Renal System Flashcards
As early as the ___ week, the kidneys begin to form. the nephrons start functioning at around ___ weeks.
third, eight
Kidney migration from the pelvis to their final location is not complete until ___ years old.
six
A normal adult kidney measures…
9-12 cm.
The parechymal volume of the ___ kidney is smaller than the ___.
right, left
The left kidney usually lies __ cm higher than the right.
1-2 cm
The vessels enter the renal pelvis in this order, anterior to posterior…
vein, artery, ureter
The adrenal gland is ___ to the right kidney.
superiormedial
The liver is ___ to the right kidney.
superiolateral
The right colic flexure is ___ to the right kidney.
inferior
The 2nd portion of the duodenum is ___ to the right kidney.
medial
The adrenal gland is ___ to the left kidney.
superior
The spleen is ___ to the left kidney.
superior
The pancreatic tail is ___ to the superior pole of the left kidney.
anterior
The left colic flexure is ___ to the left kidney.
inferior
The diaphragm is ___ to the kidneys.
posterior
The psoas and quadratus lumborum muscle are ___ to the kidneys.
posterior
The cortex is the ___echoic part of the renal parenchyma.
iso or hypo
The medullary pyramids are the ___echoic part of the renal parenchyma.
an
The renal sinus is the ___echoic part of the renal parenchyma.
hyper
This is the outer part of the renal parenchyma, from the sinus to the capsule.
renal cortex
This is the inner part of the renal parenchyma, from the base of the pyramids to the center of the kidney.
renal medulla
This is the cavity within the kidney that houses the renal pyramid.
renal sinus
These pass into the renal sinus through the hilum.
nerves and blood vessels
These appear as anechoic equally spaced triangles between the cortex and renal sinus.
medullary pyramids
This is a funnel shaped transition from the major calyces to the ureter.
renal pelvis or collecting system
This is the medial opening of the kidney, the entry/exit of the artery, vein, and ureter.
renal hilum
This is the slit-like opening in the middle of the concave medial border of the kidney.
renal hilum
These are the recesses in the internal medulla of the kidney which enclose the pyramids.
the renal calyces
This is the portion of the urinary collecting system within the kidney that unite to form the renal pelvis.
major calyx
This is the portion of the urinary collecting system that collects urine from the medullary pyramids.
minor calyces
This is the apex of the medullary pyramids.
renal papilla
This is the fibrous sheath enclosing the kidney and the adrenal glands.
gerota’s fascia
This is the functional unit of the kidney.
nephron
This consists of the renal corpuscle, proximal convoluted tubules, descending and ascending limbs of henle’s loop, distal convoluted tubules, and collecting tubules.
nephron
There are about ___ nephrons is the cortex of each kidney.
one million
This consists of the glomerulus and glomerular capsule or Bowman’s capsule.
renal corpuscle
At the renal hilum, the main renal artery divides into how many of what kind of artery?
five, segmental
At the level of the medullary pyramids, the segmental arteries divide into the ___ arteries, which run between the pyramids.
interlobar
At the base of the medullary pyramids, the ___ arteries branch in a manner that is parallel to the renal capsule.
arcuate
Branching off the arcuate arteries and running perpendicular to the renal capsule are the smallest renal arteries, called…
interlobular arteries.
T/F? Congenital anomalies of the genitourinary tract are more common than any other organ system.
true
Impaired renal function, infection, and calculus formation are complications associated with…
congenital anomalies of the genitourinary tract.
Variations of the normal genitourinary tract are…
-junctional defects -hypertrophied column of bertin -dromedary hump -ectopic kidney -horseshoe kidney -fused pelvic kidney -crossed fused renal ectopia -duplex kidney -renal agenesis -extrarenal pelvis
This is a partial fusion of two parenchymal renal masses during normal development.
junctional parenchymal defect or fetal lobulation
Sonographically, these appear as a triangular hyperechoic area anterior and superior on the right kidney.
junctional parenchymal defect or fetal lobulation
This is a normal variant located between 2 medullary pyramids that gives the appearance of a mass effect.
hypertrophied column of bertin
Sonographically, this normal variant has an echogenicity equal to the peripheral cortical tissue and may be confused with a double collecting system.
hypertrophied column of bertin
This is a normal variant of cortical thickening on the lateral aspect of the left kidney.
dromedary hump
This condition results from a failure of the kidneys to ‘ascend’ into the abdomen; there is an increased incidence of UPJ, ureteral reflux and multicystic renal dysplasia.
ectopic kidney or pelvic kidney
This is the most common renal fusion anomaly in which the lower poles typically connect across the midline anterior to the aorta.
horseshoe kidney
In this common renal fusion anomaly, the large u-shaped kidney lies in the hypogastrium because it is prevented from ascending by the IMA.
horseshoe kidney aka ‘cake’ or ‘lump’ kidney
Sonographically, the isthmus of the horseshoe kidney is frequently mistaken for ___. The ureters are typically located ___ to the isthmus.
lymphandenopathy, anterior
In this common renal variant, the upper and lower poles of pelvic kidneys fuse.
fused pelvic kidney aka ‘discoid’ or ‘pancake’ kidney
Sonographically, this common renal variant appears as a round irregular lobulated mass in the pelvis.
fused pelvic kidney
This is the 2nd most common renal fusion variant.
crossed fused ectopic kidney
In the common renal variant, the developing kidneys fuse within the pelvis and one kidney ascends to its normal position, carrying the other one with it across the midline.
crossed fused ectopic kidney
Sonographically, two kidneys are visualized on one side of the abdomen with the absence of a contralateral kidney. Ureters connect on both sides of the bladder thus one ureter crosses the midline.
crossed fused ectopic kidney
This is a common renal variant in which there’s a duplication of the collecting systems, occuring in approximately 15% of the population. May be complete (two ureters) or incomplete (one ureters).
duplex kidney
Sonographically, these kidneys look longer than normal and have a complete central cortical break within the hyperechoic sinus.
duplex kidney
With complete double ureters, the ureter draining the ___ pole typically inserts in an ectopic location in the bladder.
superior
A frequent complication of ectopic ureter is a…
ureterocele.
This is a prolapse of the distal ureter into the bladder, resulting in a hydroureter and hydronephrosis of the upper collecting system of the kidney.
ureterocele
In this common renal variant, the collecting system lies outside the renal sinus.
extrarenal pelvis
Sonographically, this appears as acystic collection medial the renal hilum.
extrarenal pelvis
This renal condition is associated with oligohydramnios and pulmonary hypoplasia and is incompatible with life.
bilateral renal agenesis
This renal condition is associated with uterine duplication (bicornuate uterus) and sminal vesicle agenesis.
unilateral renal agenesis
This is a rare renal anomaly in which a third kidney, smaller than the other two, is present.
supranumerary kidney
This renal condition is a common cause of urinary obstruction in the male neonate patient.
posterior urethral valve
This renal condition involves an abnormal congenital membrane located within the posterior male urethra that obstructs it.
posterior urethral valve
Sonographically, this appears as a VERY large bladder, hydroureter, hydronephrosis*, and dilated posterior urethra (‘keyhole’ appearance).
posterior urethral valve
Posterior urethral valves account for about ___ of all boys with end-stage renal failure.
25%
What are the two categories of renal cysts?
acquired and congenital
T/F? Simple and non-simple cysts belong to the congenital category.
false, the acquired category
T/F? Cysts that are inflammatory, hemorragic, or septated are considered simple cysts.
false, non-simple
T/F? Simple cysts are rare.
false, common
Simple renal cysts are seen more commonly over what age?
50 yo
What part of the kidney are simple cysts usually located in?
cortex
Sonographically, this appears as an echogenic material layering the the dependent portion of a renal cyst, associated with reverberation echoes without shadowing.
pyelogenic cyst or calyceal diverticulum
In this renal condition, a simple renal cyst happens to connect the renal pelvis and becomes infected, causing recurring UTIs and a predisposition for stone formationand hematuria. Loin pain in a common initial symptom.
pyelogneic cyst or calyceal diverticulum
What is a renal sinus cyst that does not connect with the collecting system called?
parapelvic cyst
When scanning a parapelvic cyst, you should use Doppler to rule out what pathology with a similar appearance?
renal artery aneurysm
Is a parapelvic cyst simple or non-simple?
simple
T/F? A parapelvic cyst with always have smooth borders.
false, can have irregular borders with a hydro-cauliflower appearance
When echoes are seen within a renal cyst, the echoes should be seen in two view to rule out what?
artifact
What are the four criteria for a cyst?
-acoustic enhancement -absence of internal echoes -sharply defined thin walls -round or oval shape
If the renal cyst has a thick septation, irregular walls, and solid components within,…
it’s an atypical cyst and suggests a malgnant lesion.
If the renal cyst has a thing septation, minimal wall calcification, no internal echoes (or just artifact),…
it’s a typical benign cyst.
Patients with ___ have increased risk of non-simple cysts and calcifications of these cysts.
polycystic disease
T/F? It is possible for a non-simple cyst to be malignant.
true
A kissing cyst is simple or non-simple?
non-simple
This adult condition is a bilateral renal enlargement caused by numerous cysts of varying sizes.
Autosomal Dominant Polycystic Kidney Disease (APKD)
In advanced APKD, destruction of renal tissue leads to…
renal failure and hypertension.
The renal disease is associated with arterial aneurysms, especially the ‘berry’ aneursyms.
APKD
This is the most common genetically determined childhood cystic disease of the kidney.
Autosomal Recessive Polycystic Kidney Disease (ARPKD)
Sonographically, this appears in the fetus as bilaterally enlarged kidneys, hyperechoic kidney parenchyma with anechoic areas within them, oligohydramnios, distended bladder, and loss of cortical medullary distinction.
ARPKD
This is the most common cause of an abdominal mass in the newborn.
multicystic dysplastic kidney (MCKD)
This renal condition can be bi- or unilateral and is usually the result of atresia of the UPJ during fetal development.
MCKD
This renal condition involves the development of cortical and medullary cysts in patients with end stage kidney disease and on dialysis from noncystic causes.
acquired cystic disease
Acquired cysts can sometimes hemorrhage resulting in…
pain and hematuria.
___ cysts can sometimes hemorrhage resulting in pain and hematuris.
acquired
Patients with acquired cystic disease have a ___ times greated risk of developing renal cell carcinoma.
100
This is a congenital dysplastic cystic dialation of the medullary pyramids due to tubular ectasia or dysplasia.
medullary sponge kidney
In this renal condition, calcium deposits form in the medullary pyramids making them hyperechoic on u/s.
medullary sponge kidney
Sonographically, this appears as equally spaced calcified renal pyramids.
medullary sponge kidney
What are the two main complications of medullary sponge kidney?
stones and infections
Medullary sponge kidney is seen mainly in what age group?
children to young adults
Patients with medullary sponge kidneys often have what other pathology?
medullary nephrocalcinosis
This is an inherited disorder of elastic connective tissue.
Ehler-Danlos syndrome
What pathology is associated with parathyroid adenoma, Caroli’s disease and Ehler-Danlos syndrome?
medullary sponge kidney
Is medullary sponge acquired or inherited?
acquired
What causes the cysts in ARPKD?
abnormal proliferation and dilation of renal tubules
ARPKD is associated with what other pathology?
hepatic fibrosis
In ADPKD, what other organs may contain cysts?
liver, pancreas, and spleen
This is an inherited disease which usually presents in the 2nd or 3rd decade of life with serious visual impairment.
Von Hippel-Landau disease
This syndrome can often have related tumors like renal cell carcinoma, pheochromocytomas, and islet cell tumors.
Von Hippel-Landau disease
Von Hippel-Landau disease can often have related tumors like…
renal cell carcinoma, pheochromocytomas, and islet cell tumors.
junctional fold defect
or
fetal lobulation
column of bertin
dromedary hump
ectopic kidney
horseshoe kidney
cross fused kidney
duplex kidney
ureterocele
extrarenal pelvis
hydronephrosis
supranumerary kidney
posterior urethral valve
renal cysts
milk of calcium cyst
peri or para pelvic cysts
hemorrhagic cyst
autosomal recessive polycystic kidney disease
ARPKD
Multicystic dysplastic kidney
MCDK
medullary sponge kidney
angiomyolipoma
RCC
RCC
RCC
Wilm’s tumor
focal acute pyelonephritis
xanthogranulomatous pyelonephritis
fetal renal artery thrombosis
acute tubular necrosis
hydronephrosis
nephrocalcinosis
nephrolithiasis
bladder diverticula
urachal cyst
transitional cell cancer
parvus tardus waveform
