BRANT: Chapter 48: Pelvocalyceal System, Ureters, Bladder and Urethra Flashcards
PBR 1 edition
It is now the imaging method of choice for evaluation of hematuria and as a screening examination of the pelvicalyceal system and ureters.
CT urogram
CT IVP
In CT urogram, thin-slice MDCT acquisitions are reformatted in longitudinal planes to provide visualization of the collecting system comparable to the traditional intravenous pyelogram (IVP), also called the
Excretory urogram
T/F: The CT urogram is limited by lower spatial resolution than the IVP, which is based on traditional radiography
True
T/F: Retrograde pyelography, performed by cystoscopic catheterization of the ureteral orifice followed by injection of contrast, is independent of renal function, provides high-quality images of the ureter and the collecting system, and is another alternative commonly utilized by urologists.
True
It is the imaging method of choice for screening for hydronephrosis but is limited in its ability to demonstrate small uroepithelial tumors.
US
The collecting tubules of a medullary pyramid coalesce into a variable number of papillary ducts that pierce the tip of the papilla and drain into the receptacle of the collecting system called a ____
Minor calyx
The sharp-edged portion of the minor calyx projecting around the sides of a papilla is called the ____
Fornix of the calyx
Name the entity pointed by the red arrow
Extrarenal pelvis
A so-called extrarenal pelvis is predominantly outside the renal sinus and is larger and more distensible than the more common intrarenal pelvis, which is surrounded by renal sinus fat and other structures
The following statements are true, except:
a. Infundibula extend between minor calyces and the renal pelvis.
b. The ureters have an outer fibrous adventitia that is continuous with the renal capsule and with the adventitia of the bladder.
c. The mucosa lining the entire pelvicalyceal system, ureters, and bladder is transitional epithelium or uroepithelium
d. The ureters enter the bladder at a non-oblique angle.
d. The ureters enter the bladder at a non-oblique angle.
OBLIQUE
3 main points of ureteral narrowing, where calculi are likely to become impacted, are:
a. Ureteropelvic junction (UPJ)
b. Site at which the ureter crosses the pelvic brim
c. Ureterovesical junction (UVJ)
Weigert–Meyer rule states that:
a. Ureter draining the UP moiety insertion, obstructs/refluxes?
b. Ureter draining the LP moiety insertion, obstructs/refluxes?
a. UP (ectopic): medial and inferior, obstructs (ureterocele)
b. LP (orthotopic): lateral and superior, refluxes
The Weigert–Meyer rule states that with complete ureteral duplication, the ureter draining the upper pole passes through the bladder wall to insert inferior and medial to the normally placed ureter draining the lower pole.
The upper pole ureter is commonly tortuous and dilated. The ectopic ureterocele and its associated dilated ureter may simulate a multiseptated cystic mass in the pelvis.
The upper pole ureter often ends as an ectopic ureterocele reflecting obstruction because of its ectopic insertion. The lower pole ureter inserts in, or near, the normal location in the bladder trigone and is subject to vesicoureteral reflux because of distortion of its passage through the bladder wall by the ectopic ureterocele. (“Upper pole obstructs; lower pole refluxes.”)
The anomaly in retrocaval ureter is due to faulty embryogenesis of the inferior vena cava, with abnormal persistence of the ____ anterior to the ureter instead of the right supracardinal vein posterior to the ureter
Right subcardinal vein
Retrocaval ureter is a developmental variant in which the right ureter passes behind the inferior vena cava at the level of ____ vertebra.
L3 or L4
The ureter exits anteriorly between the cava and the aorta to return to its normal position.
Which urinary tract stone will not be detected on conventional radiograph:
a. Calcium oxalate
b. Brushite
c. Uric acid
d. Cystine
c. Uric acid
Which urinary tract stone will not be detected on conventional radiograph:
a. Calcium phosphate
b. Cystine
c. Brushite
d. Indinavir calculus
d. Indinavir calculus
Most common urinary tract stone is composed of:
a. Brushite
b. Struvite
c. Calcium phosphate
d. Calcium oxalate
d. Calcium oxalate
T/F: Nearly all stones are visible on unenhanced CT as high attenuation (>200 H), geometric or oval, opaque objects.
True
The single exception is the soft tissue attenuation (15 to 30 H) crystalline calculus associated with treatment of HIV patients with the antiretroviral drug, indinavir.
Ureteral dilatation: ____
> 3 mm
Stones less than 6 mm in size are likely to pass spontaneously through the ureter within 6 weeks. Stones larger than 6 mm are more likely to remain lodged in the ureter and require intervention for removal.
Mean attenuation value of phleboliths which can differentiate them from ureteroliths
160 HU
T/F: The probability that a calcification represents a phlebolith is less than 3% when the attenuation is >300 H
True
Renal collective system thickening, usually seen in pyenophrosis, is defined as ____
> 2 mm