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258 Cards in this Set
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- 3rd side (hint)
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Kidneys produce how many liters of fluid
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180 L (45 gal)
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How much of the filtrate is reabsorbed by the bloodstream?
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99%
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Where does most of the reabsorption of filtrate occur
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proximal tubule and along the entire tubule
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Where does filtrate become concentrated?
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Distal tubule and collecting ducts
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What causes the filtrate to become concentrated?
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Hormonal influence
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Becomes urine
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What hormone is secreted by the posterior portion of the pituitary gland in response to changes in osmolality of the blood?
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Antidiuretic hormone (ADH)
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Antidiuretic hormone is also known as
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vasopressin
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What stimulates ADH release?
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decreased water intake because the blood osmolality tends to increase
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What suppresses ADH?
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Excess water intake
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Increased urine volume
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diuresis
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Pain
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Dysuria
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Early sign of kidney disease (Inability to concentrate and dilute urine) is a fixed specific gravity or fixed osmalality of
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1.010 or 300 mOsm/L
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Ratio of solute to water
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osmolality
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paramount for control of extracellular volume and both serum and urine osmolarity
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regulation of salt and water
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Filtrate in the glomerular capillary normally has the same osmolality as blood which is
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280 to 300 mOsm/kg
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Normal ingestion
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1300 ml of oral and 1000 ml of water in food
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how much water is lost
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900ml through the skin and lungs (insensible), 50 ml through sweat and 200 ml through feces.
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One pound
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500 ml
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Average american daily diet
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6 to 8 gm of sodium chloride and potassium chloride (approx. same amounts excreted in urine).
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Regulation of sodium volume depends on
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Aldosterone
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A hormone synthesized and released from the adrenal cortex
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aldosterone
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Less sodium is excreted in the urine, because aldosterone fosters renal reaborsption....what causes less sodium excretion
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Increased aldosterone
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Release of aldosterone from the adrenal cortex is under the control of
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Angiotensin II
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Agiotensin II levels are under the control of
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Renin
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An enzyme that is released from specialized cells in the kidneys
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Renin
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What happens when pressure in the renal arterioles falls below normal (shock, dehydration)
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Renin, Angiotesin II
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Activation of this system causes
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the retention of water and expansion of the intravascular fluid volume
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Normal serum pH
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7.35 to 7.45
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The kidneys maintain normal serum levels by
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Reabsorbing and returning to the body any bicarbonate from the urinary filtrate
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The kidneys also maintain normal serum levels by
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excreting acid in the urine
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Small ion, freely filtered in the glomerulus
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Bicarbonate
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Bicarbonate is actively reabsorbed by
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the renal tubules
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Replacement of lost bicarbonate
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the renal tubular cells generate new bicarbonate
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Body's acid production
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Catabolism
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Catabolism
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breakdown of proteins producing acid compounds in particular phosphoric and sulfuric acids.
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Cannot be eliminated by the lungs
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Phosphoric and sulfuric acid
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Accumulation of phosphoric and sulfuric acid
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Lowers pH (making the blood more acidic) inhibiting cell function - must be excreted
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A normal person excretes how much acid each day?
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70 mEq
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Excess acids are bound to chemical buffers known as
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phosphate ions and ammonia
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When buffered with acid ammonia becomes
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ammonium
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Phosphate is present in the
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glomerular filtrate
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Ammonia is produced by the
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cells of the renal tubules
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Ammonia is secreted into
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the tubular fluid
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Through this buffering process, the kidney is able to excrete large quantities of
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acid in bound form (does not lower pH)
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Regulation of blood pressure
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important function of the kidney
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What specialized cells in the kidney regulate bp?
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Vasa Recta
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What happens when the vasa recta detect a decrease in bp?
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specialized juxtaglomerular cells called denta cells near the afferent, efferent and distal tubule - secrete renin
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Renin converts
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angiotensinogen to angiotensin I which is then converted to angiotensin II
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Angiotensin II
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most powerful vasoconstrictor known; increases blood pressure
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When the vasa recta detect an increase in bp what happens
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renin secretion stops
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Renal clearance is the
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ability of the kidneys to clear solutes from the plasma
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One particular useful measure for renal clearance
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creatinine
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creatinine is an
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endogenous waste product of skeletal muscle
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where is creatinine filtered
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at the glomerulus
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where is creatinine excreted
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rine
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creatine is a good measure of
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GFR
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Adult GFR
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125 mL/min
200 mL/min |
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When the kidney detect a decrease in the oxygen tension in renal blood flow they release
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erythropoietin
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Erythropoietin is a
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glycoprotein from the kidney sthat simulates the blood marrow to produce RBC's to carry oxygen throughout the body
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The kidneys are also responsible for the final conversion of which vitamin?
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Vitamin D to its active form, 1,25-dihydroxycholecalciferol
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The kidneys are also responsible to produce
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prostaglandin E and prostacyclin
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Prostaglandin E and prostacyclin have a
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vasodilatory effect and are important in maintaining renal blood flow
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Major waste product of protein metabolsim is
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urea
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how much urea is excreted daily?
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25 to 30 g
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What must be excreted daily?
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Urea
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Other waste products of metabolism that must be excreted are
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creatinine, phosphates and sulfates and uric acid (a waste product of purine metabolism)
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The kidneys serve as the primary mechanism for excreting drug
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metabolites
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Bladder
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reservoir for urine
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Bladder filling and emptying mediated by
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coordinated sympathetic and parasympathetic nervous system control mechanism involving the detrusor muscle and the bladder outlet
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Conscious awareness of bladder filling
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sympathetic neuronal pathways that travel via the spinal cord to the level of T10 through T12.
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Which nerve innervations allows for continued bladder filling?
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Peripheral, hypogastric nerve
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As the bladder fills, stretch receptors are activated in the bladder wall this information is relayed from
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the detrusor muscle to the cerebral cortex via the parasympathic pelvic nerves at the level of S1 through S4.
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Bladder compliance is due in part to
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the smooth muscle lining of the bladder and collagen deposits within the wall of the bladder
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Bladder compliance is also in part due to
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neuronal mechanism that inhibit the detrusor muscle from contracting
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What keeps the detrusor muscle from contracting?
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adrenergic receptors that mediate relaxation
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Bladder pressure during filling must remain lower than
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40 cm H2O
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The low pressure in the bladder allows
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urine to freely leave the renal pelvis and enter the ureters
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When is the sensation of bladder fullness transmitted to the CNS?
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when the bladder has reached about 150 to 200 mL in adults
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Marked sense of fullness occurs at
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300 mL to 500 mL
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What causes and absent sense to void?
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neurologic changes to the bladder at the level of the supraspinal nerves, the spinal nerves or the bladder wall itself
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Micturition
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normally occurs approximately 8 times in a 24-hour period
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What happens at night to decrease the production of urine
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the release of vasopressin - makes urine more concentrated
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Nocturia
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decrease of vasopressin
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Micturition is activated at the
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micturition reflex arc within the parasympathetic and sympathetic nervous systems
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Initiation of voiding occurs
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when the efferent pelvic nerve, which originates in the S1 to S4 area, stimulates the bladder to contract, resulting in complete relaxation of the striated urethral sphincter.
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After the inititation begins there is a decrease
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in urethral pressure, contraction of the detrusor muscle, opening of the vesicle neck and proximal urethra and then a flow of urine.
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This coordination effort to produce urine voiding is by the
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parasympathetic system which is mediated by muscarinic and, to a lesser extent, cholinergic receptors within the detrusor muscle.
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Pressure generated in female bladders is
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20 to 40 cm H2O
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Obstruction of the bladder outlet such as in
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advanced benign prostatic hyperplasia (BPH) resulting in high voiding pressure - more difficult to start urine flow and maintain it.
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GFR decreases between age
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35 and 40 and then a yearly decline
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Elderly acute and chronic renal failure:
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sclerosis of the glomerulus and renal vasculature, decreased blood flow, decreased GFR, altered tubular function, and acid-base balance
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Renal function is elderly remains normal but
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renal reserve is decreased and may reduce the kidney's ability to respond effectively to drastic or sudden changes
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Elderly also experience
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decrease in glomerular filtration, combined with multiple medications in which metabolites are cleared by the kidneys placed elderly at risk for drug-drug interactions
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Elderly decreased thirst may develop
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hypernatremia - almost never occurs younger than 60
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Elderly women
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vaginal and urethral tissues atrophy (become thinner) due to decreased estrogen levels
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Decreased estrogen levels causes
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decreased blood supply to the urogenital tissues resulting in urethral and vaginal irritation and urinary incontinence
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multiparous women delivering their children vaginally have a high risk for
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stress urinary incontinence
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elderly women and people with neurologic disorders such as diabetic neuropathy, multiple sclerosis (MS), or Parkinson's disease
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often have incomplete emptying of the bladder and urinary stasis which may lead to urinary tract infection or increasing bladder pressure leading to overflow incontinence, hydronephrosis, pyelonephritis, or chronic kidney disease.
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Anuria
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decrease urine production
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Kidney disease does not always involve
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pain
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Enuresis
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involuntary voiding during sleep
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polyuria
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increased volume
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oliguria
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less than 500 mL/day
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anuraia
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less than 50 ml/day
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anemia of chronic disease
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a/k/a gradual kidney dysfunction...fatigue, shortness of breath, exercise intolerance
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best test for gradual kidney dysfunction
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hemoglobin level (better assessment of oxygen transport ability of the blood)
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upper and lower urinary assessment
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abdomen, suprapubic region, genitalia, lower back and lower extremities
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Kidneys are not usually palpable, however,
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palpation of the kidneys may detect enlargement that could prove to be very important
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Palpation of kidney
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place on hand under the patient's back with the fingers under the lower rib, place the palm of the other hand anterior to the kidney with fingers about the umbilicus, push the hand on top forward as the patient inhales deeply.
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Renal dysfunction may produce tenderness over the
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costovertebral angle (formed by the lower border of the 12th, or bottom, rib and the spine
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Abdomen ausculated to assess for bruits
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(low pitched murmurs that indicate renal artery stenosis or an aortic aneurysm)
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Abdomen also assessed for the presence of
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ascites (accumulation of fluid in the peritoneal cavity).
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To check for residual urine
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the bladder should be percussed after the patient voids
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Percussion of the bladder begins at the
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midline just above the umbilicus and proceeds downward...Sound changes from tympanic to dull
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Dullness to percussion of the bladder after voiding indicates
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incomplete bladder emptying.
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In older men, BPH or prostatis can cause difficulty with
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urination
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Prostate gland palpated by
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digital rectal examination (DRE)
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Prostate gland exam
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men over 40
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prostate gland includes a blood specimen to test the
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prostate-specific antigen (PSA).....PSA is checked before the DRE because manipulation of the prostate can cause the PSA level to increase temporarily.
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Inguinal area is examined for
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enlarged nodes, an inguinal or femoral hernia, and variococele (varicose veins of the spermatic cord)
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Uretrha
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palpated for diverticula
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Vagina assessed for
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adequate estrogen effect and any of 5 types of herniation
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urethrocele
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bulging of the anterior vaginal wall into the urethra
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cystocele is
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the herniation of the bladder wall into the vaginal vault
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pelvic prolapse
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bulging of the cervix into the vaginal vault
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Enterocele
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herniation of the bowel into the posterior vaginal wall
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rectocele
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herniation of the rectum into the vaginal wall
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To assess the urethra's system of muscular and ligament support
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the women is asked to cough and perform a valsalva maneuver
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Marshall-Boney maneuver
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when urine leakage occurs, the index and middle fingers are used to support either side of the urethra and the women repeats....if urine leakage, referral
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urine culture
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determines whether bacteria are present as well as their strains and concentrations
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urine culture and sensitivity
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identify the antimicrobial therapy that is best suited for the particular strains
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Urine exams include the following:
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urine color, clarity, odor, pH, specific gravity, protein, glucose, glycosuria, ketonuria
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Microscopic examination of the urine sediment after centrifugation to detect
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RBCs (hematuria), white blood cells (pyuria), casts (cylindruria, crystals (crystalluria, and bacteria (bacteriuria
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additional studies possible (urine telomerase activity)
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may detect bladder cancer in men
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Normally about 1 million
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RBCs pass into the urine daily (1 to 3 RBCs per high power field)
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Hematuria
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(more than three RBCs per high-power field)...more common in women
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causes of hematuria
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acute infection (cystitis, urethritis, or prostatitis, renal calculi, and neoplasm
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other causes include systemic disorders
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bleeding disorders, malignant lesions, medications (warfarin (coumadin) and heparin (heparin sodium)
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Kidney protected by
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renal fascia made of connective tissue
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Renal parenchyma is divided into two parts:
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cortex and medulla
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Medulla contains the
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loop of Henle, vasa recta, collecting ducts of the juxtamedullary nephrons
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Collecting ducts from the juxtamedullary and the cortical nephrons connect the
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renal pyramids
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Each kidney contains how many pyramids
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8-18
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The pyramids drain into
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minor calices
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minor calices drain into
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major calices
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major calices open directly into the
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renal pelvis
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Cortex is located
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farthest from the center of the kidney and around the outermost edges contains the NEPHRONS
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Each kidney has how many nephrons
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1 million located within the renal parenchyma
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Proteinuria may be a benign finding or
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may signifiy serious disease
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Occasional loss of 150 mg/day of protein in the urine, primarily albumin and Tamm-Horsfall protein (also known as uromodulin) is considered
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normal
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Dipstick exam does not detect protein concentrations of less than 30mg/dL so this test cannot be used
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for early detection of diabetic neuropathy
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early sign of diabetic nephropathy
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microalbuminuria (excretion of 20 to 200 mg/dL of protein in the urine)
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causes of persistent proteinuria include
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glomerular diseases, malignancies, collagen diseases, diabetes mellitus, preeclampsia, hypothyroidism, and use of meds (NSAIDS) non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme (ACE) inhibitors.
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Specific gravity
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measures the density of a solution compared to the density of water
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Specific gravity is altered by the presence of
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blood, protein, and casts in the urine
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Normal range specific gravity
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1.010 to 1.025
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Specific gravity methods
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Multiple test dipstick, urinometer, refractometer (measures differences in speed of light)
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Fluid increases or decreases causes what effect on specific gravity?
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Decreased liquid, specific gravity increases. Increased liquid, specific gravity decreases.
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Kidney disease (specific gravity) changes?
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Specific gravity does not change known as fixed specific gravity
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Kidney disease (specific gravity) changes?
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Specific gravity does not change known as fixed specific gravity
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Disorders decreased specific specific gravity
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diabetes insipidus, glomerulonephritis, and severe renal damage
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Disorders decreased specific specific gravity
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diabetes insipidus, glomerulonephritis, and severe renal damage
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Disorders increased specific gravity
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diabetes mellitus, nephritis and fluid deficit
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Disorders increased specific gravity
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diabetes mellitus, nephritis and fluid deficit
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Osmolality
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most accurate measurement of the kidney's ability to dilute and concentrate urine
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Healthy human osmolality
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Serum: 280 to 300 mOsm/kg
Urine: 200 to 800 mOsm/kg |
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Osmolality
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most accurate measurement of the kidney's ability to dilute and concentrate urine
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24-hour urine sample normal value
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300 to 900 mOsm/kg
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Healthy human osmolality
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Serum: 280 to 300 mOsm/kg
Urine: 200 to 800 mOsm/kg |
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Renal function tests
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used to evaluate the severity of kidney disease and the pt's kidney function
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24-hour urine sample normal value
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300 to 900 mOsm/kg
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Common tests of renal function include
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renal concentration tests, creatinine clearance and serum creatinine and blood urea nitrogen levels and serum electrolyte levels
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Renal function tests
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used to evaluate the severity of kidney disease and the pt's kidney function
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Ultrasonography is a
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noninvasive procedure to detect abnormalities such as fluid accumulation, masses, congenital malformations, changes in organ size, and obstructions
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Common tests of renal function include
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renal concentration tests, creatinine clearance and serum creatinine and blood urea nitrogen levels and serum electrolyte levels
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Ultrasonography requires a
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full bladder
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Ultrasonography is a
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noninvasive procedure to detect abnormalities such as fluid accumulation, masses, congenital malformations, changes in organ size, and obstructions
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Ultrasonography requires a
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full bladder
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Bladder ultrasonography
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noninvasive method of measuring urine volume in the bladder
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Bladder ultrasonography may be indicated for
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urinary frequency, inability to void after removal of an indwelling catheter, measurement of postvoiding residual urine volume, inability to void postoperatively or assessment of the need for catheterization.
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Computed tomography (CT) scans and magnetic resonance imaging (MRI) are noninvasive techniquest that provide
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excellent cross sectional views of the anatomy of the kidney and urinary tract.
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CT's and MRI's are used to detect
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genitourinary masses, nephrolithiasis, chronic renal infections, renal or urinary tract trauma, metastatic disease and soft tissue abnormalities
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Patches such as nicotine and nitroglycerine that have a metal backing must be
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removed as they can cause burns
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Cochlear implants are inactivated by
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an MRI, therefore, other imaging procedures are considered
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Prior to MRI the patinent must be informed to
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avoid alcohol, caffeine-containing beverages, and smoking for at least 2 hours and no iron supplements
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Nuclear scans require an injection of a
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radioisotope into the circulatory system...the isotope is then monitored as it moves....the technetium scan provides info about kidney perfusion....the renal scan provides info about kidney function such as the GFR
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Nuclear scans are used to evaluate
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actue and chronic renal failure, renal masses, and blood flow before and after kidney transplantation.....the patient is encourage to drink fluids to promote excretion.
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IV urography includes various tests such as
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excretory urography, intravenous pyelography and infusion drip pyelography
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A radiopaque contrast agent is administered by
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IV
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An IVP shows the
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kidneys, ureter and bladder via x-ray imaging as the dye moves through the upper and lower urinary system
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A nephrdyotomogram may be carried out as part of the studyto visualize
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different layers of the kideny and the diffuse structures within each layer and to differentiate solid masses
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IV urography may be used as the initial assessment of many urologic conditions
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lesions in the kedneys and ureters, renal function, multiple x-rays are obtained to visualize drainage structures in the upper and lower urinary system
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Infusion drip pyelography requires IV infusion of a large volume of a dilute contrast agent to
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opacify the renal parenchyma and fill the urinary tract - used when prolonged opacification of the drainage structures is desires so that tomograms can be made.
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In retrograde pyelography
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catheters are advanced through the ureteres into the reanl pelvis by means of cystoscopy
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cystography aids in evaluating
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vesicoureteral reflux (backflow of urine from the bladder into one or both ureters)
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In cystography, a catheter is
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inserted into the bladder and a contrast agent is instilled to outline the bladder wall
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The contrast agent may leak through a small bladder perforation
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but such leakage is harmless
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Voiding cystourethrography uses
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fluoroscopy to visualize the lower urinary tract and assess urine storage in the bladder.
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A radiopaque contrast agent is administered by
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IV
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An IVP shows the
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kidneys, ureter and bladder via x-ray imaging as the dye moves through the upper and lower urinary system
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A nephrdyotomogram may be carried out as part of the studyto visualize
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different layers of the kideny and the diffuse structures within each layer and to differentiate solid masses
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IV urography may be used as the initial assessment of many urologic conditions
|
lesions in the kedneys and ureters, renal function, multiple x-rays are obtained to visualize drainage structures in the upper and lower urinary system
|
|
|
|
Infusion drip pyelography requires IV infusion of a large volume of a dilute contrast agent to
|
opacify the renal parenchyma and fill the urinary tract - used when prolonged opacification of the drainage structures is desires so that tomograms can be made.
|
|
|
|
In retrograde pyelography
|
catheters are advanced through the ureteres into the reanl pelvis by means of cystoscopy
|
|
|
|
cystography aids in evaluating
|
vesicoureteral reflux (backflow of urine from the bladder into one or both ureters)
|
|
|
|
In cystography, a catheter is
|
inserted into the bladder and a contrast agent is instilled to outline the bladder wall
|
|
|
|
A radiopaque contrast agent is administered by
|
IV
|
|
|
|
The contrast agent may leak through a small bladder perforation
|
but such leakage is harmless
|
|
|
|
A radiopaque contrast agent is administered by
|
IV
|
|
|
|
An IVP shows the
|
kidneys, ureter and bladder via x-ray imaging as the dye moves through the upper and lower urinary system
|
|
|
|
Voiding cystourethrography uses
|
fluoroscopy to visualize the lower urinary tract and assess urine storage in the bladder.
|
|
|
|
An IVP shows the
|
kidneys, ureter and bladder via x-ray imaging as the dye moves through the upper and lower urinary system
|
|
|
|
A nephrdyotomogram may be carried out as part of the studyto visualize
|
different layers of the kideny and the diffuse structures within each layer and to differentiate solid masses
|
|
|
|
A nephrdyotomogram may be carried out as part of the studyto visualize
|
different layers of the kideny and the diffuse structures within each layer and to differentiate solid masses
|
|
|
|
IV urography may be used as the initial assessment of many urologic conditions
|
lesions in the kedneys and ureters, renal function, multiple x-rays are obtained to visualize drainage structures in the upper and lower urinary system
|
|
|
|
IV urography may be used as the initial assessment of many urologic conditions
|
lesions in the kedneys and ureters, renal function, multiple x-rays are obtained to visualize drainage structures in the upper and lower urinary system
|
|
|
|
Infusion drip pyelography requires IV infusion of a large volume of a dilute contrast agent to
|
opacify the renal parenchyma and fill the urinary tract - used when prolonged opacification of the drainage structures is desires so that tomograms can be made.
|
|
|
|
A radiopaque contrast agent is administered by
|
IV
|
|
|
|
Infusion drip pyelography requires IV infusion of a large volume of a dilute contrast agent to
|
opacify the renal parenchyma and fill the urinary tract - used when prolonged opacification of the drainage structures is desires so that tomograms can be made.
|
|
|
|
An IVP shows the
|
kidneys, ureter and bladder via x-ray imaging as the dye moves through the upper and lower urinary system
|
|
|
|
In retrograde pyelography
|
catheters are advanced through the ureteres into the reanl pelvis by means of cystoscopy
|
|
|
|
In retrograde pyelography
|
catheters are advanced through the ureteres into the reanl pelvis by means of cystoscopy
|
|
|
|
A nephrdyotomogram may be carried out as part of the studyto visualize
|
different layers of the kideny and the diffuse structures within each layer and to differentiate solid masses
|
|
|
|
cystography aids in evaluating
|
vesicoureteral reflux (backflow of urine from the bladder into one or both ureters)
|
|
|
|
cystography aids in evaluating
|
vesicoureteral reflux (backflow of urine from the bladder into one or both ureters)
|
|
|
|
IV urography may be used as the initial assessment of many urologic conditions
|
lesions in the kedneys and ureters, renal function, multiple x-rays are obtained to visualize drainage structures in the upper and lower urinary system
|
|
|
|
In cystography, a catheter is
|
inserted into the bladder and a contrast agent is instilled to outline the bladder wall
|
|
|
|
In cystography, a catheter is
|
inserted into the bladder and a contrast agent is instilled to outline the bladder wall
|
|
|
|
The contrast agent may leak through a small bladder perforation
|
but such leakage is harmless
|
|
|
|
Infusion drip pyelography requires IV infusion of a large volume of a dilute contrast agent to
|
opacify the renal parenchyma and fill the urinary tract - used when prolonged opacification of the drainage structures is desires so that tomograms can be made.
|
|
|
|
The contrast agent may leak through a small bladder perforation
|
but such leakage is harmless
|
|
|
|
Voiding cystourethrography uses
|
fluoroscopy to visualize the lower urinary tract and assess urine storage in the bladder.
|
|
|
|
In retrograde pyelography
|
catheters are advanced through the ureteres into the reanl pelvis by means of cystoscopy
|
|
|
|
Voiding cystourethrography uses
|
fluoroscopy to visualize the lower urinary tract and assess urine storage in the bladder.
|
|
|
|
cystography aids in evaluating
|
vesicoureteral reflux (backflow of urine from the bladder into one or both ureters)
|
|
|
|
A radiopaque contrast agent is administered by
|
IV
|
|
|
|
In cystography, a catheter is
|
inserted into the bladder and a contrast agent is instilled to outline the bladder wall
|
|
|
|
An IVP shows the
|
kidneys, ureter and bladder via x-ray imaging as the dye moves through the upper and lower urinary system
|
|
|
|
The contrast agent may leak through a small bladder perforation
|
but such leakage is harmless
|
|
|
|
Voiding cystourethrography uses
|
fluoroscopy to visualize the lower urinary tract and assess urine storage in the bladder.
|
|
|
|
A nephrdyotomogram may be carried out as part of the studyto visualize
|
different layers of the kideny and the diffuse structures within each layer and to differentiate solid masses
|
|
|
|
IV urography may be used as the initial assessment of many urologic conditions
|
lesions in the kedneys and ureters, renal function, multiple x-rays are obtained to visualize drainage structures in the upper and lower urinary system
|
|
|
|
Infusion drip pyelography requires IV infusion of a large volume of a dilute contrast agent to
|
opacify the renal parenchyma and fill the urinary tract - used when prolonged opacification of the drainage structures is desires so that tomograms can be made.
|
|
|
|
In retrograde pyelography
|
catheters are advanced through the ureteres into the reanl pelvis by means of cystoscopy
|
|
|
|
cystography aids in evaluating
|
vesicoureteral reflux (backflow of urine from the bladder into one or both ureters)
|
|
|
|
In cystography, a catheter is
|
inserted into the bladder and a contrast agent is instilled to outline the bladder wall
|
|
|
|
The contrast agent may leak through a small bladder perforation
|
but such leakage is harmless
|
|
|
|
Voiding cystourethrography uses
|
fluoroscopy to visualize the lower urinary tract and assess urine storage in the bladder.
|
|
|
|
A radiopaque contrast agent is administered by
|
IV
|
|
|
|
An IVP shows the
|
kidneys, ureter and bladder via x-ray imaging as the dye moves through the upper and lower urinary system
|
|
|
|
A nephrdyotomogram may be carried out as part of the studyto visualize
|
different layers of the kideny and the diffuse structures within each layer and to differentiate solid masses
|
|
|
|
IV urography may be used as the initial assessment of many urologic conditions
|
lesions in the kedneys and ureters, renal function, multiple x-rays are obtained to visualize drainage structures in the upper and lower urinary system
|
|
|
|
Infusion drip pyelography requires IV infusion of a large volume of a dilute contrast agent to
|
opacify the renal parenchyma and fill the urinary tract - used when prolonged opacification of the drainage structures is desires so that tomograms can be made.
|
|
|
|
In retrograde pyelography
|
catheters are advanced through the ureteres into the reanl pelvis by means of cystoscopy
|
|
|
|
cystography aids in evaluating
|
vesicoureteral reflux (backflow of urine from the bladder into one or both ureters)
|
|
|
|
In cystography, a catheter is
|
inserted into the bladder and a contrast agent is instilled to outline the bladder wall
|
|
|
|
The contrast agent may leak through a small bladder perforation
|
but such leakage is harmless
|
|
|
|
Voiding cystourethrography uses
|
fluoroscopy to visualize the lower urinary tract and assess urine storage in the bladder.
|
|
