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MIDS 127 - abdo > Lower Urinary System > Flashcards

Lower Urinary System Flashcards

1
Q

Where does most pathology occur in the urinary bladder?

A

Inner mucous membrane

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2
Q

How long are the ureters?

A

Typically 30cm

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3
Q

What’s the average diameter of the ureters?

A

6mm

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4
Q

Where does constriction typically occur?
A) UPJ (ureteropelvic junction)
B) UVJ (uterovesical junction)
C) Both

A

Both

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5
Q

How long is the male urethra? How long is the female urethra?

A

Male: 20cm
Female: 3-4cm

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6
Q

The voiding of urine is called:

A

Micturition

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7
Q

Stress Incontinence (most common, etiology)

A

THE most common pissing abnormality and happens in a large percent of postmenopausal women.

Etiology: genuine stress incontinence, detrusor instability, voiding difficulty (so piss build up, overflow)

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8
Q

What is the average bladder wall thickness?

A

Less than 3mm when fully distended, up to 5mm when almost empty

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9
Q

Where do the ureter jets appear?

A

At the UVJ

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10
Q

What are the 3 types of duplication bladder?

A
  1. Peritoneal fold
  2. Septum dividing bladder sag/coronally
  3. Transverse band of muscle diving bladder into two uneven cavities
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11
Q

Duplication: Ureter (list two types, most common in, unilateral or bilateral?)

A

Incomplete: bif. of ureter at or near renal pelvic and unites between kidney/bladder to enter bladder as ONE ureter
Complete: two separate renal collecting systems (think Emma), two separate ureters

Most common in: women

Can be either unilateral or bilateral!

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12
Q

Duplication of the urethra

A

Uncommon and almost exclusively in males, associated with duplication of bladder and genitalia

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13
Q

What is Diverticula: Bladder?

A

Outpouching of bladder wall. Either congenital or aquired.

Hutch’s diverticulum: ureteral insertion at a weak point in the bladder wall

Complications: intradiverticular tumours and stones, random rupture

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14
Q

Name the SA for the diverticula bladder.

A

Anechoic outpouching with thin wall/acoustic enhancement.
Connected to bladder via a narrow neck.
CD shows flow in both directions between bladder and pouch
Diverticula may not empty and may increase in size.

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15
Q

Diverticula: Urethra

A

Well seen in women.

Complications: stone formation, cancer
SA: simple or complex collection of fluids intimately related to urethra

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16
Q

What is the most common bladder outlet obstruction?

A

Posterior Urethral Valves (PUV)

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17
Q

What is the most common cause of urinary obstruction in baby boys?

A

Posterior Urethral Valves

18
Q

Describe Bladder Exstrophy

A

A defect causes a separation of the pubic symphysis. Mucosal edges of the bladder and distal ends of the ureters fuse with skin protruding through the lower central abdo wall.

19
Q

Ectopic Ureter (etiology, most common location)

A

Etiology: embryologic error in development
Most commonly arises from the sup. pelvic of a duplex kidney and so it inserts lower and more towards the middle of the base of the bladder

The ureter arise/insert in a weird location so it can cause hydroureter

20
Q

Describe a Ureterocele (etiology, complication, SA)

A

Cyst like enlargement of the lower end of the ureter.
Etiology: congenital or acquired stenosis of the distal ureter
Complications: hydroureter, hydronephrosis, and infection proximally), may obstruct a thing
SA: round oval thin walled cystic structure on the POSTERIOR wall of where we expect the distal ureteral orifice, can change shape/size depending on UVJ pressure

21
Q

What are the 4 types of Urachal Variants? (And which is the most common?)

A
  1. Patent urachus or fistula (most common) (hypoechoic tract superior to the bladder extending to umbilicus, may have fluid on either end)
  2. Urachal cyst (both ends close trapping urine in canal)
  3. Urachal sinus (closes at bladder but not umbilicus)
  4. Urachal diverticulum (closes at umbilicus but not bladder)
22
Q

What is an ‘embryonic tract that forms as the bladder begins its descent from the umbilicus into the pelvis in the fetus’?

A

Urachus

23
Q

What is the closed urachus referred to in adults as?

A

Median umbilical ligament

24
Q

What is Cystitis?

A

Bladder infection!!! Occurs most commonly in women due to the shorter urethra and proximity of pee hole opening near vagina and anus)

25
Q

What is reflux? Who is it most common in?

A

When the ureteropelvic junction valve preventing regurgitation back into the ureter is incompetent

Most common in male neonates and female children.

26
Q

What is reflux associated with?

A

Contralateral renal abnormalities (UPJ obstruction, duplex kidney), and a major cause of chronic renal failure with scarring and atrophy

27
Q

What are the sonographic findings for UVJ obstruction?

A

Megaureter, hydronephrosis, ectopic ureter (with or without ectopic ureterocele)

28
Q

What is a neurogenic bladder? Etiology?

A

Loss of voluntary control of voiding due to disturbance in the neural pathways.

Etioloy: neurologic diseases (MS, Parkinsons). Common in paraplegic patients.

29
Q

Does a neurogenic bladder increase the risk of UTIs?

A

Yes, due to incomplete emptying and small size of bladder

30
Q

What are the sonographic findings of a neurogenic bladder?

A

Trabeculated walls, ureterectasis, vesicoureteral reflux, hydronephrosis, bladder stones

31
Q

What is one of the most common bladder wall ultrasound findings?

A

Thickened bladder wall

32
Q

What can cause a thickened bladder wall?

A

Outlet obstruction (most common), neurogenic bladder, cystitis, radiation, swelling from adjacent inflammatory processes, neoplasms of any kind

33
Q

Bladder Flap Hematoma (SS, SA)

A

Blood can pool in the bladder flap after a C-Section.

SS: fever, mass, DROP in hematocrit
SA: complex mass with septations and debris and poorly defined borders

34
Q

_______ hematomas are anterior to the rectus muscle.

A

Superficial

35
Q

______ hematomas are posterior to the rectus muscle, typically in the prevesical space, ventral to the bladder.

A

Subfascial

36
Q

What are the common SS of bladder neoplasms?

A

Painless hematuria, dysuria, urinary frequency, urgency

37
Q

Papilloma is the forerunner of…

A

Transitional Cell Carcinoma

38
Q

Pailloma is hypoechoic or echogenic?

A

Echogenic

39
Q

A malignant primary urinary bladder shoudl be suspected is there is…

A

Focal wall thickening

40
Q

Who has the biggest risk for malignant bladder neoplasms?

A

White men and smokers

41
Q

What is the most common malignant bladder neoplasm?

A

TCC (transitional cell caricnoma)

42
Q

Where is the most common site for bladder mets?

A

Cervix (most common), uterus, prostate, and rectum.

MIDS 127 - abdo (14 decks)

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