Urinary System

Which kidney is higher and why?

The left because the liver is on the right

The kidney extends approx. from which vertebrae?

T12-L3

How does the kidney lie in the oblique plane of the body?

30 deg anteriorly, 20 deg from MSP

Hilum = ______________ and slit in concavity of ____________ border for transmission of blood vessels, nerves, lymphatic vessels, and ureter​

longitudinal; medial

What anatomy in the kidney is within the renal medulla?

pyramids (ends w/ papilla) and columns

What are Calyces?

cup-shaped stems that enclose one or more papilla

What unites to form the renal pelvis?

major calyces

Of the urinary system, which anatomy are retroperitoneal?

kidneys and prox ureters

Of the urinary system, which anatomy are intraperitoneal?

distal ureters, urinary bladder and urethra

What is the functional unit of the kidney?

nephron

Where are nephrons located?

both the renal cortex and medulla

What is the function of a nephron?

produces urine by removing waste from the blood

Which artiole enters the Glomerular Capsule?

afferent

What filters the blood (removing waste and water) in the Bowman's Capsule?

glomerulus

What procedure uses antegrade contrast administration?

IVU

What 3 procedures uses retrograde contrast administration?

retrograde urography, cystogrpahy, cystourethography

Lower concentrations is used for (upper or lower) ___________ parts of the urinary system. For which procedures?

lower; cystography and cystourethography

Higher concentrations is used for (upper or lower) ___________ parts of the urinary system. For which procedures?

higher; IVU and Retrograde Urography

What does the local reaction: extravasion mean?

leaking out of the vein

What does the local reaction: phlebitis mean?

swollen vein

Systemic reactions affect what?

the entire body or a specific organ system

What do you do if a patient experiences phlebitis?

stop vein access and notify nurse and/or physician

What do you do if a patient experiences extravasion?

stop injection, elevate affected extremity above heart, must have them assessed by radiologist/MD before leaving (must be all annotated in Pt chart)

When should the exposure be taken for urinary procedures?

end of expiration

What is an Intravenous Urography for?

kidney function and structure; how much time it takes for kidneys to filter contrast

What is an Retrograde Urography for?

kidney structure (IVU in reverse)

Which procedure can be used to evaluate function through voiding urine?

cystourethrography

What are contraindications for an IVU?

poor kidney function (Low GFR-glomerular filtration rate, high creatine), allergy to contrast

For which urinary system procedure must the Pt empty their bladder?

IVU

What is the normal GFR rate?

90 to 120 mL/min; any lower means renal dysfunction

How is the patient positioned for a Cystourethrography? (Males/Females) CR?

RPO for males, AP for females; both at P.S

Urogram AP projection: Patient Position and CR

Supine; MSP at the level of the iliac crest.

Urogram AP Oblique projection: Patient Position

30° RPO or LPO.

Urogram AP Oblique projection: CR

At crest, 2 inches lateral to midline of elevated side.

Retrograde Urography (RUG): Most common series

3 AP; Scout, Pyelogram, and Ureterogram.

What is the patient position for a RUG and where is the CR?

supine; at crest

Cystogram AP projection: CR

Soft tissue depression above the prominence of the greater trochanter.

Cystogram AP Axial projection: CR

10-15° caudad, entering 2 inches above pubic symphysis.

Cystogram AP Oblique projection: Patient Position

40-60° RPO or LPO.

Cystogram AP Oblique projection: CR

2 inches above pubic symphysis and 2 inches medial to elevated ASIS.

Cystogram Lateral projection: CR

MCP, 2 inches above pubic symphysis.

Male Cystourethrography: Position

35-40° RPO

What is the trigone?

triangular area of bladder base between three openings

How is the bladdder positioned?

immediately posterior and superior to pubic symphysis

The ureters enters ____________________ surface of bladder

posterolateral