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153 Cards in this Set

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The kidneys develop in the ____ & ascend in there position by ____ weeks of gestation.
pelvis, 12-15
What else occurs at the time of kidney development?
normal urine excretion
The renal pelvis is located _____.
anteriomedially
What type of contour do the kidneys have in the fetus & neonate?
lobulated contour
The kidneys are a _____ organ.
retroperitoneal
Where do the kidneys lie in relation to the vertebra?
Between the 1 & 3 vertebra
The right kidney sits slightly more ____ than the left kidney.
inferior
The average length of the adult kidney is ____.
9 - 12 cm (SAG)
What is the TRV width of the kidney?
4 - 5 cm
The AP thickness of the kidney is ____.
2.5 - 3 cm
In children, renal size ____ with ____.
varies, age
What is the renal length formula for a child less than 1 year?
4.98 + [ 0.155 x age (months) ]
The renal length formula for a child over 1 year is:
6.79 + [ 0.22 x age (years) ]
The ____ is the kidney's basic functional unit.
nephron
What does the nephron consist of?
A renal corpuscle & tubule
The ____ ____ contains more than 1 million nephrons.
renal parenchyma
What is the outer portion of the parenchyma called?
cortex
What does the cortex contain?
convoluted tubules & glomerular capsules
The _____ is the inner portion of the parenchyma.
medulla
Within the medulla are the ____ ____.
renal pyramids
What do the renal pyramids contain?
collecting tubules & loops of henle
The ____ ____ is the central portion of the kidney.
renal sinus
What does the renal sinus contain?
collecting system, arterioles and venules, lymphatics, peripelvic fat, fibrous tissue, and some of renal pelvis
There are ____ layers of ____ tissues that surround the kidney for protection & support.
3, encapsulated
What are the 3 layers of the kidney?
1) fibrous renal capsule (inner)
2) adipose capsule (mid)
3) Gerota's fascia (outer)
The fibrous renal capsule is the ____ ____.
true capsule
What capsule contains perirenal fat?
adipose capsule
What layer of the kidney is considered the renal fascia?
Gerota's fascia (outer layer)
A sheet/band of connective tissue binding together parts of the body is known as a:
fascia
Main renal arteries arise directly off the ____ aspect of the ____.
lateral, aorta
What artery enters into the renal hilum?
main renal artery
After the main artery enters the hilum it divides into 4-5 ____ ____.
segmental arteries
What do segmental arteries branch into?
interlobar arteries
The interlobar arteries course along side the ____ ____.
renal pyramids
What do the interlobar arteries form?
Arcuate arteries
Arcuate arteries branch into ____ arteries, which enter the ____.
interlobular, glomeruli
A round cluster of interconnected capillaries found in the cortex of the kidney is the:
glomeruli
What is the role of the glomeruli?
remove body waste to be excreted as urine
A small diameter blood vessel in microcirculation that branches from an artery is the ____.
arteriole
The ____ are the smallest of the body's blood vessels and are part of microcirculation.
capillaries
How thick are capillaries?
One cell thick
What do the capillaries connect?
arterioles & venules
The _____ enable the exchange of H2O, O2, CO2, between blood & tissues.
capillaries
All the kidney veins exit the ____ ____ vein to go to the ____.
main renal vein, IVC
How does the renal vein exit the hilum?
anteriorly
The ureters exit the kidney _____.
posterior-inferiorly
How does the renal artery enter the kidney?
posterior superiorly
How does the left renal vein course?
Anterior to aorta, posterior to SMA
Kidney size in patients varies with what 4 things?
Age, size of pt, gender, and state of hydration
The renal cortex is ____ & has ____ echoes.
homogeneous, low-med
Most of the time the renal cortex is slightly ____ to the liver.
hypoechoic
Sometimes in slim patients, the cortex may be ____ to the liver.
isoechoic
The medulla is ____ to the cortex.
hypoechoic
There are hyperechoic interfaces @ the ____ ____.
corticomedullary junction
What vascular landmark separates the cortex from the medulla?
arcuates
Hypoechoic triangular stuctures seen between the cortex & columns, grouped around the renal sinus is the:
renal pyramids
The renal sinus & perirenal fat is very ____ & ____ to cortex.
echogenic, hyperechoic
What structure is demarcated by bright specular reflections from the arcuate arteries?
corticomedullary junction
Inward extensions of the cortex between the pyramids are the:
Columns of Bertin
The renal cortex is more lobular in an ____ kidney.
infant
The cortex of a fetal kidney is ____ to the liver because of scarcity of fat.
isoechoic
The pyramids are ____ in relation to the cortex in the ____ kidneys.
hypoechoic, fetal
Two variants of the kidney include:
prominent column of bertin, dromedary hump
What is a dromedary hump?
A cortical bulge found on the lateral aspect of the left kidney
The prominent column of bertin contains ____ tissue in the ____.
cortical, medulla
Three anomalies of number include:
bilalteral renal agenesis, unilateral renal agenesis, and complete duplication
Bilateral renal agenesis is ____.
fatal
What is unilateral renal agenesis?
congenital absence of 1 kidney
Complete duplication of a kidney is known as a _____ kidney.
supernumery
With a supernumery kidney the ____ may or may not be duplicated.
ureter
The main anomally of position is ____ ____.
renal ectopia
A congenital condition in which the kidneys fail to migrate to their normal position is ____ ____.
renal ectopia
What are the 3 varients of renal ectopia?
pelvic kidney, crossfused renal ectopia, thoracic kidney
When the kidneys are positioned in the same quadrants & are fused together is is called:
cross fused renal ectopia
What is a thoracic kidney?
when the kidney is herniated thru the diaphragm after excessive cephaled migration during embryology
The most common form of fusion anomaly is the ____ ____.
horseshoe kidney
When someone has a horseshoe kidney, there is a ____ of the kidneys usually @ the ____ poles.
fusion, lower
When the kidneys are fused they lie in an ____ position with an ____ of tissue fusing the kidneys.
oblique (TRV), isthmus
T or F. The kidneys lie lower than normal when fused.
True
Associated conditions of the horseshoe kidney include:
urinary calculi, pyelocaliectasis
The ____ shaped kidney is a varient of the horseshoe kidney.
sigmoid
When the upper pole of one kidney is fused to the lower pole of another it is called:
sigmoid kidney
What does the sigmoid kidney & cake lump kidney cause?
Anterior malrotation of the renal pelvis
Another variant of the horseshoe kidney is the ____ kidney.
cake/lump
Where is the cake/lump kidney usually found?
In the pelvis
An often asymptomatic anomaly of the kidney that causes HBP is:
unilateral hypoplasia
When one kidney is small in size with the other having compensatory enlargement it is ____ ____.
unilateral hypoplasia
_____ hypoplasis has the worst clinical consequences & leads to ____ ____.
bilateral, renal insufficiency
Contour lobulation persisting past 5 yrs of age is called:
persistant fetal lobulation (PFF)
Unusual development of a part of the body is:
dysplasia
What normal variant is confused with hydronephrosis/obstruction?
extrarenal pelvis
When the renal pelvis lies partly outside the kidney it is an ____ ____.
extrarenal pelvis
A duplex collecting system is most common in ____ & affects ____% of births.
females, 15%
When having a duplex collecting system, the kidneys contain 2 _____ system with ____ ureters.
pyelocaliceal, 1-2
T or F. Duplex collecting system's can be seen on US.
true
IPCKD=
infantile polycystic kidney disease
APCKD=
adult polycystic kidney disease
What influences BP, blood volume & intake of salt/water?
renin-angiotensin system (RAS)
The RAS regulates what 3 things?
acid-base balance, serum electrolytes, renal production of erythropoietin
A kidney hormone that stimulates the development of RBC's in bone marrow is:
erythropoietin
What are the 3 functions of the urinary tract?
convey urine to bladder, reservoir for urine, convey urine from body
Serum _____ elevates with renal dysfunction due to destroyed nephrons.
creatinine
____ is more sensitive than BUN in determining renal dysfunction.
creatinine
What is creatinine?
A blood chemical which is a product of muscle metabolism breakdown
What 3 things is creatinine not sensitive to?
dehydration, GI bleed, increased dietary proteins
____% loss of renal function occurs before BUN & creatinine rise.
60%
When do BUN levels rise?
acute/chronic disease, renal failure, dehydration, urinary obstruction, shock, heart failure
What 5 things decrease BUN levels?
overhydration, pregnancy, liver failure, secondary smoke, decreased protein
T or F. BUN is toxic to the body.
True
What is bun?
urea breakdown of bodily proteins which contain nitrogen
What does a urinalysis evaluate?
Uric acid, protein levels, specific gravity, & pH
The ____ _____ urinalysis is used to detect chronic renal disease.
concentration dilution
What type of transducer should be used for a renal exam?
3.5 MHz or higher
A ____ MHz transducer is very helpful in identifying renal calculi.
5 MHz
Blood in urine is known as ____.
hematuria (proteinuria)
Decreased urine output is known as ____.
oligurio
A form of blood poisoning caused by the accumulation in blood of products normally excreted w/ urine:
azotemia (uremia)
An ____ x-ray is of the kidneys, ureters, & bladder using contrast.
IVP (intravenous pyelogram)
IVP can detect problems resulting from:
calculi, enlarged prostate, obstruction, and tumors
The _____ space is the portion of the abdomen & pelvis not within the peritoneum.
extraperitoneal
What does the lower urinary tract include?
ureters, bladder, urethra
What does the extraperitoneal space include?
retroperitoneal & retropubic space
The ____ transport urine from the kidney to the bladder.
ureters
The ureters are ____, & ____ to the common iliac artery.
retroperitoneal, anterior
The ureters have ____ ____ to prevent backflow.
valve folds
The ureters contain smooth muscle & _____ pushes the urine down.
peristalis
When are the ureters visualized on US?
when they are dilated
How do the ureters enter the bladder?
posterior-laterally
The ____ ____ is a hollow muscular organ.
urinary bladder
The ____ is the superior portion of the bladder @ the level of umbilicus.
apex
What is the level of connection @ the ureters called?
trigone
The ____ of the bladder is contiguous with the urethra.
neck
What are the 4 coats of the bladder from outer to inner?
serous, muscular, submucous, & mucous coats
The ____ coat is partial & is derived from peritoneum.
serous
What coat consists of 3 layers of unstripped muscular fibers?
muscular coat
What are the 3 layers of the muscular coat?
1) external- (longitudinal)
2) middle- (circular)
3) internal- (longitudinal)
The ____ coat consists of a layer of areolar tissue.
submucous
The submucous coat connects the ____ & ____ coats together.
muscular & mucous
The ____ coat is thin, smooth, and a pale rose color.
mucous
What is the mucous coat continuous with?
Lining of the renal tubules, ureters, and urethra.
The mucous coat constricts the ____ of the bladder.
rugae
The urethra is a ____ structure that carries ____.
tubular, urine
The urethra exits the bladder ____.
anteriorly
What are the 2 sphincters of the urethra?
internal & external
Is the urethra visualized sonographically?
NO
Explain the passage of urine.
collecting tubule --> renal pyramid --> minor calyx --> major calyx -->renal pelvis --> ureter --> bladder --> urethra
A sac/pouch in the wall of the bladder which may be congenital/acquired is a ____ ____.
bladder diverticulum
What are 5 lower urinary tract variants?
bladder diverticulum, duplication, exstrophy, posterior urethral valve (PUV), and ureterocele.
Eversion of the bladder is considered ____ ____.
bladder exstrohpy
With bladder exstrophy the anterior wall of the bladder does not form due to failure of the ____.
mesoderm
Posterior urethral valves occur in ____ ___ only.
male fetuses
A ____ is a cyst-like dilatation of the ureter.
ureterocele
What is a ureterocele a result of?
congenital stenosis of the uretral orfice