Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SPRING 2024: Advanced Procedures > UNIT 2: Urinary System: Anatomy and Radiography (IVP/IVU) > Flashcards

UNIT 2: Urinary System: Anatomy and Radiography (IVP/IVU) Flashcards

1
Q

Urinary System Anatomy consists of

A

2 Kidneys, 2 ureters, 1 urinary bladder and 1 urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Function of Kidneys

A
  1. Removes waste from the blood
  2. Maintain fluid and electrolyte balance
  3. Helps regulate BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Kidney: Retroperitoneal at a slight ______ angle and a ___ degree oblique

A

anterior, 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Kidneys occupy the space between _____ - ____

A

T12-L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T or F: Right kidney sits lower due to location of liver

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Kidneys may move as much as __ inch during respiration and as much as __ inches from supine to upright

A

1, 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T or F: Normal excretion of 3 to 4 liters of urine/day

A

False, 1 to 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Anatomy of a kidney

A

• Renal Capsule- outer layer
• Renal cortex- next layer as you move internally
• Renal sinus- fat filled space surrounding the renal pelvis and vessels
• Renal medulla- collecting tubules
• Renal Papilla- opening into the minor calyx
• Renal Pyramid- 8-15 cone shaped segments
• Calyces- cup shaped stems arising at the sides of the papilla of each renal pyramid
• Minor- located just passed the renal pyramids
• Major- unite to form the renal pelvis
• Renal Pelvis- unites with the ureter to create the UPJ
• Hilum- the entry and exit site for structures servicing the kidneys: vessels, nerves, lymphatics, and ureters
• Ureter- drains urine to the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The Nephron

A

• Renal corpuscle
•Glomerular capsule (Bowman capsule)
•Glomerulus
• Renal tubule
• Proximal convoluted tubule
•Nephron loop (loop of Henle)
•Distal convoluted tubule
• Collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The Ureter

A

-Peristalsis contractions work to move urine and debris down to the bladder
-Bottle-Neck at UPJ and UVJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Bladder

A

-Bladder
-Freely movable
-Adult bladder can hold up to 500ml urge for micturition is felt at about 250ml
-Males sits directly anterior to the rectum
-Females sits anterior to the vaginal canal
-The bladder lining has folds (rugae), except over the area of the trigone. In the normal bladder, the rugae disappear when the bladder is full.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Urethra

A

-Passes urine from bladder to the outside of the body
-Male Urethra divided into 3 sections
-Prostatic, urethral, spongy
-Also serves as excretory canal of the reproductive system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adrenal Glands (Suprarenal)

A

-Endocrine gland
-Produces and secretes adrenaline (epinephrine), norepinephrine, dopamine and corticol hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Urinary System Radiography

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Urography?

A

Urography is a general term for radiographic investigation of the renal drainage and collecting system which requires injection of iodinated contrast material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

2 methods of Urography

A
  1. Antegrade method
    •IVP, IVU, or excretory urography.
    •Percutaneous method
  2. Retrograde method Also called the instrumental method
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Intravenous Pyelogram(IVP) aka Intravenous Urogram(IVU) Clinical Indications:

A

• Renal Hypertension
• Kidney stone
• Urinary Tract Infection
• Anatomic Anomaly
• Renal/bladder CA
• Hydronephrosis
• Polycystic Kidney
• Trauma
• Surgical planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intravenous Pyelogram(IVP) aka Intravenous Urogram(IVU) Exam

A

-Functional study of the urinary system
• Antegrade: contrast enters the body in the normal direction of bloodflow
• Iodinated contrast material is introduced intravenously
• Contrast is conveyed through the bloodstream to the kidney and is removed from the blood during the normal filtration process
• The contrast is then excreted down the ureters and into the bladder in the urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Intravenous Pyelogram(IVP) aka Intravenous Urogram(IVU) Exam Equipment preparation

A

• Tomographic equipment if required
• Standard Radiographic equipment
• Lead markers for side, body position, time intervals, and fulcrum level if applicable
• Emergency Crash Cart
• Supplies required for obtaining intravenous access
• Up to 100 mL Intravenous Contrast media
• Emesis basin
• Positioning wedges
• Compression band if required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Intravenous Pyelogram(IVP) aka Intravenous Urogram(IVU) Exam Patient Prep

A

For an unobstructed view of the urinary tract, the bowel should be free of gas and solid material
-Low-residue diet given for 1-2 days prior
-Laxative given the evening prior
-A light meal on the evening prior to the exam
-NO FOOD for 12 hours prior, only water.

*Bowel preps are not done on infants and children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Intravenous Pyelogram(IVP) aka Intravenous Urogram(IVU) Exam Considerations

A

•Patients with Diabetes, multiple myeloma or high uric acid levels should be well hydrated
•Diabetics taking Glucophage (metformin) must stop using this medication at least 48 hours prior to the exam, and not resume its use for 24-48 hours afterwards.
•Untreated Renal Failure (assessed by taking BUN and Creatinine levels as well as GFR prior to exam)
• Allergy to Iodinated Contrast
• Premedication with antihistamine and steroids
• Asthma
• Circulatory or cardiovascular disease
• Sickle cell disease
If a patient has any of these conditions, a Radiologist should be informed prior to the administration of contrast material
The only true contraindication for an IVP is contrast media concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Intravenous Pyelogram(IVP) aka Intravenous Urogram(IVU) Procedure

A

• Patients often undergo blood test prior to exam to assess their kidney function
• BUN (normal 8-25 mg/dL)
• Creatinine (normal: 0.6-1.2 mg/dL)
• GFR (Glomerular filtration rate): calculation that considers creatinine, age, & race (normal: 120 to 125 mL/ min. values under 90 = possible renal
compromise)
• Patients fill out a questionnaire confirming they do not have any contraindications
• Patient asked to empty bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Typical Urography Sequence

A

• Scout KUB and possible scout tomogram
• Contrast Injection (30 to 100 ml)
• Immediate AP KUB or kidney film (nephrogram/blush stage)
• **3 to 4 tomo cuts through the kidneys
• 5 minute KUB
• 10 minute KUB (possibly prone)
• RPO/LPO obliques at 10 to 15 minutes (greatest concentration of contrast in the kidneys occurs at 15– 20 min after injection)
• pre-voiding KUB at 20 to 30 minutes
• AP upright post-voiding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Scout image taken before staring exam

A

-The scout radiograph usually is made supine
-The patient will stay in this position for the injection
-Upon injection, the posterosuperior portions of the collecting system fill more readily with contrast
-Location of Urinary Structures
-If patient has been properly prepped
-Kidney Stones present
-Positioning for Radiographer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

T/F: Compression bands can be used to increase pressure and visualization of the ureters

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T or F: during the IVP/IVU Intravenous access is obtained at 30-100 ml iodinated contrast agent is administered

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

T or F: Nearly all life-threatening contrast reactions occur within the first 10 minutes after injection

A

False, first 20 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Nephrograms Positioning and Evaluation Criteria

A

-After injection of contrast, a KUB with up to 4 tomograms are done during the “blush” stage
-2-5 minutes after injection
-14 X 17 CW
-CR perpendicular to MSP at the level of L1
-Side and Time Marker
-Shield Gonads
-Respiration: Expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tomograms are performed primarily to evaluate

A

Renal hypertension (high blood pressure caused by the narrowing of your arteries that carry blood to your kidneys)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Visualizing the Ureters

A

• After tomograms, the patient may be asked to lay prone to help visualize ureters
• A Valsalva maneuver also sometimes helps to demonstrate ureters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

KUB taken after Nephrogram

A

•Usually a 5 minute and 10 minute KUB are done with time markers.
-Major and Minor Calyces
-Renal Pelvis
-Ureters in entirety
-Bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Oblique KUB Positioning and Evaluation Criteria

A

• Bilateral obliques are obtained between 10 and 15 min
• 30 degree obliquity
• CR perpendicular to the iliac crest 2 inches lateral from midline on elevated side
• Side UP kidney is parallel to IR
• Side DOWN kidney is perpendicular to IR
• Breathing: expiration

-When positioned correctly, both kidneys are seen without superimposition over the spine. The pedicles are anterior to the vertebral bodies’ centers (in contrast to lumbar obliques).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

KUB taken after Oblique KUB images

A

• At 20 to 30 minutes a KUB is then obtained to show “full bladder”
• This can also be done as just a bladder film on a 10 X 12 CW
• Note distension of Stomach (patient drank a carbonated beverage prior to exam to distend stomach)

34
Q

Upright Postvoid KUB image taken after Oblique KUB

A

• After radiologist’s approval, IV is removed and the patient is asked to void completely
• A post-void image is then obtained.
• Upright full KUB
• CR: centered 2 inches below the crest
• Breathing: expiration
• Mobility of kidneys (may drop up to 2 in)
• Prolapsed bladder
• Ability to empty

35
Q

Pathology: Horseshoe Kidney

A

-Congenital disorder in which the kidneys are fused across the abdomen (aka: super kidney or renal fusion)
-Occurs in 1/400 people

36
Q

Anatomic Anomaly: duplicated ureters

A
37
Q

Anatomic Anomaly: Hydronephrosis

A

-Distention and dilation of the renal pelvis and calyces usually caused by obstruction
-Can be a stone, cyst, or a tumor

38
Q

Kidney Stones

A

Small, hard mineral deposists that form inside the kidney

39
Q

Phlebolith

A

Calcified pelvic vein that can often resemble a kidney stone

40
Q

Urine is expelled from the body via the

A

Excretory system

41
Q

Urinary system is also called the

A

Excretory system

42
Q

The calyces and the renal pelvis together are known as the

A

Pelvicaliceal system

43
Q

the _____ extends from the kidneys

A

Ureters

44
Q

The ______ conveys urine to the exterior of the body

A

Urethra

45
Q

What 2 substances do the suprarenal glands aka adrenal glands furnish

A

-Epinephrine: secreted by the medulla
-Cortical hormones: secreted by the cortex

46
Q

the left kidney is usually slightly ________ and __________ than the right kidney

A

Longer, narrower

47
Q

In AP oblique projections, the elevated kidney is demonstrated without

A

distortion, as the 30-degree rotation puts the upper kidney parallel to the IR plane

48
Q

In AP oblique projections, the dependent kidney is positioned almost perpendicular to the IR plane, so the lower kidney is oriented to demonstrate

A

the anterior and posterior surfaces in the oblique positions

49
Q

The capsule and kidney are are enveloped in a sheath called the ________ ________ which is attached to the diaphragm, lumbar vertebrae, peritoneum, and other adjacent structures

A

renal fascia

50
Q

When you breathe the kidneys move

A

1 inch

51
Q

the kidneys drop __ inches when going from supine to upright

A

2

52
Q

The essential microscopic components of the parenchyma of the kidney are called

A

Nephrons

53
Q

A nephron is composed of

A

a renal corpuscle and a renal tubule

54
Q

the renal corpuscle consists of of a double walled membranous cup called the ___________ __________ and a cluster of blood capillaries called the ____________

A

glomerular capsule (aka bowman capsule), glomerulus

55
Q

The vessel entering the glomerular capsule is called the _________ ___________ and the one leaving is called the _________ ___________

A

Afferent arteriole, Efferent arteriole

56
Q

the __________ serves a a filter for the blood

A

Glomerulus

57
Q

Each ureter is ___ to ___ long

A

10-12 inches

58
Q

The ureters convey the urine from the _______ _________ to the _________

A

Renal pelvis, bladder

59
Q

How does the bladder lie in males vs females

A

-Males: anterior to the rectum
-Females: anterior to the vaginal canal

60
Q

When the bladder is empty it is located in the

A

Pelvic cavity

61
Q

As the bladder fills, it expands into the

A

Abdominal cavity

62
Q

The portion of each ureter where it joins the bladder is called the

A

Ureterovesical junction (UVJ)

63
Q

What are the folds in the bladder called

A

Rugae

64
Q

How does the female urethra pass

A

Along the thick anterior wall of the vagina to the external urethral orifice

65
Q

How does the male urethra pass

A

From the bladder to the end of the penis and is divided into prostatic, membranous, and spongy portions

66
Q

What does the prostate do in males

A

secretes a milky fluid that combines with semen

67
Q

An upright position may be used to show

A

The mobility of the kidneys to demonstrate nephroptosis and for the detection of low grade obstruction, prolapsed bladder, ability to empty

68
Q

Antegrade contrast fillings

A

Allow the contrast medium to enter the kidney in the normal direction of blood flow

69
Q

What is percutaneous antegrade urography?

A

Introducing contrast media directly into the kidneys through a percutaneous puncture of the renal pelvis

70
Q

Which technique has the contrast media administered intravenously?

A

Intravenous Urography

71
Q

Intravenous Urography is also called

A

Excretory urography or IVP

72
Q

The Intravenous Pyelogram (IVP) demonstrates

A

the renal pelves and calyces

73
Q

Retrograde filling

A

The contrast medium is introduced against the normal flow, also called retrograde Urography

74
Q

Bladder examinations are called

A

Cystography

75
Q

A procedure that includes inspection of the lower ureters is called

A

Cystoureterography

76
Q

A procedure that includes inspection of the urethra is called

A

Cystourethrography

77
Q

Lateral projections are used to show

A

conditions such as rotation or pressure displacement of a kidney and to localize calcareous areas and tumor masses

78
Q

IVP and IVU look at the

A

Kidneys, ureters, bladder

79
Q

What is parenchyma?

A

Functional tissue or cells of an organ or gland

80
Q

Which of the following structures are NOT found in the renal cortex?

A. Loop of Henle
B. Distal convoluted tubule
C. Bowman’s capsule
D. Afferent arteriole

A

A. Loop of henle

81
Q

Where is the nephron located

A

Renal cortex

SPRING 2024: Advanced Procedures (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions