Ch 14 Urinary Flashcards
Carries blood into the glomerulus of the nephron
afferent arteriole
Site of filtration in the kidney; contain water, salts, glucose, urea, and amino acids
Bowman’s capsule
Outer parenchyma of the kidney that contains the renal corpuscle and proximal and distal convoluted tubules of the nephron
cortex
Another term for the renal fascia; the kidney is covered by the renal capsule, perirenal fat, gerota’s fascia, and pararenal fat
Gerota’s fascia
hilusArea of the kidney where vessels, ureter, and lymphatics enter and exit
hilus
Receive urine from the renal pyramids; form the border of the renal sinus
minor calyces
receives urine form the minor calyces to convey to the renal pelvis
major calyces
Function unit of the kidney; includes a renal corpuscle and a renal tubule
nephron
Part of the nephron that consists of Bowman’s capsule and the glomerulus
renal corpuscle
Area in the midportion of the kidney that collects urine before entering the ureter
renal pelvis
Space behind the peritoneal lining of the abdominal cavity
retroperitoneum
Small, membranous canal that excretes urine from the urinary bladder
urethra
Small vessels found at the base of the renal pyramids; appear as echogenic structures
arcuate arteries
Laboratory measurement the amount of nitrogenous waste and creatinine in the blood
Blood urea nitrogen (BUN)
Part of the collecting system adjacent to the pyramid that collects urine and is connected to the major calyx
calyx
A product of metabolism; laboratory test that measures the ability of kidney to get rid of waste
creatinine
Small vessel that carries blood from the glomerulus of the nephron and conducts blood to the peritublar capillaries that surround the renal tubule
efferent arteriole
Network of capillaries that are part of the filtration process in the kidney
glomerulus
Maintenance of normal body physiology
homeostasis
Portion of a renal tubule lying between the proximal and distal convoluted portions; reabsorption of fluid, sodium, and chloride occurs here and in the proximal convoluted
loop of Henle
Inner portion of the renal parenchyma that contains the loop of Henle
medullar
Right posterior subhepatic space located anterior to the kidney and inferior to the liver where fluid may accumulate
Morison’s Pouch
One several conical masses of tissue that form the kidney medulla; each consist of the loops of Henle and the collecting tubules of the nephrons
renal pyramid
Area in the midportion of the kidney where the renal vessels and ureter enter and exit
renal hilum
Central area of the kidney that includes the calyes, renal pelvis, renal vessels, fat, nerves, and lymphatics
renal sinus
Laboratory tests that measure how much dissolved material is present in the urine
specific gravity
retroperitoneal structure that exit the kidney to carry urine to the urinary bladder
ureters
Large muscle
urinary bladder
Bands of cortical tissue that separate the renal pyramids; may mimic a renal mass on ultrasound
columns of Bertin
Normal variant that occurs on the left kidney as a bulge on the lateral border
dromedary hump
Located outside the normal position, most often in the pelvic cavity
ectopic kidney
Congenital malformation in which both kidneys are joined together by an isthmus, most commonly at the lower poles
horseshoe kidney
Dilation of the renal collecting system
hydronephrosis
Interruption in the normal development of the kidney resulting in absence of the kidney; may be unilateral or bilateral
renal agenesis
First layer adjacent to the kidney that forms a tough, fibrous covering
renal capsule
Stone within the urinary system
systemurolithiasis
The urinary system has two principal functions: excreting ____ and regulating the composition of ___.
waste, blood
The right kidney lies slightly _____ than the left because the large right lobe of the _____ pushes it ____.
lower, liver, inferiorly
The kidneys move with respiration; on deep inspiration, both kidneys move ____ approximately 1 inch.
downward
With in the hilus of the kidney are other ____ structures, a ureter, and the ____
vascular, lympatics
A fibrous capsule called the ______ surrounds the kidney.
true capsule
Outside of this fibrous capsule is a covering of ______
perinephric fat
The ______ fascia surrounds the perinephric fat and encloses the kidneys and adrenal glands
perinephric
The renal fascia, known as _____ fascia, surrounds the rue capsule and perinephric fat
Gerota’s
The medullary substance consists of a series of striated conical masses, called the renal _____
pyramids
A nephron consist of two main structures, a renal ____ and a renal ____
corpuscle, tubule
Nephrons ___ the blood and produce ____
filter, urine
The renal corpuscle consist of a network of capillaries called the ____, which the surrounded by a cuplike structure known as ____
glomerulus, Bowman’s capsule
Blood flows into the glomerulus through a small ____ arteriole and leave the glomerulus through ____ arteriole.
afferent, efferent
There are three constrictions along the ureter’s course
- where the ureter leaves the renal pelvis
- kinked as it crosses the pelvic brim
- pierces the bladder wall
The main renal artery is a lateral branch of the aorta and arises just inferior to the ____ artery.
superior mesenteric
The renal vein drains into the _____ of the inferior vena cava
lateral wall
The urinary system is located posterior to the peritoneum lining the abdominal cavity in an area called the _____.
retroperitoneum
The kidney adjust the amount of ____, ____, and nitrogenous wastes
water, carbon dioxide
Both urea and uric acid are carried away from the liver into kidney by the ____ system
Vascular
The presence of an acute infection cause ____, which is ______ in the urine; pyuria means there is ____ in the urine.
hematuria, red blood cells, pus
The pH refers to the strength of the urine as a partly ____ or _____ solution
acidic, alkaline
The _______ is the measurement of the kidney’s ability to concentrate urine.
specific gravity
The specific gravity is especially ____ in cases of renal failure, glomerular nephritis, and pyelonephritis
low
A decreased ____ occurs with acute hemorrhagic processes secondary to disease or blunt trauma.
hematocrit
Impairment of renal function and increased protein catabolism result in BUN _____ that is relative to the degree of renal impairment and rate urea nitrogen excreted by the kidneys
elevation
The renal parenchyma surrounds the fatty central renal sinus, which contains these five vessels structures.
calyces, infundibula, pelvis, vessesls, and lymphatics
Dilation of the collecting system has also been noted in ____ patients, especially the right kidney
pregnant
The _____ is the area form the renal sinus to the outer renal surface
parenchyma
The _____ and _____ arteries and are best demonstrated as intense specular echoes in cross section or oblique section at the corticomedullary junction
arcuate arteries, inter lobar
The ____ generally is echo producing, whereas the medullary pyramids are ____
cortex, hypo echoic
The cortex and medullary pyramids are separated from each other by bands of cortical tissue, called ______ that extend inward to the renal sinus.
columns of Bertin
The ______ lie posterior to the renal arteries and should be identified by their lack of pulsations and absence of Doppler flow
crura
The _____ of the pyramid points toward the sinus, and the ____ lies adjacent to the renal cortex
apex, base
The ________ is a cortical bulge that occurs on the lateral border of the kidney, typically more on the left side
dromedary hump
An______ is a triangular, echogenic area in the upper pole of the renal parenchyma that can be seen during normal scanning
junctional parenchymal defect
In a patient with a(n) ______, there is fusion of the kidneys during fetal development that almost invariably involves the _____ poles
Horses shoe kidney, lower
A cystic mass presents sonographically with several characteristic features:
smooth, thin, well defined border, round or oval shape, sharp interface between the cyst and renal parenchyma, enechoic and increased posterior acoustic enhancement
A cystlike enlargement of the lower end of the ureter is called a ______
ureterocele
Sonographically, it is difficult to differentiate between a _______ cyst and a small adjacent cortical cyst.
septated
The parapelvis cyst is found in the _____ but does not communicate with the renal collecting system
renal hilum
Name 4 form of autosomal recessive polycystic kidney disease
perinatal, neonatal, infantile, and juvenile
Discuss the characteristics of autosomal dominant polycystic kidney disease
Common genetic disease that occurs in both men and women severity of the disease depends upon the genotype. Most common PKD1 (short arm of 16th chromosome) PKD2 (long arm of the 4th chromosome)
Usually a _____ renal contour is the first finding that a mass may be present requires further investigation
abnormal
Define the characteristics of renal cell carcinoma
most common of all renal tumors (85% of all kidney tumors) Twice as common in males than females (6 and 7th decade in life) Patient may report hematuria, flank pain, and palpable mass increased in patients with Von Hippel-Lindau
One of the most common benign renal tumors is called ____
adenoma
An uncommon benign renal tumor composed mainly of fat cells and commonly found in the renal cortex is _____
angiomaylipoma
A(n) ______ appears as a well-defined echogenic mass, found more often in females
lipoma
Sonographic finding include one or more fluid spaces at the _____ junction that corresponds to the distribution of the renal pyramids.
corticomedullary
Although the kidneys appear enlarged with a highly echogenic renal sinus, the intrarenal anatomy is preserved with uniform loss of renal tissue in patients with _______
renal atrophy
The most common medical renal disease that produces acute renal failure is _______
acute tubular necrosis
Chronic renal disease is loss of renal ____ as a result of disease, most commonly parenchymal disease.
function
There are three primary types of chronic renal failure:
nephron, vascular, and interstitial abnormalities
______ is when the dilated pyelocalyceal system appears as separation of the of the renal sinus echoes by fluid-filled areas that conform anatomically to the infundibula, calyces, and renal pelvis
hydronephrosis
A localized hydroneprosis occurs as a result as a result of _____, calculi, ____, or the ___.
strictures, focal mass, duplex collecting system
Hydronephrosis with a dilated ureter and bladder indicates obstruction of the _____ junction or of the ____.
uretervesical, urethra
If hydronephrosis is suspected, the sonographer should evaluate the _____
bladder
Name two condition that might mimic hydronephrosis
Grade 1 small separation of calyceal pattern known as splaying Grade 2 bear claw effect Grade 3 msssive dilation of renal pelvis
Describe the sonographic findings in acute obstruction.
Resistive index of the intrarenal vessels may be greater than .70 24 to 48 hours -RI returns to normal NO ureteral jet will be present on the affected side or flow will decreased if partial obstruction.
Ureteral jets are best visualized _____ imaging
Color Doppler
When pus is found within the obstructed renal system, the condition is called _____.
pyonephrosis
_______ is a diffuse foci of calcium deposits, which is usually located in the medulla and infrequently can also be seen in the renal cortex
Nephrocalcinosis
A renal _____ occurs when part of the tissue undergoes necrosis after the cessation of the blood supply, usually as a result of artery occlusion
infarction
The initial clinical sign of a kidney is extreme ____, typically followed by cramping on the side where the stone is located; nausea and vomiting may also occur
pain
Renal stones have very _____ foci with posterior acoustic shadowing.
echcogenic
If the stone cause obstruction, there will be ______ and depending on the location of the stone, the ureter may by dilated _____ to the level of obstruction.
hydronephrosis, superior
________ entails herniation of all layers of the bladder wall and is located in the posterior angle of the trigone
Congenital diverticulum
______ diverticula are herniations of only the two inner layers through the muscle layer
acquired
_______ is usually secondary to another condition that causes stasis of urine in the bladder
cystitis
The majority of bladder tumors in adult are _____ carcinoma
transitional cell
The major problem encountered with renal transplantation is ______.
graft rejection
Early after surgery, a baseline sonographic examination is performed to determine ____, _____, and _____.
renal size, calyceal pattern, extrarenal fluid collection
Perirenal fluid collections, such as ____, ____, ____, or ____ can be diagnosed reliably and differentiated from acute rejection
hematoma, abscess, lymphocele, urinoma
______ rejection occurs within hours of transplantation and is caused by vasculitis leading to thrombosis and usually the loss of the graft
hyperacute
_____ rejection occurs with in days to months after transplant responses.
acute
______ rejection causes include preformed antibodies, immune complexes, and cell-mediated responses.
immunologic
__________ rejection can occur months after transplantation with gradual onset.
Chronic rejection
When using ultrasound to help diagnose rejection care must be taken to visualize these 5 things
size and shape, appearance of the pyramids, cortex and parenchyma and presence of any surrounding fluid collections
The incidence of acute tubular necrosis is usually higher in _____ transplants than in _____ transplant
cadaveric, donor-relative
Early signs of obstruction are _____ or severe _____ in a patient with satisfactory renal volumes
anuria, oliguria
Renal artery stenosis exhibits an _______
jet with distal turbulence
high-velocity
_____ Doppler is not angle dependent and has a greater sensitivity to detect blood flow
Power
