Anatomy of the Prostate Gland and Perineal Region- LSRC

Question 1

Where is the prostate located?

Answer 1

Inferior to the urinary bladder and surrounds prostatic urethra

Question 2

What is the prostate?

Answer 2

Largest accessory gland of male reproductive system

Question 3

What is the superior part of the prostate close to?

Answer 3

Neck of bladder

Question 4

What is the apex/inferior of the prostate close to?

Answer 4

Fasia on the superior aspect of the external urethral sphincter

Question 5

How is the prostate separated from the pubic symphysis?

Answer 5

By the retroperitoneal fat in the retropubic space

Question 6

What is the urethral crest?

Answer 6

Midline ridge

Question 7

What is the prostatic sinus

Answer 7

Depression one acc side of urethral crest

Question 8

How does the prostatic utricle come about?

Answer 8

By fusion of paramesonephric ducts

Question 9

Arteries of prostate are derived from which artery?

Answer 9

Internal iliac artery

Question 10

Which branches from internal iliac arteries supply prostate?

Answer 10

Inferior vesicle artery

Internal pudendal and middle rectal arteries

Question 11

Where do the veins from prostate drain into?

Answer 11

Internal iliac veins

Question 12

Why do carcinomas of the prostate spread rapidly to the pelvic bone and vertebrae?

Answer 12

Veins drain into Internal iliac veins
The veins continue superiorly with vesicle venous plexus and communicate superiorly with internal vertebral venous plexus that lie in front of vertebral bodies and within neural canal

Question 13

What are the 2 capsules that the prostate has?

Answer 13

True fibrous capsule- dense and neuromuscular, containing prostatic plexus of veins and nerves
False surrounding fibrous capsular prostatic sheath- composed of condensed visceral layer of pelvic or extra peritoneal fascia

Question 14

What are the lobes of the prostate?

Answer 14

Inferoposterior lobule
Inferolateral lobule
Superomedial lobule
Anteromedial lobule

Question 15

What are the zones in the prostate?

Answer 15

Peripheral zone
Central zone (middle love)
Transition zone

Question 16

What does the prostate secrete?

Answer 16

Milky, acidic fluid

Goes together with secretions from seminal vesicles contributing to volume of semen during ejaculation

Question 17

Which lobes are affected with hypertrophy of prostate?

Answer 17

Lateral lobe affected
Median lobe involved or affected, obstruction of prostatic urethra may occur, stop urination, increase risk of bladder infections (cystitis) and kidney damage

Question 18

How are metastases of prostatic cancer spread?

Answer 18

Via lymphatic route- internal iliac and sacral lymph nodes

Venous routes following internal vertebral venous plexus to the vertebrae and brain

Question 19

Transurethral Resection of the prostate

Answer 19

All or part or just the hypertrophied part could be removed via transurethral resection

Due to close relationship of prostate to prostatic urethra

Question 20

What is radical prostatectomy

Answer 20

Involve removal of prostate with seminal vesicle, ejaculatory ducts and terminal parts of deferent ducts

Question 21

Pelvic diaphragm consists of which muscles?

Answer 21

Coccygeus

Levator ani: Pubococcygeus, Iliococcygeus

Question 22

What does pelvic diaphragm do

Answer 22

Separated pelvic cavity from perineum

Forms roof of perineum

Question 23

What are the two layers of the superficial layer of perineal fascia

Answer 23

Superficial fatty layer (campers fascia)

Deep membranous layer (Perineal or collet fascia)

Question 24

What are the two perineal pouches?

Answer 24

Superficial perineal pouch

Deep perineal pouch

Question 25

What is the superficial perineal pouch?

Answer 25

Space between perineal fascia (inferiorly) and perineal membrane (superiorly)

Question 26

What is the deep perineal pouch?

Answer 26

Space between perineal membrane inferiorly and inferior fascia of the pelvic diaphragm superiorly and inferior portion of obturator fascia

Question 27

Rupture of the membranous (intermediate) part of the urethra occurs due to what?

Answer 27

Trauma and fracture of pelvic girdle with separation of pubic symphysis and puboprostatic ligament

Question 28

What is the result of rupture of membranous part of urethra?

Answer 28

Escape of urine and blood into deep perineal pouch | Fluid may pass superiorly through urogenital and distribute extraperitonealy around prostate and bladder

Question 29

Cause of rupture of spongy part of urethra- bulb of penis and corpus spongiosum

Answer 29

Trauma like forceful blow to perineum such as falling on metal beam or incorrect transurethral catheterisation

Question 30

What does rupture of spongy part of urethra lead to??

Answer 30

Urine escaping into superficial perineal pouch May pass into loose connective tissue in scrotum, penis and superiorly deep to membranous layer of subcutaneous tissue of the inferior anterior abdominal wall

Question 31

Why can urine not pass into the thighs?

Answer 31

Membranous layer of the superficial perineal fascia blends with the fascia lata (surrounds muscle of thigh) just distal to the inguinal ligament

Question 32

Why can urine not pass into the anal triangle?

Answer 32

Superficial and deep perineal fascia are continuous with each other around the superficial perineal muscles and with posterior edge of perineal membrane

Question 33

Where is the ischio-anal fossae?

Answer 33

Located on either side of anal canal | Apex lies superiorly where elevator ani muscle arises from

Question 34

What is the aschio-anal fossa?

Answer 34

Space filled with fat and loose connective tissue

Question 35

What are the boundaries of the ischio-anal fossae?

Answer 35

Laterally- ischia and overlapping inferior part of obturator interns, covered with obturator fascia Medially- external anal sphincter Superiorly-slopping roof formed by elevator ani muscle Posteriorly- flutes maximus, sacrotuberous ligament Anteriorly- bodies of pubic bones LOOK AT DIAGRAM ON PPT

Question 36

What are the contents of the ischia-anal fossae?

Answer 36

``` Fat body- give support for anal canal Neurovascular structures- inc rectal vessels and nerves Cutaneous nerves Perforating branch of S2, S2, Perineal branch of S4 nerve Pudendal canal (Alcock canal) ```

Question 37

What is in the pudendal canal?

Answer 37

In lateral wall of ischio-anal fossae Internal pudendal vessels Pudendal nerve Nerve to the obturator interns

Question 38

The pelvic floor/ roof of perineum is divided into 2 triangles called what? divided by what?

Answer 38

Urogenital triangle anteriorly Anal triangle posteriorly Central perineal body- in-between the "2 main holes"

Question 39

Which muscles make up the pelvic diaphragm?

Answer 39

Levator ani | Coccygeus