Urinary Bladder Flashcards
What are the three different parts of the urinary bladder?
Apex - cranially
Body
Neck - caudally
How many ligaments does the urinary bladder have?
What are they?
Two lateral
One ventral
Peritoneal reflections they are
The uterus lays between what structures?
Urinary bladder - ventrally
Colon - dorsally
Pelvic urinary bladder may indicate what?
Normal variation
Congenital urinary tract anomalies
Correlate with clinical signs
Point apex may indicate?
Persistent urachal ligament
Emphysematous cystitis can place gas where?
Luminal
Wall
Ligaments
Emphysematous cystitis is associated with what other disease?
Diabetes mellitus
What are compression views used for?
To push summated tissues out of the way to confirm abnormalities like calculi.
Other differentials for mineralization in bladder?
Neoplasia
Chronic cystits
Calculi - MAIN ONE
Indications for retrograde csytogram?
1) Clinical signs
Dysuria
Pollakiuria
Chronic hematuria
2) Radiographic signs Changes in opacity of urinary bladder Caudal abdominal mass Non visualization of the bladder after trauma Abnormal shape or location
Retrograde Cystography prep
1) Fast for 24 hours
2) Enema
What type of contrast is used in positive contrast?
Negative contrast?
PC = Iodides
NC = Air, carbon oxide, nitrogen oxide
*** Air can cause emboli
Complication of pushing contrast on a maximal distended bladder?
Contrast intramural and subserosal which can cause ulcer or granuloma
Amount of positive contrast for pos contrast study?
3.5ml - 10ml per kg should be used at 20%
Views after contrast?
Lateral, DV and two obliques
What cystic calculi cannot be see radiographically?
Urate
Cystine
Positive contrast and double contrast studies are used more than negative contrast study T/F
True - neg contrast not used much
Positive contrast is good for?
Tears
Location of bladder
Abnormal communications
Hernias
Double contrast is performed by…
0.5-1ml undiluted for cats
1-6 ml undiluted for dogs
THEN
Distend bladder with neg contrast
Double contrast study used for…
Filling defects - mass vs calculi
Wall lesions
Irregular mucosa DDx
Ulcer
Neoplasia
Hyperplasia
Inadequate bladder distention
Bladder wall thickeness is normally ~?
~1mm
Bladder wall thickening DDX
Inadequate bladder distention
Inflammation
Hemorrhage
Neoplasia
Where does cystitis like to show thickening?
FOCAL thickening of cranioventral… inflammation.. almost always
Chronic cystitis can cause what to the distention properties of the bladder?
Fibrosis and restrictive
Causes for non-sessile filling defects?
Calculi
Air bubbles
Blood clots
Causes for sessile filling defects?
Neoplasia Polyps Blood clots Adherent calculi Ureteroceles
Cobra-head sign associated with?
Ureteroceles
Artifacts of cystogram
Pseudofilling defects
Large air bubble
Honeycombing
Pseduothick wall
Sonographic evaluation of UB is best done when…
The UB is moderatley full.
Sonographic normal UB wall thickness
Dogs - 1.4-2.3mm
Cat - 1.7 +/- 0.6mm
Artifact that makes pseudosludge in UB
Side lobe artifact
Poster child for TCC?
Scottish terrier
Layers of the Urinary bladder?
3 layers
Muscosa - hyperechoic
Submucosa - hypoechoic
Serosa - hyperechoic
Blood clots look like what on US?
Hyperechoic, nonshadowing, mobile
Polypoid cystitis is usually located where?
Cranioventral… associated with cystitis
DDX - neoplasia - so follow up US needed or biopsy
US characteristics of TCC?
Hypoechoic, sessile, board based, irregular
Prognostic indicators of TCC?
Wall involvement
Trigone location
Heterogeneous echotexture
Other neoplastic disease?
Leiomyoma - Single, round, well-defined intramural
Leiomyosarcoma - Single, round, well-defined intramural
Fibrosarcoma - Neck of UB of young dogs
Rhadomyosarcomas - Neck of UB of young dogs
Lymphoma
Other observations that support neoplasia?
Ureter dilation
Lymphadenopathy
US description of Ureteroceles
Cyst within a cyst… “cystception”
What dog breed is most prone to polypoid cystic changes?
Springer spaniel
