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Abd / SS > Module 8 : Prostate > Flashcards

Module 8 : Prostate Flashcards

1
Q

prostate location

A
  • inferior to bladder
  • surrounds neck of bladder nd urethra
  • posterior to pubis
  • anterior to rectum
  • levator ani muscle posterior
  • fibrous capsule
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2
Q

prostate shape

A
  • ovoid
  • inverted pyramid
  • apex = caudal
  • base = cephalic
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3
Q

prostate size

A
  • length = 3-3.5cm
  • width = 4cm
  • AP = 2-2.5cm
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4
Q

prostate weight

A
  • younger under 50 = 20grams 20ccs

- older over 50 = 40 grams 40ccs

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5
Q

prostate function

A
  • secretes alkaline fluid
    + 1/3 of semen volume
    + aids in sperm motility and activating sperm
    + neutralizes acid environment of vagina, uterus and Fallopian tubes
  • produces prostate specific antigen PSA
    + increases with age
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6
Q

anatomy

A
  • zonal anatomy
  • 4 zones in relationship to urethra and ejaculatroy duct
  • useful in localization of cancer
  • based on histological components
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7
Q

peripheral zone

A
  • largest zone
  • most common site of cancer
  • surrounds distal urethra
  • surgical capsule separates it form transition and central zone
  • posterior lateral and apical regions
  • benign prostatic hyperplasia (BPH) does not affect here
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8
Q

transition zone

A
  • two small glands on either side of proximal urethra segment
  • site of origin of benign prostatic hyperplasia
  • ducts end in proximal urethra at level of verumontanum
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9
Q

central zone

A
  • base of prostate
  • ejaculatroy ducts pass through it
  • resistant to disease process
  • zone terminates near verumontanum
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10
Q

periurethral glands

A
  • 1% of gland volume
  • embedded in the longitudinal smooth muscle of pros urethrea
  • internal prostatic sphincter
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11
Q

fibromuscular stroma

A
  • non glandular area
  • anterior surface of prostate
  • one third of prostate
  • smooth connection tissue
  • NOT PART OF ZONES
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12
Q

outer/peripheral gland

A
  • peripheral and central
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13
Q

inner gland

A
  • transition zone
  • fibromuscular stroma
  • urethral sphincter
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14
Q

seminal vesicles

A
  • paired ovoid
  • posterior to bladder
  • superior to prostate
  • SV + vas deference = ED
  • ED empty into urethra
  • 3-4cm in length 1-3cm in thickness
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15
Q

indications for US

A
    • DRE
  • increased PSA
  • urine infrequency , nocturne, decreased urine stream
  • male infertility
  • biopsy guidance
  • blood or pus in urine or semen
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16
Q

transabdominal exam

A
  • only for size and volume of prostate

- need full bladder

17
Q

prostate on US

A
  • ovoid
  • low to moderate echoes
  • homogenous
  • echogenic interface from urethra
18
Q

trans rectal TRUS

A
  • variety of types
  • end firing (viewing) probe most common
    + multiplane imaging
    + biopsy capability
  • probes covered in condom (latex or non latex)
  • ## ASK PATIENT IF LATEX ALLERGY
19
Q

TRUS scan technique

A
  • empty bladder
  • LLD position with legs bent to chest
  • DRE performed prior to TRUS
  • systemic approach axial and transverse
20
Q

TRUS scan orientation

A
  • rectum at the bottom of screen

- sag = anterior abdominal wall at top

21
Q

peripheral zone sonographic appearance

A
  • homogeneous and isoechoic
22
Q

surgical capsule US look

A
  • hypo echoic line
23
Q

central zone US look

A
  • hyper echoic or isoechoic to peripheral zone
24
Q

transition zone US look

A
  • isoechoic to peripheral zone

- hypo echoic with BPH

25
Q

corpora amylacea

A

echogenic foci = collection of protein

26
Q

periurethral glandular area US look

A
  • hypo echoic
  • blend with urethr
  • prominent in young men
27
Q

anterior fibromuscular stroma

A
  • hypechoic
28
Q

seminal vesicle

A
  • hypo echoic
  • symmetrical
  • AP 10mm
29
Q

what area used for standard echogenicity

A

peripheral zone

30
Q

lab tests

A
  • PSA
  • PSA density
  • Acid phosphate
  • alkaline phosphate
31
Q

prostate specific antigen PSA

A
  • enzyme almost exclusively in prostate
  • secreted and disposed of through ducts in prostate
  • elevated in BPH infection carcinoma
  • not specific to cause
  • normal < 4ng/ml
  • biopsy if >10ng/ml
32
Q

PSA density

A
  • PSA / prostate volume
  • cancerous tissue produces more PSA
  • density > 0.12 warrants a biopsy
33
Q

acid phosphate

A
  • found in prostate and semen

- increased in carcinoma that has spreadbeyon prostate capsule

34
Q

alkaline phosphate

A
  • produced in osteoblasts (bone) will increase if increase in osteoblast activity
  • prostate cancer spread to bone
35
Q

blood supply

A
  • prostaticovesicle arteries

- brach of IIA

36
Q

benign ductal ectasia

A
  • 1-2mm tubular structure in peripheral zone
  • hypoechoic
  • can be mistaken for prostate cancer
37
Q

calcifications

A
  • incidental findings

- benign calcifications often coarser in appearance than malignant calcifications

Abd / SS (14 decks)

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