NEURO FINAL- Amputee Sex Lecture

Question 1

_ _ are any behavior involving the secondary erogenous zones and genitalia. Secondary erogenous zones often _ _ _

Answer 1

SEX ACTS

Often CHANGE AFTER SCI

Question 2

_ is a combination of sex drive, sex acts and all those aspects of personality concerned with learned communications and relationship patterns.

Answer 2

SEXUALITY

Question 3

Sexuality is important in rehab because of the relationship of sexuality to _ _ and _ _. Can possibly impact the their _ _ and _ with _.

Answer 3

Because of relationship to SELF-ESTEEM and BODY IMAGE

Can possibly impact their SEXUAL EXPRESSION and RELATIONSHIP with OTHERS.

Question 4

What does PLISSIT (Annon) model address? What does it stand for? Which 2 should PT’s most comfortable with discussing?

Answer 4

Helps health care professionals understand what they should know

Permission*
Limited Information*
Specific Suggestion
Intensive Therapy

*=

Question 5

Permission has to do with the health care practitioner being _ and _ of the topic of sex and gives the patient _ to _ without _. 2 types of message and general description of each.

Answer 5

Permission has to do with the health care practitioner being OPEN and ACCEPTING of the topic of sex and give the patient PERMISSION TO INQUIRE without EMBARASSMENT

2 types of messages:

• Covert messages (PT to eludes to the topic being ok to discuss)
• Overt messages (introduces the subject directly)

Question 6

Limited information means that the PT provides general and basic education such as: _ and _; _ of _; describing general ways in _ _ in _ _ resolved their own problems.

Answer 6

Provides basic education such as:
ANATOMY and PHYSIOLOGY
DISPELLING of MYTHS
Describing general ways in WHICH OTHERS in SIMILAR SITUATIONS resolved their own problems.

Question 7

Effects of disabilities on sexuality: interference with _ _ due to _ _; _ _ may interfere with sexual function; and change in _ _ which may seem incompatible with maintaining a _ _ .

Answer 7

Interference with SEXUAL FUNCTION due to PHYSIOLOGIC CHANGES

PHARMACOLOGICAL AGENTS may interfere with sexual function

And change in BODY IMAGE which may seem incompatible with maintaining a SEXUAL RELATIONSHIP

Question 8

Any patient who experiences _, _ _ of a _ _ experiences a disturbance of his or her body image.

Answer 8

Any patient who experiences TRAUMA, SURGICAL REMOVAL of a BODY PART experiences a disturbance of his or her body image.

Question 9

Many _ _ _ _ modifications that need to be made post surgery, some _.

Answer 9

Many FACILITIES DO NOT ADDRESS modifications that need to be make post surgery, some DO

Question 10

Many patients may _ _ _ in order to gauge attractiveness, gain attention or in order to get _ _ _.

Answer 10

Many patients may ACT OUT SEXUALLY in order to . . . Or in order to get WHAT THEY WANT

Question 11

Basic rules for communication: provide _, don’t _ _ and be aware of _ _.

Answer 11

Provide PRIVACY
Don’t MAKE JUDGEMENTS
Be aware of CULTURAL BARRIERS

Question 12

Communicating about sex: use _ statements and avoid _ statements

Answer 12

Use BRIDGE statements and avoid BARNUM statements

Question 13

Bridge statements are statements that facilitate the transition from _, _ _ to _ or _ ones. Facilitate the transition from _ to _. Emphasize the _ _ between the patient and PT. Focus on permission _ and permission _.

Answer 13

Statements that facilitate the transition from EASY COMFORTABLE TOPICS to AWKWARD or DIFFICULT ones

Facilitate transition from GENERAL TO SPECIFIC

Emphasize the PROFESSIONAL RELATIONSHIP b/w pt. and PT

Focus on permission GIVING and permission RECIEVING

Question 14

Many times patients will _ the _ with you either _ or by _ _. Be sure to set _ and _ _ to _.

Answer 14

Many times patients will OPEN THE SUBJECT with you either DIRECTLY or by FLIRTATIOUS BEHAVIOR

Be sure to set BOUNDARIES and STAY OPEN TO DISCUSSION

Question 15

_ _ include statements that are general, deflect, depersonalize or are conversation stoppers.

Answer 15

BARNUM STATEMENTS include . . .

Question 16

What are the 2 spinal cord areas that affect erections for both men and women? Brief description (type of arousal associated). Typically work in _

Answer 16

2 spinal cord areas that affect erection:

• T11-L2: Mental arousal (psychogenic)
• S2-S4: tactile arousal (reflexogenic)

Typically work in CONJUNCTION

Question 17

SCI affects _ _ _ more than _.

Answer 17

Affects MENS SEXUAL FUNCTION more than WOMENS

Question 18

_/ _ is mediated by SNS (T11-L2), the PSNS (S2-S4) and the _ _ _ in men/ women

Answer 18

EJACULATION/ ORGASM is mediated by SNS, PSNS, and the SOMATIC NERVOUS SYSTEM in men/ women

Question 19

In women normally the psychogenic and reflexogenic systems _ _ _ in the female response cycle.

Answer 19

ARE NOT SEPARATE in the female response cycle

Question 20

With males who have SCI at levels above the cauda equina: have the ability to _ and _ an _ as long as reflexogenic feedback loop for _ is _. _ is more rare. _ is an issue.

Answer 20

Have the ability to SUSTAIN and ACHIEVE an ERECTION as long as reflexogenic feedback loop for ERECTION is INTACT

EJACULATION is more rare

FERTILITY is an ISSUE

Question 21

Males with tetraplegia or paraplegia can get a _ _ because the _ _ arc is undisturbed. _ erection is not intact. _ is rare, and _ is almost nil.

Answer 21

Can get a REFLEXOGENIC ERECTION because the SACRAL RELFEX arc is undisturbed

PSYCHOGENIC ERECTION - not intact
EJACULATION is rare
FERTILITY is almost nil

Question 22

Fertility can be _ _

Answer 22

Fertility can be ARTIFICIALLY ASSISTED

Question 23

With Cauda Equina lesions (LMN) reflexogenic erection is possible if _ _, psychogenic erection is _ (T11-L2). _ _ of ejaculation. _ is possible.

Answer 23

Cauda Equina lesions:
Reflexogenic erection is possible if ABOVE L2
Psychogenic erection is INTACT
MODERATE CHANCE of ejaculaton
FERTILITY is POSSIBLE

Question 24

In females with SCI: reflexive lubrication, engorgement, contraction is _ _. Psychogenic lubrication, engorgement and contraction is _ _ _. Fertility is usually _, _ _ returns within _ _.

Answer 24

Reflexive- USUALLY INTACT

Psychogenic IS USUALLY NOT INTACT

Fertility is usually UNAFFECTED, MENSTRUAL CYCLE returns within 6 MONTHS

Question 25

If female SCI patient gets pregnant, during childbirth uterus _ _ _, but usually _ _ is chosen due to _ _.

Answer 25

During childbirth uterus MAY CONTRACT REFLEXIVELY but usually CESARIAN SECTION is chosen due to OTHER COMPLICATIONS

Question 26

When it comes to treating sexual difficulties more _ and more _ _ exist for _ than for _.

Answer 26

More OPTIONS and more SUCCESSFUL OPTIONS exist for MEN than for WOMEN

Question 27

T/F: Sexual activity is more important than walking to some people with paraplegia? The menstrual period of a women with SCI will cease after the trauma and never resume?

Answer 27

T- more important than walking for some

F- menstruation will cease and never return

Question 28

T/F: orgasm can be reached in men and women with SCI by stimulating parts of the body other than genitals? Erection is most men with CSI can be maintained as long as stimulation is present.

Answer 28

Both are TRUE

Question 29

T/F: If the man with SCI can ejaculate, he is likely to be fertile. Cesarean sections are necessary in women with SCI because their uterine muscles will no longer contract

Answer 29

Both are False

Question 30

T/F: Fertility in men with SCI is low, but fertility is unaffected for women with SCI. Sperm from a man with SCI can be obtained via electroejaculation and store until there is enough for artificial insemination.

Answer 30

Both are TRUE

Question 31

T/F: Muscle spasms in the extremities doing sexual activity can result in eith loss or facilitation of an erection? The alteration in the body’s heat regulatory mechanism could affect fertility of a man with an SCI

Answer 31

Both are TRUE

Question 32

T/ F: It is not appropriate for therapists to address sexual concern of clients who have sustained a brain injury? People who have had a brain injury and/ or neurological injury should not be concerned with having a sexual relationship with their partner

Answer 32

BOTH ARE FALSE