Abdominal Pathology > Prostate > Flashcards

Prostate Flashcards

(73 cards)

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1
Q

What separates the prostate from the rectum?

A

Denonvillier’s fascia

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2
Q

What does the prostate secrete? What does this secretion contain

A

alkaline fluid to transport sperm. These secretions contain alkaline phosphatase, citric acid, and ProstateSpecificAntigen

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3
Q

The prostate secretes 80-85% of what?

A

the ejaculation fluid

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4
Q

What produces seminal fluid? What does this fluid do?

A

Seminal vesicles, prostate, and Cowper’s gland. Seminal fluid aids in the trnasportation of sperm.

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5
Q

What does the Vas Deferens do? What does join with?

A

The Vas Deferens conducts sperm from the testes. It joins with the seminal vesicles to form the ejaculatory duct.

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6
Q

Fluid high in sugar, prostaglandins, amino acids, and fibrinogen is produced where?

A

seminal vesicles

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7
Q

Fluid with acidic PH is produced where?

A

Fluid with a slightly high acid PH is produced by the prostate.

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8
Q

Which border of the prostate is in contact with the bladder?

A

superior border also called the base.

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9
Q

Which border of the prostate is an exit for the urethra

A

the inferior border or apex

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10
Q

Where is the prostate in relation to the peritoneum

A

it is a retroperitoneal organ

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11
Q

What perforates the prostate posteriorly?

A

Two ejaculatory ducts that course obliquely and anteriorly to join the urethra

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12
Q

How many lobes does the prostate have? What are they

A

Five. Anterior, middle, posterior, two lateral.

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13
Q

How many zones is the prostate split into? What are they

A

Four. Central, peripheral, periurethral, transitional

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14
Q

Where is the anterior fibromuscular stroma located? Is this area often concerning for pathology?

A

It is anterior to the prostatic urethra. not generally a significant area for pathology

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15
Q

The central zone comprises about 20% of glandular tissue. What happens here?

A

Area resistant to disease where the ejaculatory duct passes from the seminal vesicles to the urethra.

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16
Q

The peripheral zone comprises about 70% of glandular tissue. What happens here?

A

It surrounds the urethra and extends into the apex, it is the site for the most prostate cancer (20%)

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17
Q

The transitional zone comprises about 5% of glandular tissue. What happens here?

A

It is the site of origin for prostatic hypertrophy.

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18
Q

What are the periurethral glands

A

the tissue that lines the prostatic urethra and comprises 1% of the glandular tissue.

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19
Q
A
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20
Q

What is the surgical capsule? Is it a true capsule?

A

The connective tissue separating the peripheral and central zones that serves as a boundary for procedures. It is NOT a true capsule.

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21
Q

What divides the urethra into proximal and distal segments?

A

Verumontanum

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22
Q

What happens in the verumontanum region?

A

The ejaculatory ducts enter the urethra

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23
Q

What are seminal vesicles

A

Paired structures that store sperm.

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24
Q

What arteries supply the prostate?

A

prostaticovesical, inferior vesical, capsular, and urethral.

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25
Which artery supplies 2/3 of the prostate's blood? Which supplies the other 1/3
Capsular arteries supply 2/3 and the urethral artery supplies 1/3.
26
What is the first extra-prostatic site cancer spreads to?
the superior and inferior pedicles where nerves are located.
27
What is the prostate's average size
3.8 x 3 x 4
28
When is a prostate exam considered routine?
after age 50, though some men begin around age 40
29
What is the normal PSA value?
4-10 ng/mL depending on age. More than this is considered abnormal.
30
What level of PSA would be indicative of carcinoma?
elevation of 20% or an increase of 0.75 ng/mL
31
What kinds of examination might be done on a prostate?
transabdominal, transperineal, transrectal
32
Does a patient need to have a filled or empty bladder for a prostate exam?
distended with transabdominal, empty with transrectal.
33
What is the meausrement for the prostate volume
length x width x height
34
What are the types of seminal vesicle cysts?
Prostatic utricle, ejaculatory duct, and mullerian duct cysts
35
What pathology would you expect in a young man with painful ejaculation and urination? What are characteristics of this disease?
Seminal vesicle disease. It appears as prostatism and cystic structures with calcifications.
36
what are characteristics of a utricle cyst? Who are they more commonly found in
small (8-10mm) tear drop shaped cysts that communicate w/ the urethra found in young men.
37
What is associated with seminal vesicle agenesis
agenesis of the ductus deferens on the same side. 79% of patients have renal agenesis on the same side.
38
What is asymmetrical dilation of seminal vesicle?
One of the seminal vesicles is dilated, the other is WNL
39
What is thought to cause agenesis of seminal vesicles
An embryologic insult before separation of the ureteral bud from the mesonephric ducts around week 7
40
what are characteristics of a mullarian duct cyst? Who are they more commonly found in
remnant of mullarian duct, does not communicate w/ urethra but is attached to verumontanum by a stalk. Commonly found in infertile 30-40 year old men.
41
what is the most common cause of ejaculatory duct obstruction?
mullarian duct cysts
42
What is the most common anomaly of the prostate that is reported in 20% of infertile males with ejaculatory duct obstruction?
prostatic cysts
43
Where are midline prostatic cysts located?
prostatic utricle and mullarian duct
44
Where are paramedian prostatic cysts located?
ampulla of the vas defrens and the ejaculatory duct
45
Where are lateral prostatic cysts located?
seminal vesicle and prostate
46
What may be inside a utricle cyst? Why?
urine. these cysts communicate with the urethra which results in post-void dribbling
47
Is hematospermia serious?
Episodes last from a few weeks to 2 months. it is rarely malignant and usually resolves on its own
48
What is the first sign of urological disease
hematospermia
49
what is the most common issue in men under 50
prostatitis
50
How does acute prostatits appear?
hyperechoic with a hypoechoic halo of edema.
51
How does chronic prostatitis appear?
heterogeneous, thick and irregular, with calculi
52
What is granulomatous prostatitis?
from fungal organisms
53
how is tuberculosis diagnosed
by examining secretions also known as "milking the prostate"
54
where is tuberculosis found? What are symptoms
peripheral zone. urinary urgency, frequency, and pain
55
What is bacterial prostatitis?
bacteria that ascends the urethra. It may be acute or chronic.
56
What is BPH? who does it affect?
benign prostatic hyperplasia affects older men.
57
What are characteristics of BPH
enlarged gland, obstruction, calculi/diverticula/cystic central gland
58
What percentage of andenocarcinoma is in the peripheral zone
70%
59
What are characteristics of adenocarcinoma of the prostate
increased flow, hydronephrosis/hydroureter,
60
what is the most common malignant tumor in men
adenocarcinoma of the prostate
61
what is the 2nd most common cancer mortality in men
adenocarcinoma of the prostate
62
What are the ways of treating adenocarcinoma of the prostate?
hormone, microwave, chemo, and cyro therapies
63
what are the congenital diseases of the prostate?
agenesis of seminal vesicle or vas deferen, and prostate cysts
64
Where are most congenital prostate anomalies located?
between the prostate and bladder or the prostate and rectum.
65
Are Seminal vesicle neoplasms common?
no they are rare.
66
what is reported in 20% of infertile males with ejaculatory duct obstruction
prostate cysts
67
What cyst type is mesodermal and endodermal origin? What type is just mesodermal
utrical is meso and endodermal. mullarian is mesodermal
68
Which type of cyst most commonly contains hemorrhage or debris? WHy?
Mullarian. Stones are common in these cysts which cause hemorrhage.
69
Congenital absence of vas deferens (CAVD) is sometimes associated with what?
10-40% of the time is associated with unilateral renal agenesis.
70
Which is more tender? Acute or chronic prostatitis?
acute.
71
What bacterias are most common for causing prostatits
E coli and Pseudomonas
72
What causes nonbacterial prostatitis?
uncertain but it may be an autoimmune condition
73
What percentage of andenocarcinoma is in the transitional zone
20%
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