Urinary Tract Flashcards
how many pairs of kidneys does a fetus have
3 pairs
what do the kidneys arise from
mesoderm
what are the 3 pairs of kidneys called
Pronephros
Mesonephros
Metanephros
pronephros forms ____ in the _______. It is ______ and ____
early
4th embryological week
rudimentary
non-functioning
Mesonephros form ___ in the ____
late
4th embryological week
mesonephros function as _____ kidneys
interim
mesonephros becomes the _______ duct
mesonephric
mesonephric duct in males gives rise to (3)
epididymis
vas deferens
ED
mesonephric duct in females is _______
largely suppressed
which kidneys become the permanent kidneys
metanephros
metanephros forms ____ of the ____. Function begins at ____
end
5th
8 weeks
during fetal growth, kidneys appear to migrate from the ____ to the ______ (_____ weeks gestation)
pelvis
abdomen
12-15
ureters develop from the _______ (_____) at __ weeks gestation
mesonephric
Wolffian duct
4
bladder develops from the _____ sinus
urogenital sinus
urogenital sinus is continuous with the _____
allantois
allantois develops from the _____ and becomes the ____
yolk sac
urachus
urachus becomes the
median umbilical ligament (adults)
prior to puberty the bladder is an ______ organ. Becomes a true ____ after puberty
abdominal
pelvic structure
kidneys are in what retropertineal space
perirenal
upper and lower borders of kidneys on spine
T12-L3
what muscle do the kidneys parallel
psoas
upper poles are more ___ and _____ than lower poles
medial
post
medial margins more ___ than lateral margins
anterior
IVC and Ao more ______ than lateral margins
anterior
ureters enter ______ aspect of bladder
posterolateral
ureters are ____ to iliac vessels
anterior
ureters diameter
2-8 mm
ureter length
30 cm length
blader is:
____ to symphysis pubis
____ to prostate
____ to rectum
____ to uterus (when full)
post
sup
ant
ant
empty pelvis location
vs
distended
true pelvis
vs
extends into false pelvis/abdomen
another term for the beam shape of a kidney
reniform
lateral aspect of kidney is ______ and medial aspect is _____
convex
concave
kidney length
9-12 cm
kidney length should be within ____ to ____ of each other
1.5-2cm
____ kidney is often longer than ____
left
right
4 supportive tissues of the kidney
fibrous capsule
perirenal fat
renal (Gerota’s) fascia
pararenal fat
fibrous capsule is a ____ reflector
specular
perirenal fat is continuous with _____
renal sinus
renal fascia aka
Gerota’s fascia
renals (gerota’s) fascia anchors the kidney to the _____, separates the ____ space from the ____ spaces
post abdominal wall
perirenal
pararenal
ptosis
kidney falls when renal (Gerota’s) fascia tears
2 distinct areas of the kidney
parenchyma
sinus
parenchyma is the _____ tissue and is divided into ____ and ____
functional
cortex
medulla
what is the site of urine production
cortex
what does the cortex contain
nephrons
what are the columns of cortex AKA
columns of Bertin
each column contains an _______ artery and vein
interlobar
medulla contains
pyramids
How many pyramids are there?
8-18
pyramid base towards the ____
cortex
what is the central fatty portion of the kidney called
sinus
the sinus is continuous with _____
perirenal fat
sinus contains (4)
calyces
renal pelvis
vessels
nerves
how many minor calcyces
8-18
how many major calcyes
2-3
minor calyces AKA
infundibula
minor calcyes join to form
renal pelvis
ant to post in renal hilum (artery vein ureter)
renal vein
renal artery
ureter
______ and _____ transport urine
peristalsis
gravity
3 natural narrowings of ureter
UPJ
crossing pelvic brim anterior to iliac vessels
UVJ
______ of stones lodge at UVJ
80%
bladder has inner mucous membrane lining contains folds called _____
rugae
capacity of bladder
300-500mL
post void _____ is insignificant
<100mL
bladder neck has the _____
urethral orrifice
what portion of bladder is constant shape/position (not trigone)
neck
apex of bladder is more ____ and ____ than neck
ant
sup
apex of bladder is the side of ________ ligament attachment
median umbilical
4 layers of bladder wall
mucosa
submucosa
muscle
serosa
what is the muscle of the bladder
detrusor muscle
wall thickness of bladder
distended:
non-distended:
3mm
6mm
female urethra can pierces the _____
urogential diaphragm
males urethra enters 3 areas
prostatic, membranous, penile
blood supply to kidney (6)
Renal arteries
segmental
interlobar
arcuate
interlobular
afferent arterioles
renal arteries arise from the ___ aspect of the aorta just below ___
laterla
SMA
renal arteries divide into ____ just before entering the hilum
segmental arteries
segmental arteries AKA
lobar arteries
what arteries travel between pyramids and branch from segmental arteries
interlobar arteries
interlobar arteries branch into _____ arteries, at the base of the pyramids
arcuate
which arteries travrl into the renal cortex and branch form the arcutate arteries
intelobular
what arteries carry blood into the glomerulus of the nephron
afferent arterioles
medulla are _____ from each other
equidistant
CM junction is the location of ____ arteries
arcuate arteries
sinus is very echogenic or very echopenic
echogenic
overhydration will cause the sinus to have small ______ areas
echolucent
linear anechoic tubes best assessed in the _____ on the body
transverse
US of cortex
homogrenous
=/slightly < echogenic than liver
medulla = ____echoic
hypo
neonate US cortex is ____ echogenic compared to liver
more
cortex in neonates is ____ (thick/thin) compared to pyramids
thin
neonates pyramids are _____ and ____
hypoechoic
large
neonate sinus is ____ due to what
indistinct
very little fat
if you see a dilated ureter check for
jets
superior angulation of bladder appears (trans)
rounded
inferior angulation of bladder appears (trans)
squared
dromedary hump is located on the ____ aspect of the ____ kidney
lateral
left
with a dromedary hump you have to visualize _______ to rule out mass
CM junction
hypertrophied colum of Bertin
2 layers of cortex between pyramids
hypertrophied colum of Bertin should not measure
> 3cm
fetal lobulation has a _____ contour and an ____ of cortex but no ____
scalloped
infolding
thinning
______ of adults have fetal lobulation
51%
junctional parenchymal defect
is an incomplete embryological fusion
wedge shaped hyperechoic defect
junctional parenchymal defect typically on ____ side
right
what can junctional parenchymal defect be confused with
scarring
right kindey uses ___ as window and is scanned (compared to costals)
liver
subcostal/intercostal
left kidney is scanned in a ____ or ____ position and uses ____ as window
decubitus
oblique
spleen
use ______ to move bowel gas away to see ureter
graded compression
what is graded compression
lighter touch sup and increase as you move inferiorly
_____ is best to evaluate bladder
cystoscopy
3 sag images of kidney
measure length
hilum
lateral edge
3 trans images of kidney
both poles with even cortex
hilum with vessels
the tissue that anchors the kidneys is called
Gerota;s fascia
muscle diretly post to kidney
quadratus lumborum
the aorta and IVC are more ant than the lat aspects of the kidneys (T/F)
T
the renal sinus in a newborn is more defined than in an adult (T/F)
F
the kidney removes _______ by producing urine
metabolic waste
4 metabolic wastes
CO2, urea, uric acid, creatinine
what does the kidney balance
the amount of water and electrolytes leaving and entering the body
what does the kidney maintain
BP
kidneys process ______ of fluid per day. ____% is filtered and recirculated, ___% eliminated in the urine
180L
99
1
functional unit of the kidney
nephron
how many nephrons per kidney
millions
2 types of nephrons and their location
juxtamedullary (deep)
cortical (superficial)
2 main components of a nephron
renal corpuscle
renale tubule
renal corpuscle contains
glomerulus
Bowman’s capsule
renal tubule contains
PCT
DCT
Loop of Henle
collecting duct
network of porous capillaries
glomerulus
membrane of epithelial cells with filtration slits
Bowman’s Capsule
3 functions of nephrons
control blood concentration and volume
helps regulate blood pH
remove toxic wastes from blood
6 arteries for blood to reach nephron
renal
interlobar
arcuate
interlobular
afferent arteriole
glomerulus
3 steps of urine formation
filtration
reabsorption
secretion
glomerular filtration steps
enters afferent arteriole to glomerulus -> BP increases because of convoluted tubes -> water and dissolved substances forced through membrane (Bowman’s capsule) -> filtrate exits to renal tubule
what things aren’t filtered by nephron and how do they exit the glomerulus
RBC and large proteins that don’t exit bowman’s exit efferent artiole
tubular reabsorption : _____ and ____ are reabsorbed back into the bloodstream
nutrients
filtrate
tubular reabsorption occurs in
PCT, descending and ascending loop of Henle
what capillaries allow for tubular reabsorption
peritubular capillaries
tubular secretion: waste in _____ is secreted into the ____
blood
DCT
tubular secretion rids the body of ____ and helps control ____
certain substances
pH
ADH (name, secreted by, function, what stimulates it)
antidiuretic hormone
secreted by post pituitary
aids in retaining water in the body
decrease in blood volume stimulates ADH production
aldosterone (secreted by, acts on function, what stimulates it, influenced by)
secreted by adrenal cortex, acts on PCT
controls the rate of sodium reabsorption
stimulated by low blood volume
influenced by renin-angiotensin system
renin (secreted by, function, what stimulates it)
secreted by juxtaglomerular apparatus
acts as a catalyst (renin stimulates formation of angiotensin = stimulates release of aldosterone)
responds to a decrease in blood pressure
aldosterone function: _____ sodium n blood = ____ water = _____ blood volume
increased
increased
increased
juxtaglomerular apparatus location
at the point where the DCT, afferent, and efferent arteriole come into contact
granular cells in the _____ arteriole, release _____
afferent
renin
Macular densa cells in the _____, inhibit _____ release
DCT
renin
juxtaglomerular apparatus regulates
BP
____% loss of renal function before blood tests are evaluated
60
what is the most sensitive test for kidneys
serum creatinine
serum creatinin is a breakdown product of what
muscle metabolism that is filtered out by the kidneys
serum creatinine appears in blood normally in amounts proportional to ______
the body’s muscle mass
increased serum creatinine values seen in (3)
renal failure
chronic nephritis
urinary tract obstruction
serum creatinin is ____ sensitive than BUN
more
BUN is an end product of
protein metabolism
BUN is formed in the liver from
ammonia
BUn reflects ____ intake and ______ capacity
protein
renal excretory
increased BUN (2)
renal dysfunction and dehydration
decreased BUN (3)
hepatic damage, malnutrition, over-hydration
serum electrolytes (4)
chloride, potassium, sodium, and bicarbonate
serum electrolytes increased in (2)
acute renal failure
glomerulonephritis
serum electrolytes decreased in (2)
acute and chronic renal failure
six urine tests for kidneys
RBC
WBC
pyuria
proteinuria
pH
specific gravity
hematuria
blood in urine
hematuria occurs in (3)
inflammation, tumors, calculi
WBC in urine indicates (2)
infection
inflammation
pyuria indicates
infection
what is pyuria
pus in urine
proteinuria occurs in (4)
nephritis, polycystic disease, stones, carcinoma
alkaline = ____
basic
when pH of urine is basic =
formation of stones
specific gravity measures
abilitiy to concentrate urine
specific gravity decreases in
renal failure
specific gravity increased with
decreased urine output (dehydration)
