Prostate and Urinary Bladder Imaging Review

120 vocabulary flashcards covering prostate imaging, urinary bladder pathology, and various types of hernias based on lecture notes.

Transabdominal Prostate Imaging

One of two primary approaches for imaging the prostate, which requires a full urinary bladder to act as an acoustic window.

Transrectal Ultrasound (TRUS)

One of two primary approaches for imaging the prostate, performed by inserting a probe into the rectum.

Full Urinary Bladder

Required condition for transabdominal prostate imaging to provide an acoustic window for visualization.

Supine Position

The patient position required for transabdominal prostate imaging, often involving proper draping.

$30$ Degrees Caudal

The angle at which the probe is directed through the bladder during transabdominal prostate imaging.

Inferior Compression

A technique used in transabdominal imaging to ensure the inferior portion of the prostate is not obscured.

Prostate Base

The portion of the prostate located just inferior to the urinary bladder.

Normal Prostate Sonographic Appearance

Slightly hypoechoic compared to surrounding tissue, circular in shape, and should not be mistaken for a mass.

Prostate Scan Planes

The two planes used to image the prostate are sagittal and transverse.

Prostate Volume Measurements

Obtained using three specific measurements: Height, Width, and Length.

Age $40$

The approximate age at which the prostate gland typically begins to enlarge.

$$30\,\text{mL}$$

The volume threshold above which a prostate is considered enlarged.

Normal Prostate Volume

A measurement below the enlargement threshold, such as $21\,\text{mL}$.

Enlarged Prostate Volume

A measurement above the enlargement threshold, such as $68\,\text{mL}$.

$40$ vs $30$ Mnemonic

$40$ represents the age at which enlargement starts, while $30$ represents the volume in $\text{mL}$ that is considered enlarged.

Lateral Decubitus Position

The patient position for TRUS, where the patient faces away from the sonographer with knees bent toward the chest.

TRUS Probe Preparation

A sequence of gel, a probe cover, and more gel, similar to transvaginal probe preparation.

TRUS Bladder Filling

Requires only a small amount of urine as a landmark to determine when to stop advancing the probe.

TRUS Image Orientation

The image is inverted so the rectum is displayed at the bottom of the screen to maintain standard medical orientation.

Prostate and Seminal Vesicles (TRUS)

Structures typically located in the near field during a transrectal ultrasound.

Urinary Bladder (TRUS)

The structure typically located in the far field during a transrectal ultrasound.

TRUS Volume Planes

Height and length are measured in the sagittal plane, and width is measured in the transverse plane.

"Bear Down"

The instruction given to a patient during TRUS probe insertion, often accompanied by taking a deep breath.

Urinary Bladder

A large muscular expanding sac that functions as a reservoir for urine.

Pre-void and Post-void Images

Images in sagittal and transverse planes included in a complete ultrasound evaluation of the bladder.

Mucosa

The deepest layer of the urinary bladder wall.

Submucosa

The second deepest layer of the urinary bladder wall.

Muscular Layer

The third layer of the bladder wall, moving from deep to superficial.

Serosa

The most superficial layer of the urinary bladder wall.

Detrusor Muscle

The muscular structure that controls contractions of the urinary bladder.

Overactive Bladder

A condition where the detrusor muscle contracts before the bladder is full.

Trigone

The triangular area formed by the three openings in the urinary bladder.

Posterior Bladder Aspect

The location where the two ureters enter the bladder and where ureteral jets are visualized.

Inferior Bladder Aspect

The location from which the urethra drains the bladder.

$$1.6\text{ to }4\,\text{mm}$$

The normal range for bladder wall thickness when the bladder is fully distended.

Anterior Bladder Wall

The specific wall that should be measured for bladder wall thickness.

Empty Bladder Rule

A medical guideline stating never to measure the wall of an empty bladder because it falsely appears thickened and irregular.

Bladder Diverticulum

An out-pouching or herniation of the urinary bladder wall that can be congenital or acquired.

Urine Stasis

Stagnant urine that remains in the bladder or a diverticulum, heightening risks of infection and stones.

Communication (Diverticulum)

The identifying neck or stalk connecting a diverticulum to the bladder, distinguishing it from a dilated ureter.

Transitional Cell Carcinoma (TCC)

Also known as Urothelial Cell Carcinoma (UCC), it is the most common primary neoplasm of the urinary bladder.

Urothelial Cell Carcinoma (UCC)

Another name for Transitional Cell Carcinoma (TCC).

Most Common Urinary System Tumor

Transitional Cell Carcinoma (TCC).

Registry Selection for Bladder Mass

Transitional Cell Carcinoma (TCC) is the primary choice when an irregular bladder mass is seen on ultrasound.

TCC Anatomical Range

Besides the bladder, it can be found in the renal pelvis, ureter, and urethra.

Hematuria

The most common presenting complaint and clinical symptom of Transitional Cell Carcinoma.

Clinical Symptoms of TCC

Hematuria, dysuria, and pelvic pain.

TCC Patient Demographics

Most commonly affects men more frequently than women, typically in older adulthood.

Bladder Stone vs. Mass

A stone shows shadowing and movement, while a mass is fixed to the wall and shows internal vascularity.

Cystoscopy

A clinical procedure using a camera (cystoscope) to look inside the bladder, urethra, and prostate.

TCC Risk Factors

Smoking, increasing age, being Caucasian, being male, chronic cystitis, long-term catheter use, and schistosomiasis.

Cystitis

Chronic or repeated urinary infection or inflammation of the bladder.

Schistosomiasis

A parasitic infection acquired from contaminated freshwater containing snails, linked to bladder cancer.

Infected Snails

The intermediate host in the schistosomiasis life cycle where parasites multiply before penetrating human skin.

$48$ Hours

The approximate duration the schistosomiasis parasite can survive in water after leaving a snail.

Seminal Vesicles

Anechoic or hypoechoic tubular structures located posterior and superior to the prostate.

"Little Wings"

The sonographic appearance of the seminal vesicles on a transabdominal image of the prostate.

Seminal Gland Obstruction

A condition where seminal fluid is not released, causing the vesicles to appear larger and more prominent.

Ureter

The structure labeled Number $1$ in a posterior view diagram of the male reproductive/urinary system.

Vas Deferens

The structure labeled Number $3$ in the posterior anatomy diagram, leading toward the prostate.

Ampulla

The dilated portion of the vas deferens.

Ejaculatory Duct

The structure formed by the union of the vas deferens and the seminal vesicle duct, labeled Number $5$.

Cowper's Gland

Also known as the bulbourethral gland, it is one of three main structures producing semen.

Bulbourethral Gland

Another name for Cowper's gland.

Semen Producing Structures

The seminal vesicles, prostate, and Cowper's (bulbourethral) glands.

$1\text{ to }5$ Percent

The small percentage of semen contributed by the testes.

Transitional Zone

The prostate zone through which the urethra travels; it is the site associated with BPH.

Central Zone

The prostate zone through which the ejaculatory ducts travel.

Anterior Fibromuscular Stroma

The prostate zone that contains no glandular functioning tissue.

Peripheral Zone (PZ)

The zone containing the most glandular tissue ($70\text{ to }80$ percent) and the most common site for cancer.

PSA (Prostate Specific Antigen)

A protein produced by the prostate that is measured via a blood test to screen for disease.

Elevated PSA Causes

BPH, prostate cancer, and prostatitis can all cause an increase in this antigen.

PSA and Age

Normal ranges for this protein increase as men get older.

Hyperplasia

An increase in the number of normal cells in the tissues of an organ, leading to overgrowth.

BPH (Benign Prostatic Hyperplasia)

A non-malignant enlargement of the prostate gland common in aging men.

$4\text{th}$ Decade

The time in life (around age $40$) when BPH generally begins.

Age $50$

The age after which BPH most commonly begins to produce clinical symptoms.

BPH Diagnostic Procedures

Digital rectal exam, PSA blood test, cystoscopy, ultrasound, or biopsy.

Digital Rectal Exam (DRE)

A manual examination where a doctor feels for prostate enlargement through the rectum.

Cystoscope Insertion

An instrument inserted through the penis to examine the urethra, prostate, and bladder.

Urinary Frequency

A clinical symptom of BPH involving the need to urinate often.

Nocturia

A clinical symptom of BPH defined as waking during the night with the need to urinate.

Dysuria

A clinical symptom of BPH defined as difficult or painful urination.

BPH Symptom Mechanism

Enlarged tissue exerts pressure on the urethra, leading to weak flow and residual urine.

Serious BPH Complications

Urinary stasis, UTIs, complete urethral blockage, renal infection, and renal failure.

BPH Sonographic Findings

Enlarged gland, cysts, heterogeneous echotexture, calcifications, and post-void residual.

Homogeneous Echotexture

The uniform sonographic appearance of a normal prostate gland.

Heterogeneous Echotexture

A non-uniform sonographic appearance suggesting developing pathology like BPH.

Prostate Calcifications

Echogenic specks or speckles in the prostate that may show shadowing.

Adenocarcinoma

The most common form of prostate cancer.

Adenocarcinoma Growth Speed

A malignancy that is typically slow-growing.

Prostate Cancer Clinical Symptoms

Often asymptomatic; can include weak flow, difficulty with erections, or blood in semen.

Prostate Cancer Sonographic Findings

Enlarged prostate, hypoechoic mass, calcifications, and hypervascularity on color Doppler.

Prostate Cancer Vascularity

Hypervascularity seen on color Doppler in one region can draw attention to a subtle tumor.

Prostatitis

An infection or inflammation of the prostate that can affect men of all ages.

Prostatitis Clinical Symptoms

Groin pain, fever, body aches, penile discharge, and painful or frequent urination.

Urologist

A medical doctor who specializes in the urinary system and male reproductive organs.

Needle Guide

An attachment for the ultrasound probe used during a biopsy to direct the needle in real time.

Biopsy Patient Prep

Stopping blood thinners, performing a cleansing enema, and taking pre-procedure antibiotics.

$30\text{ to }60$ Minutes

The time frame before a biopsy during which antibiotics are administered to prevent infection.