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Stack #215704

Neuro Unit II Lecture 9

QuestionAnswer
Give two examples of a genital reflex: orgasm and erection
What types of EFFERENT fibers are involved? EFFERENTS!! PNS, SNS and Somatic
What types of AFFERENT fibers are involved? Visceral and somatic
What CNS elements are also involved? supraspinal centers and spinal cord
What other things are involved in the genital reflexes? Multiple organ systems: heart, bvs, respiratory sys, skeletal sys
What are the two types of sexual fx? Reflexogenic, psychogenic
Who has reflexogenic sexual function? Where is it primarily modulated? seen in quadriplegic patients, modulated in sc. Reflexive portion of the genital reflex
Who has psychogenic sexual function? Where is it primarily modulated? What does psychogenic fx require to be intact? How does it relate to the reflexogenic fx? Seen ONLY in healthy normal individuals. requires communication b/w sacral cord and brain. get psychogenic activation of the relfexogenic pathways
What is the sexual response cycle (SRC)? p.178 in cp study of human sexual fx from the 1960s
What is important to remember about the SRC? It is a spinal cord reflex mediated by supraspinal centers!!! (sim to the micturation reflex!!)
Men's SRC vs. Womens SRC Men more typical, women vary
What are the four phases of the SRC? Excitement, Plateau, Orgasm, Resolution
What two things are a part of excitement that are specific to either fem. or male? What are the hot spots? What causes excitement? Erection (male) hotspot glans penis, Engorrement (female) hotspot clitoris; cause: rhythmic stimulation of external genitalia & surrounding tissues
How does erection occur? What fibers are EFFERENT & what fibers are AFFERENT? fill of corp caver w/blood. Sim of somatic AFFERENTs stim sacral spinal reflex. PNS EFFERENTS cause vasodila of corp cavern. & helicine aas. filling corpus cavern
How does engorgement work? What fibers are EFFERENT & what fibers are AFFERENT? vasodialation of clitoris and labia, fill w/ blood. Somatic AFFERENTS (pudendal n) stim sacral spinal reflex circuit. PNS EFFERENTS dialate clitoris & labia.
What else can occur in females during the excitement phase that is related to engorgement? breasts may engorge & become sensitive to stimuli. Vagina elongates and produces mucoid fluid
SIMPLIFIED GENERAL STEPS OCCURING DURING EXCITEMENT: 1. Som AFFERENTS activated (pudendal n.) 2. PSNS pregangs that eventually enter the inf hypg plexus are activated 3. Postgangs that started in inf hypog plex are activated 4. These cause vasodialation of clitoris/penis
Where does the Plateau phase occur? between excitement and orgasm
What is often the longest phase of the SRC? Plateau
How do males/females appear during plateau? face, arms, and/or chest flushed
In males: What two things occur? emission and ejaculation
How does emission occur in male orgasm? SNS EFFERENTS activated in lower thoracic/upper lumbar cord -> cause contraction of sm. muscl. in epididymus, vas def., sem. vesic., & prostate. Semen into posterior urethra
What triggers ejaculation? AFFERENT signals from prostate & posterior urethra
What mediates ejaculation? It is a spinal cord mediated reflex!!
What kinds of contractions occur and in what muscles during ejaculation? Tonic/clonic contraction of ischiocavernosus & bulbocavernosus MM & pelvic floor mms.
What do the tonic/clonic contractions in male during ejaculation cause to happen? expel secretions from posterior urethra into anterior urethra and out
What part of the bladder contracts with SNS and is important to males during ejaculation? Trigone muscl. contracts w/ SNS stim., prevents retrograde ejaculation (sperm entering bladder)
What activates female rhythmic contractions of the vagina/uterus during orgasm? What does this cause to happen? SNS EFFERENT fibers from lower thoracic/upper lumbar cause the womb to rise up in the pelvic girdle. Propels sperm into vagina/uterus
What is the last phase of the SRC? Resolution
What happens during resolution? What one of the two things only happens to males? Refractory period (males only) - time after when orgasm can't occur AND Detumescence - erection/engorgement go away
What other factors, besides reflexogenic ones, have an effect on sexual response? psychogenic.
What can psychogenic factors cause to happen? Where are the signals derived? Can escalate/decline progression through SRC. Signals from cortical regions of the brain
What is potency? the ability to have sex.
What is impotence, both popular and actual meanings? popular: lack of erection, actual: inability to have sex
What are the actual steps (involving NO) that cause an erection? NO release from cavernosus nns w/ PSNS efferent stim -> NO into sm muscl and activ. cGMP -> cGMP starts vasodial & engorg. of corpus cavernos.
Why doesn't sildenafil (viagra) work for everyone? Because viagra stops the breakdown of cGMP, engorgement lasts longer. If the nerves are damaged and not secreting NO, viagra will not work
What is autonomic dysreflexia? acute syndro. of excessive, uncontrolled SNS output.
To what patients does auton. dysreflexia typically occur? pts with sc injury @ or above T6
What causes autonomic dysreflexia? decending signals, usually in the intermedlat. regions are usually inhibitory. These signals do not get through. Autonomic reflexes occur uninhibited (ie visceral spasticity)
What are the main findings with autonomic dysreflexia? bradycardia, sweating above sc injury, hypertension, headache, nasal congest., malaise, nausea
What stimulus is a common cause of autonomic dysreflexia? full bladder/colon
Full bladder/colon stim. what kind of response? SNS. No inhib from desending paths. NE acts on all alpha adrenergic paths, so get vasoconstr. -> incr. bp -> body trys to fight high bp w/ vasodial above sc injury, bradycardia
What do you treat autonomic dysreflexia with? alpha adrenergic antagonistd
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