Male Pelvis Notes Flashcards

1
Q

What is the appendix testis?

A

A small solid structure located posterior to the epididymal head.

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2
Q

What is the central zone (CZ) of the prostate?

A

A cone-shaped area of the prostate gland located deep in the peripheral zone.

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3
Q

What are the corpus cavernosa?

A

The two columns of erectile tissue forming the body of the penis.

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4
Q

What is the corpus spongiosum?

A

The mass of spongy tissue surrounding the urethra.

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5
Q

What is cryptorchidism?

A

Undescended testis.

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6
Q

What is Denonvilliers’ fascia? This is a important landmark for what?

A
  1. Separates the prostate and rectum
  2. Important landmark for radical prostatectomy.
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7
Q

What is the epididymis?

A

Long, tightly coiled ducts that carry sperm from the testis to the vas deferens.

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8
Q

What is epididymitis?

A

Inflammation of the epididymis; commonly caused by a urinary tract infection; most common cause of acute scrotal pain.

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9
Q

What is a hydrocele?

A

Abnormal accumulation of serous fluid between the two layers of tunica vaginalis.

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10
Q

What is hypospadias?

A

Urethra opening is located somewhere along the undersurface of the penis.

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11
Q

What is the mediastinum testis?

A

Thick portion of the tunica albuginea.

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12
Q

What is the peripheral zone (PZ) of the prostate?

A

The largest area of the prostate gland located just beneath the capsule.

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13
Q

What are periurethral glands?

A

Glandular tissue lining the proximal prostatic urethra.

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14
Q

What is Peyronie’s disease? What can this lead to?

A

Fibrous scar tissue most commonly along the dorsal portion of the penis within tunica albuginea that may progress to calcification(s).

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15
Q

What is polyorchidism?

A

Presence of more than two testes.

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16
Q

What is prostate specific antigen (PSA)?

A

A protein produced by the prostate; elevation is associated with carcinoma of the prostate gland.

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17
Q

What is orchitis?

A

Inflammation of the testis; commonly caused by chlamydia.

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18
Q

What is the rete testis?

A

Network of ducts formed in the mediastinum testis connecting the epididymis with the superior portion of the testis.

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19
Q

What is the space of Retzius?

A

Retropubic space between the symphysis pubis and urinary bladder.

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20
Q

What is the spermatic cord?

A

Supporting structure on the posterior border of the testes that courses through the inguinal canal.

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21
Q

What is a spermatocele?

A

A cyst arising from the rete testis.

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22
Q

What is the surgical capsule?

A

Hypoechoic connective tissue dividing the peripheral and central zones.

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23
Q

What is testicular torsion?

A

Twisting of the spermatic cord upon itself, obstructing the blood vessels supplying the epididymis and testis; also known as bell clapper.

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24
Q

What is the transitional zone (TZ) of the prostate?

A

Two small areas of the prostate gland adjacent to the proximal urethral space.

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25
Q

What is transurethral resection prostatectomy (TURP)?

A

A surgical procedure to relieve symptoms of benign prostatic hypertrophy; demonstrates as an anechoic space in the center of the prostate.

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26
Q

What is a varicocele? How does this affect fertility of a male?

A
  1. Dilatation of the spermatic veins
  2. Most common cause of male infertility.
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27
Q

What is the vas deferens?

A

A small tube that transports the sperm from each testis to the prostatic urethra.

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28
Q

What is the verumontanum?

A

Divides the urethra into proximal and distal segments.

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29
Q

What is the function of the scrotum?

A

Allows maintenance of a lower body temperature necessary for sperm survival.

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30
Q

What are the functions of the epididymis? 2

A
  1. Store and transport sperm produced by the testes
  2. Mature the sperm.
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31
Q

What are the functions of the testis?

A
  1. Produce testosterone
  2. Germinate sperm.
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32
Q

What are the functions of the prostate gland?

A

Secretes alkaline fluid to transport sperm; produces 80% to 85% of the ejaculation fluid.

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33
Q

What are the functions of the penis? 2

A
  1. Transport urine out of the body
  2. Male sex organ.
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34
Q

What is the anatomy of the scrotum? How is the scrotum divided?

A
  1. A two-compartment pouch that contains and supports each testis
  2. Divided by a medium raphe or septum.
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35
Q

Where does the epididymis empty into? Where is it located in relation to the testis?

A
  1. Empties into the ductus deferens
  2. Located lateral and posterior to the testis.
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36
Q

What are the testes?

A

Paired male reproductive organs located in the scrotum; endocrine and exocrine glands.

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37
Q

What is the tunica albuginea?

A

Fibrous sheath enclosing each testis.

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38
Q

What is the tunica vaginalis?

A

Two layers of serous membrane covering the anterior and lateral portions of the testis and epididymis.

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39
Q

What is the mediastinum testis?

A

Thick portion of the tunica albuginea located in the posterior medial border of the testis.

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40
Q

What is the rete testis?

A

Network of ducts formed in the mediastinum testis that transports seminal fluid from the testis to the epididymis.

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41
Q

What is the spermatic cord?

A

Support structure located on the posterior border of the testes; courses between the abdominal cavity and scrotum.

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42
Q

What is the prostate gland?

A

A cone-shaped retroperitoneal structure consisting of five lobes.

43
Q

The central zone (CZ) of the prostate comprises of how much of the glandular tissue? How does disease affect this portion?

A

Comprises approximately 25% of the glandular tissue; resistant to disease.

44
Q

How much does the peripheral zone (PZ) of the prostate comprise of? How resistant is it to disease?

A

Comprises approximately 70% of the glandular tissue; site for most prostate cancer.

45
Q

How much does the transitional zone (TZ) of the prostate consist of? What diseases are prevailent here?

A
  1. Comprises 5% of the glandular tissue and periurethral glands
  2. Area where benign prostatic hypertrophy (BPH) originates.
46
Q

What are the seminal vesicles? 2

A
  1. Paired structures lying superior to the prostate
  2. Stores sperm.
47
Q

What is the surgical capsule?

A

Connective tissue separating the peripheral and central zones; surgical boundary line used in transurethral resection procedures.

48
Q

What is the glans of the penis?

A

In uncircumcised men, covered with pink, moist tissue called mucosa.

49
Q

What are the corpus cavernosum?

A

Two columns of tissue running along the sides of the penis; blood fills this tissue to cause an erection.

50
Q

What is the corpus spongiosum?

A

A column of sponge-like tissue running along the front of the penis; the urethra runs through it.

51
Q

The testicular arteries arise from what? How does it course?

A

Arise from the anterior aspect of the abdominal aorta and course toward the mediastinum testis.

52
Q

What does the prostaticovesical arteries arise from? What does it supply?

A
  1. Arise from the internal iliac arteries
  2. Supply the bladder base, seminal vesicles, and the ureter.
53
Q

What is the arterial supply to the penis? How is it subdivided?

A
  1. Through the paired internal pudendal arteries
  2. Subdivided into a deep cavernosal artery and bulbouretheral artery.
54
Q

What is cryptorchidism? Where is 80% of these located?

A
  1. Undescended testis
  2. 80% are located in the inguinal canal.
55
Q

What is polyorchidism? What is this associated with?

A
  1. Presence of more than two testes
  2. Associated with inguinal hernia, testicular torsion, and malignancy.
56
Q

What is the sonographic appearance of the scrotum? 2

A
  1. Thin hyperechoic wall measuring 2 to 8 mm in thickness
  2. Small amount of anechoic fluid surrounds each testis.
57
Q

What is the normal size of adult testes?

A

3 to 5 cm in length, 3 cm in height, and 2 to 4 cm in width.

58
Q

What is the echo pattern of the testis compared to normal?

A

Coarser echo pattern compared with the normal testis.

59
Q

What is the blood flow characteristic in the testis?

A

Minimal or no discernible internal blood flow.

60
Q

What is the appearance of the spermatic cord?

A

Hypoechoic to isoechoic structure superior to the testicles.

61
Q

How does the spermatic cord appear in sagittal orientation?

A

Multiple linear strands in sagittal orientation.

62
Q

What is the shape of the spermatic cord in transverse orientation?

A

Round or oval in shape.

63
Q

Describe the echo pattern of the prostate.

A

Homogeneous structure demonstrating a medium-level echo pattern.

64
Q

How does the peripheral zone of the prostate appear?

A

Appears uniform in texture and slightly more echogenic than the central zone.

65
Q

What separates the peripheral and central zones of the prostate?

A

Hyperechoic band (surgical capsule).

66
Q

What do the seminal vesicles look like on ultrasound?

A

Appear as hypoechoic structures superior to the prostate gland.

67
Q

How does the verumontanum appear compared to the parenchyma?

A

Appears hyperechoic compared with the parenchyma.

68
Q

What is the echo pattern of the corpus spongiosum?

A

Located in the midline with a homogeneous medium-level echo pattern.

69
Q

What is the appearance of the corpus cavernosa?

A

Symmetrical, display a medium-level echo pattern and are located posterior to the corpus spongiosum.

70
Q

What covers the corpus cavernosa?

A

Highly echogenic tunica albuginea.

71
Q

Where are the cavernous arteries located?

A

Centrally located within the corpus cavernosa.

72
Q

Is preparation necessary for a sonogram of the scrotum and penis?

A

No preparation is necessary.

73
Q

What is the preferred technique for prostate examination?

A

Transrectal approach.

74
Q

What is required for transabdominal prostate examination?

A

Full urinary bladder.

75
Q

What is required for transrectal prostate examination?

A

Empty urinary bladder.

76
Q

What frequency transducer is used for adult scrotum imaging?

A

7.5 MHz to 12 MHz linear.

77
Q

What frequency transducer is used for children and small adults?

A

10 MHz to 15 MHz linear.

78
Q

What is the transducer frequency for transabdominal prostate imaging?

A

3 MHz to 5 MHz curvilinear.

79
Q

What is the transducer frequency for transrectal prostate imaging?

A

5 MHz to 8 MHz transrectal.

80
Q

What is the patient positioning for scrotum examination?

A

Supine with the legs slightly apart and a rolled towel placed under scrotum for support.

81
Q

What is the patient positioning for transrectal prostate examination?

A

Left lateral decubitus with knees flexed toward the chest.

82
Q

What is the examination protocol for scrotum?

A

Systematic evaluation and bilateral imaging of the head, body, and tail of the epididymis and upper, mid, and lower portions of the testes.

83
Q

What should be measured during scrotum examination?

A

Length, height, and width of each testis and epididymis.

84
Q

What is the examination protocol for prostate?

A

Angle caudally through the urinary bladder to visualize the prostate.

85
Q

What should be documented during prostate examination?

A

Abnormalities of the prostate should be documented and measured in two imaging planes.

86
Q

What is the examination protocol for penis?

A

Systematic dorsal, lateral, or ventral approach in the sagittal, coronal, and transverse planes.

87
Q

What are the image optimization techniques? 3

A
  1. Adjust gain settings
  2. Place focal zones
  3. Use harmonic imaging.
88
Q

What are the examination limitations? 2

A
  1. Patient cooperation
  2. Near-field reverberation.
89
Q

What are the indications for scrotal examination? 6

A
  1. Scrotal pain
  2. Trauma
  3. Enlarged scrotum
  4. Palpable mass
  5. Infertility
  6. Undescended testis.
90
Q

What are the indications for prostate examination? 4

A
  1. Enlarged prostate
  2. Changes in urination
  3. Elevated PSA level
  4. Infertility.
91
Q

What are the indications for penis examination? 4

A
  1. Vasculogenic impotence
  2. Painful erection
  3. Palpable mass
  4. Trauma.
92
Q

What is the normal level of prostate specific antigen (PSA)?

A

Normal monoclonal PSA is 4.0 ng/mL.

93
Q

What does a PSA level greater than 20 ng/mL indicate?

A

Indicates a strong likelihood for carcinoma.

94
Q

What are the clinical findings of a calculus in the scrotum? (s/s) 2

A
  1. Asymptomatic
  2. Palpable scrotal mass.
95
Q

What are the sonographic findings of a calculus? 3

A
  1. Hyperechoic focus
  2. Mobile
  3. Round in shape.
96
Q

What are the clinical findings of epididymitis? 3

A
  1. Acute scrotal pain
  2. Palpable posterior mass
  3. Leukocytosis.
97
Q

What are the sonographic findings of epididymitis? 2

A
  1. Enlarged hypoechoic epididymis
  2. Hypervascular epididymis.
98
Q

What are the clinical findings of testicular torsion? 2 (s/s)

A
  1. Sudden onset of groin or scrotal pain
  2. Nausea/vomiting.
99
Q

What are the sonographic findings of testicular torsion? 2

A
  1. Hypoechoic parenchyma (acute)
  2. Markedly absent or decreased intratesticular blood flow.
100
Q

What are the clinical findings of benign prostatic hypertrophy? 3

A
  1. Urinary frequency
  2. Dysuria
  3. Decreased urinary output.
101
Q

What are the sonographic findings of benign prostatic hypertrophy? 2

A
  1. Symmetrical prostate enlargement
  2. Hypoechoic parenchyma.
102
Q

What are the clinical findings of Peyronie’s disease? 2

A
  1. Pain with marked curvature of the penis
  2. Erectile dysfunction.
103
Q

What are the sonographic findings of Peyronie’s disease? 2

A
  1. Focal hyperechoic thickening
  2. Echogenic plaque or calcifications.