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Abdomen > Chapter 14 - Urinary System > Flashcards

Chapter 14 - Urinary System Flashcards

1
Q

Area of kidney where vessels, ureter, and lymphatics enter and exit

A

hilus

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2
Q

Another term for the renal fascia; the kidney is covered by the renal capsule, perirenal fat, Gerota’s fascia, and pararenal fat

A

Gerota’s fascia

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3
Q

Functional unit of the kidney; includes a renal corpuscle and a renal tubule

A

nephron

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4
Q

Carries blood into the glomerulus of the nephron

A

afferent arteriole

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5
Q

Receive urine from the renal pyramids; form the border of the renal sinus

A

minor calyces

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6
Q

Part of the nephron that consists of Bowman’s capsule and the glomerulus

A

renal corpuscle

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7
Q

Area in the midportion of the kidney that collects urine before entering the ureter

A

renal pelvis

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8
Q

Site of filtration in the kidney; contains water, salts, glucose, urea, and amino acids

A

Bowman’s capsule

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9
Q

Receives urine from the minor calyces to convey to the renal pelvis

A

major calyces

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10
Q

Small, membranous canal that excretes urine from the urinary bladder

A

urethra

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11
Q

Space behind the peritoneal lining of the abdominal cavity

A

retroperitoneum

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12
Q

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 tubule

A

loop of Henle

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13
Q

One of several conical masses of tissue that form the kidney medulla; each consists of the loops of Henle and the collecting tubules of the nephrons

A

renal pyramid

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14
Q

Retroperitoneal structures that exit the kidney to carry urine to the urinary bladder

A

ureters

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15
Q

Inner portion of the renal parenchyma that contains the loop of Henle

A

medulla

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16
Q

Small vessels found at the base of the renal pyramids; appear as echogenic structures

A

arcuate arteries

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17
Q

Muscular retroperitoneal organ that serves as a reservoir for urine

A

urinary bladder

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18
Q

Part of the collecting system adjacent to the pyramid that collects urine and is connected to the major calyx

A

calyx

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19
Q

Network of capillaries that are part of the filtration process in the kidney

A

glomerulus

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20
Q

Central area of the kidney that includes the calyces, renal pelvis, renal vessels, fat, nerves, and lymphatics

A

renal sinus

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21
Q

Right posterior subhepatic space located anterior to the kidney and inferior to the liver where fluid may accumulate

A

Morison’s pouch

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22
Q

Small vessel that carries blood from the glomerulus of the nephron and conducts blood to the peritubular capillaries that surround the renal tubule

A

efferent arteriole

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23
Q

Area in the midportion of the kidney where the renal vessels and ureter enter and exit

A

renal hilum

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24
Q

Laboratory measurement of the amount of nitrogenous waste and creatinine in the blood

A

blood urea nitrogen (BUN)

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25
Q

A product of metabolism; laboratory test that measures the ability of the kidney to get rid of waste

A

creatinine

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26
Q

Maintenance of normal body physiology

A

homeostasis

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27
Q

Laboratory tests that measure how much dissolved material is present in the urine

A

specific gravity

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28
Q

Normal variant that occurs on the left kidney as a bulge on the lateral border

A

dromedary hump

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29
Q

Located outside of the normal position, most often in the pelvic cavity

A

ectopic kidney

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30
Q

Stone within the urinary system

A

urolithiasis

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31
Q

First layer adjacent to the kidney that forms a tough, fibrous covering

A

renal capsule

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32
Q

Bands of cortical tissue that separate the renal pyramids; may mimic a renal mass on ultrasound

A

columns of Bertin

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33
Q

Dilation of the renal collecting system

A

hydronephrosis

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34
Q

Congenital malformation in which both kidneys are joined together by an isthmus, most commonly at the lower poles

A

horseshoe kidney

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35
Q

Interruption in the normal development of the kidney resulting in absence of the kidney; may be unilateral or bilateral

A

renal agenesis

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36
Q

The urinary system has two principal functions: excreting _______________ and regulating the composition of _______________.

A

wastes, blood

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37
Q

The right kidney lies slightly _______________ than the left kidney because the large right lobe of the _______________ pushes it _______________.

A

lower, liver, inferiorly

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38
Q

The kidneys move with respiration; on deep inspiration, both kidneys move _______________ approximately 1 inch.

A

downward

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39
Q

Within the hilus of the kidney are other _______________ structures, a ureter, and the _______________.

A

vascular, lymphatics

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40
Q

A fibrous capsule called the ________________ surrounds the kidney.

A

true capsule

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41
Q

Outside of this fibrous capsule is a covering of _______________.

A

perinephric fat

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42
Q

The _______________ fascia surrounds the perinephric fat and encloses the kidneys and adrenal glands.

A

perinephric

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43
Q

The renal fascia, known as _______________ fascia, surrounds the true capsule and perinephric fat.

A

Gerota’s

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44
Q

The medullary substance consists of a series of striated conical masses, called the renal _______________.

A

pyramids

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45
Q

A nephron consists of two main structures, a renal _______________ and a renal _______________.

A

corpuscle, tubule

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46
Q

Nephrons _______________ the blood and produce _______________.

A

filter, urine

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47
Q

The renal corpuscle consists of a network of capillaries, called the _______________, which is surrounded by a cuplike structure known as _______________.

A

glomerulus, Bowman’s capsule

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48
Q

Blood flows into the glomerulus through a small _______________ arteriole and leaves the glomerulus through a(n) _______________ arteriole.

A

afferent, efferent

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49
Q

There are three constrictions along the ureter’s course: (1) _______________, (2) _______________, and (3) _______________.

A

where the ureter leaves the pelvis, where it is kinked as it crosses the pelvic brim, and where it pierces the bladder wall

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50
Q

The main renal artery is a lateral branch of the aorta and arises just inferior to the _______________.

A

superior mesenteric artery

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51
Q

The renal vein drains into the _______________ of the inferior vena cava.

A

lateral walls

52
Q

The urinary system is located posterior to the peritoneum lining the abdominal cavity in an area called the _______________.

A

retroperitoneum

53
Q

The kidneys adjust the amounts of _______________ and _______________ leaving the body so that these equal the amounts of substances entering the body.

A

water, electrolytes

54
Q

The principal metabolic waste products are _______________, _______________, and nitrogenous wastes.

A

water, carbon dioxide

55
Q

Both urea and uric acid are carried away from the liver into the kidneys by the _______________ system.

A

vascular

56
Q

The presence of an acute infection causes _______________, which is _______________ in the urine; pyuria means there is _______________ in the urine.

A

hematuria, red blood cells, pus

57
Q

The pH refers to the strength of the urine as a partly _______________ or _______________ solution.

A

acidic, alkaline

58
Q

The _______________ is the measurement of the kidney’s ability to concentrate urine.

A

specific gravity

59
Q

The specific gravity is especially _______________ in cases of renal failure, glomerular nephritis, and pyelonephritis.

A

low

60
Q

A decreased _______________ occurs with acute hemorrhagic processes secondary to disease or blunt trauma.

A

hematocrit

61
Q

Impairment of renal function and increased protein catabolism result in BUN _______________ that is relative to the degree of renal impairment and rate of urea nitrogen excreted by the kidneys.

A

elevation

62
Q

The renal parenchyma surrounds the fatty central renal sinus, which contains these five structures:

A

calyces, infundibula, pelvis, vessles, and lymphatics

63
Q

Dilation of the collection system has also been noted in ______________ patients, especially the right kidney.

A

pregnant

64
Q

The _______________ is the area from the renal sinus to the outer renal surface.

A

parenchyma

65
Q

The _______________ and _______________ arteries are best demonstrated as intense specular echoes in cross section or oblique section at the corticomedullary junction.

A

Interlober vessels, arcuate

66
Q

The _______________ generally is echo producing, whereas the medullary pyramids are _______________.

A

cortex, hypoechoic

67
Q

The cortex and medullary pyramids are separated from each other by bands of cortical tissue, called _______________, that extend inward to the renal sinus.

A

columns of Bertin

68
Q

The _______________ lie posterior to the renal arteries and should be identified by their lack of pulsations and absence of Doppler flow.

A

crura

69
Q

The _______________ of the pyramid points toward the sinus, and the _______________ lies adjacent to the renal cortex.

A

apex, base

70
Q

The _______________ is a cortical bulge that occurs on the lateral border of the kidney, typically more on the left side.

A

dromedary hump

71
Q

A(n) _______________ is a triangular, echogenic area in the upper pole of the renal parenchyma that can by seen during normal scanning.

A

junctional parenchymal defect

72
Q

In a patient with a(n) _______________, there is fusion of the kidneys during fetal development that almost invariably involves the _______________ poles.

A

horseshoe kidney, lower

73
Q

A cystic mass presents sonographically with several characteristic features:

A

smooth, thin, well-defined border, round or oval shape, sharp interface between the cyst and renal parenchyma, anechoic, increased posterior acoustic enhancement

74
Q

A cystlike enlargement of the lower end of the ureter is called a(n) _______________.

A

ureterocele

75
Q

Sonographically, it is difficult to differentiate between a(n) _______________ cyst and a small adjacent cortical cyst.

A

septated

76
Q

The parapelvic cyst is found in the _______________ but does not communicate with renal collecting system.

A

renal hilum

77
Q

Name the four forms of autosomal recessive polycystic kidney disease:

A

perinatal, neonatal, infantile, juvenile

78
Q

Discuss the characteristics of autosomal dominant polycystic kidney disease.

A

It is a bilateral disease, multiple cysts located in renal cortex and medulla. Cysts vary in size and may be asymmetrical. Doesn’t usually manifest until 4th or 5th decade (progressive). Approximately 50% of patients by age 60 will have end stage renal disease. Clinical symptoms: pain, hypertension, palpable mass, hematuria, headache, urinary tract infection, and renal insufficiency.

79
Q

Usually a(n) _______________ renal contour is the first finding that a mass may be present and require further investigation.

A

abnormal

80
Q

Define the characteristics of renal cell carcinoma.

A

The classic clinical presentation is nonspecific; however, patient may report hematuria, flank pain, and palpable mass. The tumor appears bilaterally, 0.1%-1.5% of patients. The incidence is increased in patients with von Hippel-Lindau and patients on long term dialysis. It is twice as common in females, usually in the 6th or 7th decade.

81
Q

One of the most common benign renal tumors is called _______________.

A

adenoma

82
Q

An uncommon benign renal tumor composed mainly of fat cells and commonly found in the renal cortex is _______________.

A

angiomyolipoma

83
Q

A(n) _______________ appears as a well-defined echogenic mass, found more often in females.

A

lipoma

84
Q

Sonographic findings include one or more fluid spaces at the _______________ junction that corresponds to the distribution of the renal pyramids.

A

corticomedullary

85
Q

Although the kidneys appear enlarged with a highly echogenic renal sinus, the intrarenal anatomy is preserved with unifrom loss of renal tissue in patients with _______________.

A

renal atrophy

86
Q

The most common medical renal disease that produces acute renal failure is _______________.

A

acute tubular necrosis

87
Q

Chronic renal disease is loss of renal _______________ as a result of disease, most commonly parenchymal disease.

A

function

88
Q

There are three primary types of chronic renal failure: _______________, _______________, and _______________.

A

nephron, vascular, and interstital abnormalities

89
Q

_______________ is when the dilated pyelocalyceal system appears as separation of the renal sinus echoes by fluid-filled areas that conform anatomically to the infundibula, calyces, and renal pelvis.

A

hydronephrosis

90
Q

A localized hydronephrosis occurs as a result of _______________, calculi, _______________, or the _______________.

A

strictures, focal masses, duplex collecting system

91
Q

Hydronephrosis with a dilated ureter and bladder indicates obstruction of the _______________ junction or of the _______________.

A

ureterovesical, posterior urethra

92
Q

If hydronephrosis is suspected, the sonographer should evaluate the _______________.

A

bladder

93
Q

Name two conditions that might mimic hydronephrosis.

A

peripelvic cysts, renal vessels in the peripelvic area, extrarenal pelvis

94
Q

Describe the sonographic findings in acute obstruction.

A

The resistive index of the intrarenal vessles may be greater than 0.70 for 48-72 hours after obstruction. The RI returns to normal. No ureteral jet will be present on the affected side, or flow will be decreased if the obstruction is partial.

95
Q

Ureteral jets are best visualized by _______________ imaging.

A

color Doppler

96
Q

When pus is found within the obstructed renal system, the condition is called _______________.

A

pyonephrosis

97
Q

_______________ is a diffuse foci of calcium deposits, which is usually located in the medulla and infrequently can also be seen in the renal cortex.

A

nephrocalcinosis

98
Q

A renal _______________ occurs when part of the tissue undergoes necrosis after the cessation of the blood supply, usually as a result of artery occlusion.

A

infarction

99
Q

The major problem encountered with renal transplantation is _______________.

A

graft rejection

100
Q

Early after surgery, a baseline sonographic examination is performed to determine _______________, _______________, and _______________.

A

renal size, calyceal pattern, external fluid collections

101
Q

Perirenal fluid collections, such as _______________, _______________, _______________, or _______________ can be diagnosed reliably and differentiated from acute rejection.

A

hematoma, abscess, lymphocele, urinoma

102
Q

_______________ rejection occurs within hours of transplantation and is caused by vasculitis leading to thrombosis and usually the loss of the graft.

A

hyperacute

103
Q

_______________ rejection occurs within days to months after transplant.

A

acute

104
Q

_______________ rejection causes include preformed antibodies, immune complexes, and cell-mediated responses.

A

immunologic

105
Q

_______________ rejection can occur months after transplantation with gradual onset.

A

chronic

106
Q

When using ultrasound to help diagnose rejection, care must be taken to visualize these five things:

A

the size/shape of kidneys; the appearance of the pyramids, cortex, and parenchma; and the presence of any surrounding fluid collections

107
Q

The incidence of acute tubular necrosis is usually higher in _______________ transplants than in _______________ transplants.

A

cadaveric, doner-relative

108
Q

Early signs of obstruction are _______________ or severe _______________ in a patient with satisfactory renal volumes.

A

anuria, oliguria

109
Q

Renal artery stenosis exhibits a(n) _______________ jet with distal turbulence.

A

high-velocity

110
Q

_______________ Doppler is not angle dependent and has a greater sensitivity to detect blood flow.

A

power

111
Q

The initial clinical sign of a kidney stone is extreme _______________, typically followed by cramping on the side where the stone is locatd; nausea and vomiting may also occur.

A

pain

112
Q

Renal stones have very ________________ foci with posterior acoustic shadowing.

A

echogenic

113
Q

If the stone causes obstruction, there will be _______________ and, depending on the location of the stone, the ureter may be dilated _______________ to the level of obstruction.

A

hydronephrosis, superior

114
Q

_______________ entails herniation of all layers of the bladder wall and is located in the posterior angle of the trigone.

A

Congenital diverticulum

115
Q

_______________ diverticula are herniations of only the two inner layers through the muscle layer.

A

Acquired

116
Q

_______________ is usually secondary to another condition that causes stasis of urine in the bladder.

A

cystitis

117
Q

The majority of bladder tumors in adults are _______________ carcinoma.

A

transitional cell

118
Q

A 75-year old male was experiencing right upper quadrant pain. An incidental finding was seen on the right kidney. What is this incidental finding?

A

It is most likely a right upper pole renal cyst.

119
Q

What pathology is demonstrated on these longitudinal scans of both kidneys of a young adult male? Explain how the sonographer can be certain that the lesion is not hydronephrosis.

A

It is polycystic renal disease. Both images show enlarged kidneys, with cysts of various sizes. All cysts are distinct lesions and do not connect with the central renal sinus to indicate hydronephrosis.

120
Q

A 6-year-old male presents with multiple urinary tract infections. What pathology do the images demonstrate?

A

medullary sponge kidneys

121
Q

A 14-month-old child presents with a palpable right-sided mass, decreased appetite, and lethargy. What is the sonographic finding?

A

Wilms’ tumor

122
Q

A 43-year-old female presented for an abdominal ultrasound examination. Name the abnormality that these images demonstrate.

A

angiomyolipoma

123
Q

Does this patient have hydronephrosis? Explain why or why not.

A

No. The hyperechoic pyramids are consistent with nephrocalcinosis.

124
Q

A young adult male presents with flank pain after renal transplant surgery. What are the sonographic findings?

A

Two fluid collections: one adjacent to the lower pole of the renal transplants and another within the anterior abdominal wall at the incision site.

125
Q

A 54-year-old female presents with right flank pain. What does the sonogram demonstrate?

A

small stone in the renal sinus

126
Q

Outer parenchyma of the kidney that contains the renal corpuscle and proximal and distal convoluted tubules of the nephron

A

Cortex

127
Q

Outer parenchyma of the kidney that contains the renal corpuscle and proximal and distal convoluted tubules of the nephron

A

Cortex

Abdomen (4 decks)

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