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prostate and penile Flashcards

1
Q

PROSTATE ANATOMY

A

flattened cone shape retro organ

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2
Q

bordered by

A

bladder superiorly|urogenital diaphragm inferiorly|pubic bone anteriorly|rectum posteriorly

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3
Q

___________ ____________ ________________ separates prostate anteriorly from pubic bone

A

anterior prostatic fat/fasica

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4
Q

____________ _________ and ____________ _________________ support the gland laterally

A

levator ani|obturator internus

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5
Q

____________________ ______________ separates prostate from rectum

A

denonvilliers fascia

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6
Q

anterioir gland attached to symphsis pubis and pubic bones by _________________ _________________

A

puboprostatic ligaments

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7
Q

base is the _______________ portion situated _________________

A

superior portion||situated below inf margin bladder

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8
Q

apex is the _________________ portion situated ___________________

A

inferior portion||situated superior to urogenital diaphragm

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9
Q

each vas deferens empties spermatic fluid into an _________________ ____________ f ipsilateral seminal vesicle

A

ejaculatory duct

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10
Q

right and left ejaculatory ducts pass thru ___________ zone and empty into the _________________

A

central ||prostatic urethra

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11
Q

______________________ long ridge in urethra that holds the openings of the ejaculatry ducts

A

verumontanum

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12
Q

VASCULTURE

A

internal iliac —> inferior vesical arteries —> small perforating arteries

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13
Q

ant plexus of santorini merges w/ ______________ __________ vein to drain into internal iliac vein

A

dorsal penile vein

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14
Q

GLANDULAR PROSTATE ZONES

A

1) peripheral zone 70%|2) central zone 25%|3) transitional zone 5%|4) periurethral glandular zone ||NOT glandular |anterior fibromuscular stroma

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15
Q

PERIPHERAL ZONE|______ %|_________ and __________ to distal prostatic urethra|________ % cancers originate here |occurence of BPH?

A

70 %|posterior and lateral|70 %|less common site for BPH

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16
Q

CENTRAL ZONE|______ %|located at ___________ of gland ______________ to urethra|narrows to peak at ____________________|seminal vesicles and vas deferens merge to form _________|______ % cancer originate here

A

25%|base / posterior|area post to verumontanum |ejaculatory ducts|10 %

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17
Q

TRANSITIONAL ZONE |_____ %|__________ zone surrounds prox prostatic urethra|2 lobes located _________|__________ and ______________ to verumontanum |________ % cancers originate here|______ % BPH

A

5 %|central|1 on each side of urethra|superolateral|20 %|95 %

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18
Q

FIBROMUSCULAR REGION (ant zone)

A

thick sheath covers entire ant prostate surface about 1/3 size gland ||made of smooth muscle and fibrous tissues ||NO glandular tissue = not affected by cancer, inflammation, or BPH (not fxnal)

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19
Q

secretes an _____________ fluid included in male ejaculate

A

alkaline

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20
Q

_____________ cells produce PSA which is measured to assess prostate health

A

acinar

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21
Q

PSA is produced by

A

acinar cells

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22
Q

PSA is measured to assess

A

increasing levels of benign or malig tissue

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23
Q

PSA levels|0 - 4 ng/ml|4 - 10 ng/ml|> 10 ng/ml

A

normal|benign or potential malig|malig

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24
Q

PSA varies w/

A

age|prostate volume|BPH |malignancy|prostatitis

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25
does cancer or BPH elevate PSA more?
cancer||(not all cancers cause elevated PSA)
26
PAP
elevated w/ prostate carcinoma
27
Paired pouch like glands at the base of the bladder
seminal vesicles
28
sem ves located __________ __________ to prostate
superior posterior
29
sem ves located ___________ to bladder and __________ to rectum
posterior inferior |anterior
30
seminal vesicle store ______________ and secrete ______________
store sperm and secrete fructose for ejac||secretions mix w/ prostatic fluid to form semen
31
sem ves secrete fructose to provide _____________ and ____________
energy for sperm|alkalinity to enhance sperm mobility
32
PROSTATE SONOGRAPHY TECHNIQUES
full bladder|eval echotexture and size prostate and sem ves
33
txr for transrectal
7.5 - 11 MHZ
34
TRUS
bx guidance||provides transverse and sagittal views|- scan trans sem ves to urethra|- scan L to R sag||contraindicaitons |- rectal abnormalities like fissures neoplasms hemorrhoids or prostatitis
35
patient prep for TRUS
cleansing enema 30-60 min prior|drink 8-16 oz water 30 min prior |7-8 MHZ
36
patient position TRUS
left lateral lithotomy|LLD|knee - elbow position
37
prostate volume
L x W x H x 0.52||utilized to determine PSA density
38
prostate image orientation TRUS
sag |rectum post|bladder ant|apex to R|base to L||axial|rectum post|bladder ant|L prostate on R|R prostate on L
39
echogenicity prostate
homo|medium level echoes|symmetirc oval shape|smooth capsule||peripheral zone slightly hyper|central/transitional zone not differentiated
40
eiffel tower sign
shadowing created by calcifications in the urethra/verumontanum area
41
seminal vesicle echogenicity
hypo to prostate |diamond/ovoid shape|irregular borders
42
BPH is an enlargement of the _________ and ___________ zones related to _________________________
transitional and periurethral |testosterone||(also causes general increase in gland size)
43
BPH occurs as early as
30 yrs
44
BPH labs
elevated PSA
45
95% BPH occurs in _______________ zone
transitional zone
46
symptoms BPH
urinary frequency, nocturia, weak urine stream, incomplete emptying
47
_____________ _______________ may cause calcifications in inner gland
corpora amylacea
48
SA early BPH
inner gland coarser than peripheral/central|punctate calcificaitons|diffuse enlargement
49
SA later BPH
nodularity, more calcifications, necrosis of cysts|increase color inner gland||- eval kidneys
50
inflammation/prostatitis
bacterial or non bacterial cause|prostadynia
51
symptoms prostatitis
fever, pain, urinary frequency/urgency/difficulty
52
SA prostatitits
hetero peripheral gland|hypo halo , periurethral area|abscess|hypervascular
53
prostatic cysts
congenital or acquired
54
________________ ____________ cyst can lead to infertility
ejaculatory duct
55
calcifications related to
prior infection||single or multiple|benign finding
56
corpora amylacea calcifications commonly seen in __________ __________
central zone
57
most frequently diagnosed malignancy in a men
extra capsular prostate carcinoma
58
risk factors carcinoma
age - > 65|african american|fam hx 2-3 x greater risk
59
prostate carcinoma labs
elevated PSA significantly over 4 ng/ml||4-10 sus|> 10 highly sus||elevated PAP
60
carcinoma location
70% peripheral|20% transitional|10% central
61
prostate staging|1|2|3|4
1 clinically palpable|2 palpable nodule confined to prostate|3 palpable nodule extending thru capsule|4 mets
62
SA extra capsular carcinoma
focal mass|hypo|peripheral zone|shadowing from dense masses
63
SA intracapsular carcinoma
bulging capsule|disruption tissues|hypervascular
64
mets to sem ves
asymmetrical enlargement|disruption tubular confguration
65
2 main erectile structures of penis
corpus cavernosa CC
66
corpus cavernosa and corpus spongiosum is covered by the _____________ ______________
tunica albuginea
67
_________ and _________ ____________________ arteries course thru R and L CC
R and L cavernosal arteries
68
_____________ ________________ extends over ends of corpus cavernosa
glans penis
69
what fills w/ bld during an erection?
sinusoids of CC
70
_________________ and _______________ arteries travel through the corpus spongiosum
urethra and urethral arteries
71
internal iliacs give rise to ________________ ____________, _____________________, and ______________ arteries
internal pudendal, bulbourethral, and penile arteries
72
______________________and ________________ provide primary venous outflow
superficial dorsal vein|deep dorsal vein
73
indications for sonographic eval
erectile dysfunction|priapism|peyronie|palpable areas|trauma
74
probe penis
7-10 MHZ linear
75
____________ imaging best to eval peyronie
2D
76
___________ imaging best to eval vascular insufficiency as cause for ED
PW
77
________ imaging best to eval priapism
PW
78
inability to acheive a full and persistent erection
erectile dysfunction
79
ED can be caused by
vascular insufficiency||obesity|diabetes|metabolic syndromes medications|peyronie|substance abuse|enlarged prostate|prostate cancer treatment
80
_______________ and ______________ arteries are evaluated w/ ED
cavernosal and dorsal
81
unwanted, persistent, painful erection lasting more than 4 hours
priapism||spontaneous or caused by meds|excessive arterial inflow and inadequate venous outflow
82
development of scar tissue and fibrous plaque formation involving tunica albuginea
peyronie disease
83
causes restriction and curvature of affected side penis during erection and can be painful
peyronie disease
84
SA peyronie
hyper areas along outer margins corpus cavernosa
85
penile cancer is usually identified on the ____________ ____________ or _______________
glans penis|foreskin
86
penile cancer symptoms
focal area skin thickening/discoloration|palpable lump|ulcer may bleed|red rash|crusty bumps|flat bluish brown growths|odorous discharge|inguinal lymphadenopathy
87
most common cancer of penis
squamous cell carcinoma
88
SA penile cancer
focal mass|solid|hypo|irregular borders|internal vascularity
89
panile trauma
penile fracture - blunt force when erect||CC can be fractured causing subcutaneous bleeding and pain

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