CPR 63 - Imaging and Clinical Anatomy of the Urinary System

Question 1

What does each marking refer to on the radiograph?

Answer 1

Question 2

What does each number and arrow indicate?

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Question 3

Where is urinary tract stone pain usually felt? Why?

Answer 3

Pain usually raidates from the infrascapular region into the groin and occasionally into the scrotum/labia and upper thigh. The visceral efferents from the kidney enter the CNS at the T11-L2 levels and this is what causes the referred pain.

Question 4

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Question 8

Describe the types of PKD.

Answer 8

Polycystic Kidney Disease

Autosomal Dominant - more common variant, cysts form from all segments of the nephron, renal failure doesn’t usually occur until late adulthood

Autosomal Recessive - cysts progressively form from the collecting ducts causing kidney to enlarge and fail in infancy or childhood

Question 9

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Question 12

What is the typical approach to removing a kidney? What structures does this approach involve cutting through?

Answer 12

The posterior approach is the most common approach to removing a kidney. It involves cutting through the skin > subcutaneous tissue > latissimus dorsi > serratus posterior inferior > thoracolumbar fascia posterior layer > sacrospinalis > throacolumbar fascia middle layer > quadratus lumborum > thoracolumbar fascia anterior layer > pararenal fat > renal fascia (gerota’s fascia) > and perirenal fat to gain access to the kidney. The renal artery, renal vein, and ureter must then be cut to remove the kidney.

Question 13

When a kidney transplant is performed, how is the new kidney inserted?

Answer 13

It is placed and attached in the iliac fossa and the iliac artery and vein are ligated to it.

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Question 15

Label and say what type of imaging modality this is.

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Question 16

What is stress incontinence and what causes it?

Answer 16

Stress incontinence is urine leakage that occurs during times of increased intra-abdominal pressure (ie - coughing/laughing). This is caused by weakened pelvic floor and perineal muscles.

Question 17

What is a cystocele and what causes it?

Answer 17

It is a prolapse of the bladder into the vaginal canal. Common causes include: repetitive straining for bowel movements, constipation, chronic or violent coughing, heavy lifting, being overweight/obese.