Test Chapter 14

Front 1

Urinary System consists of?

Back 1

2 kidneys

2 ureters

1 urinary bladder

1 urethra

Front 2

What location is the 2 kidneys and 2 ureters located in?

Back 2

Retroperitoneal

(Behind towards back)

Front 3

Right Vs. Left Kidney

Back 3

Right is slightly lower and inferior than the left due to the kidney

Front 4

Suprarenal (Adrenal Gland)

Back 4

-Located superior and medial to each kidney

-Part of the endocrine system

-Located in the fatty capsule (That surrounds each kidney)

Front 5

Lower Rib Cage

Back 5

-Forms a protective enclosure for kidneys

Front 6

Average adult size kidney

Back 6

-150 grams

-10-12 cm long

-5-7.5 cm wide

-2.5 cm thick

Front 7

How many kidneys do you need that is absolutely essential for normal health

Back 7

Atleast One

Front 8

Kidney Orientation-Angles

Back 8

Psoas Muscle, cause the longitudinal plane of the kidneys to form a vertical angle of 20 degrees with midsagital plane

Front 9

Adipose Capsule or perirenal fat

Back 9

-surrounds kidney

-mass of fatty tissue (Adipose=fat) surrounds kidney

-permits visualization of kidneys on ab X-rays

Front 10

Functions of Urinary System

Back 10

-removes wastes

-regulate water levels in blood

-regulate acid-base balance and electrolyte levels in blood

Front 11

What is the primary Function of urinary system

Back 11

Production of urine and its elimination

Front 12

Urine Production

(2.5 liters- 2500ml)

Back 12

-Average water intake for humans in a 24 hour period

Front 13

Urine Production

(1.5L-1500ml)

Back 13

-From large amounts of blood flow through kidneys average of ___ of urine is formed

Front 14

Calyces

Back 14

-Hallowed flattened tubes

-Major calyces unit to form renal pelvis

Front 15

_____ minor calyces from ___major calyces

Back 15

*4-13 minor calyces = 2 to 3 major calyces

Front 16

Where is urine formed

Back 16

-Formed in microscopic/nephron portion of kidney

Front 17

Urine path

Back 17

-Passes through collecting tubules, minor calyx, and major and renal pelvis then ureter then bladder to urethra

Front 18

Structural and functional unit of kidney is termed?

Back 18

Nephron

Front 19

The total functional portion of kidney is termed?

Back 19

Renal Parenchyma

Front 20

Cortex

Back 20

Microscopically the Glomeruli,Glomerular capsules and proximal and distal convoluted tubules of the many nephrons are located within the cortex of the kidney

Front 21

3 constricted points of ureter

Back 21

Ureteropelvic

Brim of pelvis

Ureterovesical junction

Front 22

Ureteropelvic

Back 22

Renal pelvis funnels down into small ureter

Front 23

Brim of pelvis

Back 23

Where the iliac blood vessels cross over ureters

Front 24

Ureterovesical junction

Back 24

Where ureter joint the bladder

Front 25

is the muscle of the trigone smooth or rough?

Back 25

Smooth

Front 26

The remaining aspect of the inner mucosa of the bladder has numerous folds called?

Back 26

Rugae

Front 27

The total capacity of the bladder is?

Back 27

350-500ml

Front 28

This injection is the entire dose of cm injected into venous system all at 1 time

Back 28

Bolus injection

Front 29

The injection where a specified amount of cm is introduced over a specified period?

Back 29

Drip Infusion

Front 30

This needs done before procedure, techs must insure pt is fully aware of risks and sign consent form

Back 30

Informed concent

Front 31

What are the 3 main veins we use during venipuncture?

Back 31

Median cubital

Cephalic

Basilic

Front 32

What area of the arm are the median, cephalic, and basilic located?

Back 32

Antecubital fossa

Front 33

For a bolus fill amount injection of 50-100ml of cm into adult, what size needles?

Back 33

18-22 gauge

Front 34

Where is the tourniquet placed for an IV

Back 34

3-4 inches above site

Front 35

Bevel of the needle should be facing which way?

Back 35

Upward

Front 36

Ionic iodides?

Back 36

The parent compound of the molecule is a carboxyl group in the form of benzoic acid

Front 37

Cation Organic iodides

Back 37

Salt consisting of sodium, meglumine or both

Front 38

Which salts increase solubility of CM

(Iodides)

Back 38

Cation organic iodides

Front 39

Which has higher osmolality and greater chance of reaction?

Back 39

Iodides cation organic duhh

Front 40

Once injected the ___ dissociates separate ions in blood?

Back 40

Cation

Front 41

this disassociation creates a ____ condition, or an increase in the blood plasma osmolality

Back 41

Hypersonic condition

Front 42

These contrast against also contain iodine needed for opacity but contains no positively charged ions

Back 42

Non Organic iodide

Front 43

Lower osmolality and less chance of __

Back 43

reaction

Front 44

Because of their non ionizing native ____ contrast agents are of low osmolality and do not increase the osmolality of blood plasma

Back 44

Non organic iodide duh

Front 45

Researchers indicated that its are less likely to have cm reactions or more likely to have less severe reactions or side effects when ___ are used/

Back 45

Nonionic

(Don't use because of cost)

Front 46

What are to common side effects after iodinated CM?

Back 46

Hot flash

metallic taste

Front 47

What are the normal creatine levels?

Back 47

.6-1.5 mg/dl

Front 48

What are normal bun levels?

Back 48

8-25 mg/100ml

Front 49

This medication must be withheld for atlas 48 hours after procedure with type 2 diabetes

Back 49

Metformin

Front 50

Patients may be premeditated before an ____ cm procedure is performed

Back 50

Iodinated CM

Front 51

A combo of ___ and ___ can be given before iodinated cm 12 hours prior to exam

Back 51

predizone and benadryl

Front 52

What are two types of local reactions?

Back 52

Extravasation

Phlebitis

Front 53

Extravastation

Back 53

leakage or iodinated cm outside the vessel and into the surrounding tissues

Front 54

Protocol for extravasation?

Back 54

1 notify

2 elevate extremely above heart

3 use cold compress followed by warm compresses

4 document incident

Front 55

Systemic 3 reactions

Back 55

Mild

Moderate

Severe

Front 56

Mild reaction

Back 56

Nonallergic reactions

Front 57

Moderate reactions

Back 57

True allergic reaction

(Anaphylactic reaction)

-because ,predate reactions may lead to life-threatening condition, assistance is a must without delay

Front 58

Severe

Back 58

Vasovagal reaction Life Threatening

Front 59

Mild reaction summery

Back 59

-Anxiety -Lightheaded -warm -flushed sensation

-nasuea and vomiting -syncope(Fainting) -metalic taste -milt urticaria (Scattered Hyves) itching

Front 60

Moderate reaction

Back 60

-Moderate to severe hyves -laryngeal swelling (Chocking sensation from closure of larynx) -Tachycardia (Rapid heartbeat) -angioedema (swelling of soft tissues) - hypotension( Low BP) -Bradicardia (Slow hb)

Front 61

Severe reaction

Back 61

-Hypotension (Systolic Bp <80bpm) -Bradicardia (<50 bpm) -no detectable pulse -laryngeal swelling -convulsion -loss of consciousness - arrhythmia - cardiac arrest - diminished urine output - aura (No urine output) - no pulse -pulmonary edema - vasculitis of limb pain -seizures

Front 62

Purpose of IVU (Intravenous urography)

Back 62

1 visualize collecting portion of urinary system

2 assess functional ability of kidney

3 evaluate urinary system for pathology/ anatomy anomalies

Front 63

Contraindications of IVU

Back 63

1 hypersensitivity to iodinated cm

2 aura or absence of urine excretion

3 multiple myeloma

4 diabetes especially diabetes mellitus

5 severe hepatic or renal disease

6 congestive heart failure

7 pheochromocytoma

8 sickle cell anemia

9 taking metformin withheld 48 hours

10 renal failure, acute or chronic

Front 64

Anuria

Back 64

Complete cessation of urinary secretions by kidneys (Anuresis)

Front 65

Hematuria

Back 65

Blood in urine

Front 66

Lasix

Back 66

Brand name for diuretic

Front 67

micturation

Back 67

act of voiding or urination

Front 68

Oliguria

Back 68

excretion of a diminished amount of urine in relation to fluid intake

Front 69

Polyuria

Back 69

Passage of a large volume of urine in relation to fluid intake during a given perion

Front 70

Renal agenesis

Back 70

absence of formation of a kidney

Front 71

syncope

Back 71

loss of consciousness by reduction cerebral blood flow

fainting

Front 72

urinary incontinence

Back 72

involuntary passage of urine through urethra

Front 73

Benign prostatic hyperplasia

(BPH)

Back 73

1 enlargement of prostate

2 5th decade in life 50 older in men

3 may cause uretal compression and obstruction

4 floor of bladder may appear elevated and indent

Front 74

Ectopic kidney

Back 74

- fales to asend in the abdomen and stays in pelvis

- interfere with birth process

Front 75

Horseshoe Kidney

Back 75

-fusion of kidneys during fetal development

- 95% of cases involve fusion of lower poles of kidney

- doesn't affect kidney

Front 76

Polycystic Kidney disease

Back 76

- most common cause of enlarged kidneys (Cysts)

- adult= this form is hereditary

Front 77

Staghorn

Back 77

-large stone that grows and fills the renal pelvis completely blocking flow of urinec

-associated with UTI

Front 78

Renal cell carcinoma (Hypernephroma)

Back 78

Most frequent type of malignant tumor of the kidney

Front 79

Vesicorectal (Vesicocolonic) fistula

Back 79

Artificial opening between the urinary bladder and rectum or aspects of the colon

Front 80

Pylonephritis

Back 80

Patchy, blunting of calyces dull of weekend patchy parts

Front 81

Pt prep

Back 81

-IVU and barium enema similar

-Same pt same day

-IVU 1st than barium enema

Front 82

Pt prep for IVU

Back 82

1 light evening meal before procedure

2 bowl cleansing laxative

3 NPO after midnight (min 8 hours)

4 enema on morning of exam

Front 83

Pt void before IVU exam 2 reasons

Back 83

1 A bladder that is too full could rupture, especially if compression is applied early in exam

2 Urine already present in bladder dilutes contrast media that accumulates there

Front 84

Pregnancy precautions

Back 84

-if pt is a female, a menstrual history must be obtained

Front 85

Contraindications to ureteric Compressions

Back 85

1 possible ureteric

2 Ab mass

3 Ab aortic aneurysm

4 recent ab surgery

5 severe ab pain

6 acute ab trauma

Front 86

Scout Image

- taken for

Back 86

1 verify pt preparation

2 determine whether exposure factors are acceptable

3 verify positioning

4 detect any abnormal calcification

Front 87

Nephrogram image

Back 87

-Radiographs taken early in the series

-B/C individual nephrons are microscopic, the nephron phase is a blush of the entire renal parenchyma

- this blush results from dispersion of cm throughout the many nephrons

-the usual nephrogram is obtained with a radiograph at 1 minute after the start of injection

Front 88

Hypertensive urogram

Back 88

-this exam is performed on pts. with high bp

-dieretic= before procedure if have High BP

Front 89

Retrograde Cystography

Back 89

- purpose= performed after instillation of an iodinated cm via urethral catheter

-Procedure= the cm is allowed to flow in by gravity and catheter

Front 90

CT for renal calculi

Back 90

-has almost replaced IVU

-Contiguous, fine transverse slices from kidneys through the urinary bladder can provide noninvasive assessment for stones without use of iodinated Cm

Front 91

Sonography

Back 91

can also be used to evaluate the kidney to determine whether cysts or masses are present

Front 92

Nuc Med

Back 92

Radionuclides used to determine whether a physical blockage exists in the ureter and to evaluate for vesicoureteral reflux

Front 93

AP projection (Scout series) IVE

Back 93

Upper left and right AEC

Front 94

Nephrotomography and nephrography (IVU)

Back 94

-select correct exposure angle

-10 degree caused angle or less producing larger section of tissue in relative focus

-CR= midway between xiphoid process and iliac crest

- males and females can/should be shielded

Front 95

RPO and LPO

Back 95

-Part position

- rotate body 30 degrees for both R and L posterior oblique position

-Position

- no excessive obliquity is evident, not projected into the vertebral bodies of L-spine

-If kidneys is superimposed over spine= excessive rotation

Front 96

Ap projections= post void

Back 96

-Clinical indication

-position may demonstrate enlarged prostate (Possible Bph benign prostatic hyperplasia)

-Erect position demonstrates nephroptosis

(Abnormal positional change of kidney)

Front 97

AP projection: ureteric compression

Back 97

-should not be used for patients with history of abdominal masses, obstruction, abdominal aortic aneurysms, or recent surgery

- Trendelenburg position with 15 degree tilt which approximates the same effect can be used

-tilt head down feet up

Front 98

RPO (30 degree) male AP projection female

Voiding cystourethrography

Back 98

-oblique body 30 degree into the RPO position