Ch 63 Fetal Urogenital System

Question 1

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

Answer 1

cloacal exstrophy

Question 2

failure of the testes to descend into the scrotu

Answer 2

cryptorchidism

Question 3

abnormal congenital opening of the male urethra on the top side of the penis

Answer 3

epispadias

Question 4

dilated renal pelvis in the fetus; most common fetal anomaly

Answer 4

fetal hydronephrosis

Question 5

ovarian mass that results from maternal hormone stimulation and is usually benign

Answer 5

fetal ovarian cyst

Question 6

condition in which both ovarian and testicular tissues are present

Answer 6

hermaphroditism

Question 7

forms when the inferior poles of the kidney fuse while they are in the pelvis

Answer 7

horseshoe kidney

Question 8

collection of fluid in the vagina and uterus

Answer 8

hydrometrocolpos

Question 9

dilated ureters

Answer 9

hydroureters

Question 10

abnormal congenital opening of the male urethra on the undersurface of the penis

Answer 10

hypospadias

Question 11

autosomal recessive disease that affects the fetal kidneys and liver; the kidneys are enlarged and echogenic on ultrasound

Answer 11

infantile polycystic kidney disease (IPKD)

Question 12

the level of the urethra where the urinary tract may become obstructed

Answer 12

megacystis

Question 13

dilation of the lower end of the ureter; the common presentation of ureterovesical junction obstruction

Answer 13

megaureter

Question 14

multiple cysts replace normal renal tissue throughout the kidney; usually causes renal obstruction

Answer 14

multicystic dysplastic kidney disease (MSCK)

Question 15

occurs when the kidney does not migrate upward into the retroperitoneal space

Answer 15

pelvic kidney

Question 16

occurs only in male fetuses; is manifested by the presence of a valve in the posterior urethra

Answer 16

posterior urethral valve

Question 17

term used to describe renal diseases other than renal agenesis that result in renal failure and facial or structural abnormalities caused by oligohydramnios

Answer 17

Potter’s sequence

Question 18

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

Answer 18

Potter’s syndrome

Question 19

dilation of the fetal abdomen secondary to severe bilateral hydronephrosis and fetal ascites; fetus also has oligohydramnios and pulmonary hypoplasia

Answer 19

prune belly syndrome

Question 20

dilated renal pelvis without involvement of the calyces

Answer 20

pyelectasis

Question 21

renal system fails to develop

Answer 21

renal agenesis

Question 22

a small part of the lumen of the allantois that persists while the urachus forms

Answer 22

urachal cyst

Question 23

congenital outpouching of the distal ureter into the bladder

Answer 23

ureterocele

Question 24

junction of the ureter entering the renal pelvis; most common site of obstruction

Answer 24

ureteropelvic obstruction (UPJ)

Question 25

junction where the ureter enters the bladder

Answer 25

ureterovesical junction (UVJ)

Question 26

condition that causes a massively distended bladder (prune belly)

Answer 26

urethral atresia

Question 27

Dilation of the posterior urethra is highly suspicious for an obstructive process such as __________, also known as "Key - hole sign"

Answer 27

Posterior Urethral Valve Syndrome {PUVO}

Question 28

PUVO {posterior urethral valve syndrome} occurs ONLY in _____ fetuses

Answer 28

MALE

Question 29

______ is a cystic dilation of the intravesical {bladder} segment of the distal ureter.

Answer 29

Ureterocele

Question 30

An ectopic ureter does not insert near the ________ angle of the trigone of the bladder

Answer 30

posterolateral

Question 31

With FEMALES, an ectopic ureter may insert into the _____ or _____

Answer 31

vagina or uterus

Question 32

With MALES, an ectopic ureter may insert into the _____, _____, or _______.

Answer 32

Seminal vesicle, vas deferens, or ejaculatory ducts

Question 33

Sonographic appearance of an ectopic ureter

Answer 33

1. Usually unilateral 2. Large, tortuous dilated ureter 3. Ipsilateral hydronephrosis 4. Normal amiotic fluid

Question 34

With ureterocele, females are more likely to present with _______

Answer 34

Renal duplication

Question 35

With ureterocele, males more commonly with _____ renal collecting system

Answer 35

Normal

Question 36

Complete duplication of the uterus and vagina

Answer 36

Uterus didelphys

Question 37

Duplication of the uterus

Answer 37

Bicornuate uterus

Question 38

Single uterine tube and horn

Answer 38

Unicornuate

Question 39

Three sets of excretory organs develop in the embryo:

Answer 39

1. Pronephros {nonfunctioning} 2. Mesonephros {Function for a short time} 3. Metanephros {Permanent kidneys}

Question 40

The permanent kidneys {metanephros} begin to develop early in the ___th week

Answer 40

5th week

Question 41

The permanent kidneys develop from two different sources:

Answer 41

1. The metanephric diverticulum or ureteric bud | 2. The metanephric mesoderm

Question 42

The ureteric bud gives rise to the...

Answer 42

1. Ureter 2. Renal pelvis 3. Calyces 4. Collecting tubules

Question 43

The fetal bladder is derived from the ______ derivative known as the urogenital sinus

Answer 43

hindgut

Question 44

The fetal testes produce _____ that cause the masculinization of the external genitalia.

Answer 44

androgen

Question 45

The ____ elongates to form the penis. Sonographically called turtle sign!

Answer 45

Phallus

Question 46

Between ___ - ___ weeks the kidneys are slightly HYPERechoic wit regard to surrounding tissue

Answer 46

18-20 weeks

Question 47

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

Answer 47

25 weeks

Question 48

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.

Answer 48

4mm | 7mm

Question 49

The ureters typically measure less than ___ to ___ mm in diameter and should NOT be filled with anechoic fluid

Answer 49

1 to 2 mm

Question 50

The bladder wall is normally ___ mm or less and is best measured at the level of the _________

Answer 50

2mm | Umbilical artery

Question 51

Abnormal amniotic fluid levels after ___-___ weeks could indicate renal anomalies

Answer 51

14-16 weeks

Question 52

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 ____

Answer 52

* urethra and the vagina | * Clitoris

Question 53

The kidneys should be evaluated by assessing their _____, _____, and ______.

Answer 53

anatomy, texture, and size

Question 54

At ____ weeks the bladder can be seen.

Answer 54

13 weeks

Question 55

In males the _____ becomes the penis

Answer 55

Phallus

Question 56

Unilateral is more common than bilateral renal agenesis {T/F}

Answer 56

TRUE

Question 57

Bilateral renal agenesis is often referred to as _______

Answer 57

Potter's syndrome

Question 58

Associated anomalies with bilateral renal agenesis ... {4}

Answer 58

1. cardiac defects 2. musculoskeletal disorders 3. central nervous system anomalies 4. Gastrointestinal anomalies

Question 59

Unilateral agenesis may be associated with _____ anomalies in females and _____, ______, or _____ in males

Answer 59

Uterine anomalies in females Testicular hypoplasia, agenesis, or hypospadias in males

Question 60

Crossed ectopic kidneys are usually fused together and found on the ____ side

Answer 60

right

Question 61

Exstrophy of the bladder occurs primarily in _____ and the incidence is __ in ___ births

Answer 61

Males | 1 in 30,000 births

Question 62

In early development the urinary bladder is continuous with the ______.

Answer 62

allantois

Question 63

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.

Answer 63

Urachus

Question 64

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 .

Answer 64

Urachal fistula ******

Question 65

If only a SMALL part of the lumen of the allantois persists, it is called a _______

Answer 65

urachal cyst {or a vesicoallantoic cyst}

Question 66

If a LARGER portion of the lumen of the allantois persists it may cause a _______ to develop. {The term patent urachus is often used}

Answer 66

urachal sinus

Question 67

_______ is a heterogenous group of heritable, developmental, and acquired disorders

Answer 67

Renal Cystic Disease

Question 68

______ is used to describe diseases that are associated with renal failure, oligohydramnios, and Potters facies.

Answer 68

Potter's sequence