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VASC 4 > Renal Vasculature > Flashcards

Renal Vasculature Flashcards

1
Q

What is the relationship of the RRA to the aorta? IVC?

A

Anterolateral; posterior

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2
Q

What is the relationship of the LRA to the aorta?

A

Lateral or posterior

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3
Q

What do the renal arteries divide into?

A

4 anterior segmental arteries, 1 posterior segmental arteries

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4
Q

What are the segmental arteries?

A

4 anterior, 1 posterior

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5
Q

What do the segmental arteries branch into?

A

Interlobar (medullary)

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6
Q

Where are the interlobar/medullary arteries?

A

Between collecting system calyces

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7
Q

What do the interlobar/medullary arteries divide into?

A

Arcuate (cortical) arteries

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8
Q

Where do the interlobar/medullary arteries divide?

A

Corticomedullary junction

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9
Q

What do the arcuate/cortical arteries divide into?

A

Interlobular (parenchymal) arteries

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10
Q

What is the size of a normal kidney?

A

10-12 cm (as small as 8)

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11
Q

What approach may be needed to visualize the LRA?

A

Coronal

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12
Q

Where does the LRV pass between before entering the IVC?

A

Aorta and SMV

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13
Q

What 2 vessels does the LRV receive?

A

Lt suprarenal and gonadal veins

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14
Q

Which renal vein is longer?

A

LRV

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15
Q

Which side is it more common to see accessory veins?

A

Right

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16
Q

What is the waveform of the suprarenal aorta like?

A

Low resistance

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17
Q

What is the PSV of the suprarenal aorta?

A

80-100 cm/s

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18
Q

What is the waveform of the infrarenal aorta like?

A

High resistance

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19
Q

What is the waveform of the main renal artery like?

A

Low resistance

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20
Q

What is the PSV of the main renal artery?

A

74-127 cm/s

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21
Q

What is the normal RA(PSV)/Ao(PSV) ratio?

A

<3.5

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22
Q

What is PSV indicates stenosis >/= 60% in the main renal artery?

A

> 180 cm/s

23
Q

What is the waveform of the segmental artery like?

A

Moderate resistance (sharp upstroke, dicrotic notch)

24
Q

What are 2 characteristics of the segmental artery waveform?

A

Dicrotic notch, early systolic peak

25
Q

What is a normal acceleration time (AT) of the segmental artery?

A

<0.07 s

26
Q

What is the AT grey zone of the segmental artery?

A

0.07-0.1 s

27
Q

What is an abnormal waveform of the segmental artery like?

A

Loss of ESP, tardus parvus waveform

28
Q

What is an abnormal AT of the segmental artery?

A

> 0.1 s

29
Q

What is the PSV of the interlobar/medullary arteries?

A

30-40 cm/s

30
Q

What is the velocity of the arcuate/cortical and interlobular/parenchymal arteries?

A

20-30 cm/s

31
Q

What is a normal end diastolic ratio?

A

> /= 0.33

32
Q

What is an abnormal diastolic end ratio?

A

<0.23

33
Q

What are the renal vein waveforms like near the IVC?

A

Pulsatile

34
Q

What is the renal vein waveform like distal to the IVC?

A

Phasic

35
Q

What can renal artery stenosis/occlusion cause?

A

Renal ischemia

36
Q

What can renal ischemia trigger?

A

Renin-angiotension (causes hypertension)

37
Q

What does renin-angiotensin cause?

A

Hypertension

38
Q

What is considered a hemodynamically significant diameter reduction for a renal artery stenosis?

A

> 50-60%

39
Q

What is renal artery stenosis often seen in?

A

Young patients with HTN, patients with accelerating or uncontrollable HTN, patients with renal insufficiency and discrepancy kidney size

40
Q

What is an abnormal RA(PSV)/Ao(PSV) ratio?

A

> 3.5

41
Q

What is an abnormal AT time for renal artery stenosis?

A

> 0.07 s

42
Q

What is the most correctable cause of HTN?

A

Renal artery stenosis?

43
Q

What is used to treat renal artery stenosis?

A

Stent

44
Q

What does the kidney look like with renal artery occlusion?

A

Decreased size

45
Q

What is sonographically seen with renal artery occlusion?

A

No main artery visualized or absent or low blood flow (tardus parvus)

46
Q

What other conditions can cause an increased resistance w/in the kidney?

A

Urinary tract obstruction, acute and chronic parenchymal disease

47
Q

What does the patient clinically present with for acute renal vein thrombosis?

A

Pain and hematuria

48
Q

What is sonographically seen with acute renal vein thrombosis?

A

Enlarged kidney with altered echogenicity, enlarged vein with absent signal

49
Q

What does the patient clinically present with for chronic renal vein thrombosis?

A

Asymptomatic, nephrotic syndrome, hematuria

50
Q

What is nephrotic syndrome?

A

Proteinuria, foamy urine, swelling or edema, weight gain, fatigue, loss of appetite

51
Q

What can cause the same reaction as renal vein thrombosis?

A

Extrinsic compression

52
Q

What is the most common factor of renal vein thrombosis

A

Primary renal disease

53
Q

What can cause renal vein thrombosis?

A

Hypercoaguable states, renal, IVC, or ovarian tumor thrombus, abdominal surgery, trauma, dehydration

54
Q

What is the most common cause of renal vein thrombosis in children?

A

Dehydration

VASC 4 (6 decks)

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