Abdm Ultra: 100812: Renal Anatomy

Front 1

What are the 5 functions of the kidneys?

Back 1

1. Remove nitrogenous wastes
2. Maintain electrolyte, acid-base,
and fluid balance of blood
3. Homeostatic organ
4. Acts as blood filter
5. Release hormones: calcitriol &
erythropoietin

Front 2

Urine normally contains no _____, ____, or ______.

Back 2

proteins
RBCs
WBCs

Front 3

What are the 3 parts of urinary function?

Back 3

1) filtration (of water, small soluble organic molecules, and mineral ions, from blood to urine)
2. reabsorption (of water, glucose, amino acid, and sodium, from urine back to blood)
3) secretion (of undesirable molecules from blood to urine)

Front 4

What are the 3 common waste products in urine?

Back 4

1) urea
2) uric acid
3) ammonia

Front 5

What sits atop the kidneys?

Back 5

The adrenal glands

Front 6

The tubes which transport urine from the kidneys to the bladder are called the ____.

Back 6

ureters

Front 7

Urine leaves the bladder through the ____.

Back 7

urethra

Front 8

Venous obstructions result in _____ of the affected structure.

Back 8

enlargement

Front 9

Arterial obstructions result in _____ of the affected structure.

Back 9

shrinkage

Front 10

The ____ passes posterior to the IVC.

Back 10

RRA

Front 11

The ____ passes between the SMA and the aorta.

Back 11

LRV

Front 12

From anterior to posterior, what is the order of the renal artery, renal vein, and ureter?

Back 12

1) Renal vein
2) Renal artery
3) Ureter

Front 13

Near what vertebra is the upper pole of the kidneys located?

Back 13

T12

Front 14

The kidneys, like the pancreas, are ______.

Back 14

retroperitoneal

Front 15

A malignant growth within the perioteum, such as a liver cancer, will usually tend to spread to another organ ____ the peritoneum.

Back 15

within

Front 16

The kidney has an outer layer and inner layer of ___ ____.

Back 16

fibrous capsule

Front 17

Immediately beneath the outer layer of fibrous capsule lies the region called the _____.

Back 17

cortex

Front 18

Beneath the cortex lies the region called the _____.

Back 18

medulla

Front 19

Within the medulla are triangular structures known as the ___ ____.

Back 19

medullary pyramids

Front 20

Between the medullary pyramids are the ___ ____, which are actually an extension of the ____.

Back 20

renal columns
cortex

Front 21

Another name for a renal column is a ____ __ ____.

Back 21

column of Bertin

Front 22

The collecting area for a renal pyramid is called a ____ ____.

Back 22

minor calyx

Front 23

Minor calyces converge to form ____ _____.

Back 23

major calyces

Front 24

Major calyces converge into a region called the ____.

Back 24

hilum

Front 25

The area of the hilum is padded with ____ _____.

Back 25

adipose tissue

Front 26

The _____ is the functional unit of the kidney.

Back 26

nephron

Front 27

The capillary ball which filters blood is called the ______.

Back 27

glomerulus

Front 28

The filtrate from the glomerulus is received by the ____ _____, which is the beginning of the collecting system.

Back 28

Bowman's capsule

Front 29

The arteriole entering the glomerulus is called the _____ arteriole, while the arteriole exiting the glomerulus is called the ____ arteriole.

Back 29

afferent
efferent

Front 30

The capillaries which surround the collecting tubules are called the _____ ______.

Back 30

peritubular capillaries

Front 31

The 2nd part of the collecting system (after Bowman's capsule) is called the ____ ____ ____.

Back 31

proximal convoluted tubule

Front 32

The 3rd part of the collecting system is called the _____ __ ____.

Back 32

loop of Henle

Front 33

The 4th part of the collecting system is called the _____ _____ _____.

Back 33

distal convoluted tubule

Front 34

The 5th part of the collecting system is called the ____ ___.

Back 34

collecting duct

Front 35

The 9 elements of the arterial structure of the kidney, beginning with the aorta and ending with the glomerulus, are:

Back 35

1) aorta
2) renal artery
3) segmental artery
4) lobar artery
5) interlobar artery
6) arcuate artery
7) interlobular artery
8) afferent arteriole
9) glomerulus

Front 36

The 8 elements of the venous structure of the kidney, beginning with the glomerulus and ending with the IVC, are:

Back 36

1) glomerulus
2) efferent arteriole
3) peritubular capillaries and vasa recta
4) interlobular vein
5) arcuate vein
6) interlobar vein
7) lobar vein
8) segmental vein
9) renal vein
10) IVC

Front 37

What are the vasa recta?

Back 37

A specific type of peritubular capillary, which are straight and lie parallel to the loop of Henle.

Front 38

What is unique about the capillary structure of the renal system?

Back 38

The fact that there are two separate capillary beds - one being the glomerulus, the other being the convoluted tubules. The glomerulus capillary bed is unique in that it has arterioles both entering and exiting it.

Front 39

What is another name for a nephron?

Back 39

Uriniferous tubule

Front 40

85% of nephons are _______ nephrons, which are (longer / shorter).

Back 40

cortical
shorter

Front 41

15% of nephons are _______ nephrons, which are (longer / shorter).

Back 41

juxtamedullary
longer

Front 42

Which type of nephrons include vasa recta?

Back 42

juxtamedullary

Front 43

What are 3 common nitrogenous wastes in urine?

Back 43

1) urea
2) uric acid
3) creatinine (ammonia is a derivative of this)

Front 44

What are 4 ions in urine?

Back 44

1) sodium
2) postassium
3) sulfate
4) phosphate

Front 45

Renal function is controlled by the ____ and ____.

Back 45

heart
brain

Front 46

The hypothalamus communicates with the ____ ____ gland, which releases _____.

Back 46

posterior pituitary
ADH

Front 47

The bladder has ____ and ____ sphincters.

Back 47

internal (involuntary, smooth muscle)
external (voluntary, skeletal muscle)

Front 48

After pregnancy, the _____ sphincters become weaker.

Back 48

external

Front 49

The bladder lies posterior to the ____ _____.

Back 49

pubic symphysis

Front 50

In males, the bladder lies anterior to the ____.

Back 50

rectum

Front 51

In females, the bladder lies anterior to the ____ and ____.

Back 51

vagina
uterus

Front 52

Each ureter is about ___ long.

Back 52

25 cm

Front 53

The ureters enter the bladder on its _____ _____ surface.

Back 53

posterior inferior

Front 54

The ureters and bladder are (intraperitoneal / retroperitoneal)

Back 54

retroperitoneal

Front 55

The 3 layers of the ureter, from outermost to innermost, are:

Back 55

1) Outer fibrous coat = adventitia
2) Middle muscular coat = muscularis
3) Inner = mucosa = transitional epithelium

Front 56

The muscularis has inner ___ layers and outer ____ layers.

Back 56

longitudinal
circular

Front 57

Is urine transported only by gravity?

Back 57

No, the ureters play an active role.

Front 58

What layer of the ureter stretches (without breaking) when the ureter fills?

Back 58

The transitional epithelium

Front 59

The _____ is an area within the bladder, between the entry point of the ureters and the urethra, which is particularly prone to infection.

Back 59

trigone

Front 60

When empty, the bladder is shaped like ___.

Back 60

an upside-down pyramid

Front 61

What is the only part of the bladder which never contracts?

Back 61

The trigone

Front 62

The bladder wall has ___ layers, just like the ureters.

Back 62

3

Front 63

The muscularis layer of the bladder is called the ____ _____.

Back 63

detrusor muscle

Front 64

How long is the urethra in
1) males?
2) females?

Back 64

1) 20 cm
2) 3-4 cm

Front 65

Why do females have more urinary tract infections from stool contamination than males?

Back 65

Because of the short length of the urethra

Front 66

What is the name for the abnormal presence of the albumin protein in urine?

Back 66

Albuminuria

Front 67

The kidney is responsible for removal of (inorganic / organic) waste products.

Back 67

organic

Front 68

The columns of Bertin host the ____ veins and arteries.

Back 68

interlobar

Front 69

The area between the cortex and medulla contains the ____ veins and arteries.

Back 69

arcuate

Front 70

A ___ bladder is best to appreciate the urethral jets.

Back 70

full

Front 71

The kidneys are best evaluated when the bladder is _____, as this should eliminate any urine in the kidney which might be mistaken for hydronephrosis.

Back 71

empty

Front 72

Unlike the liver, a thorough kidney scan requires knowledge of _____ data, because many pathologies could have the same appearance.

Back 72

clinical

Front 73

The 2 most common reasons for renal scans are:

Back 73

1) pain
2) hematuria (or any change in urine color)

Front 74

____ mimics renal pathologies.

Back 74

AAA

Front 75

The kidney extends from vertebrae ___ to ___.

Back 75

T12
L4

Front 76

The kidney, including its fibrous capsule, is enclosed by ___ ____, which cannot be seen sonographically.

Back 76

Gerota's fascia

Front 77

What is the difference between the renal "pelvis" and "hilum"?

Back 77

"Pelvis" only refers to the calyces (major and minor)

"Hilum" refers to not only the ureter, but also the vessels, nerves, and lymphatics.

Front 78

Are the ureters normally sonographically visible?

Back 78

No. If you see them, be suspicious of hydronephrosis.

Front 79

The pelvis is (echogenic / nonechogenic)

Back 79

nonechogenic

Front 80

The sinus is (echogenic / nonechogenic)

Back 80

echogenic

Front 81

What are 7 common pitfalls in renal scanning?

Back 81

1. Failure to scan both kidneys
2. Mistaking prominent renal pyramids for hydronephrosis
3. Mistaking prominent pyramids for cysts
4. Confusing normal renal arteries for the ureter
5. Failure to scan through the bladder to search for stone at the uretero-vesicular junction
6. Inability to visualize left kidney due to anterior probe placement
7. Failure to scan the aorta in suspected renal colic (acute pain)

Front 82

Renal arteries and veins are best seen in _____ view.

Back 82

transverse

Front 83

Arcuate vessels may appear ____ due to fat in their walls.

Back 83

bright

Front 84

How close should the length of the kidneys be to each other?

Back 84

Within 1 cm

Front 85

What normal variant is a lateral kidney bulge with the same echogenicity as the cortex?

Back 85

Dromedary hump

Front 86

What normal variant involves cortical tissue indenting into the sinus?

Back 86

Hypertrophied column of Bertin

Front 87

What normal variant involves a sinus divided by a hypertrophied column of Bertin?

Back 87

Double collecting system

Front 88

What normal variant involves kidneys connected, usually at lower pole?

Back 88

Horseshoe kidneys

Front 89

What normal variant involves kidneys outside the normal renal location?

Back 89

Renal ectopia