Human Sexuality Exam Flashcards
(125 cards)
1
Q
common diseases associated with sexual dysfunction
A
depression cardiovascular disease chronic respiratory disease musculoskeletal disorders cancer
2
Q
When should nitroglycerin not be taken for sexual dysfunction?
A
patients on sildenafil
3
Q
What antidepressant negatively affect all aspects of sexual function?
A
venlafaxine
mirtazapine
4
Q
What is required for an orgasm?
A
intact sympathetic NS
muscle tone
5
Q
What is Erotophilia and Erotophobia referring to?
A
Positive or negative emotional responses to sexuality
6
Q
Outercourse
A
Any form of sexual intimacy that does not involve intercourse
7
Q
FROTTEURISM
A
Touching or rubbing a non-consenting person in a sexual manner or the recurrent urge to do so (like bus sexual assult)
8
Q
VOYEURISM
A
peeping tom
9
Q
dyspareunia
A
painful intercourse
10
Q
sexual arousal disorder
A
Persistent or recurring absence of sexual fantasy
Lack of receptivity to sexual activity
11
Q
sexual aversion disorder
A
fear and disgust of sex
12
Q
categories of orgasmic disorders
A
primary: never had one
secondary
13
Q
What conducts orgasms?
A
CNS (Spinal cord)
ACCUMBENS NUCLEUS: reward center
14
Q
Vaginismus
A
Involuntary contraction of muscles around vaginal opening
15
Q
Exam procedure for dyspareunia
A
monomanual exam
then bimanual and speculum
16
Q
siladenafil
A
vasodilator for sexual dysfunction
17
Q
intersexuality
A
individuals who do not conform to traditional male or female classification
18
Q
pseudohermaphrodite
A
two testes or two ovaries but with ambiguous genital appearance
19
Q
Woffian
A
male
20
Q
Mullerian
A
female
21
Q
hypospadius
A
opening of penis on underside
22
Q
What is MIF and what is it produced by?
A
inhibits mullerian (female) development By Sertoli cells
23
Q
Tumescence
A
Parasympathetic NS
24
Q
path of male external genitalia differentiation
A
SRY –> TDF –> GONADS (Sertoli: MIH; Leydig: Testosterone) –> DHT (converted from testosterone) –> differentiation
25
What hormone are Sertoli cells affected by
FSH
26
What hormone affects Leydig cells?
LH
27
What cells influence Mullerian formation?
Sertoli
28
What does the genital tubercle develop into?
male or female glans
29
XX virilized
too much androgen; ovaries present
| internally female, externally ambiguous
30
What can XX virilized be caused by?
congenital adrenal hyperplasia
| from mom: adrenal tumor or excessive androgens
31
What is congenital adrenal hyperplasia caused by
```
male outside (phenotype), female inside
enzyme block --> deficient cortisol production--> pituitary secretes high levels of precursors (that also leads to other hormones like testosterone)
aka adrenal genital syndrome
```
32
What is the precursor of all steroid hormones?
cholesterol
| need it to produce androgens, cortisol, aldosterone
33
What are the two forms of congenital adrenal hyperplasia
21-hydroxylase deficiency: 90%; low mineralcorticoid; MASSIVE androgens
11-hydroxylase deficiency: high mineralcorticoid and androgens
34
What does 21-hydroxylase deficiency cause?
high androgens, low testosterone and aldosterone
35
XY undervirilized
defect in testicular differentiation
36
5-alpha-reductase deficiency
cant convert testosterone to DHT --> minimally virilized male --> massive virilization at puberty
(think end organ failure)
37
XY androgen insensitivity syndrome
```
female outside, male inside
testicular feminization syndrome
testosterone receptor defect
abdominal testes, no uterus, phenotypically female
(think end organ failure)
```
38
XO chromosome (most common chromosomal abnormality)
turner's syndrome
39
XXY
klinefelter's syndrome
40
XXX
Triple X syndrome
premature ovarian failure
poor pregnancy congenital malformation
41
XXY
tall
severe acne
hyperactive
"super psycho male"
42
XO/XY
Mixed gonadal dysgenesis
43
XX/XY
Hermaphrodite
44
Classic symptoms of turner's syndrome
short stature, abnormal facies, webbed neck
ovarian failure before birth, infertility
disruption of mitosis --> impaired growth
"knuckle, knuckle, dimple, knuckle"
45
Gender dysphoria
transexualism
cross gender identification
NO physical intersex
46
90% cause of Klinefelter's and symptoms
older pregnancies
externally male
hypogonadism (no secondary secual characteristics)
XXY
eventual infertility
small penis, diminished hair, enlarged breast tissue
undetected in a lot
47
juvenile gender dysphoria
four or more of the following:
desire to be other sex
preference for cross-sex roles in play/dress
persistent fantasies about being the other sex
intense desire to participate in stereotypic games of opposite sex
strong prefer. for playmates of opposite sex
48
what age is transexuality fixed by?
12-18 months
49
difference between CAH and F to M trans
CAH: internally female, excessive androgen, look male, raised as male, male puberty
Trans: trapped in wrong body, all else female
50
Site of sperm production
SEMINIFEROUS TUBULES (10% semen)
51
Function of Sertoli cells
protect and nourish sperm
| blood-testis barrier
52
What take places at the epididymis?
sperm maturation
| store sperm at epididymis tail
53
Where does testicular artery come from?
off aorta in abdomen by kidney (bc testis originate in abdomen)
54
risks of retained abdominal testes
high temp so impaired sperm production
| high risk of cancer
55
seminal vesicle
60% of semen
56
what is ejaculatory duct from?
vas deferens and seminal vesicle
57
What structures are combined in the prostate?
ejaculatory duct and urethra
58
what does prostate gland do?
30% volume of semen (fructose for sperm flagella ATP)
59
WHAT ARE THE THREE SECTIONS OF URETHRA
Prostatic, Membranous, & Penile (spongy)
60
BULBOURETHRAL GLAND (Cowper's gland)
at base of penis
| pre-ejaculate fluid: sterilized urethra before ejaculation
61
corpora cavernosa (two of them)
engorged with blood --> erection
62
corpus spongiosum
protect and guard urethra during engorgement
| wrap around urethra
63
What physiological change needs to occur to produce erection?
needs vascular and neural
1. increase arterial blood to corpora cavernosa
2. decrease venous outflow (close off)
blood in and not out
64
what is tumescence mediated by?
nitric oxide
65
how does nitric oxide
released by Parasympathetic postganglionic cell
| cause arterial inflow and block venous outflow
66
what is a common initial vascular disease presentation in males?
erectile dysfunction (if see this symptom, check other vascular dysfunction)
67
What does internal pudendal artery supply and where does it come from?
dorsal penile artery down to cavernous artery
| from internal iliac a.
68
venous sinusoid
cavities in cavernosa --> can expand with erection and collapse when flaccid
69
what does the tunica albuginea do?
stretch during tumescence and pinch of venous outflow
70
action of PNS v. SNS in tumescence
Parasympathetic: initiate tumescence, nitric oxide, muscle relaxation (arterial dilation)
Sympathetic: ejaculation and resolution, smooth muscle contraction (arterial constriction)
71
bulbocavernosus muscle
muscle surrounding urethra --> clears urethra
72
ischiocavernosus muscle
contract during sexual excitation and ejaculation to close off vein
73
Nerve route of Somatic Input of tumescence
dorsal nerve --> internal pudendal n. --> bulbocavernosus and ischiocavernosus muscles
74
afferent stimulation v psychogenic impulse during tumescence
afferent: from touch
psychogenic: no touch
75
what is involved in somatic input of tumescence
afferent stimulation
psychogenic impulse
motor input
76
How can pts with spinal cord injury have tumescence?
reflex arc from direct touch stimulation
77
what are the stages of tumescence and what nerve system involved?
excitement: efferent parasymp
orgasm - emission: efferent symp
organsm - expulsion: efferent symp/somatic
resolution: efferent symp
78
Masters and Johnson: 2 principle physio changed
1. vasocongestion
| 2. myotonia
79
4 phases of human sexual response cycle (M+J)
excitement
plateau
orgasm
resolution
80
what happens to testis during tumescence?
testis elevation and enlargement
81
What are the two stages of male orgasm?
stage 1: sense of ejaculatory inevitability bc fluid in urethra
2: ejaculation, muscle contraction
BP and pulse rises
82
Helen Singer-Kaplan's triphasic model
sexual desire: psych
excitement: vascular
orgasm: muscle
83
Difference between MJ and Singer-Kaplan's model***
HSK considered DESIRE***
84
causes of erectile disorders***
vascular: 40%
diabetes: 35%
medication: anti-HTN, anti-depressants
injury: eg prostate
85
most common sexual dysfunction in young men***
premature ejaculation***
86
priapism
failure of detumescence (>4hrs)
extremely painful erection
can lead to proprial fibrosis
87
What drug classes contribute to ED?***
```
Anti-HTN: beta blockers, diuretics
Anti-cholinergic
Anti-depressant
Anti-psychotics
Sedatives/drug abuse
```
88
Types of testosterone in blood
tightly bounded to SHBG
loosely bound to albumin (68%)
free
89
ED diagnostic test
measure free testosterone
90
What does viagra (Sildanefil) do?
prolong vasodilation (PDE5 inhibitor)
91
Paramesonephric duct v Mesonephric
```
Para = Mullerian, female
Mesonephric = Wolfian, male
```
92
Kallmann's Syndrome
```
hypogonadotropic hypogonadism
deficient hypothalamic GnRH
infertility
abnormal pubertal maturation
usually in males
```
93
adrenarche
increase in adrenal androgen; ~age 6
| secondary sex characteristics (hair, sebaceous glands)
94
Pubarche
appearance of pubic hair
95
Gonadarche
FSH and LH activation of gonads
male: testicular enlargement
female: ovulation from LH surge
96
Thelarche
breast development (breast buds)
97
Spermarche
first ejaculation
98
premature thelarche
<2 yo: self limiting
| >2 yo: can have uterine bleeding
99
precocious puberty
development of secondary sexual characteristics before 8yo --> reduce adult height
100
what does bone age tell you?
pubertal age
101
When is menarche?
one year after growth spurt
102
FIRST SIGN OF GROWTH SPURT IN GIRLS***
Breast buds! (sometimes pubic or axillary hair)
103
Female Tanner Stages (SMR)***
1: nipple elevation (preadolescence)
2: breast bud; elevation of breast and nipple as small mound
3: elevation of breast and areola (no separation of contour)
4: secondary mount from areola and nipple projection
5: mature stage; only nipple projection (areola recedes)
104
First sign of male puberty***
testicular enlargement
105
First ejaculation stage
SMR3
106
Male Tanner Stages***
1: no hair
2: testicular enlargement; some downy hair
3: pub hair coarse and curly at base
4: adult quality hair, NOT on thighs
5: adult quality and QUANT ON thighs
107
Gynecomastia
breast enlargement in boys (40-65%); resolves itself within 3yrs
108
Sexual orientation
ID of physical/emotional attraction to others
109
cisgender
someone not transgender
110
gender nonconforming
gender fluid (not quite at transgender level)
111
nonbinary
gender nonconforming individual identifies as neither male or female
112
transmasculine/transfeminine
directionality of gender identity of gender nonconforming individual
113
gender affirmation
recognizing, accepting and expressing one’s gender identity
114
Feminizing hormone therapy
estrogen (17-beta-estradiol)
+ androgen blocker (sprinolactone)
+/- progestagen ()
115
Biggest adverse effect of androgen blockers***
hyperkalemia
116
masculinizing hormone therapy
testosterone
| side effect: acne
117
5 P's of sexual history
```
Partners
Practices
Past History of STI’s
Protection from STI’s
Pregnancy Plans/Prevention
```
118
Screening for adolescent issues: HEEADSSS
```
H ome environment
E ducation, employment
E ating
A ctivities (peer-related), affect, ambitions, anger
D rugs
S exuality
S uicide/depression
S afety from injury and violence
```
119
celibacy
refraining from intercourse bc not married (doesnt have to be virgin)
120
chastity
refraining from intercourse and other activities (and thoughts) bc moral purity or virtuousness
121
paraphilia
OVERDEPENDENCE ON CULTURALLY UNACCEPTABLE/ UNUSUAL STIMULUS FOR SEXUAL AROUSAL/ SATISFACTION
122
transvestic fetish
arousal from dressing like opposite sex
123
treatment for variant sexual behavior
DECREASING VARIANT SEXUAL AROUSAL:
AVERSIVE CONDITIONING
COVERT SENSITIZATION
INCREASE NONVARIANT SEXUAL AROUSAL:
MASTURBATORY CONDITIONING
EXPOSURE
SYSTEMATIC DESENSITIZATION
124
Raptophilia***
Sexual gratification from rape
125
Coprophilia***
Sexual gratification from defecation
