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SONOCAN ABD Review > Urinary System Notes > Flashcards

Urinary System Notes Flashcards

1
Q

What is acute tubular necrosis (ATN)? What is it the most common cause of?

A

Ischemic necrosis of tubular cells; most common cause of renal failure.

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2
Q

What does the afferent arteriole do?

A

Carries blood entering the glomerulus.

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3
Q

What is an angiomyolipoma?

A

A benign tumor composed of blood vessels, smooth muscle, and fat.

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4
Q

What is angiotensin? 3

A

Polypeptide in the blood that:
1. Causes vasoconstriction
2. Increase in blood pressure
3. Release of aldosterone.

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5
Q

What is Bowman’s capsule?

A

A cup-like structure surrounding the glomerulus.

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6
Q

What does the efferent arteriole do?

A

Carries the blood away from the glomerulus.

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7
Q

What is fascia?

A

Fibrous connective membrane of the body that may be separate from other structures.

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8
Q

What is Gerota’s fascia?

A

Protective covering of tissue surrounding each kidney.

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9
Q

What is glomerulonephritis?

A

Inflammation of the glomerulus of the kidney.

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10
Q

What is the glomerulus composed of?

A

Structure composed of blood vessels or nerve fibers.

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11
Q

What is a hypertrophied column of Bertin?

A

Enlargement of a column of Bertin that extends into the renal pyramid.

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12
Q

What is an infundibulum?

A

Portion of the collecting system composed of the minor and major calyces.

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13
Q

What is a medullary pyramid?

A

Renal pyramid.

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14
Q

What is a papilla?

A

Blunt apex of the renal pyramid.

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15
Q

What is a parapelvic cyst?

A

Fluid-filled mass of lymphatic origin located within the renal sinus.

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16
Q

What is pelviectasis?

A

Dilation of the renal pelvis.

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17
Q

What is renal colic?

A

Sharp, severe flank pain radiating to the groin.

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18
Q

What is renal failure?

A

The inability of the kidneys to excrete waste, concentrate urine, and conserve electrolytes.

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19
Q

What is renal insufficiency?

A

Partial kidney function failure characterized by less than normal urine output.

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20
Q

What is a renal lobe?

A

Portion of the kidney consisting of a single pyramid, bordered on both sides by the interlobar arteries, with cortical tissue at its base.

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21
Q

What is renal parenchyma?

A

The functional tissue of the kidney consisting of the nephrons.

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22
Q

What is renal sinus lipomatosis?

A

Excessive accumulation of fat in the renal sinus.

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23
Q

What is renin?

A

Renal enzyme that affects blood pressure.

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24
Q

What is a staghorn calculus?

A

Large stone forming in the renal pelvis and extending into some or all of the calyces.

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25
Q

What is a twinkle artifact?

A

Quick fluctuating color Doppler signal from a rough surface or highly reflective object.

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26
Q

What is the urachus?

A

Epithelial tube connecting the apex of the urinary bladder to the umbilicus.

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27
Q

What is a ureterocele?

A

Prolapse of the distal ureter into the urinary bladder.

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28
Q

What is the nephron?

A

The basic functional unit of the kidney.

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29
Q

What is the composition of a nephron? What is each composed of?

A

Composed of
1. Renal corpuscle (glomerulus, Bowman’s capsule, afferent arteriole, efferent arteriole)
2. Renal tubule (proximal convoluted tubule, loop of Henle, distal convoluted tubule).

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30
Q

How many nephrons does each kidney contain?

A

More than one million nephrons.

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31
Q

What are the functions of the urinary system? 5

A
  1. Produces urine and erythropoietin
  2. Influences blood pressure, blood volume
  3. intake or excretion of salt and water through the renin–angiotensin system
  4. Regulates serum electrolytes
  5. Regulates acid–base balance.
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32
Q

What is the renal capsule?

A

Fibrous capsule (true capsule) surrounding the cortex.

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33
Q

What is the renal cortex? What does it contain?

A
  1. Outer portion of the kidney, bound by the renal capsule and arcuate vessels
  2. Contains glomerular capsules and convoluted tubules.
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34
Q

What is the medulla?

A

Inner portion of the renal parenchyma where the renal pyramids lie.

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35
Q

What are renal pyramids?

A

Triangular structures with a narrow tip (apex) that sits within the minor calyx and a wider base that abuts the renal cortex; contain tubules and the loops of Henle.

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36
Q

What does the collecting system consist of? 2

A

Consists of the infundibulum and renal pelvis.

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37
Q

What is the column of Bertin?

A

Inward extension of the renal cortex between the renal pyramids.

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38
Q

What is the renal sinus?

A

Central portion of the kidney containing the major and minor calyces, peripelvic fat, fibrous tissues, arteries, veins, lymphatics, and part of the renal pelvis.

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39
Q

What is the renal hilum?

A

Contains the renal artery, renal vein, and ureter.

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40
Q

What is the main renal artery? Which side is longer?

A

Arises from the aorta; the right renal artery is longer than the left and demonstrates low-resistance blood flow.

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41
Q

What are segmental arteries?

A

Branches of the main renal artery that demonstrate low-resistance blood flow.

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42
Q

What are interlobar arteries?

A

Branches of the segmental artery that course alongside the renal pyramids.

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43
Q

What are arcuate arteries? What is it a branch of?

A
  1. Boundary between the cortex and medulla
  2. Branches of the interlobar artery located at the base of the medulla.
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44
Q

What are interlobular arteries?

A

Give rise to the afferent arteries to enter the glomerulus.

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45
Q

What is the main renal vein?

A

Formed from the junction of tributaries in the renal hilum; courses anterior to the renal artery.

46
Q

What are segmental veins?

A

Formed by the convergence of the interlobar veins forming the main renal vein.

47
Q

What are interlobar veins?

A

Formed by the convergence of the arcuate veins; course in between the medullary pyramids.

48
Q

What are arcuate veins?

A

Parallel the arcuate arteries and course along the base of the medullary pyramids.

49
Q

What is the anatomy of the ureter?

A

Tubular structure connecting the renal pelvis to the urinary bladder, measuring 25 to 34 cm in length and 4 to 7 mm in diameter.

50
Q

What is the arterial supply to the ureter? 4

A
  1. Renal artery,
  2. Testicular or ovarian artery,
  3. superior vesical artery
  4. Hypogastric artery.
51
Q

What is the anatomy of the urethra?

A

A small tubular structure that drains urine from the bladder; 20 cm in length in males and 3.5 cm in length in females.

52
Q

What are the support structures of the kidneys? 6

A
  1. Psoas muscle
  2. Quadratus lumborum muscle,
  3. Transversus abdominis muscle
  4. Gerota’s fascia
  5. Perinephric fat
  6. Renal capsule.
53
Q

Where are the kidneys located?

A

Paired bean-shaped structures lying in a sagittal oblique plane in the retroperitoneal cavity, between the first and third lumbar vertebrae.

54
Q

What is a dromedary hump? Which side is most often affected?

A
  1. Cortical bulge on the lateral aspect of the kidney
  2. Demonstrated most often on the left.
55
Q

What is a hypertrophied column of Bertin?

A

Enlarged column of Bertin extending from the cortex into the renal pyramids.

56
Q

What is renal duplication?

A

Embryonic remnant of the fusion site between the upper and lower portions of the kidney.

57
Q

What is agenesis?

A

Absence of the kidney(s); unilateral or bilateral.

58
Q

What is a pelvic kidney?

A

Failure to ascend with development; associated with a short ureter.

59
Q

What is renal ptosis?

A

Unusual mobile kidney that descends from the normal position toward the pelvis.

60
Q

What is the size of an adult kidney?

A

9.0 to 12.0 cm in length, 4.0 to 5.0 cm in width, 2.5 to 3.0 cm in height.

61
Q

What is the normal sonographic appearance of the renal capsule?

A

Well-defined echogenic line surrounding the kidney.

62
Q

What is the normal sonographic appearance of the renal cortex?

A

Homogeneous, fine, moderate, to low-level echogenicity; less echogenic compared with the normal liver parenchyma.

63
Q

What is the normal sonographic appearance of the renal medulla?

A

Hypoechoic triangular structures between the renal cortex and sinus; may appear anechoic.

64
Q

What is the normal sonographic appearance of the renal sinus?

A

Hyperechoic; most echogenic.

65
Q

What is the recommended preparation for a renal ultrasound?

A

No preparation required; adults should drink 8 to 16 ounces of water 1 hour before the examination.

66
Q

What transducer frequency is recommended for adults?

A

3.0 to 5.0 MHz.

67
Q

What transducer frequency is recommended for children?

A

5.0 to 7.0 MHz.

68
Q

What transducer frequency may be required for obese patients?

A

2.0 MHz.

69
Q

What is the fasting requirement for renal vessel examination?

A

Nothing by mouth for 6 to 8 hours before the examination.

70
Q

What frequency transducers are used for adults in renal examinations?

A

3.0 to 5.0 MHz.

71
Q

What frequency transducers are recommended for children and small adults?

A

5.0 to 7.0 MHz.

72
Q

What frequency transducer may be required for obese patients?

A

2.0 MHz may be required.

73
Q

What type of transducer provides a wider field of view?

A

Curvilinear transducers.

74
Q

What are sector or vector transducers best used for?

A

They have a smaller footprint, great for intercostal imaging.

75
Q

What patient positioning is usually recommended for adult renal examinations?

A

Supine, posterior oblique, or lateral decubitus position.

76
Q

What is the recommended positioning for pediatric patients during renal examinations?

A

Prone position.

77
Q

What is the benefit of the left posterior oblique (LPO) position?

A

Allows bowel to move away from the right kidney.

78
Q

What does the subcostal or intercostal approach aid in?

A

Visualizing the liver and kidney relationship.

79
Q

What should be included in the examination protocol for renal imaging?

A

Systematic approach in sagittal, coronal, and transverse planes.

80
Q

What measurements should be taken during a renal examination?

A

Length, height, width, and cortical thickness of each kidney.

81
Q

What imaging technique is used to evaluate renal vasculature?

A

Color Doppler imaging.

82
Q

What should be documented in the examination?

A

Abnormalities and measurements in two imaging planes.

83
Q

What is the normal range for creatinine levels?

A

0.6 to 1.2 mg/dL.

84
Q

What is the significance of elevated creatinine levels? 3

A
  1. Indicates renal failure,
  2. Chronic nephritis
  3. Urinary obstruction.
85
Q

What is the normal range for blood urea nitrogen (BUN) levels?

A

11 to 23 mg/dL.

86
Q

What conditions can cause elevated BUN levels? 3

A
  1. Acute or chronic renal disease
  2. Dehydration
  3. Urinary stasis.
87
Q

What is hematuria?

A

Visible or microscopic red blood cells in the urine.

88
Q

What does proteinuria indicate? What is it associated with?

A

Abnormal amount of proteins in the urine, associated with various renal conditions.

89
Q

What is the most common renal cystic disease in infants?

A

Multicystic dysplasia.

90
Q

What is the etiology of renal abscess?

A

Risk factor includes diabetes and infection.

91
Q

What are the clinical findings of renal cell carcinoma? (S/s) 3

A
  1. Painless gross hematuria
  2. Uncontrolled hypertension
  3. Flank pain.
92
Q

What is the most common solid renal tumor in infants?

A

Mesoblastic nephroma.

93
Q

What is the significance of the resistive index greater than 0.7?

A

Associated with acute renal obstruction.

94
Q

What is the echogenicity of a smaller renal mass?

A

Hyperechoic

95
Q

What are the characteristics of a focal bulge in renal contour?

A

Indistinct borders and hypervascular mass

96
Q

What are common sites for metastasis from renal tumors? 3

A
  1. Lung
  2. Liver
  3. Long bones
97
Q

What are potential complications of renal tumors? 7

A
  1. Extension into the renal vein and IVC
  2. Adrenal tumor
  3. Abscess
  4. Focal pyelonephritis
  5. Adenoma
  6. Angiomyolipoma
  7. Wilms’ tumor (nephroblastoma)
98
Q

What are risk factors for Wilms’ tumor? 6

A
  1. Beckwith-Wiedemann syndrome
  2. Hemihypertrophy
  3. Sporadic aniridia
  4. Male prevalence
  5. Omphalocele
  6. Age 5 years or less
99
Q

What are common symptoms of Wilms’ tumor? 5

A
  1. Palpable mass
  2. Abdominal pain
  3. Nausea/vomiting
  4. Gross or microscopic hematuria
  5. Hypertension
100
Q

What is the typical appearance of a Wilms’ tumor on ultrasound? 4

A
  1. Predominately
  2. Solid
  3. Well-defined renal mass with variable echo pattern
  4. Echogenic rim
101
Q

What is the echogenicity of renal cell carcinoma?

A

Variable echo pattern with occasional calcification (10%)

102
Q

What are the common symptoms of renal cell carcinoma? 4

A
  1. Asymptomatic
  2. Flank pain
  3. Hematuria
  4. Hypertension
103
Q

What is the sonographic appearance of renal artery stenosis? 3

A
  1. Peak systolic velocity greater than 180 cm/s
  2. Spectral broadening
  3. Absence of diastolic flow
104
Q

What is renal dialysis?

A

A process of diffusing blood across a membrane to remove substances a normal kidney would eliminate.

105
Q

What are common complications of renal transplant? 7

A
  1. Renal artery stenosis
  2. Renal artery thrombosis
  3. Primary renal vein thrombosis
  4. Hematoma
  5. Urinoma
  6. Lymphocele
  7. Abscess
106
Q

What is the normal sonographic appearance of a renal transplant? 3

A
  1. Renal sinus appears hyperechoic,
  2. Renal cortex appears hypoechoic
  3. Prominent renal pyramids
107
Q

What are the layers of the bladder wall? 3

A
  1. Serosa
  2. Muscle
  3. Mucosa
108
Q

What is the normal bladder wall thickness when distended?

A

3 mm

109
Q

What is bladder exstrophy?

A

Failure of the mesoderm to form over the lower abdomen, associated with epispadia

110
Q

What is the sonographic finding of bladder diverticulum?

A

Anechoic pedunculation of the urinary bladder

111
Q

What are common symptoms of bladder cancer? 3

A
  1. Painless hematuria
  2. Frequent urination
  3. Dysuria
112
Q

What is the appearance of bladder sludge on ultrasound?

A

Hyperechoic focus within the urinary bladder with posterior acoustic shadowing

SONOCAN ABD Review (22 decks)

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