Flashcards Davies Abdomen 4
The arcuate arteries are seen running parallel to the _____
renal capsule
The _____ arteries branch off the arcuate arteries and run perpendicular to the renal capsule.
interlobular
The interlobular arteries branch off the _____ arteries and run perpendicular to the renal capsule
arcuate
The interlobular arteries branch off the arcuate arteries and run perpendicular to the _____
renal capsule
Name the fascia which encloses the kidneys, adrenal glands, and perinephric fat.
Gerota’s fascia or perirenal space
The Gerota’s fascia encloses the _____, ____, and _____
kidneys
adrenal glands
perinephric fat
Gerota’s fascis is also known as the
perirenal space
a concentrated area of collecting tubules which is sonographically seen in newborns and infants as hypoechoic equally space triangles
medullary pyramids
medullary pyramids
collecting tubules which appear as hypoechoic triangles in newborns and infants
_______ associated with oligohydramnios and pulmonary hypoplasia is incompatible with life
bilateral renal agenesis
bilateral renal agenesis associated with ____ and _____ is incompatible with life.
oligohydramnios
pulmonary hypoplasia
What is associated with unilateral renal agenesis in women?
uterine duplication (bicornuate uterus)
What is associated with unilateral renal agenesis in men?
seminal vesicle agenesis
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
crossed renal ectopia
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.
Sonographic appearance of crossed renal ectopia
two kidneys on one side of the abdomen
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
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
Sonographic appearance of crossed fused renal ectopia
two kidneys fused at the upper and lower poles on one side of the abdomen
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
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.
The isthmus of horseshoe kidneys is ____ to the distal abdominal aorta.
anterior
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)
With ____ duplication of the ureters, the ureter draining the upper portion always inserts in an ectopic location in the bladder
complete
A frequent complication of _____ is a ureterocele.
ectopic ureter
a prolapse of the distal ureter into the bladder with cystic dilatation
ureterocele
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
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
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
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.
3
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
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
