Renal Vasculature

Question 1

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

Answer 1

Anterolateral; posterior

Question 2

What is the relationship of the LRA to the aorta?

Answer 2

Lateral or posterior

Question 3

What do the renal arteries divide into?

Answer 3

4 anterior segmental arteries, 1 posterior segmental arteries

Question 4

What are the segmental arteries?

Answer 4

4 anterior, 1 posterior

Question 5

What do the segmental arteries branch into?

Answer 5

Interlobar (medullary)

Question 6

Where are the interlobar/medullary arteries?

Answer 6

Between collecting system calyces

Question 7

What do the interlobar/medullary arteries divide into?

Answer 7

Arcuate (cortical) arteries

Question 8

Where do the interlobar/medullary arteries divide?

Answer 8

Corticomedullary junction

Question 9

What do the arcuate/cortical arteries divide into?

Answer 9

Interlobular (parenchymal) arteries

Question 10

What is the size of a normal kidney?

Answer 10

10-12 cm (as small as 8)

Question 11

What approach may be needed to visualize the LRA?

Answer 11

Coronal

Question 12

Where does the LRV pass between before entering the IVC?

Answer 12

Aorta and SMV

Question 13

What 2 vessels does the LRV receive?

Answer 13

Lt suprarenal and gonadal veins

Question 14

Which renal vein is longer?

Answer 14

LRV

Question 15

Which side is it more common to see accessory veins?

Answer 15

Right

Question 16

What is the waveform of the suprarenal aorta like?

Answer 16

Low resistance

Question 17

What is the PSV of the suprarenal aorta?

Answer 17

80-100 cm/s

Question 18

What is the waveform of the infrarenal aorta like?

Answer 18

High resistance

Question 19

What is the waveform of the main renal artery like?

Answer 19

Low resistance

Question 20

What is the PSV of the main renal artery?

Answer 20

74-127 cm/s

Question 21

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

Answer 21

<3.5

Question 22

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

Answer 22

> 180 cm/s

Question 23

What is the waveform of the segmental artery like?

Answer 23

Moderate resistance (sharp upstroke, dicrotic notch)

Question 24

What are 2 characteristics of the segmental artery waveform?

Answer 24

Dicrotic notch, early systolic peak

Question 25

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

Answer 25

<0.07 s

Question 26

What is the AT grey zone of the segmental artery?

Answer 26

0.07-0.1 s

Question 27

What is an abnormal waveform of the segmental artery like?

Answer 27

Loss of ESP, tardus parvus waveform

Question 28

What is an abnormal AT of the segmental artery?

Answer 28

>0.1 s

Question 29

What is the PSV of the interlobar/medullary arteries?

Answer 29

30-40 cm/s

Question 30

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

Answer 30

20-30 cm/s

Question 31

What is a normal end diastolic ratio?

Answer 31

>/= 0.33

Question 32

What is an abnormal diastolic end ratio?

Answer 32

<0.23

Question 33

What are the renal vein waveforms like near the IVC?

Answer 33

Pulsatile

Question 34

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

Answer 34

Phasic

Question 35

What can renal artery stenosis/occlusion cause?

Answer 35

Renal ischemia

Question 36

What can renal ischemia trigger?

Answer 36

Renin-angiotension (causes hypertension)

Question 37

What does renin-angiotensin cause?

Answer 37

Hypertension

Question 38

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

Answer 38

>50-60%

Question 39

What is renal artery stenosis often seen in?

Answer 39

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

Question 40

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

Answer 40

>3.5

Question 41

What is an abnormal AT time for renal artery stenosis?

Answer 41

>0.07 s

Question 42

What is the most correctable cause of HTN?

Answer 42

Renal artery stenosis?

Question 43

What is used to treat renal artery stenosis?

Answer 43

Stent

Question 44

What does the kidney look like with renal artery occlusion?

Answer 44

Decreased size

Question 45

What is sonographically seen with renal artery occlusion?

Answer 45

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

Question 46

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

Answer 46

Urinary tract obstruction, acute and chronic parenchymal disease

Question 47

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

Answer 47

Pain and hematuria

Question 48

What is sonographically seen with acute renal vein thrombosis?

Answer 48

Enlarged kidney with altered echogenicity, enlarged vein with absent signal

Question 49

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

Answer 49

Asymptomatic, nephrotic syndrome, hematuria

Question 50

What is nephrotic syndrome?

Answer 50

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

Question 51

What can cause the same reaction as renal vein thrombosis?

Answer 51

Extrinsic compression

Question 52

What is the most common factor of renal vein thrombosis

Answer 52

Primary renal disease

Question 53

What can cause renal vein thrombosis?

Answer 53

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

Question 54

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

Answer 54

Dehydration