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DMST 254 ABD 1 > The prostate > Flashcards

The prostate Flashcards

1
Q

What is the location of the prostate in comparison to the bladder?

A

Inferior

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2
Q

The prostate surrounds what?

A

The bladder neck and proximal urethra

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3
Q

What is the location of the prostate in relation to the symphysis

A

Posterior

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4
Q

What is the location of the prostate in comparison to the rectum?

A

Anterior

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5
Q

What is the location of the prostate in relation to the Levator ani muscles?

A

Posterolateral

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6
Q

What is the shape of the prostate? What way does the apex and the base face?

A
  1. Ovoid (inverted pyramid)
  2. Apex (caudal)
  3. Base (cephalic)
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7
Q

What is the size of the prostate?

A

Length: 3 - 3.5 cm
width: 4 cm
AP: 2- 2.5 cm

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8
Q

What is the weight of the prostate (volume)? 3

A
  1. 20 grams (20cc) up to 50 years
  2. <40 grams (40cc) over 50 years
  3. 1cc = 1g
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9
Q

What is the physiology of the prostate?

A

Fibromuscular and glandular organ

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10
Q

What does the prostate produce and secrete?2

A
  1. Alkaline fluid
  2. Prostate specific antigen
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11
Q

What does the alkaline fluid of the prostate do? 3

A
  1. consists of 1/3 of semen volume
  2. Aids in sperm motility and activating sperm
  3. Neutralizes acidity of vagina, uterus, and tubes
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12
Q

Prostate specific antigen (PSA) increases with what?

A

Age

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13
Q

What are the four zones of the prostate?

A
  1. Peripheral
  2. Transition
  3. Central
  4. Periurethral
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14
Q

How are the four zones of the prostate are positioned?

A

Positioned in relationship to the urethra and ejaculatory duct

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15
Q

What is the four zones of the prostate useful for?

A

Localization of cancer

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16
Q

What is the largest prostate zone?

A

Peripheral

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17
Q

Most prostate cancers are located in which prostate zone? And how frequent is it?

A

Peripheral and it has a 70% chance of being here

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18
Q

What does the peripheral zone surround?

A

Distal urethra

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19
Q

The Surgical capsule of the peripheral zone separates it from what?

A

Transitional zone and the central zone

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20
Q

What zone of the prostate is the prostate base?

A

The central zone

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21
Q

Which zone of the prostate does the ejaculatory duct travel through?

A

The central zone

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22
Q

What zone is the most resistant to disease?

A

The central zone

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23
Q

Which zone of the prostate terminates near verumontanum?

A

The central zone

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24
Q

Is there BPH in the peripheral zone?

A

Nope

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25
Q

Label the pictures

A
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26
Q

What is the transition zone?

A

2 small lobes on each side of the proximal urethra

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27
Q

What zone of the prostate is the origin of BPH

A

Transition zone

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28
Q

Which zone of the prostate enters at the proximal urethra at level of verumontanum

A

Transition zone

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29
Q

How much of the periurethral glandular area takes up in terms of gland volume?

A

1%

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30
Q

What does the periurethral glandular area do?

A

Internal prostatic sphincter

31
Q

Where is the periurethral glandular area embedded?

A

In smooth muscle of proximal urethra

32
Q

What is the fibromuscular stroma? What does it consist of?

A
  1. Non-glandular area, anterior surface of prostate
  2. Smooth muscle and connective tissue
33
Q

How much of the prostate does the fibromuscular stroma take up?

34
Q

Sonographically, it is difficult to do what for the prostate?

A

Identify separate zone

35
Q

What is the location of the seminal vesicles?2 (in relation to the bladder and prostate)

A
  1. Posterior to bladder
  2. Superior to prostate
36
Q

What is the dimensions of the seminal vesicles?

A
  1. Length: 3-4 cm
  2. Thickness: 1-3 cm
37
Q

What is the shape of the seminal vesicles?2

A
  1. Paired
  2. Ovoid
38
Q

What forms the ejaculatory ducts?

A

Vas deferens and the seminal vesicles

39
Q

The ejaculatory duct empties into what?

40
Q

Why would we ultrasound the prostate? 6

A
  1. Positive DRE
  2. Increased PSA
  3. Urinary frequency/ nocturia/ decreased urine stream
  4. Male infertility
  5. Biopsy guidance
  6. Blood, pus in urine and/ or semen
41
Q

In terms of the prostate, what do we assess for with transabdominal/ transvesicular? What would we need to do from the tech side? 3

A
  1. Size and volume only
  2. We would use a curvilinear transducer
  3. Ensure patients would need full bladder
42
Q

When scanning the transabdominal area how would the prostate appear? 4 (shape, echoes, echo texture, central interface)

A
  1. Ovoid structure
  2. Low to moderate level echoes
  3. Homogenous
  4. Echogenic interface centrally
43
Q

When imaging the seminal vesicles how would they look? 3

A
  1. Hypiechoic
  2. Symmetrical
  3. Medium/ low level echoes
44
Q

Wat is TRUS?

A

Transrectal transducers: side firing or end-firing

45
Q

Which TRUS is most common ?

A

End firing

46
Q

What does end firing TRUS do? 2

A
  1. Multiplanar imaging
  2. Can be connected to a biopsy device
47
Q

What is the frequency of the TRUS?

A

7-10 MHz or higher

48
Q

The TRUS is usually covered with what?

A

Condom (inquire about latex allergies, the probe is also sterilized with a high level disinfectant)

49
Q

What does the patient need to do for a TRUS?4

A
  1. Patient needs to have a empty bladder
  2. LLD position, legs bent to chest
  3. DRE performed prior to TRUS
  4. Systematic approach
50
Q

What is the systematic approach for TRUS? 3

A
  1. Transverse (axial) and Sagittal (longitudinal) views
  2. From apex to base
  3. Measurements as needed
51
Q

What is the TRUS scan orientation? (Sag and trans orientation) 3

A
  1. Rectum at bottom of image
  2. Sag: anterior abdominal wall at the top and patient’s head on the left side of the monitor
  3. Trans: anterior abdominal wall at top of the image and patient’s right displayed on the left side of the monitor
52
Q

From left to right what is the images?

A
  1. Trans base
  2. Trans mid gland
  3. Trans Apex
53
Q

What is the sonographic appearance of the peripheral zone?

A

Used as the echogenicity standard

54
Q

What is the sonographic appearance of the surgical capsule? 2

A
  1. Separates the peripheral zone from the central zone
  2. Hypoechoic line
55
Q

What is the sonographic appearance of the central zone?

A

Hyperechoic or isoechoic to peripheral zone

56
Q

What is the sonographic appearance of the transition zone? 2

A
  1. Isoechoic to the peripheral zone
  2. Hypoechoic with BPH
57
Q

What is the sonographic appearance of the corpora amylacea? 2

A
  1. Calcified deposits that may occur within the prostate
  2. Will appear as echogenic foci
58
Q

What is the sonographic appearance of the periurethral glands? What demographic would this be more prominent in? 3

A
  1. Hypoechoic
  2. Blend with the urethra
  3. More prominent in young men
59
Q

What is the sonographic appearance of the anterior fibromuscular stroma?

A

Hypoechoic compared to the peripheral zone

60
Q

What is PSA?

A

Enzyme made almost exclusively in the prostate

61
Q

Where is PSA secreted?

A

Through ducts in prostate

62
Q

When would PSA be elevated? 3

A
  1. BPH
  2. Infection
  3. CA
    not specific to cause
63
Q

What is the normal range of PSA?

64
Q

What is the PSA density test? and why do we do it? 2

A
  1. When we take the serum PSA level/ prostate volume
  2. Cancerous tissue produces more PSA
65
Q

When would we need to do a biopsy for a PSA density test?

A

If density is >0.12. PSA level above the expected for the gland volume

66
Q

Where is Acid Phosphatase found?

A

Prostate and semen

67
Q

Why would we do a acid phosphatase test?

A

Increased in carcinoma that spreads outside the capsule

68
Q

Where is the alkaline phosphatase produced? What increases it? 2

A
  1. Produced in bone
  2. Increased in bone metastases
69
Q

What is vascular supply for the prostate? 2

A
  1. Prostaticovesical arteries
  2. Branches of the internal iliac arteries
70
Q

What is Benign ductal ectasia?

A

1 to 2 mm tubular structures in the Peripheral zone

71
Q

What can be mistaken for prostate cancer?

A

Benign ductal ectasia

72
Q

What is the sonographic appearance of the benign ductal ectasia?

A

Hypoechoic

73
Q

What are calcifications in the prostate? And why are they significant? 2

A
  1. Incidental findings
  2. Benign calcifications coarser in appearance than malignant

DMST 254 ABD 1 (26 decks)

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