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LMC Ultrasound > AB-Renal > Flashcards

AB-Renal Flashcards

1
Q

the urinary system consists of:

A

kidneys
ureters
bladder

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2
Q

the principle functions of the urinary system:

A

excreting waste

regulating blood composition

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3
Q

normal kidney measurements:

A

9-12 cm long, 5 cm wide, 2.5 cm thick

a difference of 1.5-2cm in kidney lengths is concerning

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4
Q

the layers surrounding the kidney from lateral to medial

A 
Gerota's Fascia
Perinephric Fat
True Capsule
Cortex
Sinus: Medulla and Renal Pyramids
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5
Q

The Kidneys are located in…

A

retroperitoneum

posterior to the peritoneum lining the abdominal cavity

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6
Q

the left renal A is located at…

the right renal A is located at…

A

4 o’clock

10 o’clock

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7
Q

where do kidneys develop and when do the move?

A

the developing kidneys ascend from the pelvis at 9 weeks and move to their normal location

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8
Q

Cortex

A

where veins, arteries, Bowman’s Capsule, and convoluted tubules are located
responsible for filtration of blood

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9
Q

Medulla

A

Responsible for absorption

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10
Q

Arcuate Arteries

A

located at the base of the pyramid

separates the medulla from the cortex

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11
Q

Nephrons

A

Functioning unit of the Kidneys

filters the blood and produces urine

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12
Q

2 main structures of Nephron

A

renal tubules

renal corpuscle

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13
Q

Renal Corpuscle

A

network of capillaries (glomerulus)

surrounded by a cup like structure (Bowman’s Capsule)

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14
Q

afferent arteriole:

efferent arteriole:

A

bring blood into glomerulus

takes blood away/leaving glomerulus

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15
Q

Juxtaglomerular apparatus:

A

structure that helps regulate blood pressure in the kidney

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16
Q

loop of Henle

A

goes down into the renal pyrimids

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17
Q

3 Constriction Typically seen along ureters

A
  1. where ureters leave the renal pelvis
  2. where it kinks as it crosses the pelvic brim
  3. where it pierces the bladder wall (UVJ)
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18
Q

Bladder

A

large muscular bag, the wall should measure < 3mm in trans when stretched, posterior and lat opening for the ureters to enter, anterior opening for urethra

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19
Q

UVJ

A

Ureterovesicular Junction
where ureters enter the bladder
most common site for kidney stones

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20
Q

vascular supply

A

aorta
renat arteries
segmental, interlobar, arcuate
Afferent in > Bowman’s > cleaned (Glomerulus) > Efferent to Vein

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21
Q

Urine Formation and Flow

A

nephrons remove waste thanks to the glomerulus. filtered fluid passes renal corpuscle, renal tubule. waste products pass into collecting ducts. Ducts drain into pyramids, down minor calyces into major calyces, into the renal pelvis, down ureters and into the bladder.

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22
Q

vascular supply to ureters

A

proximal- renal artery
mid- testicular/ovarian artery
distal (near bladder)- superior vesical

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23
Q

Lab Tests for Renal Disease

A 
Urinalysis                   Hematocrit:
Urine pH                    Hemaglobin 
Specific Gravity         Protein
Blood/Hematuria       Serum Creatine
Creatine
Blood Urea Nitrogen (BUN)
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24
Q

CRF

A

Chronic Renal Faiure

most common cause is Diabetes

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25
Q

Normal Variants

A 
Column of Bertin
Dromedary Hump
Junctional Parenchymal
Fetal Lobulation
Sinus Lipomatosis
Extrarenal Pelvis
Horseshoe Kidney
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26
Q

Renal Anomalies

A 
Renal Agenesis
Renal Hypolasia: incomplete devel. of kidney. Fewer than 5 calyces
Incomplete Duplication
Double Collecting system
Renal ectopia
polycystic
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27
Q

Ureterocele

A

cyst like enlargement of the lower end of the ureter

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28
Q

Bladder Pathology

A

diverticula
cystitis
bladder calculi
bladder tumors

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29
Q

Diverticula

A

appears as a pouch-like herniation of the bladder wall

congenital or acquired

30
Q

cystitis

A

thickening of bladder wall, usually form infection

more common in females

31
Q

bladder calculi

A

stone in bladder. can come from kidney of form in the bladder.

32
Q

most common primary bladder neoplasm:

A

Transitional Cell Carcinoma (TCC)

TCC accounts of 90% of malignancies that involve bladder, renal pelvis, and ureters

33
Q

Polycystic Kidney Disease

A

ADPKD- Autosomal Dom./Adult Polycystic disease

ARPKD- Autosomal Recessive- relatively rare

34
Q

Angiomylolipoma

A

Most common Benign Tumor (Hamartoma)
mass composed of fat, blood vessels, smooth muscle
usually discovered incidentally
highlyechogenic

35
Q

Medullary Sponge Kidney

A 
developmental anomaly
(interlobar renal calcification)
occurs in medulary pyramids
consist of cystic or fusiform dilation of the distal collecting ducts
cause unknown
36
Q

Renal Cell Carcinoma

A

Hypernephroma or Grawitz’s tumor

most common neoplasm-85% of kidney tumors
seen in 60-70 yr patients

37
Q

Nephroblastoma

A

Wilm’s Tumor
most common abdominal malignancy in children
90% of patients are younger than 5yr
50% arise from adrenal medulla
2x-8x more common in patients with horseshoe kidneys

38
Q

Oncocytoma

A

uncommon renal tumor usually benign

increased in middle aged to older patients

39
Q

Renal Fungal Disease

A

Candida Albican

most common form of fungal urinary track infection

40
Q

Pyonephrosis

A

contains pus -sick sick patients

41
Q

pyelonephritis

A

inflammation of the kidney
cortex large compressing renal sinus
treated with antibiotics

42
Q

Pyonephrosis and Renal Fungal Disease

A

have the same clinical symptoms

43
Q

Hydronephrosis

A

Urinary Tract Obstruction (UTO)
interconnected fluid filled calyces
it is graded 1-4 for severity

44
Q

Acquired causes of Hydronephrosis:

A 
bladder tumor
normal pregnancy
prostate enlargement
calculi
pelvic mass
carcinoma of cervix
Retroperitneal Fibrosis
neurogenic bladder
45
Q

intrinsic causes of Hydronephrosis

A 
bladder neck obstruction
calculus
congenital defect
stricture
UPJ obstruction
inflamation
posterior urethral vallues
pyelonephritis
utererocele
46
Q

Nephrolithasis

Urolithiasis

A

stone within the kidney

stone within the urinary tract

47
Q

Renal Infartion

A

part of the tissue under goes necrosis after cessation of blood supply
usually a result of artery occlusion.

48
Q

Posterior Urethral Valves

A

an obstructing membrane in the posterior male urethra as a result of abnormal in utero development. It is the most common cause of bladder outlet obstruction in male newborns. The disorder varies in degree, with mild cases followed conservatively.

49
Q

Staghorn Calculus

A

stones that are large and fill the renal collecting system

always within the Kidney

50
Q

hormomes resposible or flight or flight

A

Epinephrine: Excelorator
Noreipinephrine: Vasoconstrictor
-produced in the medulla

51
Q

sex hormone

A

Adrogen- male sex hormone
Estrogen- female sex hormone
controlled by the adrenocorticotropic hormone (ACTH) from the pituitary gland

52
Q

hormomes responsible or flight or flight

A

Epinephrine: Excelorator
Noreipinephrine: Vasoconstrictor
-produced in the medulla

53
Q

Adrenal Cortex

A

outer portion, secretes steroids that help to regulate electrolytes metabolism, carbohydrate metabolism and sex hormones

54
Q

cortisol

A

help diminish the allergic response to inflammatory disease of the body

55
Q

Conn’s Syndrome

A

(aldosteronism) -common

caused by excessive secretion of aldosterone due to adenoma of glomerulosa cells

56
Q

clinical signs of Conn’s Synd.

A

muscle weakness, High Blood Pressure, Abnormal EKG

57
Q

Glucocorticoids

A

play an important role in the metabolism of carbohydrates

primary: Cortisone and Hydrocortisone

58
Q

Cushing’s Syndrome

A

excessive secretion of cortisol usually form a tumor of the adrenal gland (adenoma or carcinoma)

59
Q

clinical signs of Cushing’s Syndrome

A

“moon face”
truncal obesity with pencil thin extremities
psychisatric disturbances

60
Q

Hypofuntion of adrenal gland

adrenocortical insufficiency

A

Addison’s disease

61
Q

primary causes of Addison’s Disease

A

autoimmune disease, TB, inflammatory process, primary neoplasm or metastises

62
Q

Clinical signs of Addison’s

A

tissue edema
fatigue
muscle and bone weakness
hyper-pigmentation of the skin

63
Q

Adrenogenital Syndrome (adrenal virilism)

A

increased secretion of sex hormones

64
Q

Waterhouse-Friderichsen Syndrome

A

bilateral adrenal hemorrhage that is complicated by adrenal insufficiency
caused by sever bacterial meningococcal infection

65
Q

A resistive index greater than___

it is suggested you have cancerous lymphnodes

A

.7

66
Q

adrenal vascular supply

A

3 arteries supply each gland
1 vein from the hilum drains to the IVC on the right
the left drains into the left renal

67
Q

primary retroperitoneal tumors

A

lymphoma
leiomysarcoma
fibrosarcoma
teratomas

68
Q

Ormond’s Disease

A

Retroperitoneal Fibroisis (RPF)
unknown cause
assoc. w/ a mallignant process
may encase and obstruct ureters and vena cava

69
Q

clinical signs of Ormond’s Disease

A

flank pain, back pain, weight loss, nausea and vomiting

70
Q

3 categories of steroids

A

Mineralocoricoids
Glucocorticoids
Sex Hormones

LMC Ultrasound (32 decks)

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