Urinary Systems 2 Flashcards
Ureterocele:
prolapse of distal ureteric mucosa in bladder causing cystic dilation
What are the 3 types of ureteroceles:
simple- in bladder wall
ectopic- inserting into bladder in an abnormal location, can be associated with renal duplication (a/w segmented hydronephrosis)
Hydroureter is located:
posteriorly and should communicate with renal pelvis and bladder
What’s the most common cause of bladder outlet obstruction in male newborns?
posterior urethral valve
it’s an obstructing membrane in the male posterior urethra
What’s the key hole sign:
describes a dilated urinary bladder with a dilated proximal urethra
If there’s no bladder, it’s likely
bilateral renal abnormalities
there’s a lot of shit on this ppt so
look and study the ppt too
What abnormalities are associated with visualization of the bladder?
isolated, unilateral, ureteral pelvic junction obstruction (UPJ) and multicystic dysplastic kidney (MCDK) are associated with normal visualization of the bladder and normal AFV
When we don’t see the bladder, what could be the reason that the fetus may not be producing urine?
bilateral renal agenesis bilateral multicystic kidneys bilateral severe renal dysplasia bilateral severe UPJ obstruction ARPKD severe IUGR
When we don’t see the bladder, what could be the reason that the fetus may not be storing urine?
bladder exstrophy
cloacal exstrophy
bilateral single system ectopic ureters
Megacystitis:
can be a sign of bladder outlet obstruction and can be a/w: oligohydramnios, hydroureters and hydronephrosis
*most common cause is PUV
Megacystitis measurements:
bladder diameter:
>7mm in 1st tri
>30mm in 2nd tri
>60mm in 3rd tri
What are causes of megacystitis:
PUV urethral atresia/stricture Prune belly syndrome megalourethra cloacal malformation megacystitis-microcolon-intestinal hypoperistalsis syndrome
Cloacal malformation:
persistent cloaca- a confluence of the rectum, vagina and urethra into a single common channel
only in girls
challenge in pediatric surgery
Bladder exstrophy:
anterior abdominal wall and anterior wall of bladder fail to form
posterior wall of single bladder protrudes through abdo wall
a/w: separation of pubic bones, low-set umbilicus, and abnormal genitalia
both arteries running along cyst
Bladder exstrophy is mostly isolated and rarely associated with OEIS complex, what is that?
OEIS omphacele exstrophy of bladder imperforated anus spinal defects
Urethral atresia:
second most common cause of urethral level obstruction but causes the most severe form of obstruction
Prune belly syndrome is also known as
eagle Barrett syndrome
What is prune belly syndrome
bladder distension interferes with the descent of the testes (cryptorchidism) triad: absent anterior abdo musculature cryptorchidism UT abnormalities
Hydrocele:
accumulation of the fluid in the tunica vaginalis which surrounded the testes
should be evaluated after birth for inguinal hernia
Most of fetal ovarian cysts are:
benign
Amniotic fluid:
second half of pregnancy the main source of fluid production is from fetus (urine and lungs)
fluid clearance- fetal swallowing of fluid and passes back to mother’s bloodstream. direct flow across the amnion into placental blood vessels
Where does the metanephros develop?
pelvis and ascend into abdomen
an outgrowth of the mesonephric duct called the metanephric diverticulum
When do the kidneys first start to produce urine?
11wks
When does the cloaca divide?
9wks
Kidney smoothing completes in utero. True or false
False–completes in childhood
The bladder develops from the allantois. True or false
False– develops from upper part of urogenital sinus. It is, however, connected to the allantois
Male and female genitalia are identical until 11W GA,
True
Unilateral renal agenesis is often associated with oligohydramnios. True or false
False–as long as there’s one functioning kidney, there won’t be oligohydramnios
What sonographic findings are common to Potter’s sequence?
oligohydramnios, hypertelorism, limb deformities, IUGR, usually bilateral renal agenesis (lying down adrenal sign)
