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