Renal Flashcards
What is the normal size of the adult kidney?
10-12 cm L
5 cm W
3 cm T
What are the three structures found in the renal hilum?
Renal artery
Renal vein
Proximal ureter
Are the ureters typically seen on ultrasound?
No, only when dilated
What is the anatomic relationship between the spleen and the left kidney?
The spleen is located anterior to the upper pole of the left kidney
They are connected by splenorenal ligaments
What kind of organs are the kidneys?
Retroperitoneal
What are the physiological functions of the kidneys?
Filtration and excretion of metabolic waste
Electrolyte regulation
Fluid-acid base balance
Blood pressure regulation w/ RAAS
Hormonal functions by erythropoietin, calcitrol, vitamin D
What percentage of cardiac output do the kidneys receive?
20%
What level do the renal arteries branch off the aorta?
Level of L2 vertebra
Just inferior to SMA
What is the normal sonographic appearance of the renal pyramids?
Anechoic in hydrated pt
Echogenicity depends on hydration
Renal pelvis filled with urine is anechoic
What would the sonographer try when scanning kidneys?
Multiple imaging windows
One will have superior quality
Why is it important to scan through the entire kidney (top to bottom, side to side)?
We avoid missing small cysts, stones, or other pathologies
Won’t forget a portion
What are two commonly encountered impediments when scanning the kidneys?
Rib shadows and bowel gas
How does a kidney appear in cross section?
Round, with C for mid
Superior to inferior
What enhances bladder visualization?
If it is full
How is the bladder shaped?
Highly distensible
Varies when empty/full
What are the parts of the kidney?
Capsule Cortex Pyramids Sinus Pelvis
What is the transverse bladder shaped like?
Rectangle
What serves as an acoustic window for the right kidney?
Liver
How should the kidney be scanned?
In two orthogonal planes
In long and short axes
What kind of transducer is used for kidney imaging?
Curvillinear
What is the best patient positioning for RT kidney?
Supine
LLD
Where are the renal cortex and medulla?
Cortex is outside - hyperechoic
Medulla is inside - hypoechoic
Which kidney is more superior?
Left
Do the kidney axes line up with the body axes?
No
Why is the left kidney more difficult to scan?
More sup than RT
Spleen is smaller acoustic window
Oblique plane
Is it easy to visualize ureteral stones?
No
