Urinary Tract Development

Question 1

Since the kidney continues to produce urine, the urinary tract will ___ between the site of obstruction and kidney

Answer 1

dilate

Question 2

hydronephrosis

Answer 2

dilation of renal pelvis by urine

Question 3

hydroureter

Answer 3

dilation of ureter by urine

Question 4

reflux

Answer 4

urine traveling back up ureter upon contraction of detrusor –> hydroureter

Question 5

megalocytis

Answer 5

chronic distension of bladder by urine due to bladder outlet obstruction

Question 6

UPJ obstruction
1) most common cause of pediatric hydronephrosis

2) more common in ___
3) which side, bilateral in ___
4) signs and symptoms
5) how to detect
6) coexists with other congenital abnormalities?
7) 10% of UPJ obstruction show __

Answer 6

2) boys (2:1)

3) left side
bilateral = 10-40%

4) abd mass, pain, UTI
5) prenatal US
6) yes
7) ipsilateral reflux

Question 7

UPJ obstruction embryology

Answer 7

incomplete canalization of ureteric bud at 12 weeks gestation and/or abnormality of smooth muscle fibers with incr fibrosis preventing peristalsis

Question 8

ureteral duplication
1) most common renal abnormality

2) more common in __
3) define

Answer 8

2) females

3) 2 ureters ipsilaterally enter bladder –> VU-reflux into the lower pole and obstruction of upper pole
upper pole ectopically inserts into bladder or ureterocele

Question 9

signs and symptoms of ureteral duplication

Answer 9

failure to toilet train or continuous drip continuous

Question 10

ureterocele

define

located

can it be obstructive?

can it cause reflux

Answer 10

1) cystic dilation of terminal intravesical ureter (within bladder wall)
2) at the bladder neck or urethra regardless of position of orifice
3) yes if orifice is stenotic or ectopically located
4) yes if orifice is patulous

Question 11

ureterocele assoc with ___

diagnosis?

ureterocele prolapse how?

Answer 11

upper pole ureter of duplex kidney (dysplastic)

diagnosed prenatally when assoc with hydronephrosis or UTI

if urethra causing bladder outlet obstruction in girls

Question 12

what is urachus

Answer 12

connects fetal bladder to allantois in umbilical cord

forms the median umbilical ligament

Question 13

symptoms of urachal remnant

Answer 13

pain and retraction of umbilicus during micturition

Question 14

effect of urachal cyst

Answer 14

painful midline mass btwn umbilicus and suprapubic area

Question 15

urachal sinus leads too…

Answer 15

drainage of clear or puruelnt urine at umbilicus –> UTI

Question 16

clinical presentation of urachal remnant

can form into umbilcial polyp with …

Answer 16

clear fluid in umbilicus with micturition

–> umbilical polyp with local irritation

Question 17

posterior urethral valves
define

occurs from

Answer 17

abnormal congenital obstructing membrane in posterior male urethra

abnormal insertion of mesonephric duct on cloaca prior to dividing into urogenital sinus and anorectal canal