Urinary Tract Flashcards
1
Q
how many pairs of kidneys does a fetus have
A
3 pairs
2
Q
what do the kidneys arise from
A
mesoderm
3
Q
what are the 3 pairs of kidneys called
A
Pronephros
Mesonephros
Metanephros
4
Q
pronephros forms ____ in the _______. It is ______ and ____
A
early
4th embryological week
rudimentary
non-functioning
5
Q
Mesonephros form ___ in the ____
A
late
4th embryological week
6
Q
mesonephros function as _____ kidneys
A
interim
7
Q
mesonephros becomes the _______ duct
A
mesonephric
8
Q
mesonephric duct in males gives rise to (3)
A
epididymis
vas deferens
ED
9
Q
mesonephric duct in females is _______
A
largely suppressed
10
Q
which kidneys become the permanent kidneys
A
metanephros
11
Q
metanephros forms ____ of the ____. Function begins at ____
A
end
5th
8 weeks
12
Q
during fetal growth, kidneys appear to migrate from the ____ to the ______ (_____ weeks gestation)
A
pelvis
abdomen
12-15
13
Q
ureters develop from the _______ (_____) at __ weeks gestation
A
mesonephric
Wolffian duct
4
14
Q
bladder develops from the _____ sinus
A
urogenital sinus
15
Q
urogenital sinus is continuous with the _____
A
allantois
16
Q
allantois develops from the _____ and becomes the ____
A
yolk sac
urachus
17
Q
urachus becomes the
A
median umbilical ligament (adults)
18
Q
prior to puberty the bladder is an ______ organ. Becomes a true ____ after puberty
A
abdominal
pelvic structure
19
Q
kidneys are in what retropertineal space
A
perirenal
20
Q
upper and lower borders of kidneys on spine
A
T12-L3
21
Q
what muscle do the kidneys parallel
A
psoas
22
Q
upper poles are more ___ and _____ than lower poles
A
medial
post
23
Q
medial margins more ___ than lateral margins
A
anterior
24
Q
IVC and Ao more ______ than lateral margins
A
anterior
25
ureters enter ______ aspect of bladder
posterolateral
26
ureters are ____ to iliac vessels
anterior
27
ureters diameter
2-8 mm
28
ureter length
30 cm length
29
blader is:
____ to symphysis pubis
____ to prostate
____ to rectum
____ to uterus (when full)
post
sup
ant
ant
30
empty pelvis location
vs
distended
true pelvis
vs
extends into false pelvis/abdomen
31
another term for the beam shape of a kidney
reniform
32
lateral aspect of kidney is ______ and medial aspect is _____
convex
concave
33
kidney length
9-12 cm
34
kidney length should be within ____ to ____ of each other
1.5-2cm
35
____ kidney is often longer than ____
left
right
36
4 supportive tissues of the kidney
fibrous capsule
perirenal fat
renal (Gerota's) fascia
pararenal fat
37
fibrous capsule is a ____ reflector
specular
38
perirenal fat is continuous with _____
renal sinus
39
renal fascia aka
Gerota's fascia
40
renals (gerota's) fascia anchors the kidney to the _____, separates the ____ space from the ____ spaces
post abdominal wall
perirenal
pararenal
41
ptosis
kidney falls when renal (Gerota's) fascia tears
42
2 distinct areas of the kidney
parenchyma
sinus
43
parenchyma is the _____ tissue and is divided into ____ and ____
functional
cortex
medulla
44
what is the site of urine production
cortex
45
what does the cortex contain
nephrons
46
what are the columns of cortex AKA
columns of Bertin
47
each column contains an _______ artery and vein
interlobar
48
medulla contains
pyramids
49
How many pyramids are there?
8-18
50
pyramid base towards the ____
cortex
51
what is the central fatty portion of the kidney called
sinus
52
the sinus is continuous with _____
perirenal fat
53
sinus contains (4)
calyces
renal pelvis
vessels
nerves
54
how many minor calcyces
8-18
55
how many major calcyes
2-3
56
minor calyces AKA
infundibula
57
minor calcyes join to form
renal pelvis
58
ant to post in renal hilum (artery vein ureter)
renal vein
renal artery
ureter
59
______ and _____ transport urine
peristalsis
gravity
60
3 natural narrowings of ureter
UPJ
crossing pelvic brim anterior to iliac vessels
UVJ
61
______ of stones lodge at UVJ
80%
62
bladder has inner mucous membrane lining contains folds called _____
rugae
63
capacity of bladder
300-500mL
64
post void _____ is insignificant
<100mL
65
bladder neck has the _____
urethral orrifice
66
what portion of bladder is constant shape/position (not trigone)
neck
67
apex of bladder is more ____ and ____ than neck
ant
sup
68
apex of bladder is the side of ________ ligament attachment
median umbilical
69
4 layers of bladder wall
mucosa
submucosa
muscle
serosa
70
what is the muscle of the bladder
detrusor muscle
71
wall thickness of bladder
distended:
non-distended:
3mm
6mm
72
female urethra can pierces the _____
urogential diaphragm
73
males urethra enters 3 areas
prostatic, membranous, penile
74
blood supply to kidney (6)
Renal arteries
segmental
interlobar
arcuate
interlobular
afferent arterioles
75
renal arteries arise from the ___ aspect of the aorta just below ___
laterla
SMA
76
renal arteries divide into ____ just before entering the hilum
segmental arteries
77
segmental arteries AKA
lobar arteries
78
what arteries travel between pyramids and branch from segmental arteries
interlobar arteries
79
interlobar arteries branch into _____ arteries, at the base of the pyramids
arcuate
80
which arteries travrl into the renal cortex and branch form the arcutate arteries
intelobular
81
what arteries carry blood into the glomerulus of the nephron
afferent arterioles
82
medulla are _____ from each other
equidistant
83
CM junction is the location of ____ arteries
arcuate arteries
84
sinus is very echogenic or very echopenic
echogenic
85
overhydration will cause the sinus to have small ______ areas
echolucent
86
linear anechoic tubes best assessed in the _____ on the body
transverse
87
US of cortex
homogrenous
=/slightly < echogenic than liver
88
medulla = ____echoic
hypo
89
neonate US cortex is ____ echogenic compared to liver
more
90
cortex in neonates is ____ (thick/thin) compared to pyramids
thin
91
neonates pyramids are _____ and ____
hypoechoic
large
92
neonate sinus is ____ due to what
indistinct
very little fat
93
if you see a dilated ureter check for
jets
94
superior angulation of bladder appears (trans)
rounded
95
inferior angulation of bladder appears (trans)
squared
96
dromedary hump is located on the ____ aspect of the ____ kidney
lateral
left
97
with a dromedary hump you have to visualize _______ to rule out mass
CM junction
98
hypertrophied colum of Bertin
2 layers of cortex between pyramids
99
hypertrophied colum of Bertin should not measure
>3cm
100
fetal lobulation has a _____ contour and an ____ of cortex but no ____
scalloped
infolding
thinning
101
______ of adults have fetal lobulation
51%
102
junctional parenchymal defect
is an incomplete embryological fusion
wedge shaped hyperechoic defect
103
junctional parenchymal defect typically on ____ side
right
104
what can junctional parenchymal defect be confused with
scarring
105
right kindey uses ___ as window and is scanned (compared to costals)
liver
subcostal/intercostal
106
left kidney is scanned in a ____ or ____ position and uses ____ as window
decubitus
oblique
spleen
107
use ______ to move bowel gas away to see ureter
graded compression
108
what is graded compression
lighter touch sup and increase as you move inferiorly
109
_____ is best to evaluate bladder
cystoscopy
110
3 sag images of kidney
measure length
hilum
lateral edge
111
3 trans images of kidney
both poles with even cortex
hilum with vessels
112
the tissue that anchors the kidneys is called
Gerota;s fascia
113
muscle diretly post to kidney
quadratus lumborum
114
the aorta and IVC are more ant than the lat aspects of the kidneys (T/F)
T
115
the renal sinus in a newborn is more defined than in an adult (T/F)
F
116
the kidney removes _______ by producing urine
metabolic waste
117
4 metabolic wastes
CO2, urea, uric acid, creatinine
118
what does the kidney balance
the amount of water and electrolytes leaving and entering the body
119
what does the kidney maintain
BP
120
kidneys process ______ of fluid per day. ____% is filtered and recirculated, ___% eliminated in the urine
180L
99
1
121
functional unit of the kidney
nephron
122
how many nephrons per kidney
millions
123
2 types of nephrons and their location
juxtamedullary (deep)
cortical (superficial)
124
2 main components of a nephron
renal corpuscle
renale tubule
125
renal corpuscle contains
glomerulus
Bowman's capsule
126
renal tubule contains
PCT
DCT
Loop of Henle
collecting duct
127
network of porous capillaries
glomerulus
128
membrane of epithelial cells with filtration slits
Bowman's Capsule
129
3 functions of nephrons
control blood concentration and volume
helps regulate blood pH
remove toxic wastes from blood
130
6 arteries for blood to reach nephron
renal
interlobar
arcuate
interlobular
afferent arteriole
glomerulus
131
3 steps of urine formation
filtration
reabsorption
secretion
132
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
133
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
134
tubular reabsorption : _____ and ____ are reabsorbed back into the bloodstream
nutrients
filtrate
135
tubular reabsorption occurs in
PCT, descending and ascending loop of Henle
136
what capillaries allow for tubular reabsorption
peritubular capillaries
137
tubular secretion: waste in _____ is secreted into the ____
blood
DCT
138
tubular secretion rids the body of ____ and helps control ____
certain substances
pH
139
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
140
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
141
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
142
aldosterone function: _____ sodium n blood = ____ water = _____ blood volume
increased
increased
increased
143
juxtaglomerular apparatus location
at the point where the DCT, afferent, and efferent arteriole come into contact
144
granular cells in the _____ arteriole, release _____
afferent
renin
145
Macular densa cells in the _____, inhibit _____ release
DCT
renin
146
juxtaglomerular apparatus regulates
BP
147
____% loss of renal function before blood tests are evaluated
60
148
what is the most sensitive test for kidneys
serum creatinine
149
serum creatinin is a breakdown product of what
muscle metabolism that is filtered out by the kidneys
150
serum creatinine appears in blood normally in amounts proportional to ______
the body's muscle mass
151
increased serum creatinine values seen in (3)
renal failure
chronic nephritis
urinary tract obstruction
152
serum creatinin is ____ sensitive than BUN
more
153
BUN is an end product of
protein metabolism
154
BUN is formed in the liver from
ammonia
155
BUn reflects ____ intake and ______ capacity
protein
renal excretory
156
increased BUN (2)
renal dysfunction and dehydration
157
decreased BUN (3)
hepatic damage, malnutrition, over-hydration
158
serum electrolytes (4)
chloride, potassium, sodium, and bicarbonate
159
serum electrolytes increased in (2)
acute renal failure
glomerulonephritis
160
serum electrolytes decreased in (2)
acute and chronic renal failure
161
six urine tests for kidneys
RBC
WBC
pyuria
proteinuria
pH
specific gravity
162
hematuria
blood in urine
163
hematuria occurs in (3)
inflammation, tumors, calculi
164
WBC in urine indicates (2)
infection
inflammation
165
pyuria indicates
infection
166
what is pyuria
pus in urine
167
proteinuria occurs in (4)
nephritis, polycystic disease, stones, carcinoma
168
alkaline = ____
basic
169
when pH of urine is basic =
formation of stones
170
specific gravity measures
abilitiy to concentrate urine
171
specific gravity decreases in
renal failure
172
specific gravity increased with
decreased urine output (dehydration)
