Ureter Flashcards

1
Q

Best scan of choice to look for a stone in the ureter?

A

CT non-contrast

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2
Q

Describe the “soft-tissue rim sign” for ureterolithiasis:

A

adjacent, surrounding soft tissue associated with ureteral edema from an impacted stone

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3
Q

Describe the “Comet tail sign”:

A

adjacent, irregular tapering of soft tissue mass that is from a non-calcified vein associated with phleboliths

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4
Q

What is the Weigert-Meyer Rule?

A

It is the rule regarding a duplicated system of the kidneys (two ureters).

The upper pole ureter inserts the bladder inferior-medially, while the lower pole inserts the bladder superior-laterally

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5
Q

In regards to the Weigert-Meyer Rule, which pole is more commonly obstructed, and which one more commonly refluxes?

A

Upper pole -> inserts inferior-medially usually with an associated ureterocele that obstructs (therefore, upper pole hydronephrosis)

Lower pole -> inserts superior-laterally and refluxes

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6
Q

In regards to the Weigert-Meyer Rule, which pole is most commonly associated with an ectopic ureter?

A

The upper pole

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7
Q

Best imaging modality to ID an ectopic ureter?

A

MRI

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8
Q

Describe the course of a retrocaval ureter:

A

The right ureter courses posterior and medial to the IVC, then crosses anterior to the IVC while coursing laterally towards the common iliac bifurcation.

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9
Q

What is the etiology of a retrocaval ureter?

Symptoms?

Treatment?

A

Etiology: persistent right subcardinal vein (anomaly of the IVC, not the ureter!!!)

Symptoms: flank pain (due to obstruction/hydronephrosis), UTI’s, or asymptomatic

Treatment: ureteroureterostomy with removal of retrocaval portion (it is usually aperistaltic)

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10
Q

Describe the “Drooping Lily sign”:

A

hydronephrotic nonfunctioning upper pole displaces the opacified, functioning lower pole inferiorly, thus appearing like a drooping lily

Seen in duplicated systems

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11
Q

What is “Ormond’s disease?”

What position are the ureters in compared to normal?

A

Retroperitoneal fibrosis

Medial deviation of the ureters

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12
Q

What is the “Goblet sign?”

A

Ureteral dilation just DISTAL to a ureteral TUMOR, giving an appearance of a goblet

*ureteral calculi cause distal ureteral spasm

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13
Q

The right or left ureter is more commonly affected by pregnancy associated hydroureter?

A

Right > left

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14
Q

Around which weeks is pregnancy associated hydroureter most prominent?

A

22-24 weeks

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15
Q

Etiology of pregnancy associated hydroureter?

A

1) Gravid uterine compression

2) High progesterone causes smooth muscle relaxation

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16
Q

What is the “Cobra-head deformity” or “spring-onion sign?”

A

IVP or CT with contrast shows a thin wall of an uncomplicated adult ureterocele separating ureteral and bladder contrast

On US, appears as a “cyst within a cyst”

17
Q

In a duplicated system, which moiety is associated with a ureterocele?

A

Upper pole (the ectopic moiety; inserts inferior-medially)