need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

NBME 23 Answers

nbme23/Block 1/Question#30 (reveal difficulty score)
A 52-year-old man comes to the physician ...
Pelvic splanchnics ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +10  upvote downvote
submitted by โˆ—sajaqua1(607)
get full access to all contentpick a username

The patient underwent removal of a rectal tumor which had involvement with the prostate. The prostatic capsule is rich with nerves including the pelvic splanchnic nerves, a set of parasympathetic nerves responsible for PNS autonomic regulation. Erections are a parasympathetic function.

A) Gray rami from the sympathetic chain- erections are a parasympathetic function, not sympathetic. Emission of sperm is a sympathetic function, and is directed by the inferior hypogastric nerve. C) Pudendal- the pudendal nerve is a somatic nerve that receives sensation from the penis, posterior scrotum, clitoris, and labia, as well as being responsible for some movement of the pelvic floor, and ejaculation. D) Superior hypogastric nerve- a sympathetic nerve, this contributes to the hypogastric plexus and may also contribute to sympathetic control of emission. E) Ventral ramie of S2-S4- These rami contribute to the pudendal nerve.

get full access to all contentpick a username
focus  Diagrams here are pretty good too: https://obgynkey.com/introduction-of-pelvic-anatomy-2/ "Point, Squeeze, Shoot" Point- erection: pelvic splanchnic nerves (S2-4) Squeeze- emission: superior hypogastric plexus Shoot- ejaculation: pudendal nerve +2
weirdmed51  @focus diagrams there are terrible +



 +6  upvote downvote
submitted by โˆ—bend_nbme_over(37)
get full access to all contentpick a username

Just remember Point, Squeeze, and Shoot

Erection - Point Parasympathetic NS (pelvic splanchnics S2-S4)

Emission - Squeeze Sympathetic NS (hypogastric nerve T11-L2)

Ejaculation - Shoot visceral and Somatic nerves (Pudendal nerve)

FA19 pg. 609 (nice)

get full access to all contentpick a username
llamastep1  Emission, as the first phase of ejaculation, is a sympathetic spinal cord reflex and is defined as the deposition of seminal fluid into the posterior urethra. Ejaculation or expulsion is due to the combined action of sympathetic and somatic pathways. +2
mutteringly  actually on page 613 FA19 lol +
weirdmed51  I just got the difference between emission and ejaculation (facepalm). Thank you @Ilamastep1 +
weirdmed51  S2,3, FOUR keeps penis off the FLOOR! +1



Must-See Comments from nbme23

ferrero on Precapillary resistance
yotsubato on 99%
sne on Triglyceride
sajaqua1 on Area labeled โ€˜Dโ€™ (Spinothalamic tract, right)
stinkysulfaeggs on Hypoglycemia
hayayah on Iris
soph on Peak inspiratory pressure (alveolar): ...
seagull on Area labeled โ€˜Cโ€™ (Cranial nerve 8: ...
water on Dietary change
wired-in on 28.8
beeip on Binding of permeable ligand to nuclear ...
thomasalterman on Hypoglycemia
yotsubato on Inhibition of the cytochrome P450-dependent ...
seagull on Decreased sodium bicarbonate reabsorption in ...

search for anything NEW!