Week 11- Male Pelvis

Question 1

Reproductive duct that extends from the epididymis the the ejaculatory duct

Answer 1

Vas deferens

Question 2

Superior portion of the prostate gland, which is located below the inferior margin of the urinary bladder

Answer 2

base

Question 3

Inferior portion of the prostate gland, which is located superior to the urogenital diaphragm

Answer 3

apex

Question 4

A longitudinal ridge within the prostatic urethral wall where the orifices of the ejaculatory ducts are located on either side.

Answer 4

verumontanum

Question 5

Demarcation between the inner gland and the outer gland, which normally appears hypochoic.

Answer 5

surgical capsule

Question 6

Duct that passes through the central zone and empties into the urethra; originates from the combination of the vas deferens and the seminal vesicle.

Answer 6

ejaculatory duct

Question 7

Describe the transrectal sonographic technique used to evaluate the prostate gland, including patient preparation, positioning,, image orientation, and any contraindications to the study.

Answer 7

The most common approach is the endorectal approach because it results in improved visualization of the gland and surrounding structures. The patient’s bladder must be empty. The patient is placed in the left lateral decubitus position with the knees bent into the chest. Gel and a probe cover are placed over the probe and lubricating gel is applied to the probe. The transducer is then inserted into the rectal cavity. The ultrasound image is inverted during a prostate examination with the near field at the bottom of the image and the far field at the top. In the transverse plane, the right lobe of the gland is at the left side of the image and the left lobe of the gland is on the right side. In the sagittal plane, the base of the gland is at the left side of the image and the apex of the gland is at the right side of the image. Contraindications include rectal fissures, rectal tumors, thrombosed hemorrhoids, and prostatitis, which may prevent insertion of the probe due to patient discomfort

Question 8

Where is the location of the seminal vesicles?

Answer 8

Posterior to the urinary bladder

Question 9

Denonvilliers’ fascia

Answer 9

lies between the rectum and the prostate.

Question 10

The prostate is laterally supported by which of the following?

Answer 10

the obturator internus and levator ani muscles.

Question 11

Which of the following is NOT one of the four zones within the glandular prostate?

Answer 11

Prostatic urethral

Question 12

Which zone of the glandular prostate is located at its superior edge?

Answer 12

Central

Question 13

The anterior fibromuscular region, or stroma, is ___ to the prostatic urethra.

Answer 13

anterior

Question 14

The prostatic urethra is divided into proximal and distal segments by which of the following.

Answer 14

the verumontanum.

Question 15

The inferior margin of the prostate is called?

Answer 15

the apex

Question 16

Which of the following diagnostic tests is second only to direct physical palpation of the prostate by a urologist?

Answer 16

Sonography

Question 17

The seminal vesicles are encapsulated by___

Answer 17

connective tissue

Question 18

t/f: The ejaculatory ducts enter the prostate at its superior margin.

Answer 18

FALSE

Question 19

The transition zone is made up of a single lobe superior to the verumontanum.

Answer 19

FALSE

Question 20

Sperm could not survive to complete the process of reproduction without the secretions of ________________.

Answer 20

the accessory organs???

Question 21

The prostate normally measures approximately __________ wide.

Answer 21

4cm

Question 22

Each seminal vesicle measures less than __________ in diameter.

Answer 22

1.1cm

Question 23

Normal serum prostatic specific antigen is less than __________.

Answer 23

4

Question 24

Which prostate zone borders the central zone posteriorly and laterally?

Answer 24

peripheral zone

Question 25

The tissue that lines the proximal prostatic urethra forms which prostate zone?

Answer 25

periurethral zone

Question 26

glandular zone located at the superior edge bordering the bladder and seminal vesicles

Answer 26

central zone

Question 27

inferior to urinary bladder, posterior to symphysis pubis, anterior to rectum

Answer 27

prostate

Question 28

paired gland posterior to bladder, superior to prostate

Answer 28

seminal vesicles

Question 29

benign ductal ectasia seen in ___ men

Answer 29

older

Question 30

visible as single or grouped 1-2mm diameter tubular structures in peripheral zone

Answer 30

benign ductal ectasia

Question 31

t/f: benign ductal ectasia can be mistaken for cancer bc of hypoechoic area

Answer 31

true

Question 32

normal finding, common with increasing age, show as bright echogenic foci or clumps in prostate

Answer 32

prostatic calcifications and corpora amylacea

Question 33

create a "twinkle artifact" on colour doppler

Answer 33

corpa amylacea

Question 34

corpora amylacea has __ clinical significance and typically develop along ____ capsule

Answer 34

NO | surgical

Question 35

proteinaceous debris in dialated prostatic ducts

Answer 35

corpora amylacea

Question 36

corpora amylacea can cause sound attenuation that prevents ___ exams

Answer 36

transrectal (TRUS)

Question 37

t/f: TRUS commonly preformed by general sonographer

Answer 37

FALSE usually by radiologist bc of sensitive area

Question 38

prostate associated tests after US

Answer 38

MRI | biopsy

Question 39

sigmoid colon is in the __ pelvis

Answer 39

true

Question 40

__ is continuous with the descending colon and is loosly attached to the posterior abdominal wall by ___

Answer 40

- sigmoid colon | - mesocolon

Question 41

sigmoid colon courses ___ towards the rectum

Answer 41

inferioposteriorly

Question 42

t/f: rectum is fixed in position

Answer 42

true

Question 43

small bowel is displaced out of true pelvis when ___

Answer 43

bladder is full (TA)

Question 44

on ___ peristalsis can be seen in small bowel surrounding the uterus

Answer 44

empty bladder (TV)

Question 45

anything below the ileocecal opening is considered

Answer 45

cecum

Question 46

cecum is located in what quadrant

Answer 46

RLQ

Question 47

blind ending tubular structure in RLQ

Answer 47

appendix

Question 48

appendix has characteristic __

Answer 48

gut signature

Question 49

muscular sac that stores urine

Answer 49

bladder

Question 50

4 layers of bladder

Answer 50

1. inner mucosa 2. submucosa 3. muscularis 4. serosa

Question 51

t/f: mucosa folds when bladder is empty

Answer 51

true

Question 52

serosa is the outermost layer at the superior portion and is an extention of ___

Answer 52

peritoneum

Question 53

inferior bladder composed of

Answer 53

trigone & neck

Question 54

trigone job

Answer 54

communicate with ureters and urethra

Question 55

separates the pubic symphysis from anterior bladder wall

Answer 55

space of retzius

Question 56

bladder wall measurement

Answer 56

3-6mm

Question 57

ureters can be seen through __ exam

Answer 57

TV

Question 58

ureters course ___ in the pelvis to the orifice in the ___

Answer 58

posteromedial | trigone

Question 59

t/f: urethra can be seen TV

Answer 59

true

Question 60

anechoic tube from neck of bladder to the external orifice

Answer 60

urethra

Question 61

pelvic musculature on either side of the lateral bladder walls

Answer 61

ileopsoas (PSOAS & ILIACUS)

Question 62

pelvic musculature posterior and medial to ileopsoas

Answer 62

obturator internus

Question 63

pelvic diaphragm

Answer 63

levator ani (puboccygeus, iliococcygeus, puborectalis) , coccygeus

Question 64

pelvic musculature posterior to uterus, anterior to sacrum

Answer 64

piriformis

Question 65

pelvic musculature most anterior portion of abdominopelvic wall

Answer 65

rectus abdominus

Question 66

t/f: lymph nodes are routinely seen on US

Answer 66

false

Question 67

abnormal lymph nodes typically surround ___ and ___ walls

Answer 67

vessels | pelvis sidewalls

Question 68

best exam to see lymph nodes (TA or TV)

Answer 68

TV

Question 69

when zones are compared on US, the peripheral zone may ppear more echogenic that which of the following: 1. central 2. transitional 3. periurethral 4. all of the above

Answer 69

4

Question 70

t/f: the periurethral tissue can be easily differentiated from the anterior fibromuscular stroma

Answer 70

false

Question 71

semen is composed of 1. 60% alkaline fructose, 13-33% alkaline fluid, sperm 2. 13-33% alkaline fructose, 70% alkaline fluid, sperm 3. 70% alkaline fructose, 13-33% sperm, acid fluids 4. 60% sperm, 13-33% alkaline fluid, fructose

Answer 71

1

Question 72

when imaging glandular prostate the best technique to describe the prostate is to use 1. regions 2. zones 3. A&P terminology 4. medial & lateral terminology

Answer 72

2

Question 73

which statement is NOT true about seminal vesicles 1. they are paired glands 2. they are posterior to the bladder and inferior to the prostate 3. each gland empties into the distal ductus deferes 4. they help from the ejaculatory duct

Answer 73

2 - they are superior to the prostate

Question 74

the transition zone lines the proximal prostatic urethra

Answer 74

false, the periurethral glandular zone lines the prostatic urethra

Question 75

the seminal vesicle joins with the ductus deferens to form the ejaculatory ducts

Answer 75

true

Question 76

t/f: only alkaline fluid is produced by the seminal vesicles

Answer 76

false - also fructose

Question 77

the anterior fibromuscular region or stroma 1. is anterior to most of the zonal anatomy 2. is more clinically significant than posterior glandular 3. accounds for most of the weight of the prostate 4. lies adjacent to the seminal vesicles

Answer 77

1

Question 78

which areas are posterior to the periurethral zone 1. central, anterior fibromuscular, transition zone 2. central, transition, and verumontanum 3. central, peripheral, and verumontanum 4. central, peripheral, and seminal vesicles

Answer 78

3

Question 79

alkaline, viscous, fructose is produced by the prostate gland

Answer 79

false - no fructose from prostate only from seminal vesicles

Question 80

the part of the prostate that is in contact with the bladder is the

Answer 80

base

Question 81

on a sonogram of the prostate and seminal vesicles, the prostate appears ___-echoic to the seminal vesicles

Answer 81

hyperechoic

Question 82

the prostate is supported by the

Answer 82

obturator internus and levator ani muscles

Question 83

the largest portion of the prostate is the

Answer 83

peripheral zone

Question 84

the prostate weights

Answer 84

20g

Question 85

the part of the prostate that provides an exit for the urethra is the

Answer 85

apex

Question 86

the area closest to the center of the prostate is called the

Answer 86

verumontanum

Question 87

denonviller's fascia 1. is the external coating of the seminal vesicles 2. lies between the prostate and rectum 3. denonvillier's fascia 4. lines the external wall of the urinary bladder

Answer 87

2

Question 88

the peripheral zone comprises what percentage of the glandular prostate

Answer 88

70%