Men's Health

Question 1

what is sexuality

Answer 1

how you demo attraction, intimacy and commitment

Question 2

relate sexuality to SCI patients

Answer 2

major priority sha vs other problems

Question 3

what is sexual rehab

Answer 3

salvaging and restoring and remaking and readjusting of sexual function

Question 4

what is the 4 phase model

Answer 4

excitement

plateau

orgasm

resolution

Question 5

discuss excitement phase

Answer 5

men: erection/tumescence

women: vaginal lub and accommodation; lengthening and uterine lifting

CV and respi inc
(+) sweating

Question 6

discuss plateau phase

Answer 6

males: max erection and rigidity; approaching ejaculatory inevitability
- point of return

females: outer third of vagina thickens
- orgasmic platform for recieving semen

no inc physio - maintains only

Question 7

discuss orgasmic phase

Answer 7

max HR, BP and RR

(+) ejacualtion

Question 8

discuss resolution phase

Answer 8

gradual reversal of tumenscence, pelvic vasocngestion, neuromuscular tension and CV parameters

men have additional physiologic refractory period - time before aroused again

women have no refractory - extended and repeated orgasms

Question 9

what is sexual dysfunction

Answer 9

involves physiological, psychological, social and emotional componets

Question 10

discuss sexual desire or libido

Answer 10

motivation to initiate or respond to sexual stim

hypo - not or not easily aroused

hyper - cannot control desire

Question 11

hypoactive sexual disorder

Answer 11

reduction or change in sexual drive

common in PWD

can be from meds: PD meds

Question 12

kluver-bucy syndrome

Answer 12

hyper active

affects amygdala

Question 13

discuss arousal disorders

Answer 13

ED

doesnt peak to excitement - emotional or psych effect

if physio prob treat physio
if psycho treat psycho

Question 14

discuss ejaculatory disorders

Answer 14

retrograde ejaculation

hindi maayos yung coordiantion or contraction of muscles for ejaculation

Question 15

discuss orgasmic disorders

Answer 15

inability to reach disorders

can have arousal and ejac but no orgasm

affects desire to participate

Question 16

probelms present in all 3 (arousal, ejac and orgasm)

Answer 16

fertility issues

dyspareunia: painfull sex d/t dryness of vagina

Question 17

discuss sexual nuerophysiology

Answer 17

axis of arousal

pelvic nerves innervate PFM - PSY

women: lubrication depends on normal estrogen

men: semen production and erection depent on enough testosterone
- affected by age, diet, lifestyle and stress

2 way pathway - arousal can start in brain or tocuh

Question 18

reflexogenic

Answer 18

reflex arousal from tactile

Question 19

psychogenic

Answer 19

supraspinal origin - audiotry, imaginative and visual

(+) REM reection = psychogenic prob bcs physio there is erection in morning

Question 20

discuss arousal pathways

Answer 20

PSY - sacral are

Question 21

discuss ejaculation pathways

Answer 21

SY and PSY

seminal emission: T10-L2 SY

expulsion: S2-S4 PSY and SY

SY - thoracolumbar
PSY - sacral

Question 22

discuss process of orgasm

Answer 22

can have s genital stim - psychogenic
- common in SCI

oxytocin rises in arousal and orgasm - for people to enjoy

prolactin elevated p - to reverse arousal; satisfaction

low androgen = diff orgasm

Question 23

discuss disability related sexual dysfunction

Answer 23

direct effects on vascular, neurologic, hormonal, anatomical or are connected to sex response

indirect effect of medical and physio condition

iatrogenic effects of tx

contextual factors - biopsychosocial and situatutional components

Question 24

vascular system function in sex

Answer 24

endothelial lining releases nitric oxide to vasodilate for erection

Question 25

discuss how meds affect sexual function

Answer 25

drugs that dec noradreanaline - inc SY NT = dec arousal dop blockers - dec libido dop agonist - inc libido or reward SRI - dec libido, orgasm and ejactulatory delay sympathomimetic drugs - inhib geniat arousal bcs inc SY pt taking steroids - too much testosterone also inhibs normal hormoen shit = bad

Question 26

effect of aging

Answer 26

dec elasticity of tissues more effect in male male: delayed erection, not rigid, dec ejac volume, detumenscense rapid, longer refractory (days) women: less lubrication, dec spasm during orgasm, dyspareunia

Question 27

effect of impending mortality

Answer 27

lost interest and focus more on survival fatigue, meds, body image, hormones, cattheters and secondary paralysis

Question 28

effect of neurologic changes

Answer 28

injury to PNS and CNS 2-4 yrs recovery bago malaman if may secual function pa matagal din i rehab

Question 29

effect of psychological factors

Answer 29

depression low self esteem performance anxiety esp for men

Question 30

CV factors and risk

Answer 30

HR: 110-130 peak SBP: 150-170 6 METS for long standing rela 9 METS for illegal sex SCI pt have high HR - risk for autonomic dysrelfexia

Question 31

effect of bladder and bowel control

Answer 31

odor or visible urine and stool dec sexual interest and self-esteem mapanghi - reduced sexual activity

Question 32

effect of pain issues

Answer 32

chronic pain diminish excitement and desire esp pain in genitals

Question 33

effect of fertility issues

Answer 33

quantitiy and quality of semen - SCI reduces motility and count sjogrens in women - dry = painful sex SCI in women in risk for preg, UTI and many more - CS and low birthweight - strains rela