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Normal > Midterm 2 > Flashcards

Midterm 2 Flashcards

1
Q

What layers of kidneys accommodate movement during respiration

A

Peri

Para

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2
Q

Anterior pararenal

A

Posterior peritoneum to gerotas fascia

Holds panc colon CBD SMV

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3
Q

Perirenal space

A

Space between gerotas fascia and posterior pararenal

Contains kidneys aorta ivc

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4
Q

Posterior pararenal

A

Space between gerotas fascia and post abdo wall

Psoas and QL

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5
Q

What comes out of hilum

A

Blood vessels and ureter

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6
Q

Kidney vascularity

A 
Renal
Segmental
Lobar
Interlobar
Arcuate
Interlobular
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7
Q

Kidney average size

A

11 cm

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8
Q

What aspect of the kidney decreases with age. What is it called?

A

Cortex

Parenchymal reduction

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9
Q

Parts of kidney hypo to hyper

A

Medullary pyramids
Cortex
Sinus & capsule

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10
Q

Hypo to hyper abdo organs

A

Kidney
Liver
Spleen

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11
Q

Mid sag kidney you’ll see mostly what

A

Most pyramids

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12
Q

Sag kidney layer will see

A

Kidney lateral cortex a bit of sinus

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13
Q

Renal function (3)

A

Urine formation
Homeostasis
Endocrine

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14
Q

Nephron is located in the

A

Cortex and medulla

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15
Q

Two types of nephrons

A

Cortical nephron - shorter LoH

Juxtamedullary nephron - longer LoH

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16
Q

Three sets of kidneys in embryo

A

Pronephroni
Mesonsphori
Metanephori - permanent kidneys

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17
Q

Ureter size

A

25-30 cm

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18
Q

Three layers of ureters

A
  1. Inner mucosal
  2. Medial smooth
  3. Fibrous outer
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19
Q

Proximal ureter

A

UPJ

Uteropelvic junction

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20
Q

Distal ureter

A

UVJ

ureterovesicle junction

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21
Q

Kidney normal variants

A 
Dromedary hump
Hypertrophied column of Bertin 
Double collecting system 
Horseshoe kidney 
Renal ectopia
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22
Q

In trans the bladder is what shaped

A

Square with curved edges

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23
Q

In sag the bladder is what shaped

A

Triangular

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24
Q

Specular reflector occurs with what organ

A

Bladder

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25
Q

How to calculate volume of kidneys

A

(L * w * h) * 0.523

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26
Q

How to measure length of kidney

A

In sag, diagonally

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27
Q

How to measure the height of the kidney

A

In trans, AP

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28
Q

How to measure width of kidney

A

In trans, right to left

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29
Q

Most common artifact in bladder

A

Reverberation

Mostly in near field (anterior)

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30
Q

How do you fix reverberation artifact in the bladder

A

Fix gains

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31
Q

Congenital anomalies of urinary tract related to growth (3)

A

Hypoplasia
Fetal lobulation
Compensatory hypertrophy

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32
Q

Congenital anomalies of urinary tract related to ascent (3)

A

Ectopia
Crossed renal ectopia
Horseshoe

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33
Q

Congenital anomalies of urinary tract related to Ureteral bud (6)

A 
Agenesis
UPJ obstruction
Supernumerary kidney
Duplex collecting system 
Congenital megacalices
Congenital megaureter
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34
Q

Congenital anomalies of urinary tract related to vascular development (2)

A

Retrocaval ureter

Aberrant vessels

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35
Q

Congenital anomalies of urinary tract related to bladder development

A

Bladder agenesis
Bladder duplication
Bladder exstrophy
Urachal anomalies

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36
Q

Congenital anomalies of urinary tract related to urethral development (1)

A

Diverticula

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37
Q

The displacement of one kidney to the other side - name and type of anomaly

A

Crossed renal ectopia

Ascent

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38
Q

Fetal lobulation - what is it and type of anomaly

A

Smooth indentations

Growth

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39
Q

An extra, small kidney - name and type of anomaly

A

Supernumerary kidney, ureteral bud

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40
Q

True or false :

Left kidney moving to right is more common

A

True

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41
Q

Three types of bladder duplication

A

Peritoneal fold
Internal septum
Transverse band

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42
Q

Name when bladder is outside the body, inside out

A

Bladder extrophy

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43
Q

Urethral diverticulum - what is it and what anomaly is it assoc with

A

Pocket out pouching forms next to urethra and connects to urethra

Anomalies related to urethral development

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44
Q

Urachal anomalies - what is it, name 4 and what type of anomaly is it related to

A

Remnant is the channel between bladder and umbilicus

  1. Patent urachus
  2. Urachal cyst
  3. Urachal sinus
  4. Diverticulum
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45
Q

True or false:
Congenital megaureter is most common in males and left more common

What anomaly is congenital megaureter associated with

A

True

Ureteral bud

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46
Q

What anomaly looks like a bear paw

A

Ureteropelvic junction obstruction

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47
Q

Congenital abnormality found is distal ureter that balloons at UVJ forming sac

A

Ureterocele

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48
Q

Compensatory hypertrophy

A

One kidney gets larger to compensate for the other which is smaller

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49
Q

Ectopia is related to what type of anomaly

A

Ascent

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50
Q

Horseshoe kidney is what type of anomaly

A

Ascent

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51
Q

Ureter behind ivc before entering pelvis - name and type of anomaly

A

Retrocaval and vascular development

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52
Q

Fill bladder how much before US

A

24-32 oz

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53
Q

Women’s bladder location

A

Anterior to vag

Anterior / inferior to uterus

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54
Q

Trigone

A

Two ureters

Urethral opening

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55
Q

The adrenal cortex is what kind of tissue

A

Endocrine (corticosteroids)

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56
Q

The adrenal medulla is what kind of tissue

A

Neurosecretory (catecholamines)

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57
Q

Function of adrenal glands (3)

A

Homeostasis
Salt water balance
Fight or flight

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58
Q

Lab tests for adrenal (2)

A

Aldosterone

Cortisol

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59
Q

What lab test may indicate problems with adrenal glands

A

Cortisol

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60
Q

Normal Sono appearance of adrenal gland

A

Thin hypoechoic layers separated by hyperechoic layers

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61
Q

Spleen location

A

LUQ

left hypochondrium

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62
Q

Is the spleen intra or retroperitoneal

A

Intraperitoneal

63
Q

The kidneys and adrenal glands are intra or retroperitoneal

A

Retroperitoneal

64
Q

Is the bladder retro or intraperitoneal

A

Retroperitoneal

65
Q

The spleen has smooth borders where ?

A

Superior
Posterior
Lateral
(Where contacts the diaphragm)

66
Q

Where does the spleen have gentle indentations

A

Medial

67
Q

What is the spleen composed of

A

White and red pulp

68
Q

What are the spleen ligaments (3)

A

Gastrosplenic ligament
Phrenicocolic ligament
Splenorenal ligaments

Ligaments not normally seen unless ascites

69
Q

Spleen function

A 
Immunity 
Tissue repair
Hematopoiesis 
Blood cell destruction
Blood reservoir
70
Q

Spleen average size

A

8 to 13 cm length
5 cm width
7 cm AP

71
Q

Spleen volume

A

60 to 200 ml

72
Q

True or false

It is normal to see calcified splenic artery as patient ages

A

True

73
Q

Difficulty scanning spleen

A

Lung

Intercostal

74
Q

Other helpful imaging modalities for spleen

A

CT/MRI

75
Q

The spleen arises from what kind of cells

A

Mesenchymal cells

76
Q

Spleen embryology : base of the dorsal mesentery fused with the _____

A

Base of dorsal mesentery fuses with posterior peritoneum

77
Q

Normal variants of spleen associated with number (3)

A

Accessory spleen (splenule)
Asplenia
Polysplenia

78
Q

Normal variants of spleen associated with location (2)

A

Wandering spleen

Ectopic

79
Q

Most common normal variant of spleen, describe

A

Splenule / accessory spleen

Isoechoic homogenous mass similar to spleen typically found at hilum or inferior border of the spleen

80
Q

How many lymph nodes

A

500-600 LN

81
Q

Typical locations find clusters of LN

A 
Axillary
Neck
Inguinal 
Thorax 
Abdo
82
Q

LN function (3)

A

Fluid from interstitial to venous
Absorb fat from SI to liver
Immune response

83
Q

What are the only abdo LN locations you can see if small patient and a good scan (2)

A

Panc liver

84
Q

Abdo LN sites

A 
Great vessels
Panc
Liver
Kidney 
Mesenteric region

(Order we learned structures)

85
Q

LN size

A

<1 cm in abdo

86
Q

Is the width, length or AP smallest in a LN

A

AP

87
Q

LN sono appearance what is hypo what is hyper

A

Cortex is hypo

hilum is hyper

88
Q

Hypertrophied column of bertin - what is it, where is it typically located

A

Prominent renal column extending into the sinus. Upper 2/3 of the kidney

89
Q

Junctional cortical defect is what organ variant, explain, where is it located

A

Site of failed fusion in the kidney

Anteriorly and superiorly

90
Q

Junctional cortical defect- Best seen in which plane and which kidney

A

Sag right kidney

91
Q

Extra renal pelvis - explain anomaly and best seen

A

Dilated UPJ, medial to hilum

Best seen in transverse

92
Q

Dromedary hump usually _____ kidney, best seen in _____

A

Dromedary hump usually left kidney, best in sagittal

93
Q

The renal sinus is what to the renal cortex

A

Hyperechoic

94
Q

What is the name of the parenchyma located between the pyramids

A

Renal column

95
Q

What normal variant is best seen is Sag and most often affects the left kidney

A

Dromedary hump

96
Q

What is the name of the permanent kidneys

A

Metanephori

97
Q

Name two causes of bladder duplication

A

Septation

Fold in rugae wall

98
Q

Name the two junctions of the ureters and what they stand for

A

UPJ ureteropelvic junction

UVJ ureterovesical junction

99
Q

At what level and aspect do the ureters insert into the plaster

A

Trigone posteriorly

100
Q

What anomaly is seen as a sac like structure in the bladder and what renal variant is it associated with

A

Ureterocele, duplex collecting system

101
Q

What are the two features of a normal LN

A

Oval, fatty hilum

102
Q

Two challenges when scanning the spleen

A

Ribs

Lung

103
Q

What would cause a hypoechoic structure superior to the spleen in sag

A

Long left lobe liver

104
Q

What two tests are most commonly done for the prostate

A

DRE

PSA

105
Q

Average volume of prostate

A

24 cc

106
Q

Zone with least clinical significance

A

Fibromuscular region

107
Q

Which two zones cannot be differentiated using TRUS

A

Central and transitional

108
Q

At which zone and level do the ejaculatory ducts enter the prostate

A

Central, base

109
Q

One variant associated with growth of kidney

A

Hypoplasia
Lobulation
Hypertrophy

110
Q

Name two variants associated with ascent of kidney

A

Ectopia
Cross renal ectopia
Horseshoe

111
Q

Name three variants associated with number of spleens

A

Asplenia
Accessory spleen (splenule)
Polysplenia

112
Q

Name three variants associated with bladder development

A

Bladder agenesis
Bladder duplication
Bladder exstrophy
Urachal anomalies

113
Q

Name four variants associated with Ureteral bud

A 
Renal agenesis
UPJ obstruction
Supernumerary kidney
Duplex collecting system
Congenital megaxixes
Congenital megaureter
114
Q

Kidney lab tests

A

Creatinine

BUN

115
Q

Transient pyelectasus what is it ? When is it not normal

A

Considered normal
Patient is well hydrated
Resolve by emptying bladder

Calyces and pyramids more anechoic

116
Q

Ureterocele

A

Distal ureter balloons at UVJ assoc with duplex collecting system

117
Q

Causes of bladder duplication (3)

A

Peritoneal fold
Internal septum
Transverse band

118
Q

Urachal anomalies (4)

A

Patent urachus
Urachal cyst
Urachal sinus
Diverticulum

119
Q

The seminal vesicles are ______ to the vas d/ureter and ______ to prostate

A

Seminal vesicles are inferior to vas def and ureter

And superior to prostate

120
Q

The base of the prostate is positioned ______, while the apex is ______

A

Superior - base

Inferior - apex

121
Q

Semen transport

A 
Epididymus 
Vas deferens
Seminal vesicles
Ejaculatory duct
Urethra
122
Q

Urethra travels

A

Bladder prostate penis

123
Q

Prostate blood supply

A

Prostaticovesical arteries
Inferior vesical artery
Prostatic artery

124
Q

Two regions of prostate and where

A
  1. Fibromuscular - anterior

2. Glandular - posterior

125
Q

Cancer location most to least likely

A

Peripheral (70%)
Transitional (20%)
Central (5%)

126
Q

What zone do the seminal vesicles and vas def enter

A

Central

127
Q

Seminal vesicles are located at the ______ of the prostate

A

Base

128
Q

Name the structure that divides the prostate into prox /distal or anterior/posterior

A

Verumontanum

129
Q

What zone lines the proximal prostatic urethra

A

Periurethral glandular zone

130
Q

Two main methods to screen for prostate cancer

A

DRE

PSA

131
Q

Why is using PSA as a marker for cancer not ideal. What can help?

A

Normal PSA does not necessarily exclude cancer and increased PSA does not mean cancer

PSA density may help with confusion
PSA/volume (PSAd)

132
Q

Normal PSA level

A

<1.5 ng/mL

133
Q

What anatomy is assessed for male pelvis US

A

Prostate
Seminal vesicles
Bladder

134
Q

Transabdominal US is good for / is limited to

A

Gross prostate + bladder eval

Limited to prostate size weight shape

135
Q

Almost all cancer is _____ aspect of prostate - can you visualize?

A

Posterior aspect, not visualized

136
Q

TRUS is imaged through

What’s the patient prep?

A

Full bladder

Pt drinks 20-32 oz water

137
Q

At what level do the ejaculatory ducts meet the urethra in the prostate

A

Verumontam

138
Q

Protocol for bladder volumes

A

Pre and post void volumes

139
Q

Major reasons for TRUS (3)

A

Prostate evaluation
Biopsy
Guidance therapeutic procedures

140
Q

TRUS patient position

A

Left lateral decubitus

Legs together bent up

141
Q

Transrectal probe frequency

A

7-11 MHz

142
Q

Urethra located where (apex or base)

A

Apex

143
Q

Are you able to distinguish the 4 zones of the prostate? Why/why not

A

No

Similar echotexthre

144
Q

Prostate anatomy is divided into two “glands” what are they and what’s another name for them

A

Inner gland “central”

Outer gland “peripheral”

145
Q

What is the central/inner gland comprised of (3)

A

Transitional zone
Anterior fibromuscular galndular
Internal urethra sphincter

146
Q

What is the outer gland /peripheral comprised of (2)

A

Central and peripheral zone

147
Q

Sonographic appearance of the central/inner

A

Hypoechoic

Heterogeneous

148
Q

Sonographic appearance of the peripheral/outer

A

Hyperechoic

Homogenous

149
Q

Prostate volume can be converted to weight

A

True

150
Q

Structure that separates outer and inner gland

A

Surgical capsule

151
Q

The interface between prostate and periprostatic fat

A

Prostate capsule

152
Q

Sono appearance of seminal v and vas d

A

Seminal v are hypoechoic and multi septated

Vas d are more hypoechoic to seminal v and more medial

153
Q

Normal variants for prostate (3)

A

Benign ductal ectasia
Prostatic calcification
Corpora amylacea

Normal (2 decks)

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