Chapter 13: Anatomy, Physiology, and Pathology of the Prostate Gland and Seminal Vesicles

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The prostate base is located ____________ and its __________ is positioned inferior

Superior; Apex

The paired seminal vesicles are located _________ to the prostate gland and ____________ to the base of the bladder

Superior; Posterior

Sonographic findings of seminal vesicle cysts:

1. Anechoic or complex cystic structures in the area of the seminal vesicles

The higher the PSA level, the most likely the patient will have:

Prostate cancer

Clinical findings of seminal vesicle cysts:

1. Asymptomatic 2. May be associated with Zinner syndrome (perineal pain, recurrent prostatitis, painful ejaculation, and infertility)

Sonographic findings of benign prostatic hyperplasia:

1. BPH will show an enlargement of the inner gland 2. Can lead to hypoechoic areas within the gland 3. Calcifications within the gland 4. Diffusely heterogeneous gland 5. Cystic changes within the gland

Clinical findings of prostate cancer:

1. Elevated PSA 2. Enlarged prostate 3. Blood in the urine (hematuria) or semen (hematospermia) 4. Back pain, pelvic pain, hip or thigh pain 5. Impotence 6. Decrease in the amount of ejaculated fluid

Sonographic finding of prostatitis:

1. Enlarged, hypoechoic prostate 2. Hyperemia evident with color doppler

Clinical findings of prostatitis:

1. Hematospermia 2. Painful ejaculation 3. Perineal pain 4. Dysuria

Clinical findings of benign prostatic hyperplasia:

1. Nocturia 2. Increased urinary frequency 3. Sense of urinary urgency 4. Constant feeling of having a full bladder 5. Elevated PSA

Sonographic findings of prostate cancer:

1. Varying sonographic appearances 2. Hypoechoic mass 3. May be hypervascular

The prostate is divided into ___ zones

4

Prostate cancer, in the form of _____________, is the most common cancer in men.

Adenocarcinoma

The prostate gland secretes an ___________ ____________ that constitutes between ______________% of the volume of semen

Alkaline fluid; 13-30%

The seminal vesicles secrete __________-based fluid and empty into the paired _____________ ducts

Alkaline; Ejaculatory

Location of the central zone:

Base of the prostate

Benign enlargement of the prostate gland is termed

Benign prostatic hyperplasia (BPH)

An elevation in PSA can be indicative of some disease processes, such as:

Benign prostatic hyperplasia, prostatic cancers, prostatitis, and prostatic infarcts

The second largest prostatic zone is the:

Central zone

Seminal vesicle cysts can be ____________ or ___________.

Congenital; acquired

The periurethral glandular zone is located:

Embedded in the muscle of the proximal urethra

The prostatic zone that is located anterior to the prostatic urethra and is of little clinical significance is the:

Fibromuscular zone

The seminal vesicles appear as ___________ structures between the bladder and the prostate

Hypoechoic

Prostatic cancer can sonographically mimic:

Normal anatomy, prostatitis, and BPH

Location of the transitional zone:

On both sides of the proximal urethra

The largest prostatic zone which is the most common site for malignancy is the:

Peripheral zone

The most common location of prostate cancer is within the:

Peripheral zone

The smallest prostatic zone is the:

Periurethral glandular zone

Location of the peripheral zone:

Posterior lateral, apical gland

Protein produced by the prostate gland:

Prostate specific antigen (PSA)

The ejaculatory ducts travel through the ________ and empty into the __________ at an area called the ______________.

Prostate; urethra; verumontanum

The prostate is a ___________ gland

Retroperitoneal

The ejaculatory ducts are formed by the union of the:

Seminal vesicles and ductus (vas) deferens

BPH is most often located in the:

Transitional zone

The prostatic zone that is the site for benign prostatic hyperplasia and the second most common site for malignancies is the:

Transitional zone

Zinner syndrome consists of:

Unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction


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