C8: Prostate Flashcards

(35 cards)

1
Q

describe the location/relationships of the prostate

A
  • inferior to bladder
  • surrounds neck of the bladder and the urethra
  • anterior to rectum
  • antero-medial to levator ani
  • seminal vesicles are superior
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2
Q

is the fibrous capsule of the prostate a true capsule?

A

no

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3
Q

whats the shade of the prostate?

where is apex and base?

A

ovoid, inverted pyramid

  • base is superior (base of prostate touching base of bladder)
  • apex is inferior
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4
Q

size of the prostate

A

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

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5
Q

what are the 2 types of tissue that make up the prostate

A

-fibromuscular tiss and glandular tissue

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6
Q

what type of fluid does the prostate secrete and how much?

A
  • alkaline fluid that makes up 1/3 of semen volume
  • activates sperm and helps sperm motility
  • neutralized acidity of vagina
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7
Q

does production of PSA increase with age

A

yes

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8
Q

list the 4 glandular zones of the prostate

what do they name correspond to? why are they helpful

A
  1. Peripheral
  2. Transition
  3. central
  4. periurethral glands
  • named based on relationship to urethra, ED and histological components
  • helpful to localize cancer
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9
Q

describe the peripheral zone

A
  • largest
  • common site of prostate cancer
  • surrounds the distal urethra and occupies the posterior, lateral and apical regions
  • has capsule that separated it from other zones
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10
Q

which zone does BPH not effect?

A

peripheral

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11
Q

describe the transitional zone

A
  • makes up 5% of glandular tiss
  • orgin site of BPH
  • 2 sm glands on either side of the prox urethra
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12
Q

describe the central zone

A
  • makes up 25% of glandular tiss
  • resistant to disease
  • ED passes through
  • located at base of prostate and terminates near the verumontanum
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13
Q

what is the verumontanum

A

area where the EDs join the urethra

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14
Q

describe the periurethral glands

A
  • makes up 1% of glandular tiss
  • located in the smooth muscle of the prox urethra
  • also called ‘internal prostatic sphincters’ which stop urine from flowing back into bladder
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15
Q

describe the fibromuscular stroma

A
  • makes up 1/3 of prostate
  • on anterior surface of prostate
  • made of smooth muscle and c-tissue
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16
Q

can you differentiate the zones of a norm prostate on US?

A

no. ..
- peripheral/outer is the peripheral and central zone
- inner is transition, fibro-muscluar, urethral sphincter

17
Q

where are the seminal vesicles (SV) located

A
  • superior to prostate

- posterior to bladder

18
Q

what 2 tubes form the ED? where does the ED dump into

A
  • SV and vas deferens

- ED dumps into urethra

19
Q

what do SV secrete?

A

-alkaline and viscose fluid which helps sperm viability

20
Q

list indications for US of prostate

A
    • DRE
  • increased PSA
  • nocturne, increased frequency of urination
  • infertility
21
Q

how is Trans abdominal US helpful for prostate

A

to see size and volume only… looks homogenous, low to moderate level echos, echogenic centre due to urethra

22
Q

how do SV look on US

23
Q

what kind of TRUS probes are commonly used

do you need full bladder>

A

end-firing:
allow for multi-plane imaging and biopsy guidance

No

24
Q

whats the orientation on the US screen for TRUS

A

rectum- bottom of image

in SAG and Trans, same orientation as we’re used to

25
SEE NOTES FOR US APPEARANCE OF AREAS
:)
26
which area is used as a standard for echogenicity in the prostate?
Peripheral zone
27
what the AP measurement of the SV
10mm
28
what is corpora amylacea
collection of protein material
29
what does an elevated PSA indicate? is it specific to cause? what are norm PSA valves? what value warrants a biopsy?
-BPH, infection carcinoma (2/4 of men with increased PSA dont have cancer) No -norm: <4 ng/ml.... >10 ng/ml warrants biopsy
30
what PSA density warrants a biopsy
>0.12 density
31
what is an acid phosphatase lab test what do increased valves indicate
- substance found in prostate and semen | - increased in metastatic cancer of prostate
32
what is an alkaline phosphatase lab test what do increased valves indicate
- alk phase produced in osteoblasts | - increased value means prostate cancer has spread to bones
33
where does the prostate get its blood supply?
prostaticovesicular arteries which branch from internal iliac A
34
what Is benign ductal ectasia
dilated ducts in the peripheral zone of the prostate... can be mistaken for prostate cancer
35
how do benign calcifications of prostate compare to maligant ones?
benign: courser malignant: sm and fine texture