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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
What is the proper name for kidney stones?
Nephrolithiasis
26
what are the 3 fundamental spaces in the retroperitoneum around the kidney?
Anterior pararenal Perirenal Posterior pararenal
27
What is another name for Gerota's fascia?
Anterior renal fascia
28
What is another name for Zuckerkandel's fascia?
Posterior renal fascia
29
What is CT-contrast induced nephropathy?
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
30
What blood test would confirm a CT-contrast induced nephropathy?
Rise in serum creatinine and urea which usually peaks at 72-96 hours post contrast
31
Risk factors for CT-contast induced nephropathy?
``` Renal impairment +/- diabetes mellitus Dehydration Congestive heart failure LV ejection fraction <40% Acute MI (within 24 hours) Nephrotoxic drugs ```
32
What eGFR is associated with a higher risk of CT-contrast induced nephropathy?
eGFR <60
33
What is the hydration protocol for before and after contrast administration for a CT kidney scan if eGFR is low?
1-1.5 ml/ kg/ h 0.9% normal saline 12 or 6 hours before and after contrast
34
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?
Sodium bicarbonate
35
What should you check prior to requesting a CT contrast of the kidney?
Renal function
36
Strengths of MRI of kidney? (4)
Excellent soft tissue contrast resolution Renal lesion characterisation Vascular assessment Characterises most pathologies
37
Weakness of MRI of kidney? (2)
Lengthy acquisition | Nephrogenic systemic fibrosis
38
What is an MRA?
Renal angiogram
39
What vessels can be seen on MRA?
``` Abdominal aorta Right renal artery Left renal artery Aortic bifurcation Splenic artery Lumbar arteries ```
40
What is a severe systemic fibrosing disorder associated with the exposure of gadolinium containing contrast media?
Nephrogenic systemic sclerosis
41
What does a high T1 signal in MRI scan mean?
Lots of fat
42
What does a high T2 signal with MRI mean?
Lots of fluid
43
T1 and T2 signals for cyst?
Low/ no T1 signal | High T2 signal
44
Risk factors for nephrogenic systemic sclerosis?
Renal impairment
45
Initial symptoms/ signs of nephrogenic systemic sclerosis?
Skin erythema Pruritus Pain
46
What other problems may be caused with nephrogenic systemic sclerosis?
Neuropathic symptoms Joint contractures Resp insufficiency Muscular atrophy
47
What happens with time with nephrogenic systemic sclerosis?
Skin thickens, hardens appearing wood-like
48
At what junction does the ureter empty into the bladder?
Vesico-ureteric junction
49
How long is the average ureter?
25-30 cms
50
What are the 3 subdivisions of the ureter?
Abdominal ureter Pelvic ureter Intravesical portion
51
What does the abdominal ureter coarse alongside?
Medial aspect of psoas
52
Where does the ureter enter the pelvis?
At the bifurcation of the common iliac artery
53
Where are the pelvic ureters located in relation to the SI joints?
Anterior and medial
54
What has replaced the IV urography in Ninewells?
CT urogram
55
When are x-rays taken in an IV urography?
Nephrogram (immediately taken after contrast administration) Interval excretory films Post-micturition film
56
What is the main type of imaging used to assess the collecting system, ureters and bladder?
CT urogram
57
When are images taken in CT urogram?
Pre-contrast and 5-15 mins excretory phase obtained after IV contrast
58
Where are the lymph nodes that drains the right kidney located?
IVC
59
Where are the lymph nodes that drains the left kidney located?
Aorta
60
Name of the posterior surface of the bladder?
Base
61
Name of the anterior part of the bladder that sits behind the symphysis pubis?
Apex
62
Word used to describe the walls of the bladder?
Corrugated
63
Wall of the trigone?
Smooth
64
What muscles lie inferior to the bladder?
Obturator internus | Levator ani
65
What is the posterior wall of the female bladder loosely attached to?
The anterior vagina and cervix
66
describe the state of the bladder to carry out an US?
Full
67
What can be investigated with US of bladder?
Volumetric measurement (filled bladder and post-micturition) Internal calculi Bladder wall irregularities Diverticula
68
What is the gold standard imaging used to detect leakage through the bladder wall?
Cystography (contrast placed in bladder using catheter and x-ray taken)
69
What can bladder IVU/ cystography be used to assess?
``` Leakage through bladder wall Internal calculi FIlling defects bladder wall irregularities Diverticula ```
70
What phases of a CT with contrast are used to assess the bladder?
Precontrast and excretory phaes
71
What is the gold standard imaging for assessing local staging of bladder wall tumours?
MR (better tissue contrast resolution)
72
What is the gold standard for nodal and metastatic disease staging of bladder wall tumours?
CT
73
At what part of the part of the bladder does the urethra originate from?
Antero-inferior wall of bladder
74
Parts of the urethra in males between the prostatic and penile urethra?
Membranous urethra | Bulbous urethra
75
How is a urethrogram performed?
Retrograde of filling of urethra using catheter followed by plain x-ray
76
Purpose of urethrogram?
To assess for strictures, trauma, diverticula
77
Primary imaging of choice for testes/ scrotum?
US
78
Primary imaging of choice for uterus and ovaries?
US
79
Primary imaging of choice for prostate biopsy?
US
80
What is the name of x--ray taken after radioactive dye is injected into the cervix, etc.?
Hysterosalpingogram
81
What is hysterosalpingogram used to assess?
Infertibility -> tubual patency | Uterine anomalis
82
Imaging used for local staging of prostate cancer?
MRI
83
Name of the layer of connective tissue covering the testicles?
Tunica albuginea (covered by the tunica vagenalis)
84
What causes the mediastinum testis?
infolding of the tunica albuginea
85
What can be seen in transvaginal US?
Endometrium, myometrium, fundus
86
What space does contrast spill into in a hysterosalpingogram?
Peritoneum
87
Scan of choice if concerned about prostatic malignancy?
MRI

2nd Year - Renal (6 decks)

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