Ch 63 Fetal Urogenital System Flashcards
complex malformation involving lower limb anomalies, spinal defect, anal atresia, and lower abdominal wall defect below the cord insertion involving exstrophy of the bladder and protrusion of the intestines
cloacal exstrophy
failure of the testes to descend into the scrotu
cryptorchidism
abnormal congenital opening of the male urethra on the top side of the penis
epispadias
dilated renal pelvis in the fetus; most common fetal anomaly
fetal hydronephrosis
ovarian mass that results from maternal hormone stimulation and is usually benign
fetal ovarian cyst
condition in which both ovarian and testicular tissues are present
hermaphroditism
forms when the inferior poles of the kidney fuse while they are in the pelvis
horseshoe kidney
collection of fluid in the vagina and uterus
hydrometrocolpos
dilated ureters
hydroureters
abnormal congenital opening of the male urethra on the undersurface of the penis
hypospadias
autosomal recessive disease that affects the fetal kidneys and liver; the kidneys are enlarged and echogenic on ultrasound
infantile polycystic kidney disease (IPKD)
the level of the urethra where the urinary tract may become obstructed
megacystis
dilation of the lower end of the ureter; the common presentation of ureterovesical junction obstruction
megaureter
multiple cysts replace normal renal tissue throughout the kidney; usually causes renal obstruction
multicystic dysplastic kidney disease (MSCK)
occurs when the kidney does not migrate upward into the retroperitoneal space
pelvic kidney
occurs only in male fetuses; is manifested by the presence of a valve in the posterior urethra
posterior urethral valve
term used to describe renal diseases other than renal agenesis that result in renal failure and facial or structural abnormalities caused by oligohydramnios
Potter’s sequence
characterized by a group of findings associated with oligohydramnios and renal failure or bilateral renal agenesis; findings include abnormally positioned extremities, wide-set eyes, low-set ears, and broad nasal bridge
Potter’s syndrome
dilation of the fetal abdomen secondary to severe bilateral hydronephrosis and fetal ascites; fetus also has oligohydramnios and pulmonary hypoplasia
prune belly syndrome
dilated renal pelvis without involvement of the calyces
pyelectasis
renal system fails to develop
renal agenesis
a small part of the lumen of the allantois that persists while the urachus forms
urachal cyst
congenital outpouching of the distal ureter into the bladder
ureterocele
junction of the ureter entering the renal pelvis; most common site of obstruction
ureteropelvic obstruction (UPJ)
junction where the ureter enters the bladder
ureterovesical junction (UVJ)
condition that causes a massively distended bladder (prune belly)
urethral atresia
Dilation of the posterior urethra is highly suspicious for an obstructive process such as __________, also known as “Key - hole sign”
Posterior Urethral Valve Syndrome {PUVO}
PUVO {posterior urethral valve syndrome} occurs ONLY in _____ fetuses
MALE
______ is a cystic dilation of the intravesical {bladder} segment of the distal ureter.
Ureterocele
An ectopic ureter does not insert near the ________ angle of the trigone of the bladder
posterolateral
With FEMALES, an ectopic ureter may insert into the _____ or _____
vagina or uterus
With MALES, an ectopic ureter may insert into the _____, _____, or _______.
Seminal vesicle, vas deferens, or ejaculatory ducts
Sonographic appearance of an ectopic ureter
- Usually unilateral
- Large, tortuous dilated ureter
- Ipsilateral hydronephrosis
- Normal amiotic fluid
With ureterocele, females are more likely to present with _______
Renal duplication
With ureterocele, males more commonly with _____ renal collecting system
Normal
Complete duplication of the uterus and vagina
Uterus didelphys
Duplication of the uterus
Bicornuate uterus
Single uterine tube and horn
Unicornuate
Three sets of excretory organs develop in the embryo:
- Pronephros {nonfunctioning}
- Mesonephros {Function for a short time}
- Metanephros {Permanent kidneys}
The permanent kidneys {metanephros} begin to develop early in the ___th week
5th week
The permanent kidneys develop from two different sources:
- The metanephric diverticulum or ureteric bud
2. The metanephric mesoderm
The ureteric bud gives rise to the…
- Ureter
- Renal pelvis
- Calyces
- Collecting tubules
The fetal bladder is derived from the ______ derivative known as the urogenital sinus
hindgut
The fetal testes produce _____ that cause the masculinization of the external genitalia.
androgen
The ____ elongates to form the penis. Sonographically called turtle sign!
Phallus
Between ___ - ___ weeks the kidneys are slightly HYPERechoic wit regard to surrounding tissue
18-20 weeks
By ___ weeks it is possible to distinguish the renal cortex from the medulla, outline the renal capsule clearly, and see a central echogenic area in the renal sinus region
25 weeks
The upper limit of normal for the renal pelvis AP diameter is ___ mm up to the 3rd trimester and ___ mm from the 3rd trimester to term.
4mm
7mm
The ureters typically measure less than ___ to ___ mm in diameter and should NOT be filled with anechoic fluid
1 to 2 mm
The bladder wall is normally ___ mm or less and is best measured at the level of the _________
2mm
Umbilical artery
Abnormal amniotic fluid levels after ___-___ weeks could indicate renal anomalies
14-16 weeks
In females, the urogenital sinus becomes the ____ and the ____. The urogenital folds become the labia MINORA, the labioscrotal swellings become the labia MAJORA, and the phallus becomes the ____
- urethra and the vagina
* Clitoris
The kidneys should be evaluated by assessing their _____, _____, and ______.
anatomy, texture, and size
At ____ weeks the bladder can be seen.
13 weeks
In males the _____ becomes the penis
Phallus
Unilateral is more common than bilateral renal agenesis {T/F}
TRUE
Bilateral renal agenesis is often referred to as _______
Potter’s syndrome
Associated anomalies with bilateral renal agenesis … {4}
- cardiac defects
- musculoskeletal disorders
- central nervous system anomalies
- Gastrointestinal anomalies
Unilateral agenesis may be associated with _____ anomalies in females and _____, ______, or _____ in males
Uterine anomalies in females
Testicular hypoplasia, agenesis, or hypospadias in males
Crossed ectopic kidneys are usually fused together and found on the ____ side
right
Exstrophy of the bladder occurs primarily in _____ and the incidence is __ in ___ births
Males
1 in 30,000 births
In early development the urinary bladder is continuous with the ______.
allantois
The allantois regressed to become a fibrous cord known as the ______. This cord or ligament extends from the apex of the bladder to the umbilicus.
Urachus
If the lumen of the allantois persists while the urachus forms, a ______ develops, which causes urine to drain from the urinary bladder to the umbilicus .
Urachal fistula ****
If only a SMALL part of the lumen of the allantois persists, it is called a _______
urachal cyst {or a vesicoallantoic cyst}
If a LARGER portion of the lumen of the allantois persists it may cause a _______ to develop. {The term patent urachus is often used}
urachal sinus
_______ is a heterogenous group of heritable, developmental, and acquired disorders
Renal Cystic Disease
______ is used to describe diseases that are associated with renal failure, oligohydramnios, and Potters facies.
Potter’s sequence
