Mod 6-3 Renal Anomalies Flashcards
How many people are affected by urinary tract infections, kidney stones and obstructive processes?
Milliions
Why are there routine urinary tract examinations done each year?
Because of the lower cost of doing an IVP or cystogram compared to CT or MRI
What is Agenesis?
A Congnital absence of an organ.
List characteristics of kidney agenesis.
- Relatively uncommon
- Incompatible with life
- Usually encountered with stillborn infants
- Associated with variety of congenital abnormalities including limb defects and under-developed lungs.
List characteristics of unilateral kidney agenisis.
- Usually asymptomatic
- 2 times as common as bilateral agenesis
- Most common in males
- Kidney present is usually hyperplastic (increase in organic tissue, overgrowth)
What is supernumerary kidney?
A third, small kidney wtih a separate excretory system and its own blood supply.
What is hypoplastic kidney?
A small, usually fully functioning kidney that has failed to develop to its normal size.
*Not atrophic kidney
Can hypoplastic kidney develop bilaterally?
Yes, and can result in renal failure in children.
Is hypoplasia more common unilaterally or bilaterally?
Most commonly unilaterally.
What is compensatory hypertrophy?
An acquired condition in which one kidney is required to do the work of two and it becomes enlarged.
What is malrotation?
When the kidney is rotated more or less than a normal amount and a pathology of some sort is suspected as the cause.
*The kidney may be normal
What is an ectopic kidney?
One that does not rise into its normal position during fetal development - it is abnormally located, and usually fully functional.
Where might an ectopic kidney be located in the body?
- Just above the pelvic brim
- Within the pelvis
- Above the diaphragm
Ectopic kidneys are of ______ size but occasionally are somwhat _____ and the ____ kidney appears to be more frequently affected than the right.
normal; smaller; left;
The ectopia may be crossed or uncrossed???
Research this
What will the length of the ureter be for the pelvic kidney?
Appropriate for the placement of the kidney
What can happen as a result of an ectopic kidney?
- The ureter may be kinked or twisted as a result of hte kidneys position and lead to an obstruction to the flow of urine
- Also an increased risk of trauma without the protection of the ribs and overlying soft tissue structures
What is crossed ectopia?
Both kidneys lie on the same side with the ectopic kidney somtimes fused to the normal kidney.
What is the position of the ectopoic crossed kidney ureter?
It will cross midline to insert into the proper position in the trigone of the bladder.
What other anomalies are associated with crossed fused ectopia?
- Anorectal malformation (anus and rectum do not develop properly)
- Meningomyelocele (form of spina bifida in which back bone and spinal canal do not close before birth)
What is the most common fusion abnormality?
Horseshoe kidney
What is a horseshoe kidney?
Where the lower poles of the kidney are usually joined and the kidneys are malrotated so the pelves face forward and the lwoer calyces point medially.
How can horseshoe kidneys be seen?
On plain radiographs of the abdomen and IVP
With a horseshoe kidney the pelves face ______ and the lower calyces point ______.
forward; medially
What is one of the most frequent congenital anomalies of the urinary tract?
Duplication (duplex kidney) of the collecting system.
What different forms can the duplication of the collecting system come?
- Divided or bifid renal pelvis
- Complete double pelvis, ureter and ureteovesicle orifice.
What is a bifid ureter?
Two ureters rising from the pelvis of the kidney joining together lower in the abdomen.
What are some complications that can arise from bifid ureters or duplication of the collecting system?
- Reflux
- Infection
What is the effect on radiographic technique from duplication of the collecting system?
There is none
