation

49
Q

men c incomplete conus medullaris or cauda equina lesion

A

natural ejaculation most likely to occur

50
Q

men with complete supraconal lesions

A

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

51
Q

Diabetes mellitus effect on sexual function

A

ED is correlated with score glycemic control, onset of retrograde ejaculation, impaired genital sensation (reflexogenic)

Type 1 DM: sexual dysfunction correlated with depression

52
Q

CRF effect on sexual funciton

A

Comorbidities from CRF responsible for ED, menstrual
abnormalities in women, & ↓ libido & infertility in both
sexes

Hyperprolactinemia: ↓ libido, frequency of sexual
intercourse, orgasmic difficulties

53
Q

sexual rehabilitation framework: sexual interest

A

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

54
Q

sexual rehabilitation framework: sexual response

A

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

55
Q

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

A

loss of erotic zone sensitivity or hypersensitivity in specific areas

56
Q

sexual rehabilitation framework: changes to motor function

A

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

57
Q

sexual rehabilitation framework: bladder & bowel issues

A

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

58
Q

sexual rehabilitation framework: factors associated with the condition

A

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

59
Q

sexual rehabilitation framework

A

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

60
Q

kluver-bucy syndrome symptoms

A

amnesia
hypersexuality
docility

SpeCon (6 decks)

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