Urinary: Anatomy/Congenital Flashcards

1
Q
A

Anterior pararenal space

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2
Q
A

Perirenal space

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3
Q
A

Posterior pararenal space

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4
Q

What does the posterior pararenal space contain?

A

Only fat pads

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5
Q

What does the perirenal space contain?

A
  • Kidneys
  • Proximal ureters
  • Adrenals
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6
Q

What does the anterior pararenal space contain?

A
  • Pancreas
  • Duodenum
  • Ascending and descending colon
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7
Q
A

Posterior parietal peritoneum

Note: This is the anterior border of the anterior pararenal space.

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8
Q
A

Leteroconal fascia

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9
Q
A

Anterior renal fascia (Gerota’s fascia)

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10
Q
A

Posterior renal fascia (Zuckerkandl’s fascia)

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11
Q
A

Transversalis fascia

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12
Q

What is the name of the potential space between the anterior pararenal space and the perirenal space?

A

The retromesenteric plane

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13
Q

What is the name of the potential space between the perirenal space and the posterior pararenal space?

A

The retrorenal plane

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14
Q

What is the normal length of the kidney?

A

9-15 cm

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15
Q

When should you call increased renal echogenicity?

A

If the kidney is hyperechoic relative to liver

Note: If the liver is very hyperechoic relative to the kidney, then it is a fatty liver.

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16
Q

Left kidney

A

Dromedary hump (due to mass effect from adjacent spleen)

17
Q
A

Hypertrophied column of Bertin

18
Q
A

Hypertrophied column of Bertin

19
Q
A

Junctional parenchymal defect (echogenic line in the upper 1/3 of the kidney)

Note: This is basically only seen on longitudinal ultrasound.

20
Q
A

Persistent fetal lobulation of the kidneys

21
Q

Bilateral renal agenesis…

A

Think Potter sequence

Note: Pts will likely also have hypoplastic lungs.

22
Q

Unilateral renal agenesis is associated with…

A
  • Genital anomalies in women (70%), usually unicornuate uterus
  • Genital anomalies in men (20%), usually ipsilateral absence of the epididymus and vas deferens
23
Q

How can you differentiate between renal agenesis and a surgically absent kidney?

A

Look for a pancake adrenal (elongated, flattened adrenal suggests renal agenesis because it was not molded in utero by the ipsilateral kidney)

24
Q

What are the major phases of renal contrast enhancement?

A
  • Noncontrast
  • Corticomedullary phase (25-40 seconds)
  • Nephrographic phase (70-180 seconds)
  • Excretory phase (180 seconds-8 minutes)
25
Q

What renal contrast phase?

A

Corticomedullary (25-40 seconds)

26
Q

What renal contrast phase?

A

Nephrographic (70-180 seconds)

27
Q

What renal contrast phase?

A

Excretory/pyelographic (180 seconds-8 minutes)

28
Q

What is the best contrast phase to evaluate for renal tumor invasion of the renal veins?

A

Corticomedullary (best for evaluating renal arteries and veins)

29
Q

What is the best contrast phase to differentiate clear cell and papillary RCC?

A

Corticomedullary phase

Note: Clear cell should be similar to cortex on this phase while papillary should be less than cortex.

30
Q

Where in the kidney is contrast in the corticomedullary phase?

A

In the vascular system and extracellular interstitial space (cortex is enhanced, but medulla is not)

31
Q

Where in the kidney is contrast in the nephrographic phase?

A

Through the loops of Henle and collecting tubules (fairly uniform enhancement of renal cortex and medulla)

32
Q

Where in the kidney is contrast in the excretory phase?

A

Urinary tract/collecting system (with progressive decrease in the nephrogram density)

33
Q

What is the most sensitive phase to detect renal cell carcinoma?

A

Nephrographic (70-180 seconds)

34
Q

Common causes of a delayed corticomedullary phase (e.g. corticomedullary appearance in portal venous images)

A
  • Renal failure
  • Renal artery stenosis
  • Obstructive hydronephrosis
  • Heart failure
35
Q

What is the best phase to evaluate the renal papilla morphology?

A

Excretory phase (180 seconds-8 minutes)

Note: This is when you can look for papillary necrosis.

36
Q

What is the best phase to look for a striated nephrogram (e.g. pyelonephritis)?

A

Excretory phase (180 seconds-8 minutes)