Prostate Gland, Female & Male Urethra - PDF

PROSTATE GLAND, FEMALE URETHRAE AND MALE URETHRAE DR SAM CHIME  OUTLINE Introduction Location and shape Relations and arterial supply Structures inside Lobes Capsule of the prostate Function Clinical examination  INTRODUCTION Th...

PROSTATE GLAND, FEMALE URETHRAE AND MALE URETHRAE DR SAM CHIME  OUTLINE Introduction Location and shape Relations and arterial supply Structures inside Lobes Capsule of the prostate Function Clinical examination  INTRODUCTION The largest accessory sex organ Its secretions is alkaline forming a considerable part of the semen, it contains acid phosphatase, fibrinolysin, prostaglandin and a large amount of zinc Prostatic fluid provide 20% of the volume of seminal fluid In females it is represented by paraurethral glands  INTRODUCTION Weight 8gm Size width 4cm; length 3cm; anteriorposterior diameter 2cm The prostatic ducts [20 to 30 in number] open into the prostatic sinuses on the posterior wall of prostatic urethra  PROSTATE Location True pelvis inferior to the neck of the bladder, superior to the urogenital diaphragm, behind the pubic symphysis and in front of the ampulla of the rectum  PROSTATE Shape Inverted cone/pyramidal in shape, a fibromuscular glandular organ It is about the size of a walnut The base is directed upwards the apex downwards  PROSTATE Relations Base : bladder neck; pierced by urethra & ejaculatory duct Apex : urogenital diaphragm Anterior : retropubic space & puboprostatic lig Post. : lower 1/3rd of rectum Sides : levator ani  PROSTATE Arterial supply Inferior vesical & Middle rectal Both branches of Ant div of int illiac Artery Venous drainage : Internal pudendal V Internal illiac V Lymph drainage to int illiac LN and Sacral LN Parasympathetic : pelvic splanchnic nerves[S2 S3 S4] Sympathetic: hypogastric plexuses [ L1 L2 ]  PROSTATE Most of the glandular tissue is located posterior and lateral to the prostatic urethra Most of the prostatic secretion is discharged by the contraction of smooth muscle in the prostate  PROSTATE Structures inside the prostate gland Urethra Ejaculatory ducts Prostatic urtricle Prostatic urethra: extends from base to apex features in the post wall 1 urethral crest 2 colliculus seminalis 3 prostatic sinuses  PROSTATE Anatomical lobes : median lobe and two lateral lobes Anatomical lobes show glandular tissue Surgical lobes : median lobe, 2 lateral lobes, anterior and posterior lobe  PROSTATE Lobes ( surgical ) Anterior lobe contains no glands Posterior lobe Middle lobe 2 side lobes Right & left Middle lobe is glandular It is liable to Enlargement Obstructing the urethra  PROSTATE Capsules Fibrous capsule or true capsule Fibrous sheath or false capsule Rectoprostatic fascia( Denonvillers fascia) Venous plexus found between the true and false capsule PROSTATE  PROSTATE Fibrous tissue forms postero median septum Muscular tissue : smooth muscle derived from detrusor muscles and arranged in sheets Striated muscle derived from sphincter urethrae Fibromuscular stroma is stimulated by oestrogen inhibited by testosterone Glandular tissue : arranged in 3 concentric layers around the urethra inner mucous glands intermediate submucous glands outer main prostatic glands All open via prostatic sinuses, glandular is stimulated by testosterone  PROSTATE The prostate gland is created from fibrous tissue (1/4), muscular tissue (1/4), and glandular tissue (1/2). The glandular tissue is composed of tubuloalveolar glands arranged in 3 concentric groups (mucosal, submucosal, and chief); all of them open into the urethra. The fibro muscular tissue creates the stroma and the glandular tissue types the parenchyma of the prostate gland. The lumen of tubuloalveolar gland includes small colloid masses named corpora amylacea.  PROSTATE Functions Secretes prostatic fluid which is alkaline. It contains acid phosphatase. Acid phosphatase increases in prostate cancer due to obstruction of the ducts of the gland Secretes prostaglandin  PROSTATE Examination of prostate gland PR Ultrasound Biopsy PSA  Applied anatomy Prostatitis BPH Prostate Cancer  Female urethra 4 cm long related to the anterior wall of the vagina opens in the vestible of the vagina external urethral sphinter in the deep perineal pouch  Male urethra length 20cm shape S shaped parts 4 parts 1st part is the preprostatic part 2nd part is the prostatic part 3rd part is the membranous part 4th part is the spongy part  Male urethra The 1st part has the internal urethral sphincter made up of smooth muscle 2nd part is the prostatic part which recieves the opening of the utricle, seminal colliculus and ejaculatory duct  Male urethra 3rd part is the membranous part which is surrounded by external urethral sphincter which is skeletal muscle 4th part is the spongy part which has two fossa: bulbar and navicular fossa. The bulbourethral glands open at the bulbar fossa  Male Urethra Compare the prostatic part, membrane part and the spongy part in terms of length location width openings and relations  male urethra Internal urethral sphincter lies b/w bladder neck and prostate, smooth muscle supplied by autonomic NS External urethral sphincter membranous part, skeletal muscle supplied by pudendal N  THANK YOU FOR LISTENING