Week 11- genito-urinary system Flashcards
what anatomy is covered when imaging the genito-urinary system?
abdominal aorta
Renal V
IVC
Kidneys
Ureters
Testicular/ Ovarian A + V
Superior mesenteric A
Inferior Mesenteric A
Bladder
What is it called when you image the following:
1- Kidneys & Ureters
2- Urinary bladder
3- Urethra
- Urography
- Cystography
- Urethrography
what urography procedures are there?
IV urography
Antegrade urography
Retrograde urography
what cystography procedures are there?
retrograde cystography
Voiding cystography
what is the path of IV contrast urography
Cubital fossa Basilla Vein Axillary vein Subclavian Vein Brachiocephalic Vein SVC R atrium R ventricle Pulmonary trunk Lungs Pulmonary veins L atrium L ventricle Aorta L/R renal arteries
Indications for IVPs
- Kidney Stones
- Tumours in the Kidney, ureter and/or bladder
- Scarring from UTI
- Post-surgery
- Congenital abnormalities
- Obstruction in kidney or ureter
- Hydronephrosis
- Mass/Cyst in Kidney
- Pyelonephritis
- Glomerulonephritis
- Haematuria
Contraindications for IVP
- Renal Failure
- Previous Allergy to iodine
- Generalized allergic reactions
- Multiple Myeloma
- Pregnancy
- Thyrotoxicosis
- Diabetes
- Sickle Cell Anaemia
- Pheocromocytoma
- Severe decreased Liver Function
- Metformin
- Interleukin 2 Chemotherapy
IVP imaging procedure
- Control imaging
- Pressure is applied to the bladder area, with a strap and sponge
- Once the nephrogram images have been obtained a “Full ureter filling image is attempted
- RPO and LPO Renal images are taken
- RPO and LPO images are taken of the bladder area to show the VUJ in the bladder
- If an obstruction becomes evident, then delayed images need to be take to see how the obstructed kidney is performing.
Tomographic principles
The X-ray tube takes a plain X-ray image by moving
The focal plane remains clear and all other structures are blurred above and below the focal plane
4 steps to setting up a tomogram
Set up the patient as per a normal X-ray
Move the X-ray tube to its caudal extent, and do a test run
Once the fulcrum position is determined, the x-ray tube is set to the start position
What consists of a antegrade contrast urography
- Contrast is injected into the kidneys
- Patient is usually lying prone on the x-ray table or fluoro table
This procedure is often done in the OR
Usually 50MI of 370 iodinated contrast is used
370 is a high osmolarity. Why is this okay in an antegrade urography?
Contrast is being injected straight into the ureters to be eliminated: it bypasses the kidney and is not filtered, therefore, does not affect the kidneys
indications for antegrade uropgraphy
- Kidney Stones
- Tumours in the Kidney, ureter and/or bladder
- Scarring from UTI
- Post-surgery
- Congenital abnormalities
- Obstruction in kidney or ureter
- Hydronephrosis
- Mass/Cyst in Kidney
- Pyelonephritis
- Glomerulonephritis
- Haematuria
Contraindications for antegrade urography
- Renal Failure
- Previous Allergy to iodine
- Generalized allergic reactions
- Multiple Myeloma
- Pregnancy
- Thyrotoxicosis
- Diabetes
- Sickle Cell Anaemia
- Pheocromocytoma
- Severe decreased Liver Function
- Metformin
- Interleukin 2 Chemotherapy
why would we put a needle directly into the patients kidney and inject contrast rather than an intra-venous?
this procedure is used to insert a “Nephrostomy Tube” that then is taped and secured to the back of the patient so that the kidney drain externally, as there is an obstruction in the ureter.