Flashcards Davies Abdomen 4 Flashcards by Billie Harney

The arcuate arteries are seen running parallel to the _____

renal capsule

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The _____ arteries branch off the arcuate arteries and run perpendicular to the renal capsule.

interlobular

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The interlobular arteries branch off the _____ arteries and run perpendicular to the renal capsule

arcuate

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The interlobular arteries branch off the arcuate arteries and run perpendicular to the _____

renal capsule

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Name the fascia which encloses the kidneys, adrenal glands, and perinephric fat.

Gerota’s fascia or perirenal space

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The Gerota’s fascia encloses the _____, ____, and _____

kidneys
adrenal glands
perinephric fat

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Gerota’s fascis is also known as the

perirenal space

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a concentrated area of collecting tubules which is sonographically seen in newborns and infants as hypoechoic equally space triangles

medullary pyramids

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medullary pyramids

collecting tubules which appear as hypoechoic triangles in newborns and infants

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_______ associated with oligohydramnios and pulmonary hypoplasia is incompatible with life

bilateral renal agenesis

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bilateral renal agenesis associated with ____ and _____ is incompatible with life.

oligohydramnios
pulmonary hypoplasia

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What is associated with unilateral renal agenesis in women?

uterine duplication (bicornuate uterus)

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What is associated with unilateral renal agenesis in men?

seminal vesicle agenesis

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occurs when a kidney ascends to the contralateral side. Both ureters insert into their proper corners of the trigone of the bladder. Thus, the ureter of the kidney that ascended to the contralateral side crosses the midline.

crossed renal ectopia

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crossed renal ectopia

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Sonographic appearance of crossed renal ectopia

two kidneys on one side of the abdomen

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occurs when the developing kidneys fuse in the pelvis. One kidney ascends to its normal position and carries the other one with it across the midline

crossed fused renal ectopia

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cross fused renal ectopia

occurs when the developing kidneys fuse in the pelvis. One kidney ascends to its normal position and carries the other one with it across the midline

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Sonographic appearance of crossed fused renal ectopia

two kidneys fused at the upper and lower poles on one side of the abdomen

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occur when the lower poles fuse and the kidneys ascend in the retroperitoneum. The lower poles are closer to the midline in a U-shaped configuration, opposed to the normal inverted V-shape.

horseshoe kidneys

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Horseshoe kidneys

occur when the lower poles fuse and the kidneys ascend in the retroperitoneum. The lower poles are closer to the midline in a U-shaped configuration, opposed to the normal inverted V-shape.

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The isthmus of horseshoe kidneys is ____ to the distal abdominal aorta.

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A duplex kidney is discovered with dilatation of the upper pole collecting system. In this situation, is there a partial or complete ureter duplication?

complete duplication

(dilatation of only the upper pole does not exist with partial ureteral duplication)

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With ____ duplication of the ureters, the ureter draining the upper portion always inserts in an ectopic location in the bladder

complete

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A frequent complication of _____ is a ureterocele.

ectopic ureter

a prolapse of the distal ureter into the bladder with cystic dilatation

ureterocele

a prolapse of the distal ureter into the bladder with cystic dilatation

If a ureterocele extends into the kidney it causes:

dilatation of the upper collecting system

What is the most common cause of urinary obstruction in male neonates?

posterior uretheral valves

this obstruction results from a flap of mucosa with a slit-like opening in the area of the prostatic urethra

posterior urethral valves

posterior uretheral valves

obstruction results from a flap of mucosa with a slit-like opening in the area of the prostatic urethra

What are the sonographic findings of urinary obstruction in male neonates?

dilated urinary bladder hydroureter hydronephrosis possibly a urinoma

Describe the appearance of a dromedary hump

common variant of cortical thickening of the lateral aspect of the left kidney

Describe the appearance of a junctional parenchymal defect

triangular echogenic area in the anterior aspect of the right upper pole of the kidney

common variant of cortical thickening of the lateral aspect of the left kidney

dromedary hump

triangular echogenic area in the anterior aspect of the right upper pole of the kidney

junctional parenchymal defect

Describe the appearance of a column of Bertin

may give the appearance of a mass effect although the echogenicity is equal to the peripheral cortical tissue

the hypertrophy of renal cortical parenchyma located between two medullary pyramids

columns of Bertin

Column of Bertin

the hypertrophy of renal cortical parenchyma located between two medullary pyramids

a common anomaly which occur when the renal pelvis protrudes outside the renal hilum

extrarenal pelvis

a common anomaly which occur when the renal pelvis protrudes outside the renal hilum

Songraphic appearance of an extrarenal pelvis

cystic collection medial to the renal hilum

What are the four sonographic criteria for a simple cyst?

round or ovoid shape thin wall thickness anechoic acoustic enhancement

What three criteria suggest that a cyst is atypical and possibly malignant?

multiple thick septations irregular walls large solid components

Bilateral enlargement of the adult kidney caused by numerous cysts of varying sizes is seen with which disease?

autosomal dominant (adult) polycystic kidney disease

presents as bilateral renal enlargement caused by numerous cysts of varing sizes

Cysts associated with autosomal dominant (adult) polycystic kidney disease can possibly be found where?

liver pancreas spleen

_____ is associated with aneurysm development.

ADPKD

What is the most common aneurysmal development seen with ADPKD?

cerebral (berry) aneurysms of the circle of Willis

Describe the sonographic appearance of infantile polycystic kidney disease

bilaterally enlarged echogenic kidneys with loss of the cortical medullary

Infantile polycystic kidney disease results in:

renal dysfunction

What other anomalies area associated with infantile polycystic kidney disease?

lung hypoplasia periportal hepatic fibrosis oligohydramnios

What is medullary sponge kidney?

dysplastic cystic dilatation of the collecting tubules of the medullary pyramids

medullary sponge kidney

Describe the sonographic appearance of medullary spongy kidney

equally spaced hyperechoic medullary pyramids

Due to the dysplastic collecting tubules of the medullary pyramids, _____ tends to deposit within them

calcium

What is the most common cause of an abdominal mass in the newborn?

multicystic dysplastic kidney disease

List four sonographic features of multicystic dysplastic kidney disease

cysts of varying shape and size absence of communication between cysts absence of renal sinus absence of renal parenchyma

What contralateral renal abnormalities are found when multicystic dysplastic kidney disease is unilateral?

ureteropelvic junction obstruction renal agenesis or hypoplasia pelvocalectasis

Name three anatomic anomalies that appear as pseudotumors of the kidney

Column of Bertin Dromedary hump fetal lobation

What is the term which refers to patients on chronic hemodialysis that develop bilateral renal cysts?

acquired cystic disease

______ is seen with patients on chronic hemodialysis

acquired cystic disease

Acquired cystic disease is associated with a slightly higher incidence of _____

renal cell carcinoma

On occasion, patients with acquired cystic disease, have cysts that may hemorrhage resulting in _____, _____, and _____.

flank pain hematuria intracystic echogenic collections

What would a sonographer look for in a patient with a history of tuberous sclerosis?

renal cyst formation multiple renal angiomyolipomas

multisystemic disorder associated with renal cyst formation and multiple renal angiomyolipomas.

tuberous sclerosis

Tuberous sclerosis

multisystemic disorder associated with renal cyst formation and multiple renal angiomyolipomas

What are other names for renal cell carcinoma

hypernephromas adenocarcinomas von Growitz tumor

hypernephromas

renal cell carcinoma

renal adenocarcinomas

renal cell carcinoma

von Growitz tumor

renal cell carcinoma

Renal cell carcinoma is associated with what four diseases?

adult polycystic kidney disease acquired cystic disease Von Hippel-Lindau syndrome Tuberous sclerosis

Sonographic appearance of renal cell carcinoma

encapsulated, solid mass that is hypoechoic relative to normal, adjacent renal parenchyma

What additional areas should be evaluated whenever a solid renal mass is detected?

ipsilateral renal vein and inferior vena cava for tumor invasion contralateral kidney and renal vein retroperitoneum for lymphadenopathy liver for metastases

What common sonographic artifact is demonstrated with renal angiomyolipoma, hepatic lipoma, and adrenal myelolipoma?

propagation speed artifact because sound travels slower in fat than in soft tissue

A sound pulse in a fat containing tumor is delayed and objects that are behind the tumor are artifactually placed:

further from the transducer

What mass should be suspected when a filling defect is noted in the bladder?

transitional cell carcinomas

The majority of transitional cell carcinomas arise in the _____

bladder

What is the most common solid tumor in children diagnosed by ultrasound?

Wilm's tumor (nephroblastoma)

Wilm's tumor is also called:

nephroblastoma

Nephroblastoma is also called:

Wilm's tumor

Most patients that are diagnosed with a Wilm's tumor are less than ___ years old.

What are the ultrasound findings associated with significant acute pyelonephritis?

renal enlargement hypoechoic parenchyma absence of sinus echoes

What is pyonephrosis?

the presence of pus in a dilated renal collecting system, secondary to infected hydronephrosis

pyonephrosis

Pyonephrosis is secondary to:

infected hydronephrosis

What are three sonographic features of pyonephrosis?

dependent echoes within a dilated pelvocaliceal system shifting urine-debris level gas shadowing from infection

What malignant tumor is associated with the urinary collecting system (renal pelvis, ureter, and bladder)?

transitional cell carcinoma

Transitional cell carcinoma is associated with the ______

renal pelvis, ureter, and bladder

Where is transitional cell carcinoma typically found?

bladder

What are two of the most common explanations for bilateral renal masses?

malignant lymphoma/ Hodgkin's disease metastases

What is the sonographic appearance of a renal mycetoma?

hypechoic, nonshadowing mass

What is mycetoma?

fungal ball

What tumors commonly imaged with ultrasound are associated with Von Hippel-Lindau Syndrome?

renal cell carcinoma hemangioma pheochromocytoma pancreatic cystadenoma/cystadenocarcinoma adenoma islet cell tumor cysts associated with a variety of organs

Give examples of prehepatic, intrahepatic, and posthepatic portal hypertension

Portal vein thrombosis cirrhosis; schistosomiasis Budd-Chiari Syndrome

Example of prehepatic portal hypertension

portal vein thrombosis

Example of intrahepatic portal hypertension

cirrhosis; schistosmiosis

Example of posthepatic portal hypertension

Budd-Chiari Syndrome

Identify causes of renal vein thrombosis

inferior vena cava or renal vein extrinsic compression nephrotic syndrome renal tumors renal allografts trauma

List four sonographic indications for acute renal vein thrombosis

dilated thrombosed renal vein absence of venous flow within the kidney enlarged hypoechoic kidney high resistive renal artery waveform