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HD CC > Problems of the Male Reproductive system > Flashcards

Problems of the Male Reproductive system Flashcards

1
Q

Prostate dimensions

A

3cm Long
4cm Wide
2cm AP depth

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2
Q

Prostate lobes

A

Isthmus- anterior
Inferoposterior
Middle lobe

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3
Q

Prostate glandular regions

A

Peripheral Zone
Central Zone
Transition Zone

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4
Q

Peripheral zone

A

70%

Surrounds urethra

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5
Q

Central zone

A

25%

Surrounds ejaculatory ducts

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6
Q

Transition zone

A

5%

Surrounds proximal urethra

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7
Q

Prostate function

A

Secretes a fluid making up semen

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8
Q

Main hyperplasia of prostate

A

Epithelial + stromal cells small glands of TRANSITION ZONE

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9
Q

Main area of prostate cancer

A

Peripheral Zone

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10
Q

BPE Causes

A

Advancing age
–> age related enlargement caused by increased cell proliferation + decreased apoptosis
Testicular androgens
Oestrogen
Prostatic stromal + epithelial tissue interactions
Neurotransmitters from gland

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11
Q

Stromal cells + testosterone

A

Testosterone –> estradiol

–> leads to stromal cell proliferation

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12
Q

Epithelial cells + testosterone

A

Testosterone –> DHT

DHT binds AR –> antagonises epithelial cell apoptosis

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13
Q

Estradiol leads to

A

Apoptosis of epithelial cells

Proliferation of stromal cells

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14
Q

BPE Symptoms

A 
SHITE
Slow stream
Hesitancy
Intermittent flow
Terminal dribbling
Emptying is incomplete
FUN
Frequency
Urgency
Nocturia
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15
Q

BPE Diagnosis

A

History
DRE
Ultrasound- biopsy
Blood test- PSA

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16
Q

PSA levels

A 
40-49= 0-2.5ng/ml
50-59= 0-3ng/ml
60-69= 0-4ng/ml
>70= 0-5ng/ml
Less than 10ng/ml usually due to BHP
17
Q

BPE treatment

A

Alpha 1 adrenergic blockers

5 alpha reductase inhibitors

18
Q

Alpha 1 adrenergic blockers

A

Relaxes smooth muscle in bladder neck + prostate improving urine flow rate

19
Q

5 alpha reductase inhibitors

A

Type I + II
Stops conversion of Testosterone –> DHT
Finasteride

20
Q

BPE surgery

A 
Transurethral resection of the prostate
Open prostatectomy
UroLift
Laser ablation
Transurethral microwave
High energy ultrasound therapy
21
Q

Prostate cancer

A

Similar symptoms to BPH

PSA (if raised) much higher than in BPH

22
Q

Direct inguinal hernia

A

Less common
Old age
Not in deep inguinal ring
Doesn’t extend beyond superficial inguinal ring
Neck is medial to inferior epigastric artery

23
Q

Indirect inguinal hernia

A 
More common
Young
Enters deep inguinal hernia
Reaches scrotum
Neck is lateral to inferior epigastric artery
24
Q

Three finger test

A

Index finger on deep inguinal ring
Middle finger on superficial inguinal ring
Ring finger on saphenous opening
Patient asked to cough
–> felt on deep inguinal, then indirect
–> felt on superficial inguinal, then direct
–> felt at saphenous opening, then femoral

25
Q

Direct inguinal hernia anatomy

A

Hasselbach’s triangle

Rectus abdominis, inferior epigastric, inguinal ligament

26
Q

Indirect inguinal hernia facts

A

Associated with failure of inguinal canal to close properly after passage of testis in utero

27
Q

Erection MOA

A

Lots more blood flow into lacunar space (surrounded by cavernosal smooth muscle)
Lots more inflow due to vasodilation, more smooth muscle –> compresses + stretches veins and reduces outflow
Blood remains maintaining erection

28
Q

What is pressure within penis to close off venous return

A

200mmHg

29
Q

Parasympathetic effect on penis

A 
AP travels down neurone
Ca comes in
Releases NO
NO goes into smooth muscle in arteries, causing activation of soluble guanylyl cyclase
Causes cGMP production
cGMP relaxes smooth muscle --> ERECTION
30
Q

Sympathetic effect on penis

A

Symp. neurone releases NA
Works on Alpha 1 adrenoreceptor
Contracts smooth muscle
–> Ejaculation

31
Q

Phosphodiesterase type 5

A

breaks down cGMP

Stops erection

32
Q

Sildenafil

A

PDE-5 inhibitor
Increases intracellular cGMP conc.
Stops breakdown of cGMP–> keeps smooth muscle relaxed –> erection stays
No more than 1 a day

33
Q

PDE 5 inhibitors

A

Vardenafil (Levitra)

Tadalafil (Cialis)

34
Q

Peyronie’s disease

A

Scar tissue forms in shaft of penis

  • -> bending or deformities
  • -> painful erections + difficulties with sex
35
Q

Peyronie’s disease treatment

A

Surgical

Non-surgical= stretching, topical verapamil, para-aminobenzoate

36
Q

Para-aminobenzoate

A

B group of vitamins

Used to treat disorders associated with excess formation of fibrous tissue

37
Q

Varicocele

A

Varicose veins of scrotum (pampiniform venous plexus)
Always left testis
2 degree rise in temp
35-40% infertile men have it

HD CC (22 decks)

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