abdo review- Male pelvis Flashcards
prostate location?
- anterior to rectum
- posterior to symphysis pubis
- surrounding 1st part of urethra
what tissue id the prostate made of?
- glandular tissue
- non-glandular tissue
what are the 4 zones of the prostate?
- anterior
- transitional
- central
- peripheral
what zone is closest to the abdomen?
- anterior zone
what is the innermost part of the prostate gland, that surrounds the urethra where it passes through the organ?
transition zone
% of prostate cancers in the transition zone?
10%
what zone surrounds the transition zone?
central zone
% of prostate cancer in the central zone?
5%
what zone is located in the back of the prostate gland closest to the rectum?
peripheral zone
what prostate zone contatins the most cancer?
peripheral zone- 80% of cancers
seminal vesicles on ultrasound?
- hypoechoic
contral and peripheral zones on u/s?
- homogeneous
- hypoechoic area in posterior prostate
transition zone on u/s?
moderately hypoechoic
what is prostate-specific antigen (PSA)?
- protein made by prostate
- measured by blood test
high PSA indicates?
- malignancy (mainly)
- enlarged prostate
- infection
- UTI
- tests (cystoscopy/biopsy)
- catheter
normal PSA level?
0-4
PSA higher than ___ is concidered a possible indicator of prostate cancer?
10
prostate calcifications?
- normal finding
- most common in older individuals
what is corpora amylacea?
- proteinaceous debris
- sound attenuation
- creates twinkle artifact
- no clinical significance
what is the most common prostate problem for men younger than 50?
acute prostatitis
what is prostatitis?
focal or diffuse inflammation of the prostate
symptoms of prostatitis?
- lower back pain
- low grade fever
- dysuria
- urinary urgency
- enlarged prostate
what is prostatitis caused by? (2)
- UTI
- STI
prostatitis on u/s?
- normal
- hypoechoic
- edmatous gland
- slightly enlarged
- increased colour
what is BPH?
- benign prostatic enlargement
what does BPH result from?
- hyperplastic nodules form around the urethra and may obstruct the flow of urine causing urinary retention
where does BPH occur?
transition zone
what can BPH cause?
- pyelonephritis
who does BPH typically affect?
- men over 50
- 70% of men aged over 70
what is the most common prostate problem for men older than aged 50?
BPH
BPH on u/s?
- transition zone irregular
- enlarged
- cysts
- calcifications
- central and peripheral zone may be compressed
BPH
enlarged prostate (BPH) treatments (3)?
- alpha blockers
- 5- alpha-reductase inhibitors
- surgery
most common typer of surgical procedure for benign prostatic hyperplasia?
- TURP
What is TURP?
- transurethral resection of the prostate
- removes symptoms of enlarged prostate
what is often the 1st indication of malignant prostatic tumors?
bone matastases
whos at risk for prostate cancer?
- African American men
- > 60 years
- genetics
sono features of prostate cancer?
- hypoechoic lesion in peripheral zone
- isoechoic
- near capsule
- in apex
- greatest portion of PZ
- increased colour
- capsule bulging
prostate cancer treatment?
- prostatectomy
- radiation therapy
- radioactive seed implants
- cryotherapy
- hormone therapy
- chemo
- watchful waiting
- clinical trials
where is the periurethral gland?
lines prostatic urethra
where are the seminal vesicles located?
- superior to gland
- stores sperm
function of the verumontanum?
- divides prostatic urethra into prox and dist segments
- where ejaculatory ducts enter the urethra
functions of the prostate?
- secretes alkaline fluid to transport sperm
- produces 80-85% of ejaculation fluid
- produces PSA
what do secretions of the prostate gland contain?
- alkaline phosphatase
- citric acid
- PSA
what regulates prostate growth and function?
- testosterone
- dihydrotestosterone
3 main prostate pathologies?
- infection (prostatitis)
- benign (BRH, cysts)
- malignant
what is parenchymal degenerative cysts most commonly associated with?
- BPH
- in transitional zone
what is a Parenchymal Degenerative Cyst?
- no clinical significance
- if large can contribute to urinary or ejaculatory obstruction
Parenchymal Degenerative Cysts on u/s?
- unilocular or thinly septated multilocular cyst in a BPH nodule in the transitional zone
what is Retention Cysts associated with BPH?
- focal cysts on the surface of the prostate
- <1cm
what do Retention Cysts associated with BPH occur from?
duct obstruction
Retention Cysts associated with BPH
where are congenital cysts usually located?
- in or close to midline
- Wolffian or pronephric ducts or mullerian ducts
what are utrical cysts caused by?
dilation of prostatic utricle
what are itrical cysts associated with?
unilateral agenesis
where are utrical cysts always located?
midline
where are mullerian duct cysts located?
- mainly midline but might extend laterally
mullerian and utricle cysts on u/s?
- tear dropped shaped pointy end pointing to verumontanum
- thick-walled
utricle cyst
ejaculatory cysts on u/s?
- fusiform shape
- usually small
cystic neoplasms on prostate?
- rare
- cystadenoma
- cystadenocarcinoma
abscess
what is menatospermia?
- blood in semen
caused of hematospermia?
- trauma
- infection
- obstruction
- hypertension
- vascular abnormalities
- idiopathic
what are seminal vesicle cysts?
- rare
- solitary
- asymptomatic unless large
seminal vesicle cysts are associated with?
- ipsilateral renal anomalies
- polycystic disease
- hemivertebra
- ipsilateral absence of testis
what can minic SV cysts or prostate cysts?
- ectopic uterocele
- cowpers duct cyst
- bladder diverticulum
calcifications of SV can occur with?
- diabetes
- infection
most connon reson for elevated PSA?
- BPH
The goal of PSA testing is to
identify early stage prostate cancers
