Renal retro test review Flashcards
UPJ obstruction
(Ureteropelvic junction)- This is called a congenital condition (present from birth). The blockage is caused when there is a narrowing of area between the ureter and the part of the kidney called the renal pelvis. Urine can build up and damage the kidney as a result.
Ureterocele
a swelling at the bottom of one of the tubes (ureters) that carry urine from the kidney to the bladder. The swollen area can block urine flow.
PUV
posterior urethral valve is an obstructing membrane in the posterior male urethra as a result of abnormal in utero development (keyhole bladder)
Bladder diverticulum
an area of weakness in the bladder wall through which some of the lining of the bladder is forced out and creates a pouch where urine can collect and may not come out.
Common normal variants
column of bertin dromedary hump, junctional parenchymal defect, fetal lobulation, lobar dysmorphism, duplex collecting system, bifid renal pelvis (incomplete duplex), extrarenal pelvis, horseshoe kidney
Echogenicity of the kidney cortex
Cortex- darker than the inner medulla because of the increased perfusion of blood.
Echogenicity of the kidney sinus
echogenic an intense area of echoes.
Echogenicity of the kidney Medullary and pyramids
hypoechoic calyces is anexchoic when dilated such as hydronephrosis-otherwise not seen
Most common pediatric renal mass
Nephroblastoma aka wilms tumor. Most common tumor age 1-8, 90 % found under 5 years old. 2-8 times higher found in horseshoe kidneys. Clinically presents as flak mass, hematuria, fever, and anorexia
location of renal cysts/prevalence
Exophtic: cyst projects outward away from the kidney,
Cortical: lies within renal cortex,
Parapelvic: originates in renal parenchyma and protrude into renal sinus,
Peripelvic: originates in the renal sinus, 50% 50 years of age
(renal path slide 4-5)
Flow of urine
nephron-collecting duct-minor calyces-major calyces-renal pelvis-ureter-bladder-urethra
(slide 13)
Location of kidneys
in the retroperitoneal cavity, on both the right and left sides of the body
Neuroblastoma
(slide 30-31 pg 457)
a.50% arise from the adrenal medulla, and tumors have been found in the neck, mediastinum, retrperitoneum, and pelvis,
b. Clinical symptoms, depend on location of tumor. If adrenal- enlarged abdomen,HTN,diarrhea,bone pain if metastasized,
c. 2nd most common abdominal tumor in childhood, Arises in the sympathetic chain ganglia and adrenal medulla,
d. Normally seen between 2 months to 2 years,
e. Neuroblastoma-common in children < 5 years old. Weight loss, decrease in energy, abd protusion,fever. Rapid metastasis to the lymph nodes, lungs, bone and liver
Metastasis to the adrenal glands come from what primary tumors
(slide 26 pg, pg 455) lung 33%, breast 30%, melanoma, gastric, colon, kidney, thyroid
Hormones of the adrenal glands
Sex hormone (Androgen-male sex hormone. Estrogen-female sex hormone)
epinephrine and norepinephrine
Aldosterone
Cortisol
Sex hormone
Androgen-male sex hormone. Estrogen-female sex hormone. Secretes both regardless of gender. Secreted in minute quantities, almost insignificant effects. Controlled by ACTH from the pituitary gland. Hypofunction is termed Addison’s Disease.
epinephrine and norepinephrine
Responsible for flight or fight- pg 448 Adrenal Medulla produces them Both hormones are amines, referred to as catecholamines.
Aldosterone
Steroid hormone (mineralcorticoid) produced by outer section of adrenal cortex in the adrenal gland. Excessive secretion (Conn’s Syndrome-aldosteronism) due to adenoma of glomerulosa cells or less common adrenal hyperplasia or adrenal carcinoma.
Cortisol
Steroid hormone (glucocorticoid) produced by zona fasciculate of adrenal cortex. Excessive secretion of cortisol (cushing’s syndrome) normally from an adenoma or carcinoma of the adrenal gland or a pituitary tumor.
R. Renal artery
arises from the posterolateral wall of the aorta, travels POSTERIOR to the IVC to supply the Kidney
L. Renal artery
arises from the posterolateral wall of the aorta DIRECTLY into the hilus of the kidney.
R. Renal vein
leaves the renal hilus to enter the lateral wall go the IVC. Shorter than L. Renal vein
L. Renal vein
leaves the hilum , travels anterior to the aorta and posterior to the SMA to enter the lateral wall of the IVC.
Vascular supply to kidney
Aorta- renal arteries - segmental- interlobar – Arcuate
Blood supply to nephrons
Renal arteries- afferent arteriole - Bowmans capsule- Glomerulus- efferent arteriole - renal veins Cleaned blood back into the circulatory system.
Most common location for kidney stone to be found
ureterovesical junction
Staghorn calculus
stone that fills entire kidney lots of shadowing pg 402
Renal fungal infections Most commonly affects patients
Immunocompromised
Diabetis mellitus
drug abusers
Infants with longstanding indwelling catheters
Renal fungal infections, Most common form of fungal urinary tract infection is……
Candida albicans
Renal fungal infections, Clinical symptoms
Flank pain
Fever
Chills
Renal fungal infections, Sonographic findings
ungal balls will be echogenic,
mobile,
nonshadowing structures within the renal collecting system
column of bertin
location-medulla
indention of the renal sinus
similar to renal parenchyma and contiguous with cortex
dromedary hump
location-lateral border of the kidney
identical to renal cortex
junctional parenchymal defect
location-upper pole of renal parenchyma
echogenic triangular area
best seen in sagittal scan
fetal lobulation
location-surface of kidney
indentations between the calyces
best seen on sagittal scan
lobar dysmorphism
location-middle and upper calyces
elongation of upper and middle calyces
best seen on sagittal scan
duplex collecting (complete) system
location-central renal sinus
two echogenic regions separated by moderately echogenic parenchymal tissue
best seen on sagittal scan
bifid renal pelvis (incomplete duplication)
location- central renal sinus
middle calyces, two echogenic regions
one ureter entering the bladder on each side of the bladder
extrarenal pelvis
location-long renal pelvis that extends outside the renal bladder
central cystic region that extends beyond medial renal border
best seen on transverse view at the level of the midpole
horseshoe kidney
location-kidneys seen more medial anterior to the spine
fusion of the polar region, usually the lower poles
Lab tests that indicate renal failure
Urinalysis, Urine pH, Specific Gravity, Blood, Hematocrit, Hemoglobin, Protein, Creatinine Clearance, Blood Urea Nitrogen (BUN), Serum Creatinine
