Prostate Flashcards

0
Q

Rectum is ____ to the prostate

A

Posterior

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1
Q

What 4 factors assoc with inc PSA (prostate specific antigen)

A

Patient age
Prostate volume inc
Benign prostatic hyperplasia
Prostate cancer

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2
Q

Zone most likely involved with cancer

A

Peripheral zone

70%, Cancer is hypo peripherally oriented lesion

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3
Q

BPH is in what zone

A

Transitional zone

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4
Q

Trans rectal US image patient position

A

LLD

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5
Q

Lab test for prostate cancer

A

PSA prostate specific antigen

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6
Q

MC symptoms of Prostatism

A

Difficult initiation of voiding
Nocturia
Small stream

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7
Q

Indication for transrectal

A

Abnl digital rectal exam
Abnl lab indicating prostate cancer
Guidance for biopsy
Monitor prostate cancer treatment

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8
Q

Color Doppler in transrectal exam

A

Allows improved perception of pathologic vessels assoc with cancer

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9
Q

US appearance of prostate cancer

A

Hypo, hyper, Iso lesions

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10
Q

Patient prep for transrectal biopsy

A

A cleansing enema immediately prior to exam and antibiotics given before and after exam.

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11
Q

Prostate gland anatomic classification used

A

Zonal anatomy

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12
Q

The prostaticovesical arteries that supply prostate are branches off the

A

Internal iliac arteries

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13
Q

Display of prostate with transrectal US

A

The rectum is shown at the bottom of the screen

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14
Q

Transrectal prostate sag plane. The most lateral images of the gland show

A

The peripheral zone

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15
Q

Frequency for transrectal imaging

A

7-8MHz

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16
Q

Seminal vesicles in transrectal US looks

A

Hypoechoic, symmetrical, irregular shape

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17
Q

US appearance of BPH

A

Enlarged prostate gland, focal or diffuse

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18
Q

Cyst associated with infertility

A

Ejaculatory duct cyst

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19
Q

Acute prostatitis with an anechoic mass

A

abscess

20
Q

4 zones of Prostate

A
Peripheral zone (prostate cancer)
Transitional zone (BPH)
Central zone
Fibromuscular stroma (nonglandular region)
21
Q

What area in the prostate Is not affected by cancer

A

Fibromuscular stroma

Not affected by cancer, prostatitis, or hyperplasia

22
Q

Fibromuscular Stroma

A

Non glandular anterior part of prostate. Not affected by cancer, prostatitis, or hyperplasia.

23
Q

Benign Prostatic Hyperplasia (BPH)

A

Enlargement of inner prostate gland. Hypo to peripheral zone.
95% in transitional zone
Originates from inner gland

24
Q

Ejaculatory ducts pass through ___ and empty into urethra

A

The central zone

25
Q

Seminal vesicles are 2 sac-like out pouchings of the vas deferans situated adj to the ____ aspect of the prostate between the urinary bladder and rectum

A

Superior / posterior

26
Q

The base of the prostate is the ____ part of the gland

A

Superior

27
Q

The apex of the prostate is the __ part of the gland

A

Inferior

28
Q

The demarcation between the inner gland and the outer gland is called the

A

Surgical capsule

29
Q

The prostate is situated in the retroperitoneum and is bordered ant by _____, post by _____, sup by _____, and inf by ______

A

Ant by the pubic bone
Post by the rectum
Sup by the urinary bladder
Inf by the urogenital diaphragm

30
Q

Prostate-Specific Antigen PSA

A

Produced by prostate acinar cells. Rises in relationship to the amount of tissue (benign or malignant)

Rises with patient age, prostate volume, BPH, and prostate cancer

PSA rises 10 times more in cancer than BPH

1.5-4 ng/mL inc risk cancer

Black, old men, fam hx, prior disease, prior prostate bx

31
Q

Fibromuscular stroma is ___ to prostate

A

Anterior

32
Q

Denovilliers fascia is located ___ to the prostate

A

Posterior

33
Q

When see a solid testicular mass evaluate

A

Periaortic region for lymphadenopathy

34
Q

Function

A

Fluid transport for sperm mobility

35
Q

Prostate size

A

Oval/cone shape
Walnut size
4 x 3.8 x 3 cm

Base (sup)
Apex (inf)

36
Q

Prostate Cancer

A

MC cancer in men

2nd cancer death after lung

37
Q

Vasectomy

A

Remove vas deferens

38
Q

Blood supply

A

Internal iliacs art and vein

39
Q

Surgical capsule

A

Boundary between central and peripheral zones

40
Q

Patient prep

A

Cleansing enema

Urethra is in center of prostate

41
Q

Cysts

A

Müllerian duct cysts: MC pelvic cyst, above base of gland. Connect to prostate by stalk. May have cancer.

Utricle cysts: midline close to verumontanum. Assoc with hypospadias (urethra under penis). May have cancer.

Seminal vesicle cyst: assoc with ipsilateral renal agenesis. Sup to prostate.

Prostatic cyst: congenital/acquired. Lat to prostate.

Ejaculatory Duct cyst

42
Q

BPH

A

MC prostate disease
90% of males over 80 yrs
95% in transition zone

Bladder outlet obstruction, hesitancy, dribbling, urine retention, nocturia

Hypo/hyper hetero/homo well defined. May compress central and peripheral zone.

43
Q

Calculi

A

2nd to prostatitis, BPH, urine, ca+ of corpora amylacea
Incidental finding

Ejaculatory duct Ca+
Periuretheral duct Ca+

44
Q

Prostatitis

A

Inflammation of prostate
forms in acinar prostate primarily in peripheral zone

Fever chills discomfort when void. Low back pain. Painful perineum/rectum

Hard swollen tender prostate
Acute: hypo rim surrounding periuretheral tissue. Hetero.

Chronic: diffuse/focal hetero, focal hypo, abscess, ca+

Granulomatous prostatitis

45
Q

Prostate Cancer

A
Most common cancer in men. 
MC adenocarcinoma 
> 50 yrs
Develops in acinar tissue
80% in peripheral gland. 

2nd MC cause of cancer death besides lungs

Fam hx, hormone, age, environmental

Micrurition, uremia, weak stream, bone pain, weak, obstruction, urgency, change in bowel habits, wt loss.

Hypo peripheral lesion with poor margins. Hyper-Iso. Asymmetry. Ca+. Inc color. Hypervascular

Prostatectomy

46
Q

Prostatic acid phosphatase PAP

A

Not 100% specific for cancer

Dx with biopsy/excision/surgery

47
Q

Largest zone

A

Peripheral