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81 Cards in this Set
- Front
- Back
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kidney location
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T12-L3
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ureter location
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anterior to psoas major muscles
lateral aspect of transverse process of L3, L4, L5 |
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what prevents reflux of urine in bladder
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valves at junction of ureter and bladder
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number and size anomalies of kidney
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renal agenesis
potter's syndrome (bilateral agenesis) supernumerary kidney hypoplasia acquired atrophic kidney |
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fusion anomalies of kidney
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horseshoe kidney
complete fusion crossed ectopia |
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position anomalies of kidney
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malrotation
ectopic kidney nephroptosis (kidney prolapse) |
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renal pelvis, ureter, bladder, and urethral anomalies
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duplication (duplex kidney)
ureterocele ureteral diverticula bladder diverticula posterior urethral valves polycystic kidney disease medullary sponge kidney |
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Renal agenesis
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only one kidney present
- however, the one kidney exhibits compensatory hypertrophy to compensate for missing kidney - often left kidney is missing |
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which kidney is often missing in renal agenesis?
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left kidney
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where do you see compensatory hypertrophy of kidney?
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renal agenesis
hypoplasia of kidney (comp hypertrophy in other kidney) |
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Potter's syndrome (bilateral agenesis)
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no kidneys present.
not compatible with life |
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supernumerary kidney
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extra kidney (total of 3)
3rd kidney has seperate pelvis, ureter and blood supply - often becomes infected - need surgical removal - usually not seen in KUB or IVU |
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hypoplasia of kidney
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- less develop kidney with smaller size compared to norm kidney
- BUT contains normal nephrons (just less # cells?) - NOT like acquried atrophic kidney |
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acquired atrophic kidney
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reduced amt of parenchyma due to vascular disease or inflam disease
- reduced amt of FUNCTIONAL tissue - but starts out as normal kidney - NOT like hypoplasia of kidney - |
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horseshoe kidney
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most common fusion anomaly
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horse shoe kidney
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lower poles of both kidney are joined AT MIDLINE
- connected by band of connective tissue or normal renal parenchyma - may have roation on one or both kidney - renal function NOT impaired |
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horse shoe kidney
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both kidney fused at lower pole AT MIDLINE OF BODY
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complete fusion of kidney
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results in single irregular mass that does not resemble a kidney
- donut, cake, disk shape |
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crossed ectopia
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one kidney moves PAST MIDLINE to fuse with other kidney
- both kidney demonstarte anormal position, shape,rotation |
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crossed ectopia
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both kidneys are on same side (L/R) and fused
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crossed ectopia vs. horseshoe kidney
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horseshoe: lower pole fused at MIDLINE
crossed ectopia: can be fused anywhere but both kidney must be on one side |
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malrotation of kidney
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rotation of kidney as they acsend from pelvis in utero
- no prob unless causes obstruction |
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where does utero kidney go to and from?
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starts from pelvis and ascends to ab (normally)
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ectopic kidney
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kidney not in normal position
- pelvis kidney (pelvic/sarcal area) - intrathoracic kidney (found above diaphragm) |
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ectopic kidney
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kidney not found in normal position
- increase incidence of ureteropelvic junction obstruction or vesicouretral reflux |
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vesicouretteral reflex
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backward flow of urine from bladder into ureter
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intrathoracic kidney
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- a type of ectopic kidney but found above diaprhagm
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how to differentiate ectopic kidney from nephroptosis
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by ureter length
- nephroptosis has long ureter cuz its mobile - ecotpic kidney has a fixed length ureter (short if in pelvis) |
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nephroptosis (kidney prolapse)
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a very mobile kidney
- common in slender athletic people - may drop towards pelvis in erect position - can differnetiate it form ectopic kidney from length of ureter - nephroptosis has long ureter (cuz mobile) - ectopic kidney has shorter ureter (if ectopic in pelvis) |
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duplication (duplex kidney)
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vary from
- bifid renal pelvis - double renal pelvbis, ureter, ureterovescial orificae anomolies impaire renal drainage, leading to calculi formation or infection |
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ureterocele
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cyst like dialtion of ureter NEAR opening ot bladder
- rad app -- cobra head if ureter is CM filled and bladder is CM filled |
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cobra head sign is in...
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ureterocele
- see if CM fills ureterocle - if ureterocele not CM filled, will look like radiolucent mass in CM filled opacified bladder (fig 6.7 a and b) |
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ureteral diverticula
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diverticula / outpouching in ureter
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bladder diverticula
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outpouching in bladder
- caused by chronic bladder obstruction - ex. elderman with chronic prostate problem |
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posterior ureterhal valves
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thin mucosal folds that stick into lumen of urethra (posteriorly)
- can cause urine obstruction -exclusive to males - can cause HYDRONEPHROSIS or HYDROURETER or renal dmg retrograde urogram CANNOT visualize it fig 6.9 ca |
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what can posterior uretheral valves lead to ?
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hydronephrosis
hydroureter renal dmg |
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what procedure best shows posterior uretheral valves?
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retrograde urogram
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when can you start to see polycystic kidney disease
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seen at birth by multiple lucent lesions
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polycystic kidney disease source
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congenital
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polycycstic kidney disease classed as
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autosomal recessive or autosmomal dominant
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polycystic kidney disease
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multiple tiny cyst in nephrons at birth. they enlarge and detroy tissue
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polycystic kidney disease best shown with
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IVU shows..
- bilat. kidney ENLARGEMENT - poor visualization of renal outline (from cyst) - calyces appear distored |
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medullary sponge kidney
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congenital dilation of renal tubules
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what does medullary sponge kidney lead to
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since renal tubules are dilated.
- urinary stasis - increase levels of calcium phospahte (nephrocalcinosis) - only diagnosed when infection occurs and you go see Dr. |
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where you we put new kidney in kidney transplant?
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usually in right pelvis
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Urinary tract infection (UTI)
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inflam of urinary epithelium by invasion and colonization of bacteria (e. coli, fungi candida or parasite schisosmiasis)
schisosmiasis from snail dropping (travel south) clinical signs - dysuria - hard to void piss - frequency - feel like pissing alot - lower back pain or suprapublic pain pain can also travel down scrotum |
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factors that contribute to UTI
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0 efficiency of host defense
- viirulence or ability to evade or overwhelm host defense mechanism |
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what is urinary tract
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(ureter, renal, pelvis, and renal prenchyma)
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pyelonephritis
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infection of one or both urinary tract (ureter, renal, pelvis, and renal parenchyma)
has acute and chornic |
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acute pyelonephritis
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acute infection of urinary tract (ureter, renal, pelvis, and renal parenchyma)
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CHORNIC PYELONEPHRITIS
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PERSISTENT OR RECURRING EPISODES OF acute pyelonephritis (leads to SHRUNKEN fibroitic kidney)
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clincal signs of pyelonephritis
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rapid onset fever, chills, malaise and flank pain (L spine region)
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glomerulonephritis and causes
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inflam of glomerulus (where urine is produced)
causes: immune. prob, drugs, toxin, vascular disorders, system disease (diabetes) viral (hep B, C , HIV) clincal signs - hematuria , proteinuria |
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acute glomerulonephritis AKA is....
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(bright's disease)
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chornic glomerulonephritis
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leads to chronic renal failure
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clincal signs of glomerulonephritis
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hematuria (blood in urine) and proterinuria (protein in urine)
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proteinuria
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protein in urine is bad
- proteins normally are too big to cross glomerulus |
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nephrotic syndrome
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excreation of "3.5g" or more protein in urine/day
characterisitic of glomerular injury clincal sign - edema |
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any protein is urine is usually problem in...
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glomerulus
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Renal failure (acute)
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acute and rapidly progressing (within hours)
- process may be reverssible - associated with oliguria (urine output less than 30 ml/hr or 400 ml/day |
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oliguria
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(urine output less than 30 ml/hr or 400 ml/day
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renal failure (chronic)
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preossing to end stage renal fialure (months to years)
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other terms used with renal failure
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renal insufficiency, renal failure, uremia
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what is renal failure
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significant loss of renal function (less than 10% remains - end stage renal failure)
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uremia
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syndrome of renail failure and includes
- elevated blood urea, creatinine - fatique - anorexia - nausea - vomitting - neuro changes |
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treatment for renal failure
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dialysis (mechanicam removal of water, electrolyes and toxins from blood
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Cystitis
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inflammation of urinary bladder
- more common in females common cuase - bacteria - urinary stasis (holding pee allday) (enlarge prostate cna lead to this or pregnancy) - catherization clincal signs - pain, urgency and frequency |
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interstitial cystitis
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cause pelvic pain with discomfort BEFORE AND AFTER voiding
- invovles bladder submucosa |
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inflammatory disease of GU
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UTI
pyelonephritis (acute/chronic) glomerulonephritis (acute (bright diseease) chronic) cystitis what inflam can lead to... renal failure nephrotic syndrome |
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normal urine components
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nitrogen waste (urea, uric acid, creatinine)
electrolytes (NaCl, sulfates, phosphates) pigment (yellow pigment from bile) normal colour should be faint yellow cirrhosis give u dark yellow Ca of liver give u orange urine |
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abnormal urine components
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glucose (glycouria)
albumen (albumineuria) blood (hematuria) ketones (incomplete oxidize fat) white blood cell (pus = pyuria) cast cells (solid formed within kideny tubules white blood cell df |
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ketones in urine will...
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urine will foam
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pus or white blood cell in urine will
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look cloudly
smell necrotic |
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pH of urine
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4.5 - 8
(outside range is cystitis) |
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normal specs of urine
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95% h20, 5% dissolved solids and gas
normal pH 6 (4.5-8) specific gravity (1.002- 1.040) amt of dissolved stuff |
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HYPOplasia of kidney is associated with HYPERplasia of other kidney. True?
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True.
makes sense. if one kidney was lacking, the otehr will have "compensatory" hyperplasia |
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horseshoe kidney often result in a rotation anomlay on one or both sides. true or false?
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true
- often the superior aspect of kidneys are tilted outward instead of inward (normally, sup poles are more posterior than lower poles) |
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two pathologies which can lead to compensatory hypertrophy
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solitary kidney
hypoplasia of kidney |
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how do we get ureterocele?
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congenital STENOSIS of ureteral orifice, leading to the cystic dilation we see before bladder
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most renal stones are radiolucent or radiopaque?
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radioopaque (80%)
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renal trauma should be suspectef if......
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# of 12th rib
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