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DIAGNOSTIC IMAGING > Retroperitoneal Space and Upper Urinary > Flashcards

Retroperitoneal Space and Upper Urinary Flashcards

1
Q

the space between the peritoneum (serosa) and the dorsal body wall

A

peritoneal space

organs partly covered by peritoneum are retroperitoneal

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2
Q

Most abdominal organs are fully covered by

A

peritoneum (serosa)

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3
Q

between the peritoneum and usually has a tiny amount of fluid

A

peritoneum space

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4
Q

What are the structures within the retroperitoneal space

A

1) Kidneys
2) Ureters
3) Adrenal glands
4) Aorta
5) Caudal Vena Cava
6) Some lymph nodes

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5
Q

fluid within the retroperitoneal space

A

Retroperitoneal effusion

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6
Q

What does retroperitoneal effusion look like on radiographs?

A

1) Focal/ Wispy if small amount of diffusion
2) Loss of distinction of hypaxial muscles, vessels and kidneys
*With no distinction from fluid, you cant tell if there is also a soft tissue mass
3) If large volume, expansion of retroperitoneal space, ventrally displaces GI tract

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7
Q

Fluid within the retroperitoneal space is ____________ opacity and will

A

soft tissue opacity and will border efface with retroperitoneal soft tissues

normally there is contrast because of the presence of fat

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8
Q

Why is there normally contrast within the retroperitoneal space

A

presence of fat

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9
Q

Why might you only see retroperitoneal effusion

A

because it is separated from the peritoneal space

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10
Q

What causes retroperitoneal effusion

A

1) Hemorrhage- trauma, coagulopathy, neoplasia
2) Urine leakage- kidneys, ureters, urethra (some portions)
3) AKI
4) Foreign body abscesses- grass awns into the hypaxial muscles

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11
Q

What occurs with large volume of retroperitoneal effusion

A

expansion of retroperitoneal space, ventrally displaces GI tract

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12
Q

What causes increased visibility of the retroperitoneal structures (opposite of fluid)

A

Retroperitoneal gas

rarely can gas also arise from retroperitoneal disease

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13
Q

The retroperitoneal space is a cranial connection to

A

mediastinum of the thorax and caudal connection to intrapelvic region

rarely can gas also arise from retroperitoneal disease

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14
Q

What is located cranial-dorsal-medial to kidneys

A

adrenal glands

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15
Q

T/F: Mineralization of the adrenal glands in cats is significant

A

False

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16
Q

What might mineralization or mass of the adrenal glands in dogs indicate

A

1) Benign adenoma
2) Primarily malignant neoplasia (pheochromocytoma or adenocarcinoma)
3) Other neoplastic (endocrine) metabolic causes

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17
Q

T/F: adrenal glands are rarely seen on radiographs

A

true

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18
Q

Is the left or right kidney more cranial?

A

right

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19
Q

Is the left or right kidney more caudal

A

left

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20
Q

How does fasting affect the visualization of the kidneys?

A

it enhances it. food or fecal material can sometimes block the kidneys

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21
Q

If is commonly hard to see the ______ kidney on VD

A

right

but it is sometimes hard to see left kidney on VD

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22
Q

If you have good visibility and cant see a kidney, what may indicate if it is small/absent

A

prior nephrectomy
renal aplasia (congenital)

23
Q

Dogs have kidneys that are shaped ___________
while cats have _________

A

dogs- more elongated
cats- slightly rounder

24
Q

Size of kidneys on radiographs is best evaluated when the patient is in what position

A

VD

lateral is subjective evaluation based on experience

25
Q

How do you tell the size of the kidney

A

Divide kidney length by length of L2

Dogs: 2.5-3.5x length of L2
Cats: 2.5-3.5x length of L2
older cats can be down to 2x length L2
Not strict limits

26
Q

What is normal length of kidney on VD

A

Dogs: 2.5-3.5x length of L2
Cats: 2.5-3.5x length of L2

27
Q

What determines enlarged kidney in dog

A

> 3.5x length of L2

28
Q

What determines the enlarged kidney in cat

A

> 3x length of L2

29
Q

marked dilation of the renal pelvis, sometimes used to imply ureter obstruction

A

hydronephrosis

30
Q

lesser dilation of renal pelvis, less likely affect kidney radiographic size

A

pyelactasia

31
Q

enlargement compensating for loss of function of opposite kidney, contralateral kidney often (not always) small

A

compensatory hypertrophy

32
Q

common degenerative change to kidneys, and can uncommonly get disturbingly large

A

renal cysts

33
Q

fluid between the kidney cortex and capsule, various causes

A

perinephric pseudocyst

34
Q

many cysts in kidneys, especially in some breeds like persian cats, Himalayan cats, cairn terriers, bull terriers

A

Polycystic kidney disease

35
Q

amyloid deposition in kidneys, especially in some breeds

A

amyloidosis

36
Q

What cause bilateral enlarged kidneys

A

1) Renal lymphoma (cats)
2) FIP (cats)
3) Hydronephrosis

often mildly enlarged
1) AKI
2) Congential portosystemic shunt

Metastatic neoplasia
Polycystic disease

37
Q

What causes unilateral kidney enlargement

A

1) Hydronephrosis

often muldly or relatively enlarged
1) Compensatory hypertrophy

often with abnormal shape
1) Primary renal tumor
2) Renal cysts
3) Metastatic neoplasia

38
Q

What measurements dictate small kidney(s)

A

Dogs <2.5x L2
Cats <2.5 or <2x L2

39
Q

What could cause bilateral small kidneys

A

Chronic renal degeneration
Renal dysplasia/hypoplasia (young)

40
Q

What could cause unilateral small kidney

A

Chronic renal regeneration
atrophy secondary to chronic obstruction
renal dysplasia/hypoplasia (more often bilateral)

41
Q

What could cause kidneys to be irregular shape but not small

A

infarcts or other mild chronic renal degeneration

42
Q

What could cause changes in kidney opacity

A

1) Nephroliths- if in region of renal pelvis
2) Focal dystrophic mineralization in cortex

43
Q

Where in the kidneys do nephrliths occur

A

renal pelvis

44
Q

Where in the kidneys does focal dystrophic mineralization occur

A

renal cortex

45
Q

T/F: ureters are visible in on rads

A

False- not typically
but you can use positive iodinated contrast agen (often iohexol) to see rads, fluoroscopy, or CT

46
Q

Where do ureteroliths typically occur on rads

A

small mineral objects in the retroperitoneal space between the renal pelvis and urinary bladder

47
Q

Urteroliths are more common in cats or dogs

A

cats

48
Q

What might trick you into seeing uteroliths

A

the deep circumflex iliac artery/vein seen end on due to summating with itself, soft tissue stacked in the direction of beam will appear mineral opaque

also end-on bowel

49
Q

What should you do to confirm uteroliths

A

ultrasound

50
Q

IV injection of iodinated contrast medium what when filtered by kindeys, contrast opacifies kidneys, ureters, and urinary bladder

A

Excretory Urography

51
Q

Technique where contrast is injected into the renal pelvis
difficult to do

A

Pyelogram

52
Q

T/F ultrasound is usually better than radiographs at evaluating upper urinary system

A

True

53
Q

T/F: CT give more info about the upper urinary system than ultrasound

A

True- but it is really expensive
IV contrast generally required for abdomen CT but may cause issues with severe kidney disease

CT is good for ectopic ureters and masses

54
Q
A

DIAGNOSTIC IMAGING (16 decks)

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