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Spring Semester 2013 > Chapter 14 Urinary System > Flashcards

Chapter 14 Urinary System Flashcards

1
Q

Carries blood into the glomerulus of the nephron

A

afferent arteriole

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2
Q

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

A

Bowman’s capsule

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3
Q

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

A

cortex

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4
Q

Another term for the renal fascia; the kidnet is covered by the renal capsule, perirenal fat, Gerot’s fascia, and paprenal fat

A

Gerota’s fascia

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5
Q

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

A

hilus

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6
Q

Recieves urine from the minor calyces to convey to the penal pelvis

A

major calyces

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7
Q

Recieves urine from the renal pyramids; forms the border of the renal sinus

A

minor calyces

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8
Q

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

A

nephron

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9
Q

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

A

renal corpuscle

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10
Q

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

A

renal pelvis

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11
Q

Space behind the peritoneal lining of the abdominalcavity

A

retroperitoneum

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12
Q

Small, membranous canal that excretes urine from the urinary bladder.

A

urethra

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13
Q

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

A

arcuate arteries

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14
Q

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

A

BUN- blood urea nitrogen

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15
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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16
Q

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

A

creatinine

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17
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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18
Q

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

A

glomerulus

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19
Q

Maintenance of normal body physiology

A

homeostasis

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20
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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21
Q

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

A

medulla

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22
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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23
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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24
Q

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

A

renal hilum

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25
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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26
Q

Lab test that measures how much dissolved material is present in the urine

A

specific gravity

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27
Q

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

A

ureters

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28
Q

Muscular retroperitoneal organ that serves as a reservoir for urine

A

urinary bladder

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29
Q

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

A

columns of Bertin

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30
Q

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

A

dromedary hump

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31
Q

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

A

ectopic kidney

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32
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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33
Q

Dilation of the renal collecting system

A

hydronephrosis

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34
Q

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

A

renal agenesis

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35
Q

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

A

renal capsule

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36
Q

Stone within the urinary system

A

urolithiasis

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37
Q

The urinary system has 2 principle functions: excreting ___ and regulating the composition of ___.

A

wastes;blood

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38
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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39
Q

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

A

downward

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40
Q

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

A

Congenital diverticulum

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41
Q

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

A

Acquired

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42
Q

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

A

Cystitis

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43
Q

The majority of bladder tumors in adults are ___ carcinoma.

A

transitional cell

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44
Q

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

A

vascular; lymphatics

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45
Q

A fibrous capsule called the ___ surround the kidney.

A

true capsule

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46
Q

Outside of this fibrous capsule is a covering of ____.

A

perinephric fat

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47
Q

The ___ fascia surrounds the perinephric fat and encloses the kidneys and adrenals.

A

perinephric

48
Q

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

A

Gerota’s

49
Q

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

A

pyramids

50
Q

A nephron consists of two main structures; a renal ___ and a renal ___.

A

corpuscle; tubule

51
Q

Nephrons ____ the blood and produce ___.

A

filter; urine

52
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

53
Q

Blood flows into the glomerulus through a small ___ arteriole and leaves the glomerulus through a ___ arteriole.

A

afferent;efferent

54
Q

There are 3 constrictions along the ureters course:

A

where the ureter leaves the renal pelvis; where it kinks as it crosses the pelvic brim; where it pierces the bladder wall

55
Q

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

A

superior mesenteric

56
Q

The renal vein drains into the ___ of the IVC.

A

lateral walls

57
Q

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

A

retroperitoneum

58
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

59
Q

The principle metabolic waste products are ___, ___, and nitrogenous wastes.

A

water; carbon dioxide

60
Q

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

A

vascular

61
Q

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

A

hematuria; RBC’s;pus

62
Q

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

A

acidic, alkaline

63
Q

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

A

specific gravity

64
Q

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

A

low

65
Q

A decreased ___ occurs with acute hemmorhagic processes secondary to disease or blunt trauma.

A

hematocrit

66
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

67
Q

The renal parenchyma surrounds the fatty central renal sinus, which contains what 5 structures?

A

calyces, infundibula, pelvis, vessels, lymphatics

68
Q

Dilation of the collecting system has been noted in ___ patients, especially the right kidney.

A

pregnant

69
Q

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

A

parenchyma

70
Q

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

A

arcuate arteries, interlobar

71
Q

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

A

cortex; hypoechoic

72
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

73
Q

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

A

crura

74
Q

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

A

apex;base

75
Q

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

A

dromedary hump

76
Q

A ___ is a triangular, echogenic area in the upper pole of the renal parenchyma that can be seen during normal scanning.

A

junctional parenchymal defect

77
Q

In a patient with a ___ there is fusion of the kidneys during fetal development that almost invariably involves the ___ poles.

A

horseshoe kidney; lower

78
Q

A cystic mass presents sonographically with what characteristics?

A

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

79
Q

Sonographically, it is difficult to differentiate between a ___ cyst and a small adjacent cortical cyst.

A

septated

80
Q

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

A

renal hilum

81
Q

Name the 4 forms of autosomal polycystic kidney disease.

A

perinatal, neonatal, infantile, juvenile

82
Q

Discuss the characteristics of autosomal dominant polycystic kidney disease.

A

common; severity depends on genotype; most common is PKD1 (located on the short arm of the 16th chromosome) which is more severe than PKD2 (long arm of 4th chromosome), may be a spontaneous mutation, bilateral mutiple cysts in cortex and medulla; 50% of patients by age 60 have ESRD

83
Q

Usually a ___ renal contour is the first finding that a mass may be present and requires further investigation.

A

abnormal

84
Q

Define the characteristics of renal cell carcinoma.

A

most common of all renal tumors; accounts for 85% of tumors; 2X more common in males; hematuria, flank pain, palpable mass; increased incidence in patients with Hippel Landau disease and in dialysis patients

85
Q

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

A

adenoma

86
Q

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

A

angiomyolipoma

87
Q

A ___ appears as a well defined echogenic mass, found more often in females.

A

lipoma

88
Q

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

A

corticomedullary

89
Q

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 ___.

A

renal atrophy

90
Q

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

A

acute tubular necrosis

91
Q

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

A

function

92
Q

Name the 3 primary types of chronic renal failure.

A

nephron, vascular, and interstitial abnormalities

93
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

94
Q

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

A

strictures; focal masses; duplex collecting system

95
Q

Hydronephrosis with a dilated ureter and bladder indicated obstruction of the ___junction or of the ___.

A

ureterovesical; urethra

96
Q

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

A

bladder

97
Q

Name 3 conditions that might mimic hydronephrosis.

A

parapelvic cyst, renal vessels in the parapelvic area, extrarenal pelvis

98
Q

Describe the sonographic findings in acute obstruction.

A

resistive index of the intrarenal vessels greater than .70 for 48-72 hours after obstruction; RI then returns to normal; No ureteral jet will be seen on the affected side, or flow will be decreased if the obstruction is partial

99
Q

Ureteral jets are best visualized by ___ imaging.

A

color Doppler

100
Q

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

A

pyonephrosis

101
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

102
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

103
Q

The major problem encountered with renal transplantation is ___.

A

graft rejection

104
Q

Early after surgery, a baseline sonographic exam is performed to determine ___, ___, and ___.

A

renal size, calyceal pattern, extrarenal fluid collections

105
Q

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

A

hematoma, abscess, lymphocele, urinoma

106
Q

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

A

Hyperacute

107
Q

___ rejection occurs within days to months after transplant.

A

Acute

108
Q

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

A

Immunologic

109
Q

___ rejection can occur months after transplantation with gradual onset.

A

Chronic

110
Q

When using US to diagnose rejection, what things must be evaluated?

A

kidney size and shape; appearance of pyramids, cortex, parenchyma; presence of any fluid

111
Q

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

A

cadaveric; donor relative

112
Q

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

A

anuria; oliguria

113
Q

Renal artery stenosis exhibits a _____ jet with distal disturbance.

A

high velocity

114
Q

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

A

Power

115
Q

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

A

pain

116
Q

Renal stones have very ___ foci with posterior acoustic shadowing.

A

echogenic

117
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 the obstruction.

A

hydronephrosis; superior

Spring Semester 2013 (13 decks)

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