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MIDS 137 > Ch 5a (normal prostate) > Flashcards

Ch 5a (normal prostate) Flashcards

1
Q

What is the ejaculatory duct?

A

-Duct that passes through central zone + empties into urethra
-Originates from confluence of vas deferens + seminal vesicle

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2
Q

What is the prostate?

A

-Accessory gland of male reproduction system
-Muscle driven mechanical switch b/w urination + ejaculation

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3
Q

What are seminal vesicles?

A

-Paired simple tubular glands that extend from an out pouching of the vas deferens
-Lie obliquely + caudally to prostate

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4
Q

Where are seminal vesicles located?

A

-Superior + posterior to prostate
-B/w urinary bladder + rectum

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5
Q

What are vas deferens (aka ductus deferens)?

A

Reproductive duct that extends from epididymis to ejaculatory duct

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6
Q

What is the verumontanum?

A

Longitudinal ridge of tissue on posterior prosthetic urethral wall where the orifices of ejaculatory ducts are located

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7
Q

What ducts are responsible for development of male reproductive system?

A

Mesonephric ducts

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8
Q

What will the mesonephric ducts develop into in males?

A

Portion of each duct develops into an:
-ejaculatory duct
-vas deferens
-seminal vesicle

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9
Q

Where does the prostate form from?

A

Urogenital sinus

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10
Q

What shape is the prostate?

A

Funnel-shaped exocrine gland surrounded by a fibromuscular capsule

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11
Q

How much does the prostate weigh?

A

Approx 20-25 grams

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12
Q

Measurement of prostate?

A

4 x 3 x 2 cm

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13
Q

What does the prostate surround?

A

Proximal male urethra

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14
Q

What is the cephalic + caudal parts of the prostate called?

A

Cephalic: the base (continuous with bladder neck)
Caudal: the apex (adherent to urogenital diaphragm)

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15
Q

Why would we use a TA u/s to assess the prostate?

A

Used to get volume estimate (transrectal u/s used for more detailed assessment)

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16
Q

What 3 structures pass through the prostate?

A

-2 ejaculatory ducts
-urethra

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17
Q

The prostatic urethra passes through which portion of the gland?

A

Central portion

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18
Q

What 2 structures form the ejaculatory duct at the prostate base?

A

-duct of seminal vesicle
-ampullae of vas deferens

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19
Q

The ejaculatory duct joins what structure in the midline of the central zone?

A

Joins the urethra at the verumontanum

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20
Q

What is a utricle?

A

Small epithelium lined diverticulum at apex of verumontanum (fetal remnant of urogenital sinus)

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21
Q

What appearance does the utricle have on TRV images of the prostate?

A

Eiffel Tower appearance

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22
Q

What arteries supply prostate with blood?

A

Internal iliac arteries

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23
Q

The internal iliac arteries bifurcate into what arteries?

A

-prostatic artery
-inferior vesicle artery

Then further branch into:
-urethral artery
-capsular arteries

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24
Q

What does the venous drainage contain?

A

Prostatic venous plexus b/w facial layer + capsule

(drains blood from prostate into the internal iliac veins)

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25
Q

What structure is the primary anatomic reference point in the prostate?

A

Urethra: divides it into an anterior fibromuscular part + posterior glandular part

26
Q

4 zones of prostate?

A

-peripheral (70%)
-central (25%)
-transition (5%)
-periurethral (less than 1%)

27
Q

What type of tissue accounts for two-thirds of the prostate + contains the 4 zones?

A

Glandular tissue

28
Q

Where is the peripheral zone located?

A

Along posterior, lateral + apical aspects of gland

29
Q

Which zone is the largest?

A

Peripheral

30
Q

M/c location for carcinomas + prostatitis to occur?

A

Peripheral zone

(70% of prostate cancers arise here)

31
Q

SF of the peripheral zone?

A

-homogeneous
-isoechoic

32
Q

How can the peripheral + central zones be delineated?

A

By a thin hyperechoic band separating the 2 zones called the surgical capsule (shaped like a semicircle)

33
Q

Where is central zone located?

A

-Base of prostate
-Surrounds ejaculatory ducts
-B/w peripheral + transition zone

34
Q

Is prostate cancer commonly found in central zone?

A

No, 5%

35
Q

SF of central zone?

A

More echogenic compared to peripheral zone

36
Q

M/c zone for benign prostatic hyperplasia (BPH)?

A

Transition zone

37
Q

What does the transition zone contain?

A

2 small lobules lateral to proximal urethral segment

38
Q

Is cancer common in transition zone?

A

Kinda, 20%

39
Q

Normal volume measurement of prostate?

A

30mL and under

40
Q

What can the prostate volume go up with BPH?

A

Can get up to 200mL

41
Q

SF of transitional zone?

A

-heterogeneous + more visible

42
Q

Which zone m/c has calcifications?

A

Periurethral zone

43
Q

Location of periurethral zone?

A

Directly around urethra, embedded in the smooth muscle wall of the urethra

44
Q

What is the anterior fibromuscular stroma?

A

-Nonglandular region composed of smooth muscle
-Forms anterior portion of prostate

45
Q

Do seminal vesicles fluctuate in size/shape?

A

Yes, depending on level of sexual activity

(fluid within is anechoic with low level echoes)

46
Q

SF of vas deferens?

A

Thick-walled tubular structures

47
Q

Where does the ampullary of the vas deferens lie in relation to the seminal vesicles?

A

Adjacent + medially to seminal vesicles

48
Q

How are ejaculatory ducts formed?

A

At junction of ampulla of the vas deferens + seminal vesicles

49
Q

Reasons for a prostate evaluation?

A

-Abnormal DRE
-Differentiation b/w cystic + solid lesions
-Abnormal PSA blood test
-Check for prostatitis
-Evaluate infertility
-Guidance during biopsy
-Pt has urination/ejaculation symptoms

50
Q

Does TA imaging of prostate need full or empty bladder?

A

Full

51
Q

Does TRUS require a full or empty bladder?

A

Empty

52
Q

What pt position is used during a TRUS exam?

A

LLD with knees toward chest (similar to fetal position)

53
Q

In SAG where is the base + apex on an image?

A

Base: left side screen
Apex: right side screen

54
Q

Location of prostate?

A

B/w urinary bladder + rectal wall (surrounds urethra)

55
Q

What does the urethra look like on u/s?

A

Hypoechoic line, dark shadow

56
Q

Base of prostate is made up of what mostly?

A

Central zone

57
Q

At what level of the prostate are the ejaculatory ducts seen?

A

Central gland

58
Q

Do calcification’s normally occur in the ejaculatory ducts?

A

Yes

59
Q

What structures must we always image during a prostate exam?

A

-seminal vesicles
-vas deferens

60
Q

SF of seminal vesicles + vasa deferentia on u/s?

A

Seminal vesicles: Lateral + superior to base of prostate. Hypoechoic.

Vasa deferentia: B/w seminal vesicles. Thick walled + enter base of prostate.

61
Q

What 2 groups of blood vessels should be seen on u/s exam?

A

-periurethral vessels (center of prostate at level of verumontanum)

-capsular vessels (penetrates into tissue of gland)

MIDS 137 (14 decks)

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