Renals A&P

Question 1

location of the kidneys?

Answer 1

retroperitoneal
flank region
either side of the spine

Question 2

size of a normal kidney? (SAG, TRV, AP)

Answer 2

11-13 cm SAG
5-7 cm TRV
2-3 cm AP

Question 3

what is the true capsule?

Answer 3

the capsule surrounding the kidneys. AKA renal capsule

Question 4

what is the fibrous sheath surrounding kidneys, adrenals, and perinephric fat?

Answer 4

gerota’s fascia

Question 5

what muscles are both kidneys anterior to?

Answer 5

kidneys are ANT to psoas & quadratus lumborum muscles

Question 6

which kidney is lower?

Answer 6

right kidney due to the liver

Question 7

how much longer is the left kidney compared to the right kidney?

Answer 7

0.5 cm longer

Question 8

which area of the kidney is the brightest on US?

Answer 8

sinus

Question 9

what is the sinus made of?

Answer 9

connective tissue, fat, and major calyces

Question 10

what is the hilum?

Answer 10

entrance to the sinus

Question 11

what structures enter & exit through the hilum

Answer 11

renal artery
renal vein
ureter
lymphatic vessels

Question 12

what is the renal pelvis and what is its function?

Answer 12

it is the expanded superior end of the ureter that functions as a urine reservoir

Question 13

list the areas of the kidney from deep to superficial:

Answer 13

hilum, sinus, medulla, cortex

Question 14

what is the renal parenchyma made of?

Answer 14

1. medulla
2. cortex

Question 15

about how many major calyces are there per kidney?

Answer 15

2-3

Question 16

about how many minor calyces are there per kidney?

Answer 16

8-18

Question 17

where are the renal pyramids located?

Answer 17

medulla

Question 18

what separates the renal pyramids?

Answer 18

renal columns/columns of bertin

Question 19

what structures are the most hypoechoic structures in the abdomen?

Answer 19

renal pyramids

Question 20

what is the functional layer of the kidneys called?

Answer 20

renal cortex

Question 21

what are the functional units of the kidney?

Answer 21

nephrons

Question 22

where in the cortex are nephrons located?

Answer 22

outer cortex

Question 23

what is the size of a normal cortex?

Answer 23

1.5 cm

Question 24

renal pyramids in children look larger than adult. T/F?

Answer 24

false – in infants

Question 25

what age are the kidneys iso or hyperechoic to the liver?

Answer 25

infant to 3 months

Question 26

what is the normal echogenicity of the kidneys in an adult?

Answer 26

iso or hypoechoic to liver/spleen

Question 27

what happens to the cortex as we age?

Answer 27

there is natural thinning of the cortex

Question 28

renal veins are larger & easier to visualize on US than arteries. T/F?

Answer 28

true

Question 29

the LRV is longer than the RRV. T/F?

Answer 29

true

Question 30

does the RRA pass posterior or anterior to the IVC?

Answer 30

posterior to the IVC

Question 31

the LRV passes anterior to the aorta and posterior to the SMA. T/F?

Answer 31

true

Question 32

renal functions? (4)

Answer 32

1. excretion 2. maintain blood pressure by regulating fluid volumes 3. acid/base balance 4. electrolytes

Question 33

what hormones affect renal function? (2)

Answer 33

1. aldosterone 2. ADH

Question 34

what does aldosterone do?

Answer 34

it reabsorbs sodium and excretes potassium to maintain blood pressure

Question 35

what does ADH do?

Answer 35

decreases the amount of water being excreted

Question 36

what lab value is the most specific for renal function?

Answer 36

serum creatinine

Question 37

there is an increase in creatinine once there is some kind of renal dysfunction

Answer 37

false -- 50% of renal function is lost before creatinine starts increasing

Question 38

what does elevated BUN indicate?

Answer 38

acute or chronic renal disease other conditions: renal damage/failure, urinary obstruction, CHF, GI bleeds, shock, starvation

Question 39

what does decreased BUN indicate? (4)

Answer 39

1. overhydration 2. pregnancy 3. liver failure 4. low protein

Question 40

2 renal variants relating to the shape of the kidneys?

Answer 40

1. hypertrophied column of bertin 2. dromedary hump

Question 41

what does a hypertrophied column of bertin look like? what is it actually?

Answer 41

a mass extending towards the sinus of the kidney. in reality it's just enlargement of the renal columns.

Question 42

what is a dromedary hump?

Answer 42

a bulge in the left kidney capsule due to spleen compressing against it

Question 43

what are the 3 renal variants relating to the number of kidneys?

Answer 43

1. bilateral renal agenesis 2. unilateral renal agenesis 3. supernumerary kidney

Question 44

3 renal variants relating to the location of the kidney?

Answer 44

1. pelvic kidney 2. cross fused renal ectopia 3. thoracic kidney

Question 45

what is a cross fused renal ectopia?

Answer 45

renal variant where both kidneys are on one side & fused together

Question 46

how can a kidney end up in the thoracic cavity?

Answer 46

diaphragmatic hernia in utero

Question 47

3 renal variants due to kidneys fusing?

Answer 47

1. horseshoe kidney 2. cake or lump kidney 3. sigmoid kidney

Question 48

which fusion variant is the most common?

Answer 48

horseshoe kidney

Question 49

what is a cake/lump kidney?

Answer 49

kidneys are fused medially and in the pelvis region

Question 50

what are the 3 hypoplastic variants of the kidney?

Answer 50

1. unilateral hyperplasia 2. persistent fetal lobulation 3. double collecting system

Question 51

what is unilateral hyperplasia?

Answer 51

a variant in which one kidney is underdeveloped. the other usually enlarges to take over the function for both kidneys

Question 52

what is persistent fetal lobulation?

Answer 52

a renal variant where lobulation in the contour of the kidney stays after 5yo

Question 53

what is a double collecting system?

Answer 53

a renal variant with 2 collecting systems -- 2 sinuses and 2 ureters out of 1 hilum

Question 54

what is the most common renal variant?

Answer 54

double collecting system

Question 55

the contour of the kidneys may be lobulated in kids under 5 yo. T/F?

Answer 55

true

Question 56

a prominent renal vein can mimic a cyst or fluid collection. T/F?

Answer 56

true