final urinary test review

function of the urinary system

detox

blood pressure regulation

regulation of blood composition

inner fascia surrounding kidney

renal capsule

middle fascia surrounding kidney

layer of phrenic fat

outer layer fascia surrounding kidney

renal fascia (gerota’s fascia)

compensentory hypertrophy

only one kidney is present, it gets larger to accommodate increased workload

peripheral parenchyma

where filtration of blood occurs

made up of renal medulla and cortex

renal sinus

where urine is collected

made up of infundibulum and renal pelvis

renal cortex

outer portion of the parenchyma, contains renal corpuscle, proximal and diet convoluted tubule

column of Berlin

band of cortical tissue separating medullary pyramids from each other

renal medulla

inner, cone shaped portion of the peripheral parenchyma that drain into the minor calyces

renal papilla

apex of the medullary pyramid, indents into each minor calyx

renal sinus in kidney

collecting system, portion containing the infundibulum, renal pelvis and renal hilum

infundibulum

portion of renal pelvis that consists of the minor and major calyx

renal calyx

cavities within the renal infundibulum in which urine collects before flowing into renal pelvis

renal pelvis

upper basin or expanding end of the proximal ureter

renal hilum

medial portion of the kidney where RA/RV/ureter enter/exit

where the ureters lead the renal pelvis

UPJ

where the ureter pierces the bladder wall

UVJ

where the ureter kinks as it crosses the pelvic brim

pelvic inlet

3 strictures along the ureters

UPJ, UVJ, pelvic inlet

peristalsis of the ureters is based on

body state of hydration

there are _____ of smooth muscle that make up the detrusor muscle of the bladder

3 layers

female urethra has

membranous portion

the RA’s are bilateral branches of

AO just INF to the SMA

renal corpuscle consists of

glomerulus

Bowmans capsule

bowmans space

uremia

raised levels of urea and nitrogenous waste in the blood

uremia is elevated when___

kidneys are damaged

uric acid

formed from breakdown of nucleic acids

creatinine

waste product that comes from the normal wear and tear on muscles of the body

urine PH

important in kidney stone management

specific gravity

measures kidneys ability to concentrate urine

dark urine =

high specific gravity

light urine =

low specific gravity

blood-hematuria -presence of RBC’s

suggest trauma, neoplasm, renal dysfunction, vascular inflammatory process

blood-hematuria - presence of WBC’s

suggest infection, inflammation, necrosis

hemoglobin

present in urine whenever damage to RBC’s occur

injured kidneys lead to____

AKF

protein

found in urine when glomerular damage in present

protein is commonly found in ________

neoplasms, stones, chronic infection, pyelonephritis

sodium

should be elevated

HTC

occurs with hemorrhage secondary to disease or blunt trauma

serum albumin

decrease of albumin in blood with neoplasms, stones, chronic infection, pyelonephritis

BUN

concentration of urea nitrogen in the blood

serum creatinine

elevates due to renal dysfunction

sono eval of kidney vs. liver

most hyperechoic

renal sinus

sono eval of kidney vs. liver

isoechoic

cortex

sono eval of kidney vs. liver

mot hypoechoic

parenchyma

normal residual urine for adults

20 cc or less

renal variants

slight alterations on anatomy

prominent columns of Bertin

hypertrophied extensions of the normal columns

dormedary hump

bulge of cortical tissue in the lateral surface of the kidney

usually LK

fetal lobulation

cortex of kidney is scalloped

junctional parenchymal defect

triangular echogenic area along the cortex extending into collecting system

extrarenal pelvis

presence of the renal pelvis outside the confines of the renal hilum

duplex collecting system

2 separate collecting systems each with their own ureter

isthmus

connection bridge of renal parenchyma

bosniak classification system

classification of renal cyst for concerning characteristics

parapelvic cysts mimmic____

hydronephrosis

von hippel-lindau

autosomal dominant genetic disorder

bilateral renal cysts and masses

acquired cystic kidney disease

associated with dialysis pts

autosomal RECESSIVE polycystic kidney disease

rare genetic disorder on chromosome 6

perinatal

progresses to renal failure

massively enlarged echogenic kidneys

juvenile

present with HTN, renal insufficiency, nephromegaly, liver problems, carols disease

autosomal DOMINANT polycystic kidney disease

genetic disorder

bilateral disease

4-5th decade of life

most common dominant polycystic kidney disease

ADPKD1

Multicystic dysplastic kidney

nonhereditary

bilateral is incompatible with life

most common form of cystic disease in neonate

neonates with multi cystic dysplastic kidneys

multicystic kidneys with absence of renal parenchyma

adults with multi cystic dysplastic kidneys

echogenic atrophied kidneys

renal cell carcinoma is males

2x more common

nephroblastoma

wilm’s tumor

renal disease- end stage___

renal atrophy

renal disease- cortical thickness___

measure greater than 6 mm

acute renal disease

enlargement and hypoechoic cortical tissue

acute tubular necrosis

most common cause of AKI

damage due to lack of oxygen

is reversible

renal function improves in acute tubular necrosis=

echogenicity decreases

pre renal

secondary to hypofunction of kidney

renal

parenchymal disease

post renal

obstruction of urine flow

chronic kidney disease

loss of renal function due to renal disease

most common parenchymal disease

3 typed of chronic kidney disease

nephron

vascular

intersitial

chronic kidney disease kidneys are____

bilateral small, echogenic

pyonephrosis

associated with urosepsis

secondary to long standing obstruction

emphysematous

air is present

xanthogranulomatous

a staghorn calculi

nephrocalcinosis

increased echogenicity of renal cortex

medullary nephrocalcinisis

increased echogenicity of the medullary pyramids bilaterally

typical first location for renal transplant

RLQ

1

blue

intralobar artery

2

blue

renal column

3

blue

papilla of pyramid

4

blue

cortex

5

blue

minor calyx

6

blue

medullary (renal) pyramid

7

blue

renal capsule

8

blue

interlobar top vein

9

blue

arcuate vien

10

blue

arcuate artery

11

blue

interlobar bottom vein

12

blue

interlober artery

13

blue

lobar artery