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Normal Anatomy > Midterm #2 > Flashcards

Midterm #2 Flashcards

1
Q

are kidneys retroperitoneal or intraperitoneal?

A

retroperitoneal

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2
Q

where are the kidneys located?

A

RUQ and Right Hyperchondrium

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3
Q

which kidney sits more superior in the body?

A

left kidney because the right is pushed down by the liver

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4
Q

which muscle is considered the “kidney bed”

A

Quadratus Lumborum

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5
Q

what muscles lie posterior medial and posterior to the kidneys?

A
  • Psoas

- QL

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6
Q

what are the external layers of the kidneys?

A 
1    Renal Capsule
(Tough fiberous capsule) 
2   Perirenal Fat
(Surrounds capsule)
3   Gerota’s Fascia
(Anchor’s the kidney)
4   Pararenal Fat
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7
Q

what are alternate names of the renal capsule?

A

true capsule/fibrous capsule

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8
Q

what is an alternate word for perineohric fat?

A

adipose capsule/packing fat of Zukerkandl

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9
Q

what is another name for Fascia of Gerota?

A

perirenal fascia/perinephric fascia

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10
Q

what is another name for pararenal fat?

A

pararenal body

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11
Q

what are the 4 retroperitoneal spaces pertaining to the kidney?

A
  • anterior pararenal space
  • perirenal space
  • retrorenal space
  • Posterior pararenal space
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12
Q

Anterior Pararenal Space

A

Fat area between the posterior peritoneum and Gerota’s fascia

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13
Q

what other organs does the Anterior Pararenal Space contain?

A
  • pancreas
  • descending portion of the duodenum
  • ascending and descending colon
  • superior mesenteric vessels
  • inferior portion of the common bile duct
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14
Q

Posterior Pararenal Space

A

Space between Gerota’s fascia and the posterior abdominal wall muscles

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15
Q

what does the Posterior Pararenal Space contain?

A
  • iliopsoas and quadratus lumborum muscles
  • the posterior abdominal wall
  • contains fat and nerves.
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16
Q

Perirenal Space

A

Space separated from the pararenal space by Gerota’s fascia

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17
Q

what does the Perirenal Space contain?

A 
kidneys and adrenal glands
 perinephric fat
 ureters
 renal vessels
 aorta and inferior vena cava
 lymph nodes
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18
Q

What is the purpose of these External layers specifically for Kidney’s?

A

Perirenal fat and Pararenal fat (layers 2 and 4) accommodate movement during respiration

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19
Q

what are the 2 areas the kidneys are divided into?

A
  • Renal parenchyma

- central sinus

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20
Q

Renal Parenchyma

A
  • cortex

- medulla

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21
Q

Central Sinus

A
  • renal sinus

- renal hilum

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22
Q

Renal Cortex

A

Outer portion more superficial layer

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23
Q

Medulla

A
  • Deeper layer of the Parenchyma
  • folds into projections called renal pyramids
  • Within medulla 8 to 18 cone shaped sections called renal pyramids
  • Areas between the pyramids called the renal columns
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24
Q

Renal pyramids

A
  • triangular structures composed of medullary substance
  • Base of pyramid is toward the outer circumference of the kidney
  • The apices (narrow tip) converge toward the renal sinus
  • Renal Papilla at the apices
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25
Q

what is the Central Sinus occupied by?

A

Blood vessels
Renal pelvis
Nerves
Fat

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26
Q

Renal Hilum

A

Area where the ureter, renal artery and renal vein enters or leaves the Kidneys

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27
Q

what is the renal sinus continuous with?

A

hilum

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28
Q

Renal Arteries and Renal Veins Lie more _________ to the Renal Pelvis

A

anterior

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29
Q

are kidneys highly ________

A

vascular

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30
Q

Renal artery

A

large branch of the abdominal aorta; brings blood into each kidney

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31
Q

Renal vein

A

large branch that brings deoxygenated blood to IVC

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32
Q

order of arteries and veins as they leave the kidney

A
  • renal artery
  • renal vein
  • Segmental (arteries and veins)
  • Lobar (artery and veins)
  • Interlobar (a and v)
  • Arcuate (a and v)
  • Interlobular (a and v)
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33
Q

Collecting system

A

Where urine flows out and makes its way to the bladder then out of body

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34
Q

what are parts of the collecting system within the kidney?

A

Minor calyces
Major Calyces
Renal Pelvis
Ureter

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35
Q

what is the contour of the kidney?

A

smooth borders

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36
Q

what is the shape of the kidney?

A
  • bean

- convex and concave medially

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37
Q

what is the size of kidneys?

A
  • 11 cm length
  • varies with size of person and age
  • Cortex outer layer decreases with age
  • Known as “parenchymal reduction” measure of AP thickness
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38
Q

what is the echogenicity of the kidneys?

A
  • Normal Rt renal cortex is slightly hypoechoic or isoechoic to the liver
  • Normal Lt renal cortex is hypoechoic to the spleen
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39
Q

urine formation

A

1 function excrete metabolic waste products in the form of urine (waste taken from blood)

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40
Q

Homeostasis

A

Regulates water-salt and acid-base balance

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41
Q

what kind of gland does the kidneys act like?

A

Acts as an endocrine gland therefore secretes hormones

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42
Q

what are the two types of nephrons?

A
  • cortical nephron

- juxtamedullary nephron

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43
Q

describe cortical nephron

A

Located mostly in Cortex

Shorter loop of Henle

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44
Q

describe juxtamedullary nephron

A

Adjoining Medulla

Longer loops of Henle

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45
Q

renal corpuscle=

A

Glomerulus & Bowman’s Capsule

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46
Q

Tubules=

A

proximal, Loop of Henle, distal convoluted tubules

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47
Q

where is the loop of henle located?

A

in the medulla

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48
Q

what is filtration?

A

filters the blood and to produce urine

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49
Q

Tubular Reabsorption

A

substances needed by the body are reabsorbed into the blood

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50
Q

Tubular Secretion

A

Waste products and excess water pass into collecting ducts as urine

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51
Q

describe serum creatinine

A

Formed in muscle in small amounts, passed into blood and excreted in urine
Increase creatinine = disturbance in function

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52
Q

Blood Urea Nitrogen

A

Urea = end product of protein metabolism normally low

BUN level increases = function or perfusion impaired

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53
Q

what is caused by BUN?

A
  • ???dehydration
  • urinary tract obstructions
  • Can lead to mental confusion, disorientation and coma
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54
Q

is transient pyelectasis normal?

A

yes

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55
Q

when can Transient Pyelectasis occur?

A

patient drinks lots of water (hydrated)

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56
Q

what can Transient Pyelectasis look like on an ultrasound?

A
  • Calyces and pyramids more anechoic more prominent

- Resolves after patient empty’s bladder

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57
Q

if the whole collecting system is anechoic is this normal?

A

no

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58
Q

name the 3 sets of kidneys in the embryo

A
  • Pronephros
  • Mesonephros
  • Metanephros
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59
Q

Pronephroi

A
  • Early in 4th week gestation

- Rudimentary and nonfunctioning

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60
Q

Mesonephroi

A
  • Late in 4th week

- Function as interim kidneys

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61
Q

Metanephroi

A

permanent kidneys

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62
Q

what are the 2 sources developed from metanephroi?

A
  • uretic bud

- metanephrogenic blastema

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63
Q

what is contained in the ureteric bud?

A
  • ureter
  • renal pelvis
  • calices
  • collecting ducts
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64
Q

Ureteric bud interacts with and penetrates the ________

A

metanephrogenic blastema

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65
Q

where are the kidneys in the abdomen?

A

travel from pelvis to RUQ

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66
Q

normal varients in notes

A

write these down (lesson 12)

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67
Q

what does HCB stand for?

A

Hypertrophied Column of Bertin

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68
Q

where is the HCB usually located?

A

upper and middle thirds of the kidney

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69
Q

is the HCB a concern or a normal variant?

A

normal varient

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70
Q

what plane is the HCB best seen in?

A

saggital

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71
Q

is the junctional cortical (parenchymal) defect a concern or a normal variant?

A

normal varient

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72
Q

what is the junctional cortical (parenchymal)?

A

site of failed fusion located anteriorly and superiorly and traced medially to inferiorly into renal sinus

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73
Q

what plane is the junctional cortical (parenchymal) best seen in?

A

Saggital

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74
Q

what kidney is the Junctional Cortical (Parenchymal) Defect usually seen on?

A

right kidney

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75
Q

is the Extrarenal Pelvis a concern or a normal variant?

A

normal variant

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76
Q

what is the Extrarenal Pelvis?

A

mildly dilated UPJ (ureteropelvic junction) medial to hilum

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77
Q

what plane is the Extrarenal Pelvis best seen in?

A

Transverse (this is where we measure Ant. to Post.)

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78
Q

is the Dromedary Hump a concern or a normal variant?

A

normal variant

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79
Q

what is the Dromedary Hump?

A

bulge on the lateral aspect of the anterior kidney (not clinically significant)

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80
Q

Ureters functions as a ________

A

conduit

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81
Q

Bladder acts as a ________

A

reservoir for urine

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82
Q

Urethra functions as a _______

A

conduit

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83
Q

how long are the ureters?

A

25-30cm in length

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84
Q

where do the ureters course?

A
  • inferiorly behind the parietal peritoneum anterior to the Psoas muscle
  • crosses iliac vessels anterior to the sacroiliac joint
  • Enters inferior bladder
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85
Q

what are the 3 layers of ureters?

A
  • inner mucosal layer
  • Medial layer of longitudinal and circular smooth muscle
  • Outer fibrous layer
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86
Q

what terms describes how ureters transfer urine to bladder

A

urethral peristalsis

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87
Q

what term describes the proximal ureter as it leaves the kidney?

A

ureteropelvic junction (UPJ)

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88
Q

what is the term to describe the ureter as it enters the bladder?

A

ureter vesicle junction (UVJ)

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89
Q

is the bladder intra or retro?

A

retro

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90
Q

what muscle is the bladder wall mostly made of?

A

smooth muscle

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91
Q

inner layer of bladder forms folds called_______

A

rugae

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92
Q

where do the urethral opening lie on the bladder?

A

anterior, lower corner

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93
Q

how many planes and positions do you scan the kidneys?

A

2 planes and 2 positions

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94
Q

how many planes and positions do you scan the bladder?

A

2 planes and 1 position (supine)

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95
Q

what is the echogenicity of the bladder?

A

Anechoic fluid filled structure with echogenic walls (acts as specular reflector)

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96
Q

what is the contour of the bladder?

A

smooth when full

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97
Q

what is the shape of the bladder in TRV?

A

square with curved edges

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98
Q

what is the shape of the bladder in SAG?

A

appears triangular

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99
Q

how do you measure bladder volume?

A

(Lx W x AP {H}) x 0.523=cc

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100
Q

what do you measure in the bladder in SAG?

A

length

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101
Q

What do you measure on the bladder in TRV?

A

AP (height) and right to left (width)

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102
Q

what 2 volumes must you measure with the patient?

A

prevoid and postvoid (full bladder and emptying bladder)

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103
Q

is the bladder wall normally measured?

A

no

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104
Q

what may you see with colour doppler in the bladder?

A

jets at the UVJ

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105
Q

where can the reverberation artifact appear in the bladder?

A

mostly in the near field (anterior portion of the bladder) adjust gains to fix this

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106
Q

what are 3 pitfalls when scanning the bladder?

A
  • obese patients
  • surgical scars can produce artifacts (go around the scar)
  • abdominal dressings
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107
Q

what fused with the cloacal membrane on the 7th week in the bladder?

A

urorectal septum

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108
Q

what divides the urogenital sinus and dorsal rectum in the bladder?

A

urorectal septum fused with the cloacal membrane

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109
Q

urogenital sinus

A

bladder

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110
Q

bladder is continuous with ________

A

allantois

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111
Q

what does the allantois become?

A

urachus (fibrous cord aka median umbilical ligament )

112
Q

what 2 things occur when the bladder grows?

A
  • Distal mesonephric ducts becomes part of the connective tissue into the bladder trigone
  • Ureters open into bladder
113
Q

what are 3 anomalies (abnormalities) related to growth of the kidneys?

A

Hypoplasia
Fetal Lobulation
Compensatory Hypertrophy

114
Q

what is hypoplasia?

A

underdevelopment/incomplete

small kidneys occur which causes reduced nephrons

115
Q

what is persistent fetal lobulation?

A

seen in ultrasound as smooth indentations

116
Q

where is persistent fetal lobulation normally present?

A

in children until 4-5 years of age

117
Q

what is Compensatory Hypertrophy

A

ONE KIDNEY GETS BIGGER AND MAKES UP FOR THE SMALLER ONE

diffuse (nephrectomy, renal egenesis, e.t.c) or focal (area of normal tissue enlarged)

118
Q

what are 3 anomalies (abnormalities) related to ascent of the kidney?

A

Ectopia
Crossed Renal Ectopia
Horseshoe Kidney

119
Q

what is ectopia?

A

kidney is not located in the normal position usually in the pelvis or thorax

120
Q

do people with ectopia show symptoms?

A

no

121
Q

what are some possible complications of ectopia?

A

infection, stones, blunt, trauma

122
Q

what is crossed renal ectopia?

A

displacement of one kidney to the opposite side

123
Q

what are the 2 forms of crossed renal ectopia?

A
  • fused (85-90%)

- lying on one side without fusion

124
Q

what kidney is more common for crossed renal ectopia?

A

left kidney going to right is more common

125
Q

what is the horseshoe kidney?

A

lower pole fuse at midline

126
Q

what are some symptoms of the horseshoe kidney?

A

abdominal pain, nausea, stones, urinary tract infections

127
Q

where do you see the horseshoe kidney on ultrasound?

A

: located at lower level than normal, bridge of renal tissue (isthmus) connecting 2 kidneys

128
Q

what are the anomalies related to the ureteral bud of the kidney?

A

-agenisis
-Ureteropelvic junction obstruction
-supernumerary kidney
-Duplex Colllecting system and uterocele?
MORE ON MOODLE

129
Q

what is renal agenesis?

A

failure of formation unilateral or bilateral

No kidney

130
Q

what are the causes of renal agenesis?

A
  • absence of metanephrogenic blastema
  • absence of ureteral bud development
  • absence of interaction and penetration of the uretral buds with metanephrogenic blastema
131
Q

what is supernumerary kidney?

A

extra small kidney above, below, in front, or behind normal kidney

132
Q

is supernumerary kidney common or rare?

A

rare

133
Q

what are the symptoms of supernumerary kidney?

A

Pain
Fever
Hypertension
Palpable abdominal mass

134
Q

what is Duplex Ureter System and Ureterocele?

A

an extra ureter

135
Q

what are the types of Duplex Ureter System and Ureterocele?

A
  • complete
  • incomplete
  • unilateral
  • bilateral
136
Q

what is urecterocele?

A
  • a congenital abnormality found in the distal ureter
  • Distal ureter balloons at UVJ forming a sac-like pouch
  • associated with a duplicated collection system
  • incidental and clinically insignificant
137
Q

what are complications with Duplex Ureter System and Ureterocele?

A
  • ureteral obstruction

- recurrent or persist urinary tract infection

138
Q

what is the treatment for Duplex Ureter System and Ureterocele?

A

surgery

139
Q

what gender is congenital megaureter most common?

A

males

140
Q

which ureter is congenital megaureter most common?

A

left ureter

141
Q

what are the Anamolies Related to Vascular Development?

A
  • Retrocaval Ureter (ureter passes behind IVC)

- Aberrant Vessels (vessels enter at a place other than the hilum)

142
Q

what are the Anomalies Related to Bladder Development?

A
  • Bladder Agenesis
  • Bladder Duplication
  • Bladder Exstrophy
  • Urachal Anomalies
143
Q

what are the Anomalies Related to Urethral Development?

A

-diverticula

144
Q

what is the retrocaval ureter?

A

Abnormal embryogenesis of IVC, ureter passes behind the IVC before entering the pelvis

145
Q

does the retrocaval ureter most commonly happen in males or females?

A

males (3:1)

146
Q

which ureter does the retrocaval ureter most commonly occur?

A

right ureter

147
Q

what are the symptoms of retrocaval ureter?

A
  • right flank pain

- UTI

148
Q

what does ureterocele mean?

A

little pouch that collapses when patient empties bladder

149
Q

what is bladder agenesis?

A

bladder is absent in US

  • still born
  • very rare
150
Q

what are the 3 types of bladder duplication?

A
  • peritoneal (looks like 2 bladders) complete or incomplete
  • internal septum (like gallbladder) complete or incomplete
  • transverse band-band of muscle that divides the bladder into 2 unequal cavities
151
Q

what is bladder exstrophy?

A

part of the urinary bladder is present outside the body and often inside out

-failure of the abdominal wall to close during fetal development

152
Q

where is bladder exstrophy mostly found?

A

males (2:1)

seen in babies

153
Q

Urachus

A

remnant of the channel between the bladder and the umbilicus 4 types

154
Q

what are the 4 types of urachus?

A
  • patent urachus
  • urachal cyst
  • urachal sinus
  • diverticulum
155
Q

Urethral Diverticulum

A

“pocket” or outpouching forms next to Urethra and connects with Urethra

156
Q

Which of the following are considered an anomaly related to Growth?
A. Renal Agenesis
B. Ureterocele
C. Persistent Fetal Lobulation

A

C. Persistent Fetal Lobulation

157
Q

Which of the following anomalies is easier to diagnosis using ultrasound only?
A. Hypoplasia
B. Cross Renal Ectopia
C. Horseshoe Kidney

A

C. Horseshoe Kidney

158
Q

Which bladder anomaly is the most likely to be seen with pelvic ultrasound on an adult?
A. Bladder Duplication
B. Bladder agenesis
C. Bladder Exstropy

A

A. Bladder Duplication

159
Q

MATCH
Renal ectopia growth

Supernummary ascent

Hypoplasia ureteral bud

A

Renal ectopia=ascent
supernummary=uteral bud
hypoplasia=growth

160
Q

A person has unilateral right renal agenesis. The left kidney is enlarged what is this called?
A. Compensatory hypertrophy
B. Duplex Collecting system
C. Diverticulum

What type of anomaly is this?

A

A. Compensatory hypertrophy

growth

161
Q

If you are scanning the LUQ and there is no kidney found????
-Patient has not had surgery
List the possible Anomalies and the category they fall within

A
  • agenesis (ureteral bud)
  • ectopia (ascent)
  • Hypoplasia (growth)
162
Q

Very hydrated patient and collecting system
May be anechoic areas due to collecting system being dilated
What is this known as and how is it resolved?

A

known as transient pyelectasis

resolved by voiding (emptying bladder) and if it persists (stays there) it is not normal

163
Q

why does renal duplication artifact occur?

A

result of sound beam refraction between lower portion of spleen or liver and adjacent fat

164
Q

which kidney is renal duplication artifact more common in?

A

left kidney and also in obese patients

165
Q

what can renal duplication artifact mimike?

A

duplex collecting system
Suprarenal masses
Upper pole renal cortical thickening

166
Q

how to resolve renal duplication artifact?

A

change transducer position

use deep inspiration

167
Q

Intravenous Urography

A

radiographic examination

168
Q

Nuclear Medicine

A

IV radionuclide filtered through kidneys at a specific rate and concentration

169
Q

what makes US different from other modalities such as CT

A
  • we can scan live
  • pre and postvoid
  • see jets of urine going into bladder
170
Q

what is US good at seeing when looking at the urinary system?

A

jets

171
Q

what are the limitations of US and the urinary system?

A
  • don’t see kidney function
  • cant differenciate different masses
  • quality of scan (body habitus)
172
Q 
Pick the lab test which may indicate an Adrenal Gland problem
A. LFT’s
B. Amalyse
C. WBC
D. Aldosterone
A

D. Aldosterone

173
Q

Pick the best answer: Where should you look to locate a Right Adrenal gland when scanning?
A. Transverse Liver Right between Upper pole of Kidney and IVC
B. Transverse Liver at the level of the hepatic veins look posterior to IVC
C. Transverse Liver Right between lower pole of Kidney and IVC

A

A. Transverse Liver Right between Upper pole of Kidney and IVC

174
Q

where is the spleen located?

A
  • LUQ
  • Left hypochondrium
  • Intraperitoneal
175
Q

is the spleen in contact with the diaphragm?

A

yes

176
Q

what is inferiomedial to the spleen?

A
  • stomach
  • left kidney
  • pancreas
  • splenic flexure
177
Q

what surrounds the spleen?

A

fibrous capsule

178
Q

what is the shape of the spleen?

A

ovoid (oval)

  • convex superolateral
  • concave inferomedially
179
Q

are the borders of the spleen smooth?

A

yes
superiorly
posteriorly
latterly

180
Q

where are the gentle indentations of the spleen?

A

medial aspect

181
Q

what is the hilum composed of?

A
  • white pulp

- red pulp

182
Q

what enters and exits the hilum of the spleen?

A

-splenic artery and vein

the spleen is highly vascular

183
Q

what are the ligaments of the spleen?

A

Splenorenal ligament
Phrenicocolic ligament
Gastrosplenic ligament

184
Q

are the ligaments of the spleen usually seen?

A

no

185
Q

what are the spleens functions?

A
  • immunity
  • tissue repair
  • hematopoiesis
  • red blood cell and platelet destruction
  • blood reservoir
186
Q

do you need a spleen to survive?

A

no

187
Q

why might we scan the spleen?

A
  • LUQ pain
  • Mono (enlarged spleen)
  • suspected rupture (trauma)
188
Q

what is the best way to measure the spleen?

A

eyeballing

-compare with Lt kidney

189
Q

how big is the spleen?

A

11-12 cm in length

5cm width

190
Q

does the weight of the spleen increase or decrease with age?

A

decrease in size and weight

191
Q

what is the shape of the spleen?

A

convex superolatterly

concave inferomedially

192
Q

what is the echogenicity of the spleen?

A

higher echogenicity than the liver and left kidney

193
Q

what is the echotexture of the spleen?

A

parenchyma is homogenous

194
Q

what are some difficulties when scanning the spleen?

A
  • ribs

- air from lungs

195
Q

what are the 3 sagittal images of the spleen?

A
  • hilum
  • hilum with measurement
  • left kidney interface
196
Q

what does the spleen arise from?

A

mesenchymal cells

197
Q

the cells of the spleen differentiate to form _________

A
  • splenic pulp

- splenic capsule

198
Q

Base of the dorsal mesentery fuses with the ____________

A

posterior peritoneum

-forms the splenorenal ligament

199
Q

what are the normal varients of the spleen?

number and location

A 
number
-accessory
-asplenia
-polyspenia
location
-wandering
-ectopic
200
Q

accessory spleen

A

Homogenous isoechoic mass similar to the spleen
Typically found
hilum or inferior border of spleen

201
Q

what is the most common normal variant?

A

accessory spleen

202
Q

Asplenia

A

complete absence

rare

203
Q

Polysplenia

A

multiple small accessory spleen

204
Q

Wandering spleen

A
  • migrated from its normal location in the left upper quadrant.
  • dorsal mesentery fails to fuse properly with posterior peritoneum
  • lack of support ligaments
205
Q

Ectopic

A

The spleen is located in the abdominal cavity outside of where it should be

206
Q

where are the 4 locations you may find lymph nodes?

A
  • auxillary
  • cervical (neck)
  • inguinal
  • abdomen
207
Q

what are the functions of the lymph system?

A
  • collect and transport excess fluids, lymph
  • absorb fats from small intestine to the liver
  • help to produce cells that fight infection
208
Q

how big are lymph nodes?

A

smaller than tip of finger

209
Q

what is the sonographic appearance of a lymph node?

A

ovoid in shape
fatty hilum
-superficial nodes=high f
deep nodes=low f

210
Q

in lymph nodes is AP smaller or bigger in width than length?

A

AP is smaller than width or length

211
Q

where is the right adrenal gland located?

A

between IVC and UP of Kid near Liver

212
Q

where is the left adrenal gland located?

A

near Diaphram, Superior posterior border of Spleen

213
Q

what are the 2 parts the adrenal glands are divided into?

A
  • cortex

- medulla

214
Q

what tissue is the cortex made up of?

A

endocrine tissue-corticosteroids

215
Q

what tissue is the medulla made up of?

A

-neurosecretory tissue-catecholamines

216
Q

what is the inner layer of the renal cortex?

A
  • Zona recticularis

- gonadocorticoids

217
Q

what is the middle layer of the renal cortex?

A

zona fasciculata

-glucocorticoids

218
Q

what is the outer layer of the renal cortex?

A

zona glomerulosa

-mineralocorticoids

219
Q

what are the functions of the adrenal glands?

A

Regulate homeostasis in the body
Sodium and water balance
Fight or Flight response

220
Q

what are the hormones in adrenal glands that could indicate problems?

A

Aldosterone

Cortisol

221
Q

do we image the adrenal glands?

A

not in adults but there seen in children

222
Q

what adrenal gland is harder to visualize?

A

left side is harder

223
Q

if seen, what does the adrenal gland look like on ultrasound?

A

thin hyperechoic layers separated by hyperechoic layers

224
Q

what transports semen outside?

A 
Epididymis
Vas deferens
Join seminal vesicles
Ejaculatory ducts
Urethra
225
Q

Seminal vesicles

A

2 hollow, sacculated structures
Base bladder
Superior to prostate gland
Inferior to vas deferens and ureters

226
Q

Prostate

A

Small Chestnut sized/shaped organ
Base=Most superior part
Apex= Inferior part

227
Q

Ejaculatory ducts

A

Join Urethra approx. mid way through prostate

228
Q

Ducts

A

Transport the seminal fluid

229
Q

Seminal Vesicles

A

Adds secretions to seminal fluid

230
Q

Prostate

A

Adds secretions to seminal fluid

231
Q

Urethra

A

conduit for semen and urine

232
Q

Prostaticovesical arteries

A

from the Internal Iliac As

prostatic and inferior vesical artery

233
Q

Inferior vesical artery

A

Supplies the base of the bladder, seminal vesicles and ureter

234
Q

Prostatic artery

A

Branches to capsular and urethral arteries

Supply prostate

235
Q

Venous

A

Form a network around the sides and base of the prostate- deep dorsal penile vein draining into the internal iliac veins

236
Q

what are the 2 sections of the prostate?

A

Fibromuscular region/stroma

glandular region

237
Q

Fibromuscular region/stroma

A

Smaller section
Anterior to the prostatic urethra
Less clinical significance

238
Q

Glandular region

A

posterior portion

239
Q

what are the 4 zones of the prostate?

A
  • Peripheral
  • central
  • transition zone
  • periurethral glandular tissue/zone
240
Q

Peripheral zone

A
  • Largest ~ 70% of glandular tissue
  • 70% of cancers found here
  • posterior, lateral and apical regions of the prostate
  • Resembles “eggcup” holding the egg of the central gland
241
Q

central zone

A
  • 25% of prostatic glandular tissue
  • 5% of cancer located in Central Zone
  • Vas deferens and seminal vesicles
242
Q

Transitional zone

A

-lateral aspects of the proximal prostatic urethra
~ 5% of glandular tissue
-20 % of cancers

243
Q

Periurethral glandular zone

A

Tissue that lines the proximal prostatic urethra

244
Q

The prostatic urethra is divided by the _____________

A

verumontanum

245
Q

verumontanum

A
  • An area close to the centre of the prostate
  • separates proximal and distal prostatic urethra
  • Where ejaculatory ducts meet the urethra
246
Q

clinical indications for scanning prostate?

A
  • Prostate Problems suspected (lump on DRE)
  • Lab Values increased (PSA)
  • Urinary problems (weak stream)
247
Q

Prostate-Specific Antigen (PSA)

A

Glycoprotein produced exclusively by the prostate
Increase possible prostate cancer exists
Higher the elevation= more likely a cancer exists

248
Q

is PSA ideal?

A

no because it could be high and no cancer

249
Q

what increases when prostate increases?

A

PSA

250
Q

what is the borderline for prostate PSA level?

A

4-10 ng%

251
Q

what percent of cancer can biopsys detect?

A

80%

252
Q

What anatomy is assessed for Male Pelvis Ultrasound?

A

Prostate
Seminal vesicles
Bladder

253
Q

where on the prostate is more cancers?

A

posterior

254
Q

how many position and planes do we scan the prostate?

A

2 planes and in supine position

255
Q

what must the patient do to prepare for the prostate exam?

A

fill bladder

256
Q

what do we take images of with the prostate?

A

prostate and seminal vesicles

also image the RLQ and LLQ in sag

257
Q

what does the prostate look in an US?

A

heterogenous

symmetrical in shape

258
Q

TRUS stand for?

A

Trans Rectal Ultrasound

259
Q

Major reasons presently for TRUS?

A

Prostate cancer evaluation
Biopsy
Guidance of therapeutic procedures

260
Q

what is the patient positioning for TRUS?

A

Left lateral decubitus with legs together and bent up

Digital rectal exam before probe insertion if performed by Radiologist

261
Q

Transverse or Axial in TRUS?

A

Anterior abdominal wall is top of screen with right side of patient on left side of image
Seminal vesicles at the base to urethra at the apex

262
Q

Sagittal in TRUS?

A

Anterior abdominal wall top of screen, head of patient on the left of image – foot at right of image
From right to midline to left lobe

263
Q

what do we divide the prostate into on US?

A
  • inner gland=transitional+ anterior fibromuscular stroma glandular tissue+ internal urethra sphincter
  • outer gland=(peripheral zone + central zone)
264
Q

Outer Gland (sometimes referred to as peripheral)

A

uniform, homogenous texture

Slightly more echogenic than inner gland

265
Q

Inner Gland (sometimes referred to as central)

A

More hypoechoic

heterogeneous

266
Q

“Surgical capsule” separates ________

A

Inner and outer gland

Not always seen in young males

267
Q

Traditionally when urologists resected the prostate they believed they dissected to this line therefore called surgical capsule is it a true capsule?

A

no

268
Q

Outer Margin of the prostate ___________

A

prostate capsule

269
Q

prostate capsule

A

Clear interface between prostate and periprostatic fat

270
Q

Seminal vesicles appearance on US

A

relatively hypoechoic, multiseptated structures

271
Q

Vas deferens appearance on US

A

Seen adjacent to Seminal vesicles

272
Q

is Benign Ductal Ectasia a issue or normal variant?

A

normal variant

273
Q

what is Benign Ductal Ectasia caused by?

A

atrophy and dilatation of prostatic ducts

happens in older men

274
Q

is Prostatic Calcifications and Corpora Amylacea normal variant or an issue?

A

normal varient

275
Q

Prostatic Calcifications and Corpora Amylacea

A

More common with advancing age

Bright echogenic foci or clumps in prostate

276
Q

is Corpora Amylacea a normal variant or an issue

A

Proteinaceous debris
sound attenuation preventing TRUS examination
No clinical significance
usually not palpable

Normal Anatomy (7 decks)

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