Abd (urinary tract) Flashcards
Vasculature Branching Order
- main renal a. @ hilum
- segmental
- interlobar
- arcuate
- interlobular
Are the kidneys intra or retro?
-retroperitoneal
Kidney Size in Adults
- 9 to 12 cm L
- 4 to 5 cm W
- 2.5 to 3 cm AP
What should cortical thickness be?
- min. 1 cm
- < 1cm indicated renal disease
Functions of Kidneys
- produce hormones
- absorbs minerals
- filters blood
- produces urine
- balances water (autoregulatory)
- acid regulation
What hormone regulates BP?
-renin
What hormone regulates blood cells and stimulates bone marrow to produce more RBC’s?
-erythropoeitin
Normal Creatinine
0.6-1.2 mg/dL
What is Creatinine?
- waste product produced from meat protein and normal wear and tear on muscles
- more specific in determining renal dysfunction than BUN
When is creatinine elevated?
- renal failure
- chronic nephritis
- urinary obstruction
Normal BUN Level
11-23 mg/dL
What is BUN produced from?
-breakdown of food proteins
When is BUN elevated?
- urinary obstruction
- renal dysfunction
- dehydration
When is BUN decreased?
- overhydration
- pregnancy
- liver failure
- decrease in protein intake
- smoking
Microscopic Hematuria
- visible microscopic RBC’s in urine under a microscope
- associated with early renal disease
Macroscopic Hematuria
- visible with naked eye
- associated with infection and bladder neoplasms
Proteinuria
-abnormal amount o protein in urine
What is proteinuria associated with?
nephritis
- nephrolithiasis
- carcinoma
- polycystic disease
- hypertension
- diabetes mellitus
- increase risk of renal dysfunction
Indications for US
- increased creatine, BUN, proteinuria
- urinary tract infection
- flank pain
- hematuria
- hypertension
- decreased urine output
- trauma
- evaluate mass from other imaging (CT)
3 Sets of Kidneys in Embryo
- pronephros
- mesonephros
- metanephros
Pronephroi Kidneys
- early 4th week gestation
- rudimentary
- non functioning
Mesonephroi Kidneys
- late in 4th week
- function as interim kidneys
Metanephroi Kidneys
-permanent kidneys
Anomalies Related to Growth
- hypoplasia
- fetal lobulation
- compensatory hypertrophy
Anomalies Related to Ascent
- ectopia
- crossed renal ectopia
- horseshoe
Hypoplasia
- too few nephrons in a small kidney**
- rare
- incidental finding
- unilateral (no symptoms)
- bilateral (renal insufficiency)
Anomalies Related to Uretral Bud
- agenesis
- congenital megacalicies
- congenital megaureter
- supernumerary kidney
- duplex collecting system and retrocedes
- uretropelvic junction obstruction
Uretropelvic Junction Obstruction
- common anomaly
- caused by kink
- stones, infection, impaired function
- may be bilateral
- ballooning of pelvis
- 2:1 male:female ratio
Bladder Agenesis
- rare
- most infants are stillborn
- surviving infants are female
- many associated anomalies are present
- bladder absent on fetal US
3 Types of Bladder Duplication
1) complete/incomplete peritoneal fold separates 2 bladders
2) complete/incomplete septum divides bladder (may be multiple septa)
3) transverse band of muscle divides bladder into 2 unequal parts
Bladder Extrophy
- 1 in 30 000 live births
- 2:1 male:female ratio
- congenital absense of lower abdomen and anterior bladder wall
- associates with other anomalies
- increased incidence of bladder carcinoma
Abberent Vessels
- vascular anomaly
- during embryology, kidney receives blood from high levels of AO
- abberent renal arteries will be present if supply from lower levels persists
- compress the ureter
Retrocaval Ureter
- rare vascular anomaly
- 3:1 male:female ratio
- if infrarenal IVC does not develop from the supra cardinal vein, the ureter will pass posterior to IVC
