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RAD 312 - Radiographic Pathology > Ch 6-7 > Flashcards

Ch 6-7 Flashcards

1
Q

3 things the urinary system consists of

A

Kidneys
Ureters
Bladder

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2
Q

Functional unit of the kidney; each kidney contains more than a million

A

Nephrons

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3
Q

3 functions of the nephrons

A

Filter waste products from the blood
Reabsorb water and nutrients (e.g., glucose and amino acids) from the tubular fluid
Secrete excess substances in the form of urine

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4
Q

In the average person, the nephron filters approximately how much water out of glomerular blood each day and how much of that is excreted in the urine? Therefore, more than what percentage of water is reabsorbed into tubular blood?

A

Nephron filters approximately 190 L of water out of glomerular blood each day (this enormous amount is many times the total volume of blood in the body); however, only a small proportion of this water (1-2 L) is excreted in the urine. Therefore, more than 99% of water is reabsorbed into tubular blood

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5
Q

Tuft of capillaries with very thin walls and a large surface area where the formation of urine begins

A

Glomerulus

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6
Q

Reservoir for urine before it leaves the body

A

Bladder

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7
Q

Triangular area of the posterior bladder, between the openings for the ureters and urethra

A

Trigone

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8
Q

Where do the ureters enter the bladder and where is the urethral opening?

A

Through an oblique tunnel that functions as a valve to prevent vesicoureteral reflux during bladder contraction
The openings of the two ureters lie at the posterior corners of the trigone and the urethral opening is situated at the anterior lower corner

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9
Q

Approximately how many mL’s fills the average person’s bladder?

A

250 mL

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10
Q

Filling of the bladder stimulates autonomic nerve endings in the wall that are perceived as a distended sensation and the desire to void

A

Micturate

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11
Q

Nervous system injury results in involuntary emptying of the bladder at intervals

A

Incontinence

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12
Q

A rare congenital anomaly (born with it) in which only one kidney forms, associated with a variety of other malformations
Imaging appearance: IVU = hypertrophic single functioning kidney

A

Unilateral renal agenesis (solitary kidney)

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13
Q

A rare anomaly in which a small, rudimentary third kidney forms
Functions normally, but is prone to infections that eventually may require its removal
Imaging appearance: IVU = hypoplastic 3rd kidney, may or may not be fused

A

Supernumerary kidney

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14
Q

Appears as a miniature replica of a normal kidney, with good function

A

Hypoplastic kidney

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15
Q

An acquired condition that develops when one kidney is forced to perform the function normally carried out by two kidneys
Lone kidney usually a little bigger to make up for the other one

A

Compensatory hypertrophy

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16
Q

Abnormally positioned kidney that may be found in various locations

A

Ectopic kidney

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17
Q

Kidney in the true pelvis

A

Pelvic kidney

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18
Q

Kidney above the diaphragm

A

Intrathoracic kidney

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19
Q

Both kidneys are malrotated, and fused at the lower poles (joined by a band of normal renal parenchyma [isthmus] or connective tissue)
The most common fusion anomaly

A

Horseshoe fusion

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20
Q

Rotation of the kidney on the longitudinal or horizontal axis; asymptomatic
Imaging appearance: bizarre appearance of renal parenchyma, calyces, and pelvis

A

Malrotation

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21
Q

An ectopic kidney lies on the same side as the normal kidney and is very commonly fused

A

Crossed ectopia

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22
Q

A rare kidney anomaly that produces a single irregular mass that has no resemblance to a renal structure

A

Complete fusion

Disk, cake, lump, and doughnut kidney

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23
Q

A common anomaly that varies from a simple bifid pelvis to a completely double pelvis, ureter, and ureterovesical orifice.
Complete can be complicated by obstruction or by vesicoureteral reflux with infection

A

Duplication (duplex kidney)

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24
Q

Cystic dilatation of the distal ureter near its insertion into the bladder

A

Uretrocele

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25
Q

2 types of uretrocele

A

Simple (adult)

Ectopic (found almost exclusively in infants and children, commonly associated with ureteral duplication)

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26
Q

Nonsuppurative inflammatory process involving the tufts of capillaries (glomeruli) that filter the blood within the kidney and causes oliguria
An antigen–antibody reaction that most commonly occurs several weeks after an acute upper respiratory or middle ear infection with certain strains of hemolytic streptococci
More frequently, the inflammatory process is caused by a chronic autoimmune disorder
Causes the glomeruli to be extremely permeable, allowing albumin and red blood cells to leak into the urine (resulting in proteinuria or hematuria)

A

Glomerulonephritis

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27
Q

Smaller-than-normal amount of urine

A

Oliguria

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28
Q

Suppurative inflammation of the kidney and renal pelvis caused by pyogenic bacteria
It affects the interstitial tissue between the tubules
Patchy distribution
Often affects only one kidney but is asymmetric if both kidneys are involved.
Infection usually originates in the bladder, ascends the ureter to involve the kidneys
More common in women and children
Develops in patients with obstruction of the urinary tract (enlarged prostate gland, kidney stone, congenital defect); instrumentation or catheterization of the ureter is also a contributing factor
Causes stagnation of urine: a breeding ground for infection

A

Pyelonephritis

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29
Q

Pus-forming

A

Pyogenic

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30
Q

Painful urination

A

Dysuria

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31
Q

Pus in the urine

A

Pyuria

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32
Q

Severe form of acute parenchymal and perirenal infection with gas-forming bacteria that occurs virtually only in diabetic patients and causes an acute necrosis/death of the entire kidney
Imaging appearance: the presence of radiolucent gas shadows within and around the kidney is a pathognomonic

A

Emphysematous pyelonephritis

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33
Q

6 symptoms of pyelonephritis

A

High fever
Chills
Sudden back pain that spreads over the abdomen
Dysuria
Pyuria
Bacteria can be cultured from the urine or observed in the urinary sediment

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34
Q

Usually occurs as a secondary infection from lung involvement (hematogenous spread) but can evolve from other sites
Manifests 5 to 10 years after the primary infection
May lead to the development of small granulomas scattered in the cortical portion of the kidneys

A

Renal tuberculosis

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35
Q

Destructive process involving a varying amount of the medullary papillae and the terminal portion of the renal pyramids
Predisposing factors include diabetes, pyelonephritis, urinary tract infection, urinary tract obstruction, sickle cell disease, and phenacetin abuse

A

Papillary necrosis

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36
Q

An inflammation of the urinary bladder
Most common nosocomial infection
Most common in women due to a shorter urethra
Symptoms: urinary frequency, urgency, and burning sensation

A

Cystitis

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37
Q

4 causes of cystitis

A

Spread of bacteria present in fecal material which reaches the urinary opening and travels up to the bladder (major cause)
Instrumentation or catheterization of the bladder
Retrograde flow from urine bag (bag must be kept below the patient to prevent retrograde flow)
Sexual intercourse

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38
Q

Most commonly form in the kidney
Asymptomatic until they lodge in the ureter and cause partial obstruction, results in extreme pain that radiates from the area of the kidney to the groin
More than 80% of symptomatic renal stones contain enough calcium to be radiopaque and detectable on plain abdomen radiographs
Noncontrast helical CT used most frequently to be demonstrate
Small renal stones (= 3 mm) may pass spontaneously in the urine
Cause of kidney stones varies: often reflect an underlying metabolic abnormality, such as hypercalcemia (resulting from hyperparathyroidism), any cause of increased calcium excretion in the urine, and urinary stasis and infection

A

Urinary calculi

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39
Q

Calcium can also deposit within the renal parenchyma

A

Nephrocacinosis

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40
Q

Major causes in adult: urinary calculi, pelvic tumors, urethral strictures, and enlargement of the prostate gland
Normal parts of narrowing that are common sites: ureteropelvic and ureterovesical junctions, bladder neck, and urethral meatus
Noncontrast helical CT scanning detects mass effects, stones, and other causes better than intravenous urography
If the lesion is at or below the level of the bladder (as in prostatic hypertrophy or tumor), bilateral involvement is the rule

A

Urinary obstruction

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41
Q

Blockage above the level of the bladder causes unilateral dilation of the ureter

A

Hydroureter

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42
Q

Blockage above the level of the bladder causes unilateral dilation of the ureter and renal pelvicalyceal
Distention of the pelvis and calyces of the kidney
Condition characterized by excess fluid in a kidney due to a backup of urine

A

Hydronephrosis

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43
Q

Most common unifocal mass of the kidney (simple)
Fluid-filled, usually unilocular (septa sometimes divide the cyst into chambers)
Varies in size
May occur at single or multiple sites in one or both kidneys
Don’t usually show up on plain radiographs without contrast; show up well on ultrasound

A

Renal cyst

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44
Q

Inherited disorder in which multiple cysts of varying size cause lobulated enlargement of the kidneys and progressive renal impairment
One-third of patients also have liver cysts
Do not interfere with hepatic function
Additive
About 10% have one or more saccular (berry) aneurysms of cerebral arteries; may rupture and produce a fatal subarachnoid hemorrhage
Many are hypertensive
Most tend to be asymptomatic during the first three decades of life
Early diagnosis is made either by chance or by specific search due to family history

A

Polycystic kidney disease

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45
Q

Most common renal neoplasm
Occurs predominantly in patients older than 40 years
CT and ultrasound
Renal carcinoma originates in the tubular epithelium of the renal cortex
Classic symptom triad: hematuria, flank pain, and palpable abdominal mass

A

Renal carcinoma

Hypernephroma

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46
Q

4 most common sites of metastasis of renal carcinomas

A

Lungs
Liver
Bones
Brain

47
Q

Most common abdominal neoplasm of infancy and childhood
Arises from embryonic renal tissue, may be bilateral
Tends to become very large and appear as a palpable mass

A

Wilms’ tumor (nephroblastoma)

48
Q

Most commonly originates in the epithelium
Most common in men over age 50
Fourth most common cancer in men
Predisposing factors: industrial chemicals, cigarette smoking (presumably due to carcinogenic metabolites being excreted in urine)

A 
Carcinoma of the bladder
Urothelial carcinoma (previously: transitional cell carcinoma)
49
Q

Occurs most frequently in children who are severely dehydrated
Magnetic resonance angiography (MRA) can detect an abnormally strong signal from the renal veins, suggesting stasis (no flow) of blood
In adults, is most often a complication of another renal disease: chronic glomerulonephritis, amyloidosis, pyelonephritis, trauma, thrombus extension from inferior vena cava, direct invasion or extrinsic pressure renal tumors

A

Renal vein thrombosis

50
Q

Rapid deterioration in kidney function that results in the accumulation of nitrogen-containing wastes in the blood
Causes a characteristic urinelike odor or “fishy” breath
Two types: prerenal (causes: decreased blood flow to the kidneys [hemorrhage, dehydration, surgical shock], cardiac failure, and renal artery obstruction) and postrenal (causes: urine outflow obstruction from both kidneys, prostatic disease, and functional obstruction of the bladder neck)
Other causes: kidney diseases, such as glomerulonephritis, bilateral acute pyelonephritis, and malignant (severe) hypertension, nephrotoxic agents (antibiotics, radiographic contrast material, anesthetic agents, heavy metals, organic solvents), intravascular hemolysis, and large amounts of myoglobin (muscle protein) in the circulation from muscle trauma or ischemia

A

Acute renal failure

51
Q

May reflect prerenal, postrenal, or intrinsic kidney disease
Causes include:, bilateral renal artery stenosis, bilateral ureteral obstruction, intrinsic renal disorders, such as chronic glomerulonephritis, pyelonephritis, and familial cystic diseases
Dialysis, kidney transplant, etc.

A

Chronic renal failure

52
Q

Excessive water loss in the urine

A

Polyuria

53
Q

Presence of blood in urine

A

Hematuria

54
Q

Accelerates the heart rate

A

Epinephrine

55
Q

Striated muscle that composes the walls of the four chambers of the heart

A

Myocardium

56
Q

Smooth delicate membrane that lines the hearts walls that is continuous with the inner surface of the blood vessels

A

Endocardium

57
Q

Partition that separates the right and left sides of the heart

A

Septum

58
Q

Valves between each atrium and its associated ventricle (one on the right and one of the left side of the heart) which permit blood flow in only one direction

A

Atrioventricular valves

59
Q

The atrioventricular valves consist of flaps/cusps of endocardium that are anchored to the papillary muscles of the ventricles by cordlike structures

A

Chordae tendinae

60
Q

Valve between the left atrium and left ventricle that has two cusps

A

Mitral valve
Bicuspid valve
Left atrioventricular

61
Q

Valve between the right atrium and the right ventricle that has three cusps

A

Tricuspid valve

Right atrioventricular

62
Q

Valves that separate the ventricles from the great vessels leaving the heart

A

Semilunar valves

63
Q

Valve that lies between the right ventricle and the pulmonary artery

A

Pulmonary valve

64
Q

Valve that separates the aorta from the left ventricl

A

Aortic valve

65
Q

General circulation of the body

A

Systemic circulation

66
Q

Contraction phase of the atria and ventricles

A

Systole

67
Q

The heart chambers relax and fill with blood

A

Diastole

Relaxation phase

68
Q

Double membranous sac that surrounds the heart

Has a well-lubricated lining that protects against friction and permits the heart to move easily during contraction

A

Pericardium

69
Q

What is the function of the cardiovascular system?

A

To maintain an adequate supply of blood to all the tissues of the body by the rhythmic contractions of the heart

70
Q

System that controls heart rate

A

Autonomic nervous system

71
Q

Most common congenital cardiac lesions
Permit mixing of blood in the systemic and pulmonary circulations.
Lungs become overloaded with blood because blood is preferentially shunted from the high-pressure systemic circulation to the relatively low-pressure pulmonary circulation
Defect size and pressure differences control magnitude of shunt
Always looking at aorta
Imaging: doppler echocardiography (US) and MRI/A

A

Left-to-right shunts

72
Q

3 types of left-to-right shunts

A

Atrial septal defect (most common)
Ventricular septal defect
Patent ductus arteriosus (remnant of fetal circulation)

73
Q

Most common cause of cyanotic congenital heart disease; without surgical repair, most patients die before reaching puberty

A

Tetralogy of Fallot

74
Q

4 (tetra) abnormalities of Tetralogy of Fallot

A

High ventricular septal defect
Pulmonary stenosis
Overriding of the aortic orifice above the ventricular defect
Right ventricular hypertrophy

75
Q

Ventricular septal defects and the overriding of the aorta produce shunting of unoxygenated venous blood into the left ventricle and then into the systemic circulation, thus increasing the degree of cyanosis

A

Right-to-left shunting

76
Q

The narrowing, or constriction, of the aorta that most commonly occurs just beyond the branching of the blood vessels to the head and arms
Classic sign: normal blood pressure in the arms, but very low blood pressure in the legs
The most frequent cause of hypertension in children

A

Coarctation of the aorta

77
Q

Narrowing of the lumen of one or more of the coronary arteries
Most common cause is atherosclerosis
Results in oxygen deprivation of the myocardium and ischemic heart disease
Predisposing factors: hypertension, obesity, smoking, high-cholesterol diet, and lack of exercise

A

Coronary artery disease

78
Q

Deposition of fatty material on the inner arterial wall

A

Atherosclerosis

79
Q

Inability of the heart to propel blood at a rate and volume sufficient to provide an adequate supply to the tissues.
Causes include: intrinsic cardiac abnormality, hypertension, and any obstructive process that abnormally increases the peripheral resistance to blood flow
Imaging appearance: cardiac enlargement (large heart)

A

Congestive heart failure (CHF)

80
Q

Abnormal accumulation of fluid in the extravascular pulmonary tissues
Most common cause is an elevation of the pulmonary venous pressure usually due to left-sided heart failure but may also be caused by pulmonary venous obstruction (mitral valve disease and left atrial tumor) or lymphatic blockade (fibrotic, inflammatory, or metastatic disease involving the mediastinal lymph nodes)
Other causes: uremia, narcotic overdose, exposure to noxious fumes, excessive oxygen, high altitudes, fat embolism, adult respiratory distress syndrome, and various neurologic abnormalities
Imaging appearance: increased pulmonary venous pressure first appears as a redistribution of blood flow from the lower to the upper lung zones (this phenomenon causes prominent enlargement of the superior pulmonary veins) and fluid in the interstitial space causes a loss of the normal sharp definition of pulmonary vascular markings

A

Pulmonary edema

81
Q

Leading cause of strokes and CHF

Doesn’t show up on x-rays

A

Hypertension

High blood pressure

82
Q

Function of cardiac output and the total peripheral resistance, which reflects the condition of the walls of the blood vessels throughout the body

A

Blood pressure

83
Q

The amount of blood pumped per minute by the heart

A

Cardiac output

84
Q

What is high blood pressure?

A

Elevation of the systolic pressure above 140 millimeters of mercury (mm Hg) and of the diastolic pressure above 90 mm Hg

85
Q

Localized dilatation of an artery that most commonly involves the aorta, especially its abdominal portion
Ultrasound (ultrasonography) is the modality of choice for detection of an abdominal aortic; CTA and MRA

A

Aneurysm

86
Q

2 types of aneurysms

A

Saccular aneurysm

Fusiform aneurysm

87
Q

Aneurysm that involves only one side of the arterial wall

A

Saccular aneurysm

88
Q

Bulging of the entire circumference of the vessel wall

A

Fusiform aneurysm

89
Q

4 causes of aneurysms

A

Atherosclerosis
Syphilis or other infection
Trauma
Congenital defect such as Marfan’s syndrome

90
Q

Potentially fatal complication of closed chest trauma, such as: rapid deceleration, blast, or compression
Usually the aortic tear occurs distal to the left subclavian artery at the site of the ductus arteriosus

A

Traumatic aortic rupture

91
Q

Potentially life-threatening condition in which disruption of the intima (the inner layer) permits blood to enter the wall of the aorta and separate its layers
Creates a true and false lumen in the aorta
The false lumen may form an aneurysm as a result of the high pressure in the systemic vascular system
Most common in patients with arterial hypertension
Other causes: trauma or congenital defects, such as Marfan’s syndrome

A

Aortic dissection

92
Q

Characterized by thickening, hardening, and loss of elasticity in the arterial wall
Plaques (fatty deposits) develop in the intima that produces progressive narrowing and often complete occlusion of large and medium-size arteries
One form of arteriosclerosis
Major cause of vascular disease of the extremities

A

Atherosclerosis

93
Q

An intravascular clot in arteries or veins
Causes: stasis, endothelium injury or inflammation, or blood changes (changes in clotting mechanisms; increase in RBCs)
Doesn’t show up on plain film
Treatment: anticoagulants, such as heparin and warfarin (Coumadin), are often used to prevent intravascular clotting; however, these medications also interfere with the person’s normal ability to stop bleeding and may lead to severe hemorrhage from relatively minor trauma or interventional treatment

A

Thrombus

94
Q

Part or all of a thrombus that becomes detached from the vessel wall and enters the bloodstream in arteries or veins; potentially fatal
Lodges in other vessels, causing ischemia/occlusion
Other types: fat (due to trauma), septic (from infections), air (air bubbles introduced via trauma, surgery, injection)
Doesn’t show up on plain film

A

Embolism

95
Q

An autoimmune disease that results from a reaction of the patient’s antibodies against antigens from a previous streptococcal infection
Damages the heart valves; usually the mitral and aortic valves
Damaged valves are either stenotic (open too narrowly) or insufficient (do not close completely)

A

Rheumatic fever/heart disease

96
Q

Stenosis of the mitral valve is almost always a complication of rheumatic disease that results from thickening of the valve by fibrous tissue, calcific deposits, or both
Blood flow is obstructed from leaving the left atrium and passing into the left ventricle during diastole which causes increased pressure in the left atrium and enlargement of this chamber

A

Mitral stenosis

97
Q

Most often caused by rheumatic heart disease
Other causes: rupture of the chordae tendineae or dysfunction of the papillary muscles
Regurgitation of blood into the left atrium during ventricular systole causes overfilling and dilatation of this chamber which leads to a decrease in ventricular stroke volume and cardiac output
Affects the left atrium and borders of the heart

A

Mitral insufficiency

98
Q

Causes: rheumatic heart disease, congenital valvular deformity (especially of a bicuspid valve), or degenerative process of aging (idiopathic calcific stenosis)
The obstruction to left ventricular outflow increases the workload of the left ventricle

A

Aortic stenosis

99
Q

Causes: rheumatic heart disease, syphilis, infective endocarditis, dissecting aneurysm, or Marfan’s syndrome
Reflux of blood from the aorta during diastole causes volume overloading of the left ventricle and dilatation of this chamber

A

Aortic insufficiency

100
Q

The development of nodules or vegetations on heart valves caused by deposits of bacteria or fungi (they are larger than rheumatic fever vegetations)
Vegetations are filled with bacteria and tend to break apart easily and form septic emboli
Demonstrated on echocardiography; radiography of little use since cardiac silhouette is often unchanged

A

Infective endocarditis

101
Q

Primarily involves the lower extremities
Major source of potentially fatal pulmonary embolism
Precipitating factors: trauma, bacterial infection, prolonged bed rest, and oral contraceptives
May be the earliest symptom of an unsuspected malignancy of the pancreas, lung, or gastrointestinal system

A

Deep venous thrombosis (DVT)

102
Q

Dilated, elongated, and tortuous vessels that most commonly involve the superficial veins of the leg just under the skin

A

Varicose veins

103
Q

Occlusion of a coronary artery deprives an area of myocardium of its blood supply and leads to the death of muscle cells in the area of vascular distribution
Infarction of the heart muscle

A 
Myocardial infarction (MI)
Heart attack
104
Q

Condition in which the heart suddenly can’t pump enough blood to meet the body’s needs
Most often caused by a severe heart attack
Rare, but often fatal if not treated immediately

A

Cardiogenic shock

105
Q

A blockage in one of the pulmonary arteries in the lungs In most cases, it is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (deep vein thrombosis)

A

Pulmonary embolism

106
Q

A serous membrane that forms the innermost layer of the pericardium and the outer surface of the heart

A

Epicardium

107
Q

One of four chambers of the heart located in the bottom left portion of the heart below the left atrium, separated by the mitral valve
The thickest of the heart’s chambers and is responsible for pumping oxygenated blood to tissues all over the bod

A

Left ventricle

108
Q

The chamber within the heart that is responsible for pumping oxygen-depleted blood to the lungs
One of the heart’s four chambers located in the lower right portion of the heart below the right atrium and opposite the left ventricle

A

Right ventricle

109
Q

Right upper chamber of the heart that receives deoxygenated blood from the body through the vena cava and pumps it into the right ventricle which then sends it to the lungs to be oxygenated

A

Right atrium

110
Q

One of the four chambers of the heart located on the left posterior side
Primary role is to act as a holding chamber for blood returning from the lungs and to act as a pump to transport blood to other areas of the heart

A

Left atrium

111
Q

Hollow part or cavity in an organ, in particular each of the two main chambers of the heart, left and right

A

Ventricle

112
Q

A large vein that receives blood from the head, neck, upper extremities, and thorax and delivers it to the right atrium of the heart

A

Superior vena cava

113
Q

A large vein that receives blood from the lower extremities, pelvis and abdomen and delivers it to the right atrium of the heart

A

Inferior vena cava

RAD 312 - Radiographic Pathology (5 decks)

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