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Abdomin And Superficial Structures > Prostate > Flashcards

Prostate Flashcards

(96 cards)

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1
Q

What structure is superior to the prostate?

A

Bladder

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2
Q

What structures does the prostate surround?

A

Neck of the bladder and the urethra

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3
Q

What does the prostate lie posterior to?

A

P.S

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4
Q

What structure does the prostate lie anterior to?

A

Rectum

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5
Q

What muscles lie posterolateral to the prostate?

A

Levator ani muscles

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6
Q

Does the prostate have a capsule?

A

It has a fibrous capsule- not a true capsule

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7
Q

What is the shape of the prostate?

A

Ovoid inverted pyramid

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8
Q

What is the orientation of the prostate?

A

Apex- inferior or caudal end

Base- superior or cephalic end

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9
Q

What is the size of the prostate? (L, W and H)

A

Length: 3.0-3.5cm
Width: 4cm
Height: 2.0-2.5cm

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10
Q

What is the weight of the prostate in younger men? (Up to 50 years)

A

20 grams (cc)

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11
Q

What is the weight of the prostate in older men? (Over 50 years)

A

Less then 40 grams

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12
Q

What is the physiology of the prostate?

A

Fibromuscular and glandular tissue

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13
Q

What is the purpose of producing and secreting an alkaline fluid? (2)

A
  1. Aids in motility and activating sperm

2. Neutralizes the acid environment of vagina, uterus and Fallopian tubes

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14
Q

How much alkaline fluid is included in the semen volume?

A

1/3 of semen volume

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15
Q

What antigen does the prostate produce?

A

PSA- prostate specific antigen

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16
Q

What happens to the PSA volumes as the male ages?

A

Increases with age

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17
Q

How many zones are there in the prostate?

A

4

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18
Q

The prostate zones are positioned based on what structures?

A

Urethra and ejaculatory duct

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19
Q

What is zonal anatomy useful in detecting?

A

Localization of cancer

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20
Q

What is the zonal anatomy based on?

A

Histology also components

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21
Q

What are the zones of the prostate?

A
  1. Peripheral zone
  2. Transitional zone
  3. Central zone
  4. Periurethral glands
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22
Q

What zone of the prostate is the largest?

A

Peripheral zone

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23
Q

What is the most common site of prostate cancer?

A

Peripheral zone

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24
Q

What structure does the peripheral zone surround?

A

Distal urethra

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25
How is the peripheral zone seperated from the transition and central zone?
Surgical capsule
26
What regions of the prostate does the peripherial zone occupy?
Posterior, lateral and apical regions
27
Does BPH affect the peripheral zone?
No
28
What % of prostatic glandular tissue is included in the transitional zone?
5%
29
Where is the transitional zone located on the prostate?
Two small glands on each side of the prox urethra
30
What zone is the common origin of benign prostatic hyperplasia?
Central zone
31
Where do the ducts end in the transition zone?
Proximal urethra at the level of the verumontanum
32
What % of prostatic glandular tissue is included in the central zone?
25%
33
Where is the central zone located?
Base of the prostate
34
What structures enter the central zone?
Ducts of the vas deferens and seminal vesicles
35
What structure passes through the central zone?
Ejaculatory duct
36
Is the central zone prone to diseases?
No, relatively resistant to diseases
37
Where does the central zone terminate?
Near the verumontanum
38
What is the verumontanum?
Area where the ejaculatory duct joins urethra
39
How much prostatic glandular tissue does the periurethral glands include?
1%
40
Where are the periurethral glands located?
Embedded in the longitudinal smooth muscle of the proximal urethra
41
What is the periurethral gland know as?
"Internal prostatic sphincter"
42
What is the function of the internal prostatic sphincter?
Prevent reflux of urine
43
What is the fibromuscular stroma?
Non glandular area on anterior surface of the prostate Smooth muscle and connective tissue
44
The fibromuscular stroma makes up how much of the prostate?
1/3 of the prostate
45
What zones does the outer/peripheral gland of the prostate make up?
Peripheral and central zones
46
What zones does the inner glans of the prostate make up?
Transitional zone, fibromuscular storm and urethral sphincter
47
What is the shape of the seminal vesicles?
Paired, ovoid shape
48
Where do the seminal vesicles sit in relation to the bladder?
Posterior
49
Where do the seminal vesicles sit in relation to the prostate?
Superior
50
What 2 structures join to form the ejaculatory ducts?
SV and vas deferens
51
What are the dimensions of the seminal vesicles?
L: 3-4cm | AP (thickness): 1-3cm
52
What factors cause the seminal vesicles to vary in size and shape?
Age and sexual activity
53
What do the seminal vesicles secrete?
Alkaline, viscous fluid into the ejaculatory duct which contributes to sperm viability
54
What are some indications for an US?
- Positive DRE - Increased PSA - Urinary frequency, nocturia, decreased urine stream - Male infertility - Biopsy guidance - Blood or pus in the urine or semen
55
What are the 2 methods used to scan the prostate and seminal vesicles?
1. Transabdominal (transvesicular) | 2. Transrectal (TRUS)
56
What is TA US useful in assessing?
Size and volume of prostate only
57
What is pt prep for scanning the prostate?
Full bladder
58
What is the TA US appearance of the prostate?
Ovoid structure Low to moderate echogenic levels Homogenous Echogenic interface due to the urethra
59
What is the TA US appearance of the seminal vesicles?
Hypoechoic, medium to low level echotexture
60
What are the different type of TRUS probes?
Axial or biplane, side-firing or end-firing
61
What is the most common TRUS probe?
End-firing
62
Describe the end-firing TRUS probe
Allows for multi-plane imaging Convenient, easy to use Biopsy capability at the time of examination
63
What is the frequency used with the TRUS probes?
7-10 MHz
64
What is the pt position for a TRUS exam?
LLD, with legs bent to chest
65
What is the pt prep prior to a TRUS exam?
DRE
66
What is the scan orientation of the TRUS exam?
Rectum at the bottom of the screen Sagittal- anterior abdominal wall at the top and puts head on the left side Transverse- anterior abdominal wall at the top of image
67
What is the sonographic appearance of the peripheral zone?
Homogeneous, isoechoic
68
What is the sonographic appearance of the surgical capsule?
Separates the PZ and CZ Hypoechoic line
69
What is the sonographic appearance of the central zone?
Hyperechoic or isoechoic to the PZ
70
What is the sonographic appearance of the transition zone?
Isoechoic to the PZ Hypoechoic to the BPH Echogenic foci
71
What is another name for echogenic foci?
Corpora amylacea
72
What are corpora amylacea?
Protein deposits
73
What is the sonographic appearance of the periurethral glandular area?
Hypoechoic Blends with urethra Prominent in young men
74
What is the sonographic appearance of the anterior fibromuscular stroma?
Hypoechoic
75
What area is used as a standard for echogenicity in the prostate?
Peripheral zone
76
What is the sonographic appearance of the seminal vesicles?
Hypoechoic, symmetrical
77
What is the measurement of the seminal vesicles?
10mm AP
78
What are the 4 different lab tests used to identify function of the prostate?
1. Prostate specific antigen (PSA) 2. PSA density 3. Acid phosphatase 4. Alkaline phosphatase
79
What enzyme is made specifically by the prostate?
PSA
80
Where is PSA created and deposited?
Through ducts in the prostate
81
When is PSA elevated?
BPH, infection or carcinoma
82
Is PSA specific to cause?
No
83
What are the normal values of PSA?
< 4ng/ml
84
What fraction of men have an increased PSA but do not have cancer?
2/3
85
What is PSA density?
PSA level/prostate volume
86
Density of > 0.12 warrants what type of procedure?
Biopsy
87
Where is acid phosphatase found?
In prostate and semen in high concentrations
88
What causes increased levels of acid phosphatase?
Carcinoma that has spread beyond prostate capsule
89
Where is alkaline phosphatase produced?
Osteoblasts
90
When will levels of alkaline phosphatase increase?
Increase in osteoblastic activity
91
Is elevation of alkaline phosphatase specific to prostatic cancer?
No, associated with bony metastases
92
What vessels supply blood to the prostate?
Prostaticovesical arteries
93
What is benign ductal ectasia?
1-2mm tubular structures in the peripheral zone
94
What is the US appearance of benign ductal ectasia?
Hypoechoic
95
What can benign ductal ectasia be mistaken for?
Prostatic cancer
96
How does the appearance of benign calcifications appear compared to malignant calcifications?
Benign appear courser

Abdomin And Superficial Structures (12 decks)

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