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2nd Year - Renal > Anatomy 3 - Imaging and Anatomy Workshop (new info) > Flashcards

Anatomy 3 - Imaging and Anatomy Workshop (new info) Flashcards

1
Q

Name of the round apex of medullary pyramids?

A

Papilla

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2
Q

What does filtrate from the papilla pass into?

A

minor calyx

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3
Q

Functional unit of the kidney?

A

Nephron

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4
Q

Where is the glomerulus of a nephron located?

A

Cortex

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5
Q

Where is the tubule of a nephron located?

A

Medulla

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6
Q

What is the name of the part of the abdominal cavity that the kidneys are located in?

A

Paravertebral gutters

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7
Q

Other name for the suprarenal gland?

A

Adrenal gland

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8
Q

Vertebral level of the hilum of the left kidney?

A

L1

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9
Q

Vertebral level of the hilum of the right kidney?

A

L1/L2

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10
Q

Contents of the renal hilum? (6)

A 
Renal pelvis (posterior)
Renal artery (middle)
Renal vein (anterior)
Lymphatics
Nerves
Renal sinus fat
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11
Q

Name of the fatty compartment located within the medial aspect of the kidney which communicates with the perinephric space and contains the renal hilum, bordered by renal parenchyma laterally?

A

Renal sinus

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12
Q

Which renal vein is longer?

Why?

A

Left renal vein

Passes across the aorta anteriorly to joint the right sided IVC

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13
Q

Strengths of US of kidney? (7)

A 
Renal size
Cortical scarring
Doppler
Distention of pelvicalyceal system
Calculi
Detection of renal abnormalities
Cheap
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14
Q

Weaknesses of US of kidney? (3)

A

User dependant
Limited characterisation of focal lesions
No licensed contrast medium

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15
Q

Strengths of CT of kidney? (6)

A 
Quick
Multi-phasic assessment of kidney
Vascular assessment
Characteristises most pathologies
High spatial resolution
Multiplanar imaging possible?
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16
Q

Weaknesses of CT of kidney? (2)

A

High dose ionising radiation

Contrast induced nephropathy

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17
Q

What is a pre-contrast CT of kidney best to see?

A

Best to depict calculi -> CT stone research

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18
Q

What is best seen in the corticomedullary phase of a kidney CT?

A

Cortical enhancement

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19
Q

Time frame of the corticomedullary phase of CT kidney?

A

25-70 seconds after IV injection of iodinated contrast (80-120ml)

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20
Q

Time frame of the nephrographic phase of CT kidney?

A

80 - 180 seconds after IV injection of iodinated contrast

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21
Q

What is enhanced well in nephrographic phase of CT?

A

Renal medulla and cortex equally

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22
Q

Time frame of excretory phase of CT kidney?

A

5 - 15 minutes after IV injection of iodinated contrast

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23
Q

What is best seen in the excretory phase of CT kidney?

A

Opacification of the renal collecting system and ureters

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24
Q

What is the name for deposition of calcium in the substance of the kidney?

A

Nephrocalcinosis

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25
Q

What is the proper name for kidney stones?

A

Nephrolithiasis

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26
Q

what are the 3 fundamental spaces in the retroperitoneum around the kidney?

A

Anterior pararenal
Perirenal
Posterior pararenal

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27
Q

What is another name for Gerota’s fascia?

A

Anterior renal fascia

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28
Q

What is another name for Zuckerkandel’s fascia?

A

Posterior renal fascia

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29
Q

What is CT-contrast induced nephropathy?

A

Condition in which an impairment in renal function occurs within 3 days following intravascular administration of a contrast medium in the absence of an alternative aetiology

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30
Q

What blood test would confirm a CT-contrast induced nephropathy?

A

Rise in serum creatinine and urea which usually peaks at 72-96 hours post contrast

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31
Q

Risk factors for CT-contast induced nephropathy?

A 
Renal impairment +/- diabetes mellitus 
Dehydration
Congestive heart failure
LV ejection fraction <40%
Acute MI (within 24 hours)
Nephrotoxic drugs
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32
Q

What eGFR is associated with a higher risk of CT-contrast induced nephropathy?

A

eGFR <60

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33
Q

What is the hydration protocol for before and after contrast administration for a CT kidney scan if eGFR is low?

A

1-1.5 ml/ kg/ h 0.9% normal saline 12 or 6 hours before and after contrast

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34
Q

What should be administered 1 hour pre-procedure and 6 hours post-procedure for a contrast CT of kidney if patient has a low eGFR?

A

Sodium bicarbonate

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35
Q

What should you check prior to requesting a CT contrast of the kidney?

A

Renal function

36
Q

Strengths of MRI of kidney? (4)

A

Excellent soft tissue contrast resolution
Renal lesion characterisation
Vascular assessment
Characterises most pathologies

37
Q

Weakness of MRI of kidney? (2)

A

Lengthy acquisition

Nephrogenic systemic fibrosis

38
Q

What is an MRA?

A

Renal angiogram

39
Q

What vessels can be seen on MRA?

A 
Abdominal aorta
Right renal artery
Left renal artery
Aortic bifurcation
Splenic artery
Lumbar arteries
40
Q

What is a severe systemic fibrosing disorder associated with the exposure of gadolinium containing contrast media?

A

Nephrogenic systemic sclerosis

41
Q

What does a high T1 signal in MRI scan mean?

A

Lots of fat

42
Q

What does a high T2 signal with MRI mean?

A

Lots of fluid

43
Q

T1 and T2 signals for cyst?

A

Low/ no T1 signal

High T2 signal

44
Q

Risk factors for nephrogenic systemic sclerosis?

A

Renal impairment

45
Q

Initial symptoms/ signs of nephrogenic systemic sclerosis?

A

Skin erythema
Pruritus
Pain

46
Q

What other problems may be caused with nephrogenic systemic sclerosis?

A

Neuropathic symptoms
Joint contractures
Resp insufficiency
Muscular atrophy

47
Q

What happens with time with nephrogenic systemic sclerosis?

A

Skin thickens, hardens appearing wood-like

48
Q

At what junction does the ureter empty into the bladder?

A

Vesico-ureteric junction

49
Q

How long is the average ureter?

A

25-30 cms

50
Q

What are the 3 subdivisions of the ureter?

A

Abdominal ureter
Pelvic ureter
Intravesical portion

51
Q

What does the abdominal ureter coarse alongside?

A

Medial aspect of psoas

52
Q

Where does the ureter enter the pelvis?

A

At the bifurcation of the common iliac artery

53
Q

Where are the pelvic ureters located in relation to the SI joints?

A

Anterior and medial

54
Q

What has replaced the IV urography in Ninewells?

A

CT urogram

55
Q

When are x-rays taken in an IV urography?

A

Nephrogram (immediately taken after contrast administration)
Interval excretory films
Post-micturition film

56
Q

What is the main type of imaging used to assess the collecting system, ureters and bladder?

A

CT urogram

57
Q

When are images taken in CT urogram?

A

Pre-contrast and 5-15 mins excretory phase obtained after IV contrast

58
Q

Where are the lymph nodes that drains the right kidney located?

A

IVC

59
Q

Where are the lymph nodes that drains the left kidney located?

A

Aorta

60
Q

Name of the posterior surface of the bladder?

A

Base

61
Q

Name of the anterior part of the bladder that sits behind the symphysis pubis?

A

Apex

62
Q

Word used to describe the walls of the bladder?

A

Corrugated

63
Q

Wall of the trigone?

A

Smooth

64
Q

What muscles lie inferior to the bladder?

A

Obturator internus

Levator ani

65
Q

What is the posterior wall of the female bladder loosely attached to?

A

The anterior vagina and cervix

66
Q

describe the state of the bladder to carry out an US?

A

Full

67
Q

What can be investigated with US of bladder?

A

Volumetric measurement (filled bladder and post-micturition)
Internal calculi
Bladder wall irregularities
Diverticula

68
Q

What is the gold standard imaging used to detect leakage through the bladder wall?

A

Cystography (contrast placed in bladder using catheter and x-ray taken)

69
Q

What can bladder IVU/ cystography be used to assess?

A 
Leakage through bladder wall
Internal calculi
FIlling defects
bladder wall irregularities
Diverticula
70
Q

What phases of a CT with contrast are used to assess the bladder?

A

Precontrast and excretory phaes

71
Q

What is the gold standard imaging for assessing local staging of bladder wall tumours?

A

MR (better tissue contrast resolution)

72
Q

What is the gold standard for nodal and metastatic disease staging of bladder wall tumours?

A

CT

73
Q

At what part of the part of the bladder does the urethra originate from?

A

Antero-inferior wall of bladder

74
Q

Parts of the urethra in males between the prostatic and penile urethra?

A

Membranous urethra

Bulbous urethra

75
Q

How is a urethrogram performed?

A

Retrograde of filling of urethra using catheter followed by plain x-ray

76
Q

Purpose of urethrogram?

A

To assess for strictures, trauma, diverticula

77
Q

Primary imaging of choice for testes/ scrotum?

A

US

78
Q

Primary imaging of choice for uterus and ovaries?

A

US

79
Q

Primary imaging of choice for prostate biopsy?

A

US

80
Q

What is the name of x–ray taken after radioactive dye is injected into the cervix, etc.?

A

Hysterosalpingogram

81
Q

What is hysterosalpingogram used to assess?

A

Infertibility -> tubual patency

Uterine anomalis

82
Q

Imaging used for local staging of prostate cancer?

A

MRI

83
Q

Name of the layer of connective tissue covering the testicles?

A

Tunica albuginea (covered by the tunica vagenalis)

84
Q

What causes the mediastinum testis?

A

infolding of the tunica albuginea

85
Q

What can be seen in transvaginal US?

A

Endometrium, myometrium, fundus

86
Q

What space does contrast spill into in a hysterosalpingogram?

A

Peritoneum

87
Q

Scan of choice if concerned about prostatic malignancy?

A

MRI

2nd Year - Renal (6 decks)

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