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ABD/SMALL PARTS II > Urinary System > Flashcards

Urinary System Flashcards

1
Q

The urinary system consists of what 3 parts

A

rt/lt kidneys
pair of ureters
urinary bladder

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2
Q

Where are the kidneys located

A

anterior to the deep back muscles in the perirenal space of retroperitoneum

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3
Q

List the order that the structures enter or exit from the hilum of the kidney from anterior to posterior

A

VAU: vein exits most anterior, artery enters between vein and ureter exits most posterior

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4
Q

What are the average measurements of the normal adult kidney

A

L: 9-12cm
W: 5 cm
T: 2.5-4cm

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5
Q

functional unit of the Kidney

A

nephron

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6
Q

What 5 parts make up the nephron

A 
renal corpuscle
proximal convoluted tubule
descending and ascending portions of henle's  loop
distal convoluted tubule 
collecting tubule
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7
Q

Where is the liver in relation to right kidney

A

superolateral

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8
Q

Where is the adrenal gland in relation to right kidney

A

superomedial

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9
Q

Where is the right colic flexure in relation to right kidney

A

inferior

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10
Q

Where is the 2nd portion of the duodenum in relation to right kidney

A

medial

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11
Q

Where is the adrenal gland and spleen in relation to the left kidney

A

superior

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12
Q

Where is the pancreatic tail in relation to the left kidney

A

anterior to the upper pole

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13
Q

Where is the left colic flexure in relation to the left kidney

A

inferior

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14
Q

Which kidney is most superior

A

left kidney

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15
Q

What part of the bladder to the ureters insert into

A

interior/lateral

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16
Q

What are the 2 deep back muscles that lie posterior to the kidneys

A

psoas

quadrattus lumborum

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17
Q

Fibrous sheath encasing the kidneys and adrenal glands

A

Gerota’s fascia

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18
Q

What is the connection of the ureter to the kidney

A

uteropelvic junction

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19
Q

What is the connection of the ureter into the bladder

A

uterovesical

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20
Q

What is the normal wall thickness of the urinary bladder if distended? undistended?

A

less than 3cm

less than 5cm

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21
Q

Name the 4 branches of the main renal artery

A

segmental arteries
interlobar
arcuate
interlobular

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22
Q

Where is the segmental renal artery branch located

A

hilum

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23
Q

Where is the interlobar renal artery branch located

A

level of medullary pyramids

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24
Q

Where is the arcuate renal artery branch located

A

parallel/adjacent to renal capsule

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25
Q

Where is the interlobular renal artery branch located

A

smallest renal arteries, branch off arcuates, run perpendicular to renal capsule

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26
Q

What is the main function of the kidneys

A

remove waste from body via excretion of urine

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27
Q

What do kidneys do

A

adjust electrolyte balance in the blood to maintain homeostasis

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28
Q

List the following normal organs seen sonographically in order by decreasing echogenicity

A

renal sinus
pancreas
spleen/liver
renal cortex

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29
Q

What 2 structures, in enlarges may cause an indention of the posterior bladder wall

A

uterus

prostate gland

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30
Q

What renal variant is characterized by hypertrophy of the renal cortical tissue between the medullary pyramids

A

column of bertin

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31
Q

Common renal variant of cortical thickening on the lateral aspect of the left kidney

A

dromedary hump

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32
Q

What appears sonographically as a triangular hyperechoic area on the anterior aspect of the right kidney

A

junctional paranchymal defet/fetal lobulation

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33
Q

A frequent complication of an ectopic ureter, in which there is a prolapse of the distal ureter into the bladder resulting in hydroureter and hydronephrosis of the _____ pole collecting system of the kidney

A

duplex kidney/duplicated collecting system

upper

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34
Q

Refers to unilateral or bilateral absence of the kidneys

A

renal agenesis

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35
Q

What is renal agenesis seen as in utero

A

oligohydramnious

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36
Q

Refers to a kidney that fails to ascend from the pelvis

A

pelvic kidney/ectopic kidney

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37
Q

Renal variant where renal sinus and perirenal fat increases and replaces the normal renal parenchyma

A

renal sinus lipomatosis

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38
Q

Appears as a cystic collection medial to the renal hilum

A

extrarenal pelvis

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39
Q

_____________most common fusion anomaly in which the __________poles of the kidney are connected by an isthmus _________ to the aorta

A

horseshoe kidney
lower
anterior

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40
Q

Anomaly in which both kidneys are seen on one side of the abdomen and one of the ureters must cross the midline

A

crossed fused renal ectopia

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41
Q

Anomaly in which the kidneys fuse to form a round, flattened mass in the pelvis

A

fused pelvic kidney/discoid/pancake kidney

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42
Q

What are the 3 classifications of renal masses

A

cystic/smooth
solid/well defined border
complex/anechoic
posterior enhancement

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43
Q

Ultrasound is utilized post-procedure following a guided biopsy or aspiration in order to monitor

A

any potential bleeding or fluid collections

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44
Q

What are the sonographic criteria for a simple cyst

A

anechoic
acoustic enhancement
well defined thin wall
round or oval shape

45
Q

Simple renal cysts occur in what % of people over the age of 50

A

50%

46
Q

What are the 3 types of renal cysts

A

peripelvic
parapelvic
pyelogenic

47
Q

What are 3 possible appearances of an atypical renal cyst

A

multiple thick septations
irregular walls
solid components

48
Q

Autosomal Dominant (adult) polycystic kidney disease presents as what caused by numerous cysts of various sizes

A

bilateral renal enlargement

49
Q

What happens in advanced stages of autosomal dominant (adult) polycystic kidney disease

A

renal failure

hypertension

50
Q

most common genetically determined childhood cystic disease of the kidneys

A

autosomal recessive polycystic kidney disease

51
Q

autosomal recessive polycystic kidney disease presents as bilateral enlarged ________ kidneys

A

hyperechoic

52
Q

The appearance of ARPKD is due to

A

multiple small cysts

53
Q

With ARPKD there is a loss of

A

cortical medullary distinction

54
Q

ARPKD may be detected in utero with

A

oligohydramnios

55
Q

development of multiple cysts in chronically failed kidneys, seen in patients who have received long-term hemodialysis

A

acquired cystic disease

56
Q

genetic tumor disorder affecting multiple organs, including the kidneys. Characterized by retinal and central nervous system tumors

A

von hipple lindau

57
Q

hyperechoic benign renal tumor that results in a propagation speed artifact, mainly seen in the right kidney and is associated with tuberous sclerosis

A

angiomyolipoma/hamartoma

58
Q

most common cause of an abdominal mass in the newborn where the affected kidney is non-functioning and filled with non-communicating cysts that replace the normal renal parenchyma

A

multicystic dysplastic kidney

59
Q

multi-system disease that consists of benign tumors in multiple organs. It commonly affects the central nervous system

A

tuberous sclerosis

60
Q

with tuberous sclerosis, patients have an increased incidence of renal cyst and

A

angiomyolipomas

61
Q

congenital disorder characterized by cystic dilation of the medullary pyramids

A

medullary sponge kidney

62
Q

medullary sponge kidney is caused by what and appears

A

tubular ectasia or dysplasia

hyperechoic pyramids

63
Q

the most common solid renal mass found in adults

A

renal cell carcinoma

64
Q

renal cell carcinoma typically appears how compared to the normal renal parenchyma

A

hypoechoic

65
Q

renal cell carcinoma commonly invades into the

A

renal veins and IVC

66
Q

most common site of distant metastases for renal cell carcinoma

A

lungs

67
Q

most common childhood renal tumor

A

wilm’s tumor/nephroblastoma

68
Q

How does wilm’s tumor/nephroblastoma affect the renal countour

A

destroys it

69
Q

increased incidence of renal cell carcinoma is associated with

A

tuberous sclerosis
von hippel lindau syndrome
acquired cystic disease

70
Q

refers to dilation of the renal collecting system due to obstruction of the ureter

A

hydronephrosis

71
Q

renal dysfunction results in loss of _______ flow and an increase in _______ resistance

A

diastolic

renal artery

72
Q

Obstructive hydronephrosis is suspected with a resistive index greater than

A

0.7

73
Q

results in a reduction in glomerular filtration rate and azotemia

A

acute renal failure

74
Q

if hydronephrosis is suspected when performing an ultrasound what should be done

A

post void scan should be done to image in two planes and show if it remains

75
Q

What are the 3 types of acute renal failure

A

prerenal failure
intrinsic failure
postrenal failure

76
Q

most common cause of intrinsic acute renal failure

A

acute tubular necrosis

77
Q

What is the term for renal stones

A

nephrolithiasis

78
Q

Disorder of calcium metabolism that results in calcification of the renal parenchyma

A

nephrocalcinosis

79
Q

Refers to ischemia of the medullary pyramids

A

papillary nerosis

80
Q

will be visualized in the urine of an affected patient. It appears sonographically as triangular cystic collections in the absence of the medullary pyramids

A

sloughed papilla

81
Q

refers to infection of the collecting system, causing pus to fill the collecting system

A

pyo-nephrosis

82
Q

Pyo-nephrosis is due to

A

renal obstruction

83
Q

Papillary necrosis is associated with

A 
analgesic abuse
diabetes mellitus
urinary tract obstruction/infection
renal vein thrombosis
sickle cell disease
chronic heart failure
cirrhosis
84
Q

renal infection usually caused by gram-negative bacilli from the intestinal tract

A

acute pyelo-nephritis

85
Q

bacterial infection associated with renal ischemia which is found commonly in diabetes or immunosuppressed patients

A

emphysematous

pyelonephritis

86
Q

Gas from bacteria creates

A

comet-tail or reverberation artifact

87
Q

type of chronic peylonephritis that results from long term obstruction and is associated with a staghorn calculus

A

xanthogranulomatous pyelonephritis

88
Q

What constitutes renal artery stenosis with direct evaluation

A

main velocity greater than 180cm/sec
turbulence distal to narrowing
RAR greater than 3.5

89
Q

What constitutes renal artery stenosis with indirect evaluation

A

abnormal wave form, small hard pulse which rises and falls slowly, absent early systolic peak

90
Q

refers to occlusion of the renal artery. it is a sudden cause of prerenal failure.

A

renal artery thrombosis

91
Q

Renal vein thrombosis is associated with

A 
trauma
renal transplants
nephrotic syndrome 
extrinsic compression
renal tumors
92
Q

What are the sonographic findings of renal vein thrombosis

A

high resistance renal artery wave form,

enlarges hypoechoic kidney, dilated thrombosed renal vein, absent intrarenal venous flow

93
Q

inflammation of the bladder

A

cystitis

94
Q

cystitis occurs more often in

A

women

95
Q

cystitis is typically caused by

A

bacteria

96
Q

the sonographic findings of cystitis

A

thickened bladder wall

97
Q

most common bladder neoplasm

A

transitional cell carcinoma

98
Q

the main symptom of transitional cell carcinoma is

A

hematuria

99
Q

most common cause of renal disease leading to renal transplant

A

diabetes

100
Q

treatment of choice for end stage renal disease

A

renal transplant

101
Q

which kidney is favored to use as a transplant kidney? why?

A

left, longer renal vein

102
Q

where are transplanted kidneys typically placed

A

right iliac fossa of the pelvis in the retroperitoneum

103
Q

what two arteries are involved in the arterial anastomosis of a renal transplant

A

internal iliac/hypergastric

external iliac

104
Q

What are possible post renal transplant complications

A

fluid collections
renal artery occlusion or thrombosis
renal vein thrombosis

105
Q

What are the sonographic findings associated with renal transplant rejection

A

loss of cortical-medullary boundary,
renal enlargement,
prominent hypoechoic medullary pyramids

106
Q

What 3 labs values are typically evaluated for renal function

A

urinalysis,
serum creatinine,
blood urea nitrogen (BUN)

107
Q

How is the serum creatinine related to glomerular filtration rate

A

inversely (increased creatine=decreased filtration rate)

108
Q

urinalysis includes microscope evaluation of what contents

A 
glucose 
protein
nitrates and WBC
ketones
blood

ABD/SMALL PARTS II (10 decks)

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