Week 10- Urinary system Flashcards
Name the 3 sets of kidneys in embryo
- pronephros
- mesonephros
- metanephros
pronephroi are in __ week gestation they are rudimentary and ____ functional
- early4th
- non
mesonephroi are in __ week gestation and function as interim kidneys until the __ week
- late 4th
- 9th
metanephroi are ___ kidneys
pernament
metaphorni develop from 2 sources:
- ureteric bud
2. metanephrogenic blastema
__ forms the ureter, renal pelvis, calyces, and collecting ducst
ureteric bud
Ureteric bud interacts with and penetrates the ___ blastema
metanephrogenic
permanent kidneys start in the ___ and travel __ to end up in the ___ retroperitoneum
- pelvis
- up
- upper
T/F: kidney’s rotate medially 90 degrees as they move up in abdomen so the renal pelvis is anteromedial
true
week __ of gestation is when the final location and position of kidney’s is reached
9th
bladder is formed in the __ week of gestation
7th
what is formed by urorectal septum fusing with cloacal membrane
bladder
urogenital sinus becomes the
bladder
the following occurs as bladder ____:
- distal mesonephric ducts become part of the connective tissue in the bladder trigone
- ureters open separately into the bladder
becomes larger
___ & ___ originate from adjacent splanchnic messenchyma
Connective Tissue & Smooth muscle
epithelium of female urethra and majority of male urethra epithelium is derived from the ___
endoderm of the urogenital sinus
anomaly where the distal ureter balloons at it’s opening into the bladder forming a sac like pouch
ureterocele
- patent urachus
- urachal cyst
- umbillical-urachal sinus
- vesicourachal diverticulum
are all types of ___ anomoly
urachal
communication bw the bladder and umbillicus through urachus that has not involuted (50%)
patent urachus
a fliud-filled dialation of the mid urachus (30%)
urachal cyst
blind focal dilation of the mid urachus
umbillical-urachal sinus
blind focal dilation of the bladder end of the urachus
vesicourachal diverticulum
difference bw agenesis and hypoplasia
agenesis -unilateral or bilateral -kidney is absent hypoplasia -kidney is present but very small and may not function as well
an extra kidney that can be found superior, inferior, anterior or posterior to the normal kidney, but smaller
supernumerary
where do horseshoe kidneys normally connect at
isthmus (lower pole)
in hoseshoe kidney’s the renal parenchyma can be found ___ to the aorta and IVC
anterior
what is the most common kidney anomaly?
horseshoe
Ureteropelvic junction obstruction is common kidney anomaly found predominantly in ___
men
common location of ureteropelvic obstruction?
left kidney but can be bilateral
chronic vague back or flank pain is indication of what kidney anomaly?
UPJ (ureteropelvic junction) obstruction
obstruction of flow from the pelvis to the proximal ureter
UPJ
UPJ obstruction will cause ___ renal pelvis
enlarged
enlargement of the ureter not caused by distal abnormality of urethra or bladder
congenital megaureter
sonographically appear as a large anechoic tube from kidney to bladder and measures >7mm
congenital megaureter
anomaly where one or both kidney’s are outside of the renal fossa
renal ectopia
if kidneys are not in renal fossa where can they most likely be found
pelvis or lower abdomen
anomaly where both kidneys are on the same side
cross fused ectopia
the __ of the ectopic kidney is typically fused on the __ of the other kidney in cross fused ectopia
- UP
- LP
T/F: in cross fused ectopia the ureters insert posteriorly in the bladder trigone
TRUE
renal anomalies have a high association with what other type of anomalies
genial
triangular echogenic area of sinus fat extends into the cortex and divides the upper and lower poles of the kidney
parenchymal junction defect
incomplete fusion of the developing renal lobules and appears as “clould” like on US with indentations between renal pyramids
fetal lobulation
occurs when renal sinus is divided and each has a renal pelvis. A bifid (double) ureter may also be present
duplex collecting system
localized buldge on the lateral border of the kidney.
dromedary hump
dromedary hump is __-echoic to normal renal cortex
isoechoic
hypertrophied column of bertin causes
enlargement of cortex bw renal pyramids, amy indent renal sinus
presence of the renal pelvis outside of the renal hilum, easier to demonstrate in trv
extrarenal pelvis
extrarenal pelvis sonographic appearance
anechoic balloon like structure protruding from the hilum
adrenal glands are __and __ to the kidneys
anteromedial and superior
right adrenal is more __ to the kidney and the left adrenal is more ___ to kidney
- superior
- medial
right adrenal medial portion is ___ to the IVC
posterior
right adrenal lateral portion is ___ and ___ to the right lobe of liver
- medial
- posterior
left adrenal is _____ to aorta
posterolateral
left adrenal is ___ to the stomach and pancreas
posterior
the __ adrenal gland is triangular and caps the upper pole of __
right
right kidney
the __ adrenal gland is semilunar and extends along the ___ border of the __ from the UP to hilum
left
medial
left kidney
adrenal glands are ___-echoic to kidney
hypoechoic
size of adrenal gland
3-6cm
blood supplied to adrenal glands by
suprarenal artery
blood drained from adrenal by
suprarenal veins
difference between L and R suprarenal arteries
left is branch of inferior phrenic, right is directly from aorta
neonatal adrenal glands have a thin __ core surrounded by a thick ___ zone
echogenic
hypoechoic
thick hyopoechoic zone
adrenal cortex
thin echogenic core
adrenal medulla
t/f: neonatal adrenal glands are larger than adult glands
true
secretes a range of steroid hormones, controlled by ACTH from pituitary gland, consist of 3 zones
cortex
secretes epinephrine and norepinephrin
medulla
3 zones of adrenal cortex
- zona glomerulosa
- zona fasiculata
- zona reticularis
what zone regulates electrolyte metabolism
glomerulosa (mineralocorticoids)
___ is the principle mineralocorticoid
aldosterone
insufficient aldosterone leads to increased excretion of salt and chloride ions and water in urine resulting in ___
acidosis, lower pH
zone responsible for carbohydrate metabolism
fasiculata (glucocorticoids)
primary glucocorticoids
cortisone and hydrocortisone
glucocorticoids increase ___ levels
Blood sugar
diminishes allergic and inflammatory response
glucocorticoids
zone responsible for sex hormones
zona reticularis
androgens
male sex hormone
estrogens
female sex hormones
t/f: both sex hormones are secreted by the reticularis adrenal gland zone regardless of gender
true
in excess, ___ can cause hirsutism and virilization in females and precocious puberty in males
sex hormones (androgens & estrogen)
medulla produces catecholamines ___ & ___
Epinephrine and norepinephrine
epinephrine
heart rate accelerator
norepinephrine
vasoconstrictor
___ produces hormones for flight of fight response
medulla
adrenal glands should NOT appear __ on US
round
typically adrenals are best seen in ___ plane, through a___ window
trv
intercostal
LAG is ___ to UP of LK
anterior
RAG is ___ to IVC and __ to RK
posterior
superior
Thickened crus Accessory spleen Gastric fundus/diverticulum RV Retrocrual/retroperitoneal lymphadenopathy Pancreatic tumor UP renal cysts/tumor
structures that simulate adrenal masses
