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Contributor score: 4

Comments ...

 +0  (free120#13)

How do we know the inferior aspect of the tube doesnt rupture, releasing fluid down in between the layers of the broad ligament?

melchior  What is special about the Pouch of Douglas is that it is the lowest point of the peritoneal cavity, so even if blood gets in between the layers of the broad ligament (which I agree with you, it looks like it should), I bet it somehow makes its way down to the Pouch of Douglas due to gravity.

 +1  (nbme22#38)

You guys are way overthinking this. Chronic hypoxia causes hypertension due to SNS activation and EPO production.

teepot123  yep

Subcomments ...


After getting it wrong (because of the NBME 21 Q), I understood it like this:

– Libido is a long term state, meaning your libido could be fine, but anxiety in that MOMENT might cause psychogenic ED

– This guy has some classic SIG E CAPS criteria going on: fatigue (energy loss), sleep disturbances, concentration problems

– It says he hasn't been able to maintain any erection (vs NBME 21 guy that was able to masturbate (his long term sex drive was OK) but had performance anxiety in the moment)

Therefore, lack of sex drive fueled by depression --> low libido, but physiologically nothing wrong with him --> nighttime erections

trump2020  Bless you for including the spoiler warning +1  

submitted by hello(184),

The Q is describing the genitofemoral nerve, which runs on the external surface of the spermatic cord at the superficial inguinal ring

This Q is NOT referring to ilioinguinal nerve -- the ilioinguinal nerve exits THROUGH the superficial inguinal canal whereas this Q is asking about a nerve that is EXTERNAL to the superficial inguinal canal.

See http://www.groinpainclinic.co.uk/data/images/nervesaffected.jpg

trump2020  This is incorrect. You have it backwards. https://en.wikipedia.org/wiki/Spermatic_cord +2  
medjay7  Actually I think @hello is right. First, because that's the only way this shitty wording question makes sense, second cuz it says "that lies on the EXTERNAL SURFACE" that means outside of the spermatic cord, and the genital branch of GF nerve actually does: The genital branch of the genitofemoral nerve enters the inguinal canal via the deep inguinal ring. (https://www.ncbi.nlm.nih.gov/books/NBK430733/), and then exits to innervate the anterior and superior scrotal skin (also the cremaster muscle). +  
medjay7  CORRECTION: Nevermind, everything I said is wrong. I hate this question +  

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