genitourinary path + anatomy Flashcards
What is the danger of someone with LUTS due to prostate Ca undergoing radiotherapy
They might go into retention
Patient with prostate Ca is about to have RT- why should they have a TURP instead of an alpha blocker to relieve sx?
They need a definitive mx- hence TURP instead of tamsulosin
Effect of 5 alpha reductase on the prostate
It converts testosterone into the more active dihydrotestosterone which increases prostate growth
Example of a 5 alpha reductase inhibitor
Dutasteride, finasteride
lymphatic drainage of cervix
obturator nodes
What do the superficial inguinal lymph nodes drain?
anal canal, bladder, vagina
The pectinate line divides the pelvic rectum and the anal canal- what are the lymphatic drainage of the 2
pelvic rectum- external iliac/ common iliac nodes
anal canal- superficial inguinal lymph nodes
nerve supply to
internal
external
anal sphincters
external= pudendal
internal= lower rectal branches of the parasympathetic nerves
What is the other name for the testicular appendix and where does it originate from
Hydatid of Morgagni
Remnant of the Muerllerin duct
What is the remnant of the Wolffian duct called?
epididymal appendix
risk factors for undescended tests
Twins
low birth weight
premature
presenting sx for Wilm’s tumour
abdo mass/ pain
hypertension
haematuria
Epidemiology Wilm’s tumour:
age
race
Fhx
<5 yrs
afro-Caribbean
+ FHx
What is the risk of prolonged TURP surgery
TURP syndrome
Describe the changes seen in TURP syndrome
Fluid overload
glycine toxicity
HTN + reflex bradycardia
dilutional hyponatraemia
reduced plasma osmolality = brain oedema
What are the 5 classifications of undescended testes
retractile
ectopic
atrophic
arterial supply of prostate
prostatic arteries from INTERNAL iliac
venous drainage of prostate
prostatic venous plexus drains into
internal iliac veins
which connect
internal vertebral and Batons venous plexuses
What are the zones of the prostate
4 zones: (middle outwards)
transitional
central (posterior)
peripheral (posterior)
fibromuscular stromal zone (anterior)
transitional, central and peripheral are glandular areas
Which zone does prostate Ca arise in
peripheral zone
Which zone does BPH arise in
transitional zone
How many lobes does the prostate have
4:
anterior
posterior
median
lateral
What are the 3 parts of the urethra (proximal-distal)
prostatic
membranous
spongy
which part of the urethra recieves semen from the ejaculatory ducts
prostatic urethra