223b ped uro Flashcards
ureteric bud vs metanephric blastema
ureteric bud - renal pelvis to collecting system
metanephric blastema - glomeruli to distal tubules
mutlicystic dysplastic kidney (MDK)
loss reniform shape w/ multile non-comunicating peripheral cysts
no identifiable normal renal parenchyma - only a few glomeruli if any
ureter in pelvis is atretic (so no connection to ureteric bud)
MDK outcome
most will involute - monitor via US
nephrectomy - rarely, only if causing hypertension or mass-effect
hydronephrosis
dilation of tract from previous obstruction (or can have current obstruction, but doesn’t mean its still there)
central area of fluid collection - cystic structures connect to each other
perserved renal function
unilateral = idiopathic, UPJ obstruction
bilateral = PUV (posterior urethral valves)
ureters
loses lumen at day 40, regains from midpoint, last segment is UPJ and UVJ
vesicoureteral reflux (VUR)
benign by itself but can causes UTI and damage kidneys
bladder valve defect allowing urine to go back into kidney via ureter
abnormality of UVJ - shortening of intramural section of ureter – longer allows it to be flat when bladder squeezes
lateral displacement of ureteral orfice
VCUG - voiding cystourethrogram
ureteral duplication
2 ureteric buds with 1 metanpehric blasterma
Weigert-Meyer rule
ureters flip-flop - upper pole of kidney inserts below in kidney (inferior and medial) –> more likely for obstruction
lower moiety – ureteral ofifice inserts superiorly and laterally –> reflux more common
posterior urethral valve
bilateral hydronephrosis from valves in urethra blocking urination –> keyhole sign
can casuse potter’s syndrome
hypospadias
failure of urethral plate/ UG folds to fuse
dorsal hood, chordee, deviation of median raphe
hypospadius + undescended testis
intersex possible
undescended testicles
usually spontaneous descent until 6 months
fix after 6 months
why fix? fertility, cancer risk (seminoma), reduce risk of torsion
hypospadius + undescended testis
intersex possible
undescended testicles
usually spontaneous descent until 6 months
fix after 6 months
why fix? fertility, cancer risk (seminoma), reduce risk of torsion
hydrocele
patent processus vaginalis - brings perineal lining with testicle - if perineal doesn’t seal off
fluid = hydrocele
intraperitoneal conents = hernia
US shows black (fluid)
