Urinary Tract A&P Flashcards
are the kidneys intraperitoneal or retroperitoneal organs?
retroperitoneal
is the right or left kidney more inferior?
right
the renal medulla is the inner part that includes ______
pyramids
the renal pyramids are responsible for _____
absorption
the renal cortex contains ____
nephrons
nephrons are responsible for ______
filtration of blood
normal renal cortex size is
1 cm
what funnels urine towards the renal pelvis?
calyces
what collects urine before it moves into the ureters?
renal pelvis
______ is where the renal pelvis narrows into the proximal ureter
ureteropelvic junction (UPJ)
layers of the kidney (4)
- renal capsule
- perinephric fat
- Gerota’s fascia
- pararenal fat
acts as a barrier against physical trauma and infection for the kidney
renal capsule
helps hold the kidneys in place against the posterior muscles
perinephric fat
surrounds kidneys and adrenal glands, anchors them to surrounding structures
Gerota’s fascia
surrounds Gerota’s fascia and acts as shock absorber
pararenal fat
what is the normal length of a kidney?
9 to 12 cm
what is the normal width of a kidney?
4 to 5 cm
what is the normal AP measurement of a kidney?
2.5 to 3.5 cm
an abnormal length of a kidney is less than ____
8 cm
it is abnormal when there is a measurement difference greater than ____ between the two kidneys
1.5 cm
blood flow to the kidney (5)
- renal artery
- segmental
- interlobar
- arcuate
- interlobular
is the right or left renal vein longer?
left
functions of the kidneys (6)
- vital for homeostasis
- remove waste
- regulate electrolyte balance
- formation of urine
- regulate BP by producing renin
- maintain normal pH, iron, and salt levels in blood
the ureters enter the bladder at the ________
ureterovesicle junction (UVJ)
is the bladder retroperitoneal or intraperitoneal?
retroperitoneal
bladder location in a male
superior to prostate and anterior to seminal vesicles
bladder location in females
anterior to vagina, uterus, and rectum
bladder wall thickness should be _____
less than 4 mm
2 parts of bladder
____ is the upper portion
____ is the lower portion
apex = upper
neck = lower
the male urethra is ____ and is also a pathway for ______
longer
seminal fluid
byproduct of protein metabolism that occurs within the liver and excreted by the kidneys
blood urea nitrogen (BUN)
normal BUN levels are
5 to 15 mg/dl
increase in BUN can indicate (4)
renal disease
obstruction
CHF
GI bleeds
byproduct of muscle energy metabolism that is filtered by the kidneys
serum creatine
normal serum creatinine levels are
0.6 to 1.2 mg/dl
increase serum creatinine levels indicate
renal dysfunction
a congenital cause of renal pseudo tumor,
central unfolding of cortical tissue within the medulla
hypertrophied column of Bertin
bulge in capsule of the left kidney,
cortical thickening is due to compression by spleen
dromedary hump
triangular echogenic area in the upper pole of the renal parenchyma that is common on the right side,
results from incomplete embryonic fusion of renunculi
junction parenchymal defect
fetal lobulation
indentations in the renal outline that result from incomplete fusion of renal lobules
[kidney with bumpy contour]
fatty infiltration of the renal pelvis,
enlarged central echogenic complex
renal sinus lipomatosis
aka fibrolipomatosis
renal pelvis extends outside the hilum,
usually appears dilated
extra renal pelvis
supernumerary arteries
common (30%)
more than one renal artery
most arise from the AO
unilateral renal agenesis is associated with (3)
- bicornuate uterus
- seminal vesicles agenesis
- hypertrophied contralateral kidney
horseshoe kidney
kidneys fused at lower poles
isthmus anterior to AO
ureter anterior to isthmus
kidneys are on the same side and fused,
superior pole of one is fused to the inferior pole of the other
cross-fused renal ectopia
fused pelvic kidney is also known as
pancake, discord, or lump kidney
a fused pelvic kidney is when the kidneys are fused into a single mass at
the medial surface
shaped like an “S”
upper pole of one kidney is fused to the lower pole of the other kidney
sigmoid kidney
duplex collecting system
most common congenital anomaly of the kidneys
associated with obstruction and reflux
complete duplex collecting system
2 renal pelvis and 2 ureters
ureter from the upper pole inserts inferiorly
incomplete duplex collecting system
2 renal pelvis and partial ureters duplication
one common ureter enters the bladder
3 ways infant kidneys differ from adult kidneys
- higher cortical echodensity
- renal pyramids are larger
- little to no renal sinus fat
normal fetal kidney length
3.3 to 5.0 cm
normal fetal kidney AP measurement
1.5 to 2.5 cm
normal fetal kidney diameter
2.0 to 3.0 cm
what is the best transducer to use for renal scans?
3.0 to 5.0 MHz curved
indications for renal ultrasound (6)
- palpable flank mass
- UTI
- hepatitis
- increase BUN or creatine
- oliguria = decrease urine output
- post surgical or trauma assessment
T/F: ultrasound is the imaging choice for bladder
FALSE - cystoscopy
the renal cortex is hypoechoic to _____ and _____
liver and spleen
renal pyramids are hypoechoic to _____
renal cortex
renal sinus is highly _____
echogenic
in relation to the right kidney:
adrenal gland is ________
liver is _____
right colic flexure is _____
2nd portion of the duodenum is ______
adrenal gland = superomedial
liver = superolateral
right colic flexure = inferior
2nd portion of duodenum = medial
in relation to the left kidney:
adrenal gland and spleen are ___
pancreatic tail is ___
left colic flexure is ___
adrenal gland & spleen = superior
pancreatic tail = anterior to the upper pole
left colic flexure = inferior
3 muscles on the posterior aspect of the kidneys
diaphragm
psoas muscle
quadratus lumborum
at the hilum of the kidney:
vein exits ___
artery enters ___
ureter exits ___
vein = anteriorly
artery = between vein and ureter
ureter = posteriorly
arcuate arteries run ____ to capsule, all other arteries run ____
arcuate = parallel
all other renal arteries = perpendicular
ectopic kidney is also known as
pelvic kidney
ectopic kidney results from
failure of the kidneys to “ascend” into the abdomen from the pelvis
with ectopic kidneys, there is an increased incidence of (3)
UPJ obstruction
ureteral reflux
multicystic renal dysplasia
horseshoe kidney lies ___ in the abdomen
lower
unilateral renal agenesis may be associated with VACTERL syndrome and MURCS syndrome
what does VACTERL and MURCS stand for?
vertebral defects
anal atresia
cardiovascular anomalies
tracheoesophageal fistula
renal anomalies
limb defects
mullerian agenesis
renal agenesis
cervicothoracic somite abnormalities
bladder apex is connected to the umbilicus by the
median umbilical ligament (urachus)
renal RI is commonly use to (3)
evaluate renal transplant rejection
assess suspected hydronephrosis
evaluate renal disease
RI equation
RI = (PSV - EDV) / PSV
normal renal RI
< 0.7