Lower Urinary System Flashcards
Ureters enter the bladder at what portion?
A) Anterolateral
B) Posteroinferior
C) Anteroinferior
D) Posterolateral
B - posteroinferior
What is the medical term for voiding the bladder?
Micturition
What muscle is responsible for squeezing urine out of the bladder?
Detrusor
What are the two types of urinary retention?
- Obstructive - due to kidney stones or something causing a blockage
- Non-obstructive - disconnect between the bladder and brain - neurological or pelvic injury
What is normal bladder thickness when fully distended and when empty?
Fully distended = <3mm
Empty = <5mm
What is the most common bladder outlet obstruction?
PUV - most common cause of urinary obstruction in male infants
Can cause vesicoureteral reflux
What is the typical ultrasound feature of PUV?
Key hole sign
What abnormality causes urine to spurt onto abdominal wall from the ureteral orfices?
Bladder exstrophy - bladder protrudes out of abdominal wall - typically accompanied by hydronephrosis
What pathology is known as a cyst-like enlargement of the lower end of the ureter?
Ureterocele - round or oval thin walled cystic structure on posterior wall
What is the most common urachal variant?
Patent urachus/fistula
What are the 4 kinds of urachal variants?
- Patent urachus - it is completely open between the umbilicus and bladder - urine drains from umbilicus
- Urachal cyst - both end close causing urine to be trapped in the canal
- Urachal sinus - urachus closes at bladder but not at umbilicus
- Urachal diverticulum - urachus closes at umbilicus but not at bladder
What urachal variant can cause a palpable mass/fever/dysuria?
Urachal cyst
What is the most common cause of cystitis?
E coli.
If you see a calcification in the bladder, what are your next steps?
Turn patient LLD to determine if stone moves
What SF might you see if you have a UVJ obstruction?
Megaureter
Hydro
What pathology is known as the loss of the voluntary control of voiding due to disturbance in the neural pathways?
Neurogenic bladder
SF of neurogenic bladder?
- Trabeculated walls
- Hydro
- Bladder calculi
- Ectasia of ureter
- VUR
Patient presents with a fever and dropping hematocrit. When obtaining her history, you learn she has had a C-section. On ultrasound you see an avascular fluid collection posterior to the rectus muscle. What is the likely diagnosis?
Bladder flap hematoma
What is the most common bladder malignancy?
TCC - most common in smoking, caucasian men
What is the most common micturition abnormality?
Stress incontinence
How many ounces of water are patients asked to drink 1 hour before exam?
16
When scanning the bladder, you see an echogenic circle within the bladder lumen. What might be the most common finding?
A) Ureterocele
B) Urachal cyst
C) Patent urachus
D) Catheter
D - catheter will be a round circle
What abnormality is known as a cyst-like enlargement of the lower end of the ureter?
Ureterocele
A closed urachus is referred to what umbilical ligament in adults?
A) Medial
B) Median
C) Transverse
D) Sigmoid
B
Urachal variants may form due to what kind of neoplasm?
A) mucinous adenocarcinoma
B) cystic adenocarcinoma
C) Lymphoma
D) Sarcoma
A
What urachal variant has adenocarcinoma as a complication?
A) Urachal cyst
B) Patent urachus
C) Urachal sinus
D) Urachal diverticulum
A
What urachal variant closes at the umbilicus but not the bladder?
A) Urachal cyst
B) Patent urachus
C) Urachal sinus
D) Urachal diverticulum
D
Does an overactive bladder in neurogenic bladder cause the bladder to become large or small over time?
Small - since the bladder is overactive and is constantly releasing urine, it will not be able to hold as much and become small over time
What urachal variant closes at the bladder but not the umbilicus?
A) Urachal cyst
B) Patent urachus
C) Urachal sinus
D) Urachal diverticulum
C
What will you NOT see as a sonographic feature of neurogenic bladder?
A) Smooth walls
B) Ureterectasis
C) VUR
D) Hydronephrosis
E) Bladder calculi
A - it has trabeculated walls
What is the forerunner of a bladder Papilloma?
A) SCC
B) Lipoma
C) TCC
D) Adenocarcinoma
C
