A & P Flashcards
Each kidney is a dark __________, __________- shaped organ.
Dark red
Bean shaped
What does the urinary system consist of?
2 kidneys that secrete urine
Each kidney measures?
12 cm long, 5 cm wide, and 2.5 cm thick
What are the ureters?
Ducts leading to the kidneys
What is the bladder?
Urinary reservoir
What is the urethra?
Tube from the bladder to the surface of the body
The kidney is in the __________ space.
Retroperitoneal
The __________ kidney is slightly lower than the __________ kidney because of the liver.
Right kidney
Left kidney
With __________, both kidneys move.
Respiration
On the medial surface of each kidney is a vertical slit called the __________.
Hilus
The hilum transmits:
Renal vein
Renal artery
Ureter
Lymph vessels & sympathetic fibers
Each artery divides into __________ branches to enter the hilus of the kidney.
3
5-6 veins join to form the __________ vein, which emerges from the hilus in front of the __________ artery.
Renal vein
Renal artery
The renal vein drains into the __________.
IVC
The __________ __________ follow the renal artery to the lateral aortic lymph. Odes around the origin of the renal artery.
Lymph vessels
__________ originates in the renal sympathetic plexus and are distributed along the branches of the renal vessels.
Nerves
The __________ __________, also known as Gerota fascia, is a layer of connective tissue encapsulating the kidneys.
Renal fascia
__________ Of the renal cortex lies beneath the renal capsule.
Parenchyma
What is the cortex?
Outer portion that contains tubules
Responsible for filtration of the blood
What is the medulla?
Pyramids, which empty their contents into the collecting space
Responsible for absorption
What is the collecting space called?
Renal pelvis
What is the renal sinus?
Central portion of the kidney
Renal sinus contains a collecting system consisting of:
Major and minor calyces
Arteries and veins
Lymphatic
Part of the renal pelvis
Within the kidney, the upper extended end of the __________, which is the pelvis of the ureter, divides into 2-3 major __________, each of which divides into 2-3 minor __________.
Ureter
Major
Minor
Each minor calyx is indented by the apex of the medullary pyramid called the __________ __________.
Renal papilla
__________, are the functional units of the kidney. We have more than one million of these.
Nephrons
What is the renal corpuscle?
Network of capillaries (glomerulus) surrounded by a cup like structure (bowman’s capsule)
Has afferent & efferent arterioles
What is afferent arterioles?
Blood flow INTO the glomerulus
What is efferent arterioles?
Blood flow FROM the glomerulus
Renal tubule consists of what 3 parts:
Proximal
Loop of Henle
Distal
What are the 2 types of nephrons?
Renal corpuscle
Renal tubule
The artery subdivides within the kidneys, and a small __________, the __________ arteriole, enters the __________ capsule, where it forms a tuft of capillaries, the __________, which entirely fills the concavity of the capsule.
Vessel
Afferent
Bowman’s
Glomerulus
Blood leaves the glomerulus via the __________ arteriole, which subdivides into a network of capillaries that surround the __________ and __________ tubules and eventually unite as veins that become the __________ __________.
Efferent
Proximal and distal
Renal vein
The __________ __________ returns the cleansed blood to the general circulation.
Renal vein
What are the main arteries of the kidney?
Main renal artery Segmental arteries Lobar arteries Interlobar arteries (side of pyramid) Arcuate arteries (base of pyramid) Interlobular arteries Afferent arterioles
What are the main veins of the kidney?
Interlobular veins Accurate veins Interlobar veins Segmental veins Main renal vein
From the nephrons, the fluid moves to collecting __________ and into the __________, which leads to the __________, where urine is stored.
Tubules
Ureter
Bladder
Ureters run along the __________ muscle.
Psoas
The ureter is approximately __________ cm long.
25
What are the 3 ureter constrictions?
UPJ (ureteropelvic junction - pelvis joins the ureter)
Point at which the ureter is kinked as it crosses the pelvic brim
UVJ (ureterovesicle junction - ureter pierces bladder wall)
The __________ __________ is a large, muscular bag.
Urinary bladder
What are the 3 openings of the bladder?
2 are posterior and lateral for the ureters
1 is anterior for the urethra
When the bladder is full, the lining is __________ and __________; when the bladder is empty, the lining is a __________.
Smooth and stretched
Series of folds
What is the trigone?
Area of the inferior bladder where the ureters end at the bladder and the urethra exits
Urine is produced almost continuously and accumulates in the bladder until the increased pressure stimulates what?
Bladders nervous receptors
The __________ is a membranous tube that passes from the anterior part of the urinary bladder to the outside of the body.
Urethra
What are the 2 sphincters of the urethra?
Internal and external sphincters
__________ Is a closure of the urethra
Stricture
__________ Is inflammation of the mucous membrane in the urethra
Urethritis
__________ Is difficult urination
Dysuria
__________ Is inflammation of the bladder
Cystitis
__________ Is open bladder surgery
Cytostomy
__________ Is the removal of the bladder
Cystectomy
What are the 2 principle functions of the urinary system?
Excretion of wastes and regulation of the composition of blood
Kidneys adjust what 2 things so that it equals what entering the body?
Amount of water and electrolytes = amount of substances
Formation of urine involves what 3 processes?
Glomerular filtration
Tubular reabsorption
Tubular secretion
Regulation of the composition of blood involves not only the removal of __________, but also the conservation of __________ and __________ in the body.
Harmful waste products
Water and metabolites
Symptoms of renal infection or disease…
Flank pain Hematuria Polyuria Oliguria Fever Urgency Weight loss Generalized edema
A __________ is essential for the detection of urinary tract disorders in patients whose renal function is impaired or absent.
Urinalysis
The presence of an acute infection will cause __________, or __________ in the urine.
Hematuria or RBCs
What is pyuria?
Pus in the urine
__________ Is important in managing such diseases as bacteriuria and renal calculi.
pH
Urine pH refers to…
The strength of the urine as a partly acidic or alkaline solution
If urine contains an increased concentration of hydrogen ions, the urine is an __________ __________.
Acidic solution
__________ __________ Is the measurement of the kidneys ability to concentrate urine.
Specific gravity
The concentration factor depends on the …
Amount of dissolved waste products within it
__________ __________ Is especially low in cases of renal failure, glomerular nephritis, and pyelonephritis.
Specific gravity
Renal failure, glomerular nephritis, and pyelonephritis cause __________, which affects the ability of kidneys to concentrate urine.
Renal tubular damage
__________ Is RBCs in the urine and may indicate early renal disease.
Hematuria
An abundance of RBCs in the urine may be suggestive of…
Renal trauma, calculi, or pyelonephritis
Glomerular or vascular inflammatory - acute glomerulonephritis & renal infarction
__________ May be present whenever there is inflammation, infection, or necrosis.
Leukocytes
__________ Refers to the relative ratio of plasma to packed cell volume in the blood.
Hematocrit
A dressed hematocrit level occurs with acute __________ processes secondary to disease or blunt trauma.
Hemorrhagic
The presence of hemoglobin in urine occurs whenever there is extensive damage or destruction of the functioning __________. This condition is injurious to the kidney and can cause __________.
Erythrocytes
Acute renal failure
__________ Is commonly found in patients with benign and malignant neoplasms, calculi, chronic infection, and pyelonephritis.
Albuminuria
__________ Is the combination of specific measurements of creatinine concentrations in urine and blood serum levels is considered an __________ for determining the glomerular filtration rate.
Creatinine clearance
Accurate index
A __________ urinary creatinine clearance indicates renal dysfunction because the decrease prevents the normal excretion of creatinine.
Decreased
__________ Is the concentration of urea nitrogen in blood, which is the end product of cellular metabolism.
Blood urea nitrogen (BUN)
__________ Is formed in the liver and carried to the kidneys through the blood to be excreted in urine.
Urea
Impairment of __________ and increased __________ results in BUN elevation in relation to the degree of __________ and rate of __________ excreted by the kidneys.
Renal function and increased protein catabolism
Renal impairment and rate of urea nitrogen
Renal dysfunction will also result in __________.
Serum creatinine elevation
__________ Are said to be more specific and more sensitive in determining renal impairment than __________.
Blood serum creatinine levels
BUN
What should patients do to prepare their bodies for a renal US?
Be hydrated - 32 oz of water one hr prior to exam
NPO 6-8 hrs
Clinical findings…
UTI Palpable mass Elevated serum creatinine & BUN Severe flank pain Hematuria Decreased urine output Trauma
What transducer should be used to scan the ABD?
Highest frequency as possible ABD transducer
A scan with the patient in the supine position will show 3 distinct segments of the kidney:
Less echogenic medullary zone (numerous anechoic, triangle-shaped renal pyramids)
Moderately echogenic renal cortex
Highly reflective central renal sinus
The __________ and __________ have a distinct layer of very reflective echoes that distinguish a normal right kidney from the liver, or the left kidney from the spleen.
Renal capsule and perinephric fat
The renal arteries are located __________ from the aorta, and are easiest to see when the patient is __________ or in the __________ position.
Posterolateral
Supine or LLD
The __________ extends from the posterolateral aorta to the central renal sinus. On a longitudinal scan, it can be seen as a circular structure posterior to the IVC.
Right renal artery
Renal arteries lie __________ to the veins and can be seen with certainty if their junction with the aorta is seen.
Posterior
The __________ flows anterior to the aorta, posterior to the superior mesenteric artery to join the IVC.
Left renal vein
The __________ lies posterior to the renal arteries and should be identified by their lack of pulsations and no Doppler flow.
Diaphragmatic crura
The __________ consists of hypoechoic pyramids in a uniform distribution separated by bands of intervening parenchyma that extends towards the __________.
Renal medulla
Renal sinus
The pyramids are __________ in size, and __________ in shape and distribution.
Uniform
Triangular
The apex of the pyramid points toward the __________, and the base lies adjacent to the __________.
Sinus
Renal cortex
The __________ lie at the base of the pyramids.
Arcuate vessels
The pyramids are located at the junction between the more __________ and the __________.
Perioheral renal cortex
Central sinus
6 variants of the urinary system?
Hypertrophied column of Bertin Dromedary hump Junctional parenchymal defect Persistent fetal lobulation Extrarenal pelvis Horseshoe kidney
__________ Are the prominent invaginations of the cortex located at varying depths within the medullary substance of the kidneys.
Bertin’s columns
__________ Is a cortical bulge that occur on the lateral border of the kidney, typically more on the left. In some patients it may be so prominent that it looks like a neoplasm.
Dromedary hump
__________ Is a triangular echogenic area in the upper pole of the renal parenchyma that can be seen during normal sonographic scanning. Remnant of fusion site.
Junctional parenchymal defect
__________ Is a developmental variation that is seen. The surface of the kidney is indented between the calyces, giving the kidney a “lobulated” appearance.
Persistent fetal lobulation
The __________ tends to be larger, with long, major calyces.
Extrarenal pelvis
__________ Is a common normal variant that can be seen on sonographic examination.
Duplex collecting system
The __________ appears as two echogenic regions separated by a cleft of moderately echogenic tissue similar in appearance to the normal renal parenchyma.
Central renal sinus
Fusion anomalies of the kidneys include __________, and __________, which is the most common fusion anomaly.
Crossed renal ectopia
Horseshoe kidney
In a patient with a horseshoe kidney, there is a fusion of …
The polar regions of the kidneys
__________ Is a condition that is characterized by the deposition of a moderate amount of fat in the renal sinus.
Sinus lipomatosis
__________ Is the absence or failure of formation
Agenesis
__________ Is a defective embryonic development
Dysgenesis
__________ Is exceeding the normal number
Supernumerary
__________ Is rare and results from unilateral renal agenesis
Solitary kidney
What will a sonographer look for to make a diagnosis of solitary kidney?
A small nonfunctioning kidney
Renal enlargement
If the kidney is not seen in the normal position in the renal fossa, where should be scanned next?
Retroperitoneum and pelvis
Most true ectopic kidneys are located in the __________ and may be __________.
Bony pelvis
Malrotated
A pelvic kidney may simulate a __________.
Solid adnexal mass
What is the modality of choice to evaluate the bladder?
Cystoscopy
Scanning of the bladder should be performed when the bladder is __________ to image the walls of the bladder.
Very full
US may evaluate residual urine within the bladder - __________.
Postvoid
Use color Doppler to evaluate the __________.
Ureteral jets
