Prostate Anatomy.pptx

Lecture notes for medical students

1. Tips on using my ppt. You can freely download, edit, modify and put your name etc. Don’t be concerned about number of slides. Half the slides are blanks except for the title. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. At the end rerun the show – show blank> ask questions > show next slide. This will be an ACTIVE LEARNING SESSION x three revisions. Good for self study also . Good for self study also. Display blank slide> Think what you already know about this > Read next slide . See notes for bibliography.

2. Introduction

3. Introduction Prostate is a fibromuscular glandular organ surrounding the prostatic urethra. It lies just below urinary bladder and above urogenital diaphragm. Samosa / Inverted pyramid shaped.

4. Anatomy

5. Anatomy A normal prostate gland is approximately 20 g in volume, 3 cm in length, 4 cm wide, and 2 cm in depth. Surrounded by a fibrous capsule. Outside capsule- a fibrous sheath which is part of visceral layer of pelvic fascia.

6. Transverse section

7. Parts

8. Parts Base Apex 4surfaces- Anterior Posterior 2lateral

9. Embryology

10. Embryology Embryologically , the prostate, seminal vesicles, and ductus (vas) deferens originate from 2 separate structures- The prostate arises from a budding collection of tissue in the urogenital sinus. The seminal vesicles and the ductus deferens are formed from the mesonephric duct.

11. Embryology The prostate develops from epithelial outgrowths form the prostatic segment of the urethra that grows into the surrounding mesenchyme . This outgrowth and branching start at week 10 during embryo growth;

12. Embryology by week 12, there are 5 groups of tubules that form the lobes of the prostate.- The first group makes up the middle lobe the second and third groups make up the right and left lateral lobes; the fourth group is the posterior lobe that starts from the floor of the urethra; fifth group is the anterior lobe.

13. Arterial Supply

14. Arterial Supply Branches of- 1.Inferior Vesical artery. 2.Middle Rectal artery

15. Venous Drainage

16. Venous Drainage Veins form Prostatic venous plexus between capsule and fibrous sheath. This plexus receives- Deep dorsal vein of penis Many visceral veins The plexus drains into Internal iliac veins.

17. Lymphatic Drainage

18. Lymphatic Drainage Into Internal iliac nodes

19. Nerve Supply

20. Nerve Supply Supplied by Inferior hypogastric plexus.

21. Relations

22. Relations

23. Relations Anterior Symphysis Pubis Extraperitoneal fat in retroperitoneal space (Cave of Retzius ) Puboprostatic ligaments

24. Relations Posterior Rectum Denonvillier’s fascia ( Rectovescical septum) The ejaculatory ducts pierce the upper part to open into prostatic urethra at Veru .

25. Relations Superior Neck of urinary bladder. The urethra enters center of the base .

26. Relations Inferior Apex lies on urogenital diaphragm. The urethra leaves just above the apex on anterior surface.

27. Relations Lateral Embraced by the anterior fibres of levator ani .

28. Lobes

29. Lobes Incompletely divided into five lobes- Anterior lobe (Isthmus) Middle (Median) Posterior And 5 Rt and Lt. Lateral lobes seperated by median groove.

30. Lobes

31. Verumontanum the openings of the  prostatic ducts

32. Verumontanum The  seminal colliculus  or  verumontanum , of the prostatic urethra is a landmark near the entrance of the seminal vesicles. Distinctive median elevation of  urothelium The landmark is important in classification of several urethral developmental disorders. The margins of seminal colliculus are the following: the orifices of the prostatic utricle the slit-like openings of the ejaculatory ducts. the openings of the  prostatic ducts

33. Microscopic Anatomy

34. Microscopic Anatomy The glands of the peripheral zone lined by columnar epithelium, lie in the fibromuscular stroma , and their ducts,which are long and branched, open into posterolateral grooves on either side of the verumontanum . The glands of the CZ and TZ are shorter and unbranched .

35. Zonal Anatomy Peripheral zone (PZ), which lies mainly posteriorly and from which most carcinomas arise, and a Central zone (CZ), which lies posterior to the urethral lumen and Periurethral transitional zone (TZ), from which most benign prostatic hyperplasia (BPH) arises.

36. Zonal Anatomy

37. Sphinctors

38. Sphinctors Proximal smooth mucle urethral sphincter Distal striated urethral sphincter muscle

39. Physiology

40. Physiology Prostate produces a thin milky fluid containing citric acid and acid phosphatase which is added to the seminal fluid at the time of ejaculation.

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