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27 Cards in this Set
- Front
- Back
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What are the measurements of the normal prostate |
3cm long, 4cm wide, 2cm in AP depth |
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What are the 3 regions of the prostate? |
Peripheral zone, (70%), Central zone (25%) Transitional zone (5%) |
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What region of the prostate surrounds the ejaculatory ducts |
Central zone |
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What region of the prostate surrounds the proximal urethra |
Transitional zone |
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What region of the prostate surrounds the urethra |
Peripheral zone |
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Which region of the prostate causes the symptoms of benign prostate hyperplasia? |
Transitional zone - hyperplasia of epithelial and stromal cells causes constriction of the urethra. |
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Which region does prostate cancer normally originate from |
Peripheral zone |
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What is the function of the prostate |
Secretes a fluid making up semen |
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What is the main cause of BHP in men? |
Testosterone. Converted to estrodial in the stromal cells - proliferation ER-beta receptor lost with age - reduces apoptosis |
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Which receptors does testosterone act on in BHP, how does it act at each of these receptors? |
Converted to estrodiol and acts on ER-alpha in stromal cells causes proliferation Converted to estrodiol and acts on ER-beta to control apoptosis - levels of this receptor decrease with age |
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What are the symptoms of BHP SHITE FUN |
SHITE FUN Slow stream, Hesitancy, Intermittent flow, Terminal dribbling, Emptying incomplete Frequency, Urgency, Nocuria Also pain/burning during urination or blood in urine or semen. |
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What other conditions can develop as a result of BHP |
Histological hyperplasia Lower urinary tract infections Enlarged prostate Bladder outlet obstruction |
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What is the prostate specific antigen value of someone with BPH likely to be? |
Under 10ng/ml |
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What are the 2 types of drugs that can be used to treat BHP |
a1 antagonist 5 a-reductase inhibitor |
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What is the mechanism of action of a1 antagonists |
Relaxes smooth muscle in bladder neck and prostate, improves urine flow rate |
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What is the mechanism of action of 5-a reductase inhibitor |
Prevents the conversion of testosterone to DHT which is its more active form. 2 isoforms of 5 a-reductase inhibitors - type 2 is present in prostatic tissues |
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Name two 5a reductase inhibitors
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Dutasteride Finasteride |
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When would a prostatectomy be considered?
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Prostate >75g |
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What is the defining marker to check if a prostate is cancerous or not |
PSA levels higher than 10nm/ml indicate cancer - will be vastly higher eg.100nm |
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What are the features of a direct hernia? age, location, boundaries, and result of deep inguinal ring test, location compared to inferior epigastric vessels |
Occurs in old age, Does not enter deep inguinal ring, does not extend beyond superficial inguinal ring, neck medial to inferior epigastric artery, deep inguinal ring test is negative |
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What are the features of a indirect hernia? age, location, boundaries, and result of deep inguinal ring test, location compared to inferior epigastric vessels
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Occurs in youth, enters deep inguinal ring, reaches scrotum, neck lateral to inferior epigastric artery, deep inguinal ring test is positive |
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What is the name of the structure through which direct hernias exit the abdominal cavity |
Hesselbach's triangle, anterior abdominal wall |
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What is the usual cause of indirect inguinal hernias , which side do they normally present on |
Right side / right scrotum
Failure of processus vaginalis to close |
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What are the 2 main causes of erectile dysfunction |
Diabetes mellitus Vascular disease |
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Which parasympathetic nervous system messenger and second messenger allow relaxation of the muscle and therefore erection of the penis |
Nitric oxide acts on Soluble guanylyl cylase - causes release of cGMP and relaxation of the smooth muscle. - Erection of the penis |
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Which sympathetic nervous system messenger and second messenger allow the ejaculatory reflex of the penis |
Noradrenaline acts on a1 smooth muscle to cause contraction to allow ejaculation |
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What is the treatment of erectile dysfunction? |
PDE-5 inhibitor, prevents breakdown of cGMP, increases relaxation of smooth muscle |
