Kidneys

Front 1

What the beverages are diuretics

Back 1

Tea coffee alcohol

Front 2

What is an artificial kidney and what is it used for

Back 2

Dialyzing machine that is used for dialysis. Used when the kidneys of a patient stops functioning

Front 3

Kidneys move where during deep inspiration

Back 3

Downward ~1 inch

Front 4

Components of urinary system

Back 4

2 kidneys

1 bladder

1 urethra

2 ureters

Front 5

Function of urinary system

Back 5

Excreting wastes

Regulating blood composition

Front 6

Location of kidneys

Back 6

Lay in sagittal oblique plane in retroperitoneal cavity

Located between 12 thoracic and 4 lumbar

They lie asymetrical right is lower than left BC of liver

Front 7

Kidneys ureters and bladder are located

Back 7

In the Retroperitoneum

Front 8

What two muscles do the kidneys rest on

Back 8

Psoas and quadratus lumborum

Front 9

Each kidney is located ________ to the psoas and quadratus lumborum muscles

Back 9

Anterior

Front 10

Each kidney is located __________ to transverse abdominus muscle and liver/spleen

Back 10

Medial

Front 11

Length of kidneys range from

Back 11

9-12 cm

Front 12

Width of kidneys range from

Back 12

4-5 cm

Front 13

Height of kidneys range from

Back 13

2.5-3 cm

Front 14

Kidneys should have ____ cm in cortical thickness

Back 14

1cm

Front 15

Upper pole is the most _______ border of the kidney

Back 15

Superior

Front 16

Lower pole of kidney is the most ______ border of kidney and is more ________ than the upper pole

Back 16

Inferior

Lateral

Front 17

Superior poles lie more

Back 17

Posterior medial

Front 18

Inferior poles lie more

Back 18

Anterior and lateral

Front 19

The kidney is composed of two distinct areas

Back 19

Renal sinus and the parenchyma

Parenchyma holds the outer cortex and inner medullary pyramids

Front 20

The renal parenchyma is separated into cortex and medulla by the

Back 20

Arcuate vessels

Front 21

Back 21

Longitudinal and transverse normal kidney

Front 22

What muscle is seen here (bottom)

Back 22

Psoas

Front 23

What muscle am I pointing at

Back 23

Psoas

Front 24

What muscle am I pointing at

Back 24

Psoas

Front 25

What muscle am I pointing at

Back 25

Quadratus lumborum

Front 26

What muscle am I pointing at

Back 26

Psoas

Front 27

What is arrow pointing at

Back 27

Quadratus lumborum muscle

Front 28

Where does Psoas muscle begin from

Back 28

Hilum of the kidneys

Front 29

Psoas lies (posterior/anterior)-(medial/lateral) to kidney

Back 29

Posterior medial

Front 30

Quadratus lumborum is located (posterior/anterior) to the lower (what fraction) to the kidney and courses (lateral/medial) to the psoas muscle

Back 30

Posterior

2/3

Lateral

Front 31

Which is the deepest later of Muscles located posteriolateral to each kidney

Back 31

Transverse abdominus muscle

Front 32

Three outer layers of a kidney

Back 32

True capsule

Perirenal fat

Gerota's fascia

Front 33

____________ or fibroid capsule is the most _______ layer of the outer kidney layers

Back 33

True capsule

Most inner

Front 34

Which layer surrounds the true capsule

Back 34

Perirenal fat - layer of fat

Front 35

What does the gerota's fascia enclose

Back 35

Adrenal gland

Kidney

And perirenal fat

Front 36

Outer layer of the kidney

Back 36

Gerota's fascia

Front 37

What is the gerota's fascia surrounded by

Back 37

Pararenal fat - most superficial of kidney covering and forms part of the Retroperitoneal fat

Front 38

Pararenal fat

Back 38

most superficial of kidney covering and forms part of the Retroperitoneal fat

Front 39

Renal medulla

Shape

Contains

Back 39

Shaped like a pyramid

Henle loop and collecting tubules

Front 40

Renal cortex:

What is it

What does it contain

Back 40

Outer layer

Contains Bowman capsule

Malphigian corpuscles and proximal/distal convoluted tubules

Front 41

Renal pelvis:

Shape

Location

What happens here

Back 41

Funnel shaped

Behind renal medulla

Urine flows into here through minute openings to ureters

Front 42

Renal hilum contains

Back 42

Renal artery

Renal vein

Lymphatics

Ureter

Front 43

What is the collecting system of the kidneys

Back 43

Minor and major calyces

Front 44

Minor calyces

How many per kidney

It's function

Back 44

7-13 per kidney

Receives urine from pyramid

Forms border of renal sinus

Front 45

Major calyces

How many per kidney

Function

Back 45

2-3

Receives urine from minor calyces and convey urine to the renal pelvis

Front 46

Major calyces are also known as

Back 46

Funnel shaped tubes (infundibulum)- which connect minor calyx to renal pelvis

Front 47

How are the renal sinus echoes produces

Back 47

Front 48

The upper end of the ureter divided into 2 or 3 ____________, each of which divided into 2 or 3 _____________ which ends in the pyramids

Back 48

Major calyces

Minor calyces

Front 49

What's this

Back 49

Major calyces

Front 50

What's this

Back 50

Minor calyces

Front 51

Ureters

Back 51

Retroperitoneal structure that leave kidney carrying urine to bladder

Front 52

________________ are lateral branches of the abdominal aorta that are located just ( inferior/superior) to SMA

Back 52

Renal arteries

Inferior

Front 53

Renal vasculature:

Back 53

Front 54

Back 54

Front 55

Back 55

Renal Veins

Front 56

Back 56

Left renal vein

Longer

Right

Front 57

Back 57

Posteriorly

IVC

Front 58

Which renal artery is longer

Back 58

Right renal Artery

Front 59

Segmental artery after entering the renal hilum it divides into 4-5 segmental arteries. Does it have high or low resistance blood flow

Back 59

Low resistance

Front 60

Interlobar artery is a branch of segmental artery that courses alongside the renal pyramids. Does it have high or low resistance blood flow

Back 60

Low

Front 61

Arcuate artery: boundary between cortex and medulla. Branch off the interlobar artery located at base of the medulla

What kind of blood resistance blood flow does it have

Back 61

Low

Front 62

Arterial supply to kidney is provided by what structures

Back 62

Renal Artery

Testicular or ovarian artery

Superior vesical artery

Front 63

Right renal artery may be visualised where

Back 63

Posterior to the IVC

Front 64

How are renal arteries best visualized

Back 64

Transverse axis

Front 65

What's the most helpful landmark for localizing renal arteries

Back 65

SMA

Front 66

What's that dot

Back 66

Right renal artery

Front 67

A?

B?

Back 67

RRA

LRA

Front 68

Two dots?

Back 68

Duplicate RRA

Front 69

What's this

Back 69

Duplicate RRA

Front 70

Blue?

Back 70

Duplicate left renal arteries

Front 71

Blue on right side

Back 71

Duplicate left Renal arteries

Front 72

Two red lines

Back 72

Duplicate renal arteries

Front 73

Back 73

Duplicate renal arteries

Front 74

?

Back 74

Triplicate renal arteries

Front 75

Back 75

Triplicate renal arteries

Front 76

RRV courses _________ to the RRA

Back 76

Anteriorly

Front 77

LEFT renal vein is (anterior/posterior) to the aorta and (anterior/posterior) to the SMA

Back 77

Anterior

Posterior

Front 78

What's this

Back 78

LEFT renal Vein

Front 79

Bottom arrow

Back 79

LEFT renal vein

Front 80

What's the nutcracker phenomenon

Back 80

Aorta- LRV- SMA

The compression of the LEFT renal vein between aorta and SMA with impaired blood outflow often accompanied by distention of the distal portion of the vein.

Front 81

LRV connects to the____

Back 81

IVC

Front 82

Ways to evaluate urinary system

Back 82

US

IVP intravenous pyelogram

NCCT -noncontrast computed tomography

MRI

Front 83

Ultrasound used on kidney not just for masses but also....

Back 83

Perirenal fluid collections like hematoma or abscess

Determine Renal size and parenchymal detail

Detecting enlarged ureters and hydronephrosis

Front 84

Indication for kidney US exam

Back 84

Front 85

Patient preparation

Back 85

Nothing by mouth generally

If bladder distended from rehydration the INTRARENAL COLLECTING SYSTEM also will become distended

Some advocate fasting 6 hours- limit bowel gas

Front 86

Dilation of the collecting system had been noted in ________

Back 86

Pregnant patients...

Right kidney is generally involved with mild degree of hydronephrosis..

Goes back to normal after delivery

Front 87

Neonatal and pediatric kidneys may appear

Back 87

Lobulated

Have prominent renal pyramids

And or

Subtle sonographic distinctive between renal cortex and sinus

Front 88

Normal adult kidneys Sonographic appearance?

Back 88

Elliptical in shape - longitudinal plane

Rounded in transverse

Less echogenic than the liver and spleen (or isoechoic)

Front 89

In normal adult kidneys:

Renal capsule appearance

Back 89

Well defined echogenic line surrounding the kidney

Front 90

In normal adult kidneys:

Renal cortex appearance

Back 90

Fine mod/medium to low level echogenicity

Hypoechoic or isoechoic to liver/spleen

Front 91

In normal adult kidneys:

Medulla appearance

Back 91

Hypoechoic may appear anechoic

Front 92

In normal adult kidneys:

Columns of Berlin appearance

Back 92

Moderated medium to low echogenicity

Front 93

In normal adult kidneys:

Renal sinus

Back 93

Hyperechoic ... Most echogenic

Front 94

In normal adult kidneys:

Arcuate vessels

Back 94

Small echogenic foci at corticomedullary junction

Front 95

Cortical thickness...

If less than one cm...?

Back 95

Cortical thinning

Front 96

Cortical thickness

minimum one cm...

Back 96

Normal

Front 97

Best way to evaluate kidneys

Back 97

Right: through liver

Left: through spleen

Front 98

Patient position for kidney US

Back 98

Spine or decubitus

Front 99

Renal parenchyma should be compared to

Back 99

Spleen and liver parenchyma

Front 100

Technical aspects:

High/low resolution, real time sector scanners should be used

Back 100

High

Front 101

Technical aspects:

What is a high freq abdominal transducer most helpful in improving visualization of posterior acoustic shadowing add it is in the case of what

Back 101

Stones without shadow

I know horrible question

Front 102

What should be used to routinely evaluate genitourinary tract stones

Back 102

Harmonic imaging

Front 103

Best position to place patient to evaluate renal size

Back 103

Decubitus coronal

Front 104

Bladder is a

Back 104

Muscular bag

Front 105

How many openings does the bladder have

Back 105

3

Front 106

What is produced continuously and accumulates in the bladder until the increased pressure simulated the organs nervous receptors

Back 106

Urine

Front 107

Urethra is a ______ tube that passes from the anterior part of the urinary bladder to the outside of the body

Back 107

Membranous

Front 108

Is the urethra routinely visualized by ultrasound

Back 108

No

Front 109

How is bladder best visualized

Back 109

Moderately filled

Front 110

Post void bladder is scanned In __ planes..

Explain

Back 110

2

Anteriorposterior and transverse

Front 111

When it comes to the bladder a residue of less than __________ of urine is considered normal in an adult

Back 111

Less than 20 cc or ml

Front 112

Best modality of imaging the bladder

Back 112

Cystoscopy - usually used to examine bladder because it can diagnose early neoplasms

Front 113

What position used to demonstrate calculi movement

Back 113

Right or left decubitus

Front 114

Transabdominal ultrasound allows for visualization of most bladder lesions ______ than 5mm

Back 114

Greater

Front 115

US on bladder is performed with what kind of bladder

Back 115

Distended

Front 116

Bladder:

Proper TCG allows for minimization of anterior wall_____

Back 116

Reverberations

Front 117

How are ureteral Jets identified

Back 117

Doppler color

Front 118

When ureter is dialated it is best visualized in what angle

Back 118

Coronal- oblique with kidney as an acoustic window

Front 119

What is this

Back 119

Ureteric orifices (dilated)

Front 120

Back 120

Ureteric orifices of Dilated ureters in transverse

Front 121

Back 121

Ureter

Front 122

Back 122

Renal artery

Front 123

Back 123

Renal vein

Front 124

Back 124

Renal hilus

Front 125

Back 125

Interlobular vein

Front 126

Points to red

Back 126

Interlobular artery

Front 127

Back 127

Renal pyramids

Front 128

Back 128

Kidney cortex

Front 129

Back 129

Renal capsule

Front 130

Back 130

Medulla

Front 131

Back 131

Pelvis renal

Front 132

Back 132

Nephron

Front 133

Back 133

Collecting duct