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SPECON LEC > SEXUALITY AND MEN'S HEALTH > Flashcards

SEXUALITY AND MEN'S HEALTH Flashcards

1
Q

Vehicle to demonstrate attraction, intimacy and
commitment

A

Sexuality

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2
Q

Sexuality is a major priority to ____ patients

A

SCI, (vs. return of
sensation, ability to walk, N bowel and bladder
function)

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3
Q

salvaging and restoring
remaining function AND remaking and readjusting

A

Sexual rehabilitation

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4
Q

Who invented the 4-phase model of sexual function

A

Masters and Johnsons’ (1996)

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5
Q

What is the four-phase model

A

Excitement
Plateau (high arousal before orgasm)
Orgasm
Resolution (reversal/ dissipation of
phase 1)

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6
Q

EXCITEMENT:

A

-Tumescence/Erection of erectile tissues
-vaginal lubrication & accommodation
(lengthening & uterine lifting)
-⬆️CV and respiration parameters
-(+)sweating

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7
Q

PLATAEU:

A

M: Maximal erection & rigidity,
approaches ejaculatory inevitability
F: outer third of vagina forms a
thickening (orgasmic platform)

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8
Q

ORGASMIC PHASE:

A

-Maximal HR, BP, and RR (in healthy
individuals)
- (+) ejaculation

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9
Q

RESOLUTION

A

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

M:
-additional physiologic refractory period

F:
-extended, repeated, multiple orgasms

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10
Q

are multifactorial involving physiological,
psychological, social, and emotional
components

A

Sexual Dysfunction

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11
Q

Experience of specific sensations
that motivate the individual to
initiate or become responsive to
sexual stimulation

A

Sexual desire/Libido

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12
Q

Reduction or change in
sexual drive common
among persons with
disabilities

A

Hypoactive Sexual Desire disorder

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13
Q

What is an example of a hypoactive sexual desire disorder?

A

E.g.
(1) Kluver-Bucy
syndrome;
(2) effect of
medications
(replacement of
Dopamine in PD

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14
Q

Other sexual disorders (M&J model)

A

-Arousal disorders
-Ejaculatory dysfunction
-Orgasmic disorders

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15
Q

Disorders of
male penile
erection

A

Arousal disorders (AKA erectile dysfunction)

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16
Q

Problems with
the antegrade
seminal fluid
expulsion

A

Ejaculatory dysfunction

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17
Q

Inability to
reach orgasm

A

Orgasmic disorder

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18
Q

Problems within these three phases include _______ and
______

A

fertility issues
dyspareunia

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19
Q

STUDY PAGE 12

A

-

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20
Q

In women, lubrication
depends on:

A

-intact innervation
-(N) estrogen levels

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21
Q

In men, internal accessory
organ functioning
(including semen
production) and erection
are dependent on:

A

Adequate testosterone level

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22
Q

2 neurological pathways for genital arousal

A

Reflexogenic
Psychogenic

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23
Q

REFLEXOGENIC

A

Triggered by
direct
stimulation
of genitals

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24
Q

PSYCHOGENIC

A

Supraspinal
origin
(auditory,
imaginative,
visual, etc)

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25
Q

Presence of morning
(REM) erections is a sign
that daytime erection
problems are psychogenic
in nature

A

-

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26
Q

A. Arousal
B. Ejaculation

1.Parasympahetic
2.Sympathetic

A

A
B

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27
Q

Two phases of ejaculation

A
  • seminal emission (symph. T10-L2)
  • expulsion (parasymph. S2-S4; symph.)
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28
Q

T/F May include orgasmic attainment
without genital stimulation

A

T

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29
Q

T/F Half of men and women with complete
SCI cannot experience orgasm

A

F, CAN STILL

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30
Q

T/F High androgen levels make orgasm
more difficult in men and women

A

F, Low

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31
Q

T/FDopamine levels rise during arousal
and orgasm

A

F, Oxytocin

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32
Q

T/F Prolactin remain elevated even after orgasm

A

T

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33
Q

Disability-related sexual dysfunctions (DRSD)

A

Direct effects of vascular, neurologic (including
pain), hormonal, anatomical, damage to any area
functionally connected to sex response

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34
Q

Disability-related sexual dysfunctions

A

Indirect effect of medical/ psychological condition

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35
Q

Disability-related sexual dysfunctions

A

Iatrogenic effects of treatment (radiation, surgery,
meds, chemo

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36
Q

Disability-related sexual dysfunctions

A

Contextual factors such as biopsychosocial and
situational components

37
Q

Disability-related sexual dysfunctions

A

Medications (DA, NA, serotonin)

38
Q

Drugs that______ affect sexual function

A

↓ NA

39
Q

DA blockers _____

A

↓ libido

40
Q

DA agonists ________

A

↑ libido

41
Q

Effect of serotonin reuptake inhibitors:

A

↓ libido,
orgasmic and ejaculatory delay

42
Q

Sympathomimetic drugs ______

A

inhibit genital arousal

43
Q

T/F Aging = (↓ elasticity of tissues)

A

T

44
Q

T/F More sexual dysfunctions in F vs M

A

F, more in M

45
Q

Aging in F

A

Less vaginal lubrications,
↓ muscle spasm during orgasm,
dyspareunia ↓,

46
Q

AGING IN M

A

2-3x as long as to achieve erection,
erection not as rigid,
orgasm delayed,
↓ ejaculatory fluid volume,
penile detumescence occur rapidly,
refractory period longer (days)

47
Q

Lost interest and people tend to focus more on survival

A

Impending mortality
(Fatigue,
medications,
change of body image,
altered hormonal status,
catheters,
secondary paralysis, etc)

48
Q

Neurological changes

A

Injuries to the central and peripheral nervous
structures

49
Q

How many years of recovery before remaining neurological sexual function is known

A

Most acquired neurological damage (2-4 yrs)

50
Q

Psychological factors

A

-Depression
-Loss of self-esteem
-Anxiety (premature ejac./dec orgasmic attainment)

51
Q

Those with cardiovascular problems:
HR: ________bpm
peak SBP: ______ mmHg
METs do not exceed: ______

A

110-130
150-170
4-5

52
Q

METs during sex

A

-Walking @ treadmill c 3mph @ 5% grade
-Climbing 2 flights of stairs (6METs, 20 steps in 10 seconds) -long standing rel.

53
Q

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

A

6 METs

54
Q

Bladder & Bowel control

A

-Odor from leakage
-Visibility of urine or stool collection devices
=
↓ sexual interest and self esteem

55
Q

Two types of pain issues

A
  1. Pain in genitalia
  2. Chronic pain
56
Q

Patients with chronic pain report sexual difficulties to be ________ that of the general population

A

2x

57
Q

Fertility issues

A
58
Q

Quantity & Quality of semen

A

-intravaginal and intrauterine insemination,
-in vitro fertilization

59
Q

Causes why women are unable to participate in sex d/t/ sexual pain disorders:

A

-Sjogren’s syndrome
-Severed adductor spasm/spasticity

60
Q

T/F TBI reduces sperm motility and semen count in men

A

F, SCI

61
Q

SCI in W:

A
  • changes in bladder mx
  • delayed bowel emptying
  • difficulty in transfers
  • fatigue
  • inc risk for DVT
  • inc risk of UTI d/t pregnancy
  • pedal edema
  • skin breakdown
  • thrombophlebitis
  • vaginal spotting
62
Q

Delivery type which are common:

A

CS sections
Vacuum & forceps extractions

63
Q

T/F Low birthweight infants are also common in pregnant women with SCI

A

T

64
Q

Complete SCI above the LS spinal cord center (above ______):

A

T10
(+) reflexogenic arousal,
(-) psychogenic arousal

65
Q

Complete lesions interrupting reflexogenic pathways:

A

reliance on psychogenic arousal

66
Q

Men with sacral SCI reliant on psychogenic arousal triggers:

A

-unwanted seminal emission
-penile detumescence

67
Q

This are capable of psychogenic arousal:

A

SCI with preserved sensation in the T11-L2 level

68
Q

This indicates intact reflexogenic arousal capacity

A

Presence of (+) bulbocavernosus reflex

69
Q

Men with SCI:

A

90% have ejaculatory disorders

70
Q

Natural ejaculation most likely to occur to men with:

A

incomplete conus medullaris or cauda equina lesion

71
Q

natural ejaculation least likely to occur to men with

A

complete supraconal lesion

72
Q

FOR SCI: Orgasm is attainable in _____% of men (with ejaculation & ____% in women

A

40-45
50

73
Q

In MS, _____% of M&W experience sexual dysfunction

A

70

74
Q

Multiple Sclerosis cause decreased libio, inability to attain orgasm

A

-

75
Q
  • In ambulatory male patients with MS
A

60% = ED
50% = ejaculatory/orgasmic dysfunction
40% = reduced desire

76
Q

Women with MS

A
  • 68% unsatisfactory sexual lives d/t fatigue
  • 48% dec genital sensation
  • 35% reduced vaginal lubrication
  • 35% difficulty c arousal
  • 72% difficulty reaching orgasm,
  • sexual pain disorders
77
Q

Limb amputation

A

-Positioning with pillows or wedges,
-side-by-side intercourse
are necessary for upper limb or transfemoral
amputations

78
Q

Parkinson’s disease

A

W:
- 75% diff with arousal & orgasm
- 50% low sexual desire

M:
- 70% ED,
- 40% premature ejaculation,
- 40% delayed orgasm

79
Q

For PD, _____ drugs: increase sexual drive

A

Dopaminergic

80
Q

TBI

A
  • Decreased desire and arousal disorders are common
  • Low energy and interest in initiating sex
  • Difficulties with erection, vaginal dryness
81
Q

Stroke

A

Decrease in :
libido,
lubrication,
erectile capability,
frequency of sexual activity

82
Q

Coronary Artery Disease

A

75% of middle-aged male patients reported decreased sexual activity

80% with CHF reported inability to engage
in sexual activities

83
Q

Pulmonary disease

A

Decreased endurance

84
Q

Type of DM where sexual dysfunction is correlated with depression

A

Type 1

85
Q

In DM, ED correlates c

A

poor glycemic control,
onset of retrograde ejaculation,
impaired genital sensation

86
Q

Comorbidities from Chronic Renal Failure (CRF) responsible for ED:

A
  • W: menstrual abnormalities
  • Both sexes: dec libido and fertility
87
Q

Hyperprolactinemia

A

decreased:
libido,
frequency of sexual intercourse,
orgasmic difficulties

88
Q

STUDY REHABILITATION FRAMEWORK

A

SPECON LEC (6 decks)

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