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Abdomin And Superficial Structures > Prostate > Flashcards

Prostate Flashcards

1
Q

What structure is superior to the prostate?

A

Bladder

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2
Q

What structures does the prostate surround?

A

Neck of the bladder and the urethra

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3
Q

What does the prostate lie posterior to?

A

P.S

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4
Q

What structure does the prostate lie anterior to?

A

Rectum

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5
Q

What muscles lie posterolateral to the prostate?

A

Levator ani muscles

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6
Q

Does the prostate have a capsule?

A

It has a fibrous capsule- not a true capsule

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7
Q

What is the shape of the prostate?

A

Ovoid inverted pyramid

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8
Q

What is the orientation of the prostate?

A

Apex- inferior or caudal end

Base- superior or cephalic end

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9
Q

What is the size of the prostate? (L, W and H)

A

Length: 3.0-3.5cm
Width: 4cm
Height: 2.0-2.5cm

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10
Q

What is the weight of the prostate in younger men? (Up to 50 years)

A

20 grams (cc)

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11
Q

What is the weight of the prostate in older men? (Over 50 years)

A

Less then 40 grams

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12
Q

What is the physiology of the prostate?

A

Fibromuscular and glandular tissue

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13
Q

What is the purpose of producing and secreting an alkaline fluid? (2)

A
  1. Aids in motility and activating sperm

2. Neutralizes the acid environment of vagina, uterus and Fallopian tubes

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14
Q

How much alkaline fluid is included in the semen volume?

A

1/3 of semen volume

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15
Q

What antigen does the prostate produce?

A

PSA- prostate specific antigen

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16
Q

What happens to the PSA volumes as the male ages?

A

Increases with age

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17
Q

How many zones are there in the prostate?

A

4

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18
Q

The prostate zones are positioned based on what structures?

A

Urethra and ejaculatory duct

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19
Q

What is zonal anatomy useful in detecting?

A

Localization of cancer

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20
Q

What is the zonal anatomy based on?

A

Histology also components

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21
Q

What are the zones of the prostate?

A
  1. Peripheral zone
  2. Transitional zone
  3. Central zone
  4. Periurethral glands
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22
Q

What zone of the prostate is the largest?

A

Peripheral zone

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23
Q

What is the most common site of prostate cancer?

A

Peripheral zone

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24
Q

What structure does the peripheral zone surround?

A

Distal urethra

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25
Q

How is the peripheral zone seperated from the transition and central zone?

A

Surgical capsule

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26
Q

What regions of the prostate does the peripherial zone occupy?

A

Posterior, lateral and apical regions

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27
Q

Does BPH affect the peripheral zone?

A

No

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28
Q

What % of prostatic glandular tissue is included in the transitional zone?

A

5%

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29
Q

Where is the transitional zone located on the prostate?

A

Two small glands on each side of the prox urethra

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30
Q

What zone is the common origin of benign prostatic hyperplasia?

A

Central zone

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31
Q

Where do the ducts end in the transition zone?

A

Proximal urethra at the level of the verumontanum

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32
Q

What % of prostatic glandular tissue is included in the central zone?

A

25%

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33
Q

Where is the central zone located?

A

Base of the prostate

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34
Q

What structures enter the central zone?

A

Ducts of the vas deferens and seminal vesicles

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35
Q

What structure passes through the central zone?

A

Ejaculatory duct

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36
Q

Is the central zone prone to diseases?

A

No, relatively resistant to diseases

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37
Q

Where does the central zone terminate?

A

Near the verumontanum

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38
Q

What is the verumontanum?

A

Area where the ejaculatory duct joins urethra

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39
Q

How much prostatic glandular tissue does the periurethral glands include?

A

1%

40
Q

Where are the periurethral glands located?

A

Embedded in the longitudinal smooth muscle of the proximal urethra

41
Q

What is the periurethral gland know as?

A

“Internal prostatic sphincter”

42
Q

What is the function of the internal prostatic sphincter?

A

Prevent reflux of urine

43
Q

What is the fibromuscular stroma?

A

Non glandular area on anterior surface of the prostate

Smooth muscle and connective tissue

44
Q

The fibromuscular stroma makes up how much of the prostate?

A

1/3 of the prostate

45
Q

What zones does the outer/peripheral gland of the prostate make up?

A

Peripheral and central zones

46
Q

What zones does the inner glans of the prostate make up?

A

Transitional zone, fibromuscular storm and urethral sphincter

47
Q

What is the shape of the seminal vesicles?

A

Paired, ovoid shape

48
Q

Where do the seminal vesicles sit in relation to the bladder?

A

Posterior

49
Q

Where do the seminal vesicles sit in relation to the prostate?

A

Superior

50
Q

What 2 structures join to form the ejaculatory ducts?

A

SV and vas deferens

51
Q

What are the dimensions of the seminal vesicles?

A

L: 3-4cm

AP (thickness): 1-3cm

52
Q

What factors cause the seminal vesicles to vary in size and shape?

A

Age and sexual activity

53
Q

What do the seminal vesicles secrete?

A

Alkaline, viscous fluid into the ejaculatory duct which contributes to sperm viability

54
Q

What are some indications for an US?

A
  • Positive DRE
  • Increased PSA
  • Urinary frequency, nocturia, decreased urine stream
  • Male infertility
  • Biopsy guidance
  • Blood or pus in the urine or semen
55
Q

What are the 2 methods used to scan the prostate and seminal vesicles?

A
  1. Transabdominal (transvesicular)

2. Transrectal (TRUS)

56
Q

What is TA US useful in assessing?

A

Size and volume of prostate only

57
Q

What is pt prep for scanning the prostate?

A

Full bladder

58
Q

What is the TA US appearance of the prostate?

A

Ovoid structure
Low to moderate echogenic levels
Homogenous
Echogenic interface due to the urethra

59
Q

What is the TA US appearance of the seminal vesicles?

A

Hypoechoic, medium to low level echotexture

60
Q

What are the different type of TRUS probes?

A

Axial or biplane, side-firing or end-firing

61
Q

What is the most common TRUS probe?

A

End-firing

62
Q

Describe the end-firing TRUS probe

A

Allows for multi-plane imaging
Convenient, easy to use
Biopsy capability at the time of examination

63
Q

What is the frequency used with the TRUS probes?

A

7-10 MHz

64
Q

What is the pt position for a TRUS exam?

A

LLD, with legs bent to chest

65
Q

What is the pt prep prior to a TRUS exam?

A

DRE

66
Q

What is the scan orientation of the TRUS exam?

A

Rectum at the bottom of the screen

Sagittal- anterior abdominal wall at the top and puts head on the left side

Transverse- anterior abdominal wall at the top of image

67
Q

What is the sonographic appearance of the peripheral zone?

A

Homogeneous, isoechoic

68
Q

What is the sonographic appearance of the surgical capsule?

A

Separates the PZ and CZ

Hypoechoic line

69
Q

What is the sonographic appearance of the central zone?

A

Hyperechoic or isoechoic to the PZ

70
Q

What is the sonographic appearance of the transition zone?

A

Isoechoic to the PZ
Hypoechoic to the BPH
Echogenic foci

71
Q

What is another name for echogenic foci?

A

Corpora amylacea

72
Q

What are corpora amylacea?

A

Protein deposits

73
Q

What is the sonographic appearance of the periurethral glandular area?

A

Hypoechoic
Blends with urethra
Prominent in young men

74
Q

What is the sonographic appearance of the anterior fibromuscular stroma?

A

Hypoechoic

75
Q

What area is used as a standard for echogenicity in the prostate?

A

Peripheral zone

76
Q

What is the sonographic appearance of the seminal vesicles?

A

Hypoechoic, symmetrical

77
Q

What is the measurement of the seminal vesicles?

A

10mm AP

78
Q

What are the 4 different lab tests used to identify function of the prostate?

A
  1. Prostate specific antigen (PSA)
  2. PSA density
  3. Acid phosphatase
  4. Alkaline phosphatase
79
Q

What enzyme is made specifically by the prostate?

A

PSA

80
Q

Where is PSA created and deposited?

A

Through ducts in the prostate

81
Q

When is PSA elevated?

A

BPH, infection or carcinoma

82
Q

Is PSA specific to cause?

A

No

83
Q

What are the normal values of PSA?

A

< 4ng/ml

84
Q

What fraction of men have an increased PSA but do not have cancer?

A

2/3

85
Q

What is PSA density?

A

PSA level/prostate volume

86
Q

Density of > 0.12 warrants what type of procedure?

A

Biopsy

87
Q

Where is acid phosphatase found?

A

In prostate and semen in high concentrations

88
Q

What causes increased levels of acid phosphatase?

A

Carcinoma that has spread beyond prostate capsule

89
Q

Where is alkaline phosphatase produced?

A

Osteoblasts

90
Q

When will levels of alkaline phosphatase increase?

A

Increase in osteoblastic activity

91
Q

Is elevation of alkaline phosphatase specific to prostatic cancer?

A

No, associated with bony metastases

92
Q

What vessels supply blood to the prostate?

A

Prostaticovesical arteries

93
Q

What is benign ductal ectasia?

A

1-2mm tubular structures in the peripheral zone

94
Q

What is the US appearance of benign ductal ectasia?

A

Hypoechoic

95
Q

What can benign ductal ectasia be mistaken for?

A

Prostatic cancer

96
Q

How does the appearance of benign calcifications appear compared to malignant calcifications?

A

Benign appear courser

Abdomin And Superficial Structures (12 decks)

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