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88 Cards in this Set
- Front
- Back
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what is the primary sexual organ of the female?
-clitoris -vagina -brain -cervix |
brain
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what percentage of women c/o some type of sexual dysfunction?
10-15% 25-35% 35-45% 45-55% |
35-45%
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what is the most common c/o of women?
-low sexual desire -low sexual arousal -orgasmic dysfunction -low excitement |
low sexual desire
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which of the following intrapersonal factors are determinants of healthy sexuality?
-sense of one's self as a sexual being -one's overall health status -a general perception of well-being -quality of an individual's previous sexual experiences -all of the above -a, b, and d only |
all of them-love these damn questions eh?
xoxo-sg |
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what are the 4 phases of the female sexual response?
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1) desire (excitement)
2) arousal (plateau) 3) orgasm 4) resolution |
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if a woman has a "decreased libido" what phase of sexual dysfunction is this?
-desire (excitement) -arousal (plateau) -orgasm -resolution |
desire (excitement)
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examples of generally "positive" life events, which can contribute to sexual dysfunction are???
-birth of a child -moving -retirement -a & c -all of the above |
A & C- fucking hate A & C questions
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For partnered individuals, which of the following is pertinent in the sexual function (dysfunction) of the woman? All but what?
-duration & quality of the relationship -communication styles -number and type of ongoing life events -stressors -foreplay |
forelplay has to do with sexual satisfaction not function
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"increases interest in and responsiveness to sexual activity. Associated with faster heart rate, quicker breathing, flushed skin" What stage of the sexual response is this?
-desire (excitement) -arousal (plateau) -orgasm -resolution |
desire (excitement)
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"peak of arousal, muscles surrounding vagina contract rhythmically" What stage is this?
-desire (excitement) -arousal (plateau) -orgasm -resolution |
orgasm
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"vagina, clitoris, surrounding areas return to original state" what stage is this?
-desire (excitement) -arousal (plateau) -orgasm -resolution |
resolution
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"stimulation of all 5 senses bring about physical changes. Vaginal/vulvar lubrication, engorgement of vulva and clitoris, erection of nipples" (and nasal labrum engorgement) What is this?
-desire (excitement) -arousal (plateau) -orgasm -resolution |
arousal (plateau)
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At the most basic level, the experience of sexuality begins with?
-an individual's genotype and phenotype -birth -puberty -masturbation |
genotype and phenotype
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when do children develop a gender identity?
-infancy -toddler -early childhood -late childhood |
early childhood
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All of the following except what have a positive sexual effect on the woman?
-oxytocin -norepinepherine -prolactin -dopamine |
prolactin affect the cycle negatively along with gamma-amino butyric acid
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t/f
serotonin has mixed positive and negative affects on the sexual response cycle depending on which serotonin receptor is being activated. |
oh sooo true
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According to Dr. Trankle, what percentage of women have a form of sexual dysfunction?
5-30% 12-31% 19-50% 22-61% |
19-50%, book says 35-45%
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what is dyspareunia?
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sexual pain
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According to Dr. Trankle what are the 4 types of sexual dysfunction?
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desire
arousal orgasmic dyspareunia |
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According to Dr. Trankle, what percentage of women have problems with sexual dissatisfaction (when nondysfunctional natures) are included?
-45-55% -51-59% -61-65% -68-75% |
68-75%, sorry that question was not worded well.
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upon chart review, what percentage of charts note that women complain of sexual problems?
2% 12% 15% 18% |
2%-hence it is very under-reported.
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a general body response to sexual excitement include what?
-nipple erection -sex-tension flush -vaginal lubrication -a & b -all of the above |
a & b
vaginal lubrication is a sex organ response |
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which of the following are sex organ responses to the excitement phase?
-vaginal lubrication -thickening of vaginal walls and labia -expansion of inner vagina -elevation of cervix and corpus -tumescence of clitoris -a, b, c -all of the above |
all of the above
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all of the following are general body response to plateau?
-sex-tension flush -secretion of mucus -carpopedal spasm -generalized skeletal contractions -hyperventilation -tachycardia |
not secretion of mucus, this is a sex organ response to plateau
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which of the following are the sex organ response to plateau?
-orgasmic platform in outer vagina -full expansion of inner vagina -secretion of mucus -bartholin's gland -withdrawal of clitoris -rectal sphincter contraction |
not, rectal sphincter contraction, this is sex organ response to orgasm
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which of the following are general body response to orgasm? one is NOT!
-special skeletal muscle contractions -hyperventilation -loss of pelvic congestion -tachycardia |
not pelvic congestion-this is sex organ response to resolution
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which of the following are sex organ response to orgasm?
-contractions of orgasmic platform 0.8 sec. intervals -external rectal sphincter contractions at 0.8 sec. intervals -external urethral sphincter contractions at irregular intervals -all of the above |
all of the above
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which of the following is a general body response to resolution?
-sweating reaction -hyperventilation -tachycardia -time to take a nap -a, b, and d -all of the above |
it is actually a, b, and c. I included nap time!
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which of the following is sex organ response to resolution?
(last one of these damn things) -ready return to orgasm w/ retarded loss of pelvic vasocongestion -return of normal color and orgasmic platform in primary (rapid) stage -loss of clitoral tumescence and return to position -a only -all of them |
all of them
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which of the following decrease sexual response?
-smoking -etoh -drugs |
all of em
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when taking a patient history in regards to sexual dysfunction what must you keep in mind and ask about?
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meds
sexual orientation identify gender id. issues social habits (etoh, drugs,etc) previous surgeries (any pain?) menopause cultural background/social mores/religious values (big one) |
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what medical conditions can negatively affect a woman's sexual function?
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DM (vascular disease) affects arousal
CV dx-may cause SOB arthritis urinary incontinence-embarrassment or discomfort depression |
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What meds can cause sexual dysfunction?
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illicit drug use
alcohol abuse med changes or discontinuation cigarettes (causes erectile dysfunction in men) |
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what type of meds (classes) affect a woman's sexual desire?
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psychoactive meds
CV and HTN meds hormonal prep's ?others? this is from Dr. Trankle |
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what type of psychoactive meds cause sexual dysfunction in women?
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barbituates
antipsychotics benzo's SSRI's lithium TCA's |
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what type's of CV and HTN meds cause sexual desire problems in women?
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antilipid meds,
bblockers clonidine digoxin spironlactone |
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what type of hormonal meds cause desire problems in women?
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danazol
GnRh agonists OCP's |
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what "other" meds cause dysfunction of a woman's desire?
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dilantin
indocin ketoconazole H2 receptor blockers promotility agents |
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what does testosterone do to desire during ovulation?
-increase it -decrease it -doesn't affect it |
increased desire with inc. testosterone during desire
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what type of meds cause disorders of arousal?
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anticholinergics
antihistamines antihypertensives psychoactive meds |
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what meds cause orgasmic dysfunction?
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methydopa
amphetamines and related anorexic drugs antipsychotics benzo's ssri's narcotics trazadone TCA's (also cause painful orgasm) |
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really any variety of gyn problems cause mainly ??
-anorgasmia -painful intercourse -abnormal bleeding |
painful intercourse
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what type of gyn problems mess up the female sexual function?
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mastectomy
hysterectomy gyn malignancy present medical and mortality concerns and alter or remove physical and psychological symbols of femininity |
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what is vaginismus?
-painful contraction of the musculature of the lower 1/3 of the vagina in response to vaginal penetration -upper 1/3 -uterine contractions |
painful contraction of the musculature of the lower third of the vagina in response to vaginal penetration
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t/f
when evaluating a female for sexual dysfunction, more than one dysfunction is present and usually the male partner is also having problems such as premature ejaculation or ED |
true; true; true
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when inspecting the female external genitalia, what are the 300 things you must be looking for?
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skin color/texture for vulvar dystrophy, dermatitis
skin turgor/thickness-atrophy pubic hair amt and distribution-atrophy expose clitoris-adhesions/labial fusion assess for ulcers/lesions-hsv/CA cotton swab test of vestibule-vulvar vestibulitis/vaulvadynia (mad pain) palpate bartholin glands-cyst posterior forchette/hymenal ring for episiotomy scars and strictures |
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what is chandelier's sign?
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a woman "hits the ceiling" with cervical motion
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when performing the monomanueal exam, what are you palpating the rectovaginal surface for?
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rectal disease
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when performing the monomanueal exam, what are palpating the levator ani for?
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myalgia or vaginismus
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when performing the monomanueal exam, what are palpating the bladder/urethra for?
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urethritis, interstitial cystitis, UTI
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when performing the monomanueal exam, what are palpating the cervix for?
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cmt-infection, peritonitis
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when performing the monomanueal exam, what are assessing vaginal depth for?
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post op changes, post radiation changes, stricture
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what should you check on everyone with pelvic pain?
-hiv -gc/chlmydia -trichomonas |
gc/chlmydia
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during the bimanuel exam what are you palpating the uterus for?
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position, fibroids, endometritis, mobility
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during the bimanuel exam what are you palpating the adnexa for?
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masses, cysts, tenderness
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are we having fun yet?
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you are supposed to answer yes here!
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during the bimanuel exam what are you palpating the rectovaginal area for?
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nodules in cul de sac can be indictive of endometriosis
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why do you perform a guiac stool for?
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detection of bowel disease
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pain with bimanual exam and the pt c/o pain with uterine palpation, is indicative of what condition?
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sub acute endometritis
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when performing speculum exam what 4 general things are you evaluating?
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pH-vaginitis, atrophy
vaginal mucosa-atrophy pap smear-hpv, CA prolapse-cystocele, rectocele, uterine prolapse |
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what changes related to a woman's reproductive life can affect sexuality? (4 of these bastards)
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puberty
pregnancy postpartum menopause |
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is anyone else here sick of discussing pussy patrol?
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i know i am
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of the 4 areas that are r/t changes in reproductive life...which one is r/t sexual identity.
-puberty -pregnancy -postpartum -menopause |
puberty
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of the 4 areas that are r/t changes in reproductive life...which one is r/t discomfort, body image, fear, incontinence?
-puberty -pregnancy -post partum -menopause |
pregnancy
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of the 4 areas that are r/t changes in reproductive life...which one is r/t hypoestrogenic state can cause mood alteration, diminished sense of well being, atrophy of vagina and trigone of bladder?
-puberty -pregnancy -post partum -menopause |
menopause
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of the 4 areas that are r/t changes in reproductive life...which one is r/t discomfor, body image, fear, incontinence, fatigue, depression, can be prolonged with breast feeding?
-puberty -pregnancy -post partum -menopause |
post partum
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what are the 4 psychosocial factors of female sexual dysfunction?
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intrapersonal conflicts
historical factors interpersonal conflicts life stressors |
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of the 4 factors listed in the previous question, which is r/t religious taboos, social restrictions, sexual identity, conflicts and guilt?
-intrapersonal conflicts -historical factors -interpersonal conflicts -life stressors |
intrapersonal conflicts
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of the 4 factors listed in the previous question, which is r/t financial, family or job problems, family illness or death, depression.
-intrapersonal conflicts -historical factors -interpersonal conflicts -life stressors |
life stressors
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of the 4 factors listed in the previous question, which is r/t past or current abuse (sexual, verbal, physical) rape, sexual inexperience.
-intrapersonal conflict -historical factors -interpersonal conflict -life stressors |
historical factors
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of the 4 factors listed in the previous question, which is r/t relationship conflicts, extramarital affairs current abuse, sexual libido, sesire or practices different from partner, poor sexual communication.
-intrapersonal conflict -historical factors -interpersonal conflict -life stressors |
interpersonal conflicts
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what are the GENERAL treatments to sexual dysfunction problems (long ass list)
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address physical barriers to sexual satisfaction
education on anatomy, normal aging changes, pregnancy, menopause, encourage reading, communication HRT in menopause can decrease dyspareunia, may increase desire ? testosterone enhance stimulation routine communicate during sex kegel exercises, massage |
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what can you help your pt with who has c/o superficial dysparenunia?
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control penetration
topical lidocaine, warm baths, biofeedback |
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which sexual dysfunction is the most difficult to treat?
-desire -arousal -orgasmic -pain disorders |
desire
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what are the possible treatments for disorders of desire?
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-may be due to boredom of routine so change the routine
-premenopausal-lifestyle factors, meds, individual or couple counseling -usually no medical treatment available -peri or postmenopausal-ERT may correleate positively with sexual activity by improving physical changes of menopause testosterone may have direct role in desire |
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what are s/e of testosterone therapy for problems with desire?
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decreased HDL
voice changes acne hirstuism (kelli) clitoromegaly hepatic s/e possible possible link to breast CA |
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why should you discourage your patients from using vaseline as a lubricant?
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breaks down condoms
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what are potential treatments for arousal disorders?
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commercial lubricants, vegetable oil (dr. T's fav) mineral oil, vit. E oil.
increase foreplay distraction techniques for anxiety HRT in postmenopause viagra (not proven) pysica devices to improve engorgement |
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what are potential treatments for orgasmic disorders?
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could be caused by sexual inexperience or lack of sufficient stimulation, common in women who have never had an orgasm
treatment relies on maximizing stimulation and mainimizing inhibition kegel exercises therapy |
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what are potential treatments for pain disorders?
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tx underlying etiology
may involve laparoscopy (deep dyspareunia) 3 types of pain superficial, vaginal and deep vaginismus-treat underlying disorder, progressive muscle relaxation and vaginal dilatation |
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what is the most common cause of vaginismus?
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past sexual phobias or past abuse or trauma
therapy/counseling |
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when is it appropriate to refer to counseling?
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longstanding dysfunction
multiple dysfunctions current or past abuse psychologic dos or acut psychologic event unknown etiology no response to therapy |
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according to the AFUD (american foundation of urologic disease) what are the 4 female dysfunction disorders?
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-hypoactive sexual desire disorder
-female sexual arousal disorder -female orgasmic disorder -pain disorders |
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of the 4 AFUD female sexual disorders, which is the most common?
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hypoactive sexual desire disorder
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according to AFUD, "the persistent or recurrent inability to attain or maintain sufficient sexual excitement, causing personal distress"....is this?
-hypoactive sexual desire disorder -female sexual arousal disorder -female orgasmic disorder -pain disorder |
femal sexual arousal disorder
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for patient's c/o dryness, the overall health of __ should be noted?
-vaginal integrity -vulvar tissues -clitoral integrity - A & B only |
A & B only
vaginal and vulvar tissues should be noted--per book, pg 486 |
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approximately __ of pt's presenting with sexual dysfunction are clinically depressed.
-1/5 -1/3 -1/4 -1/2 |
1/3
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if a pt. has concurrent depression with sexual dysfunction and are taking a SSRI for their tx, what can you do?
-dose reduction -switching antidepressant -periodic use of other drug -buproprion -a, b, and c -all of the above |
all of the above
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