Ultrasound 1 kidneys-definitions & anatomy

Urine pH

the urine acidic or alkaline (Kidney stone management)

specific gravity

measures the kidneys ability to concentrate urine; the DARKER the urine, the HIGHER the __________; the LIGHTER the urine, the LOWER the ___________

blood-hematuria

presence of RBCs can suggest trauma, neoplasm, calculi, renal dysfunction, vascular inflammatory process, ect.

blood-hematuria

presence of WBCs can suggest infection, inflammation, necrosis

hemoglobin

present in urine whenever damage to RBCs occurs, this injures the kidney and can cause ARF(a cute renal failure)

protein

found in urine when glomerular damage is present (this causes serum albumin to decrease); commonly found with neoplasms (benign or malignant), stones, chronic infection, pyelonephritis

sodium

should be evaluated

gross hematuria

blood that can be seen with the naked eye, bright red urine;associated with kidney stones and renal masses

microhematuria

blood seen under a microscope by doctor; normal appearing urine; caused by anything

hematocrit(HCT)

occurs with hemorrhage secondary to disease or blunt trauma

serum albumin

there is a decrease of albumin in the blood (and an increase in the urine) with neoplasms (benign or malignant), stones, chronic infection, pyelonephritis

blood urea nitrogen (BUN)

the concentration of urea nitrogen in the blood; relative to degree of renal dysfunction (low in liver disease and high in renal disease)

serum creatinine(Cr)

elevates due to renal dysfunction; said to be more specific than BUN

upper system

the kidneys and ureters make up the

lower system

the bladder and urethra make up the

detox

blood pressure regulation

regulation of blood composition

functions of the urinary system

anterior to the RK

RT adrenal gland, liver, Morrison’s pouch, 2nd part of duodenum, right colic flecure

posterior to the LK

diaphragm, 11th and 12th rib, muscles

anterior to the LK

LT adrenal gland, spleen, stomach, panc, left colic flexure, and coils of the jejunum

posterior to the LK

diaphragm, 11th and 12th rib, muscles

renal capsule

layer of perinephric fate

Gerota’s fascia(renal fascia)

3 layers surrounding the kidneys

renal capsule AKA true capsule

inner layer encapsulation the kidney

layer of perinephric fat

middle layer

renal fascia AKA gerota;s fascia

outer layer

renal fascia AKA gerota’s fascia

anchors the kidneys and assists in preventing infection spread from surrounding organs

superior pole

mid portion

inferior pole

each kidney has a

renal hilum

the medial, concave area where the renal arteries/veins and ureters enter the kidneys; also contains lymphatic vessels

superior/posterior

the RAs are _____/__________ to the RVs

inferior

the ureters are slightly _____ to the RA

SAG 9-12cm (±/- 1-2cm)

adult kidney size

compensatory hypertrophy

only one kidney is present, the remaining kidney may be hypertrophy (get larger) to accommodate the increased workload; this lack of kidney could be congenital, surgical, anatomic variant disrupting normal function

peripheral parenchya and the renal sinus

the kidneys have 2 distinct areas

peripheral parenchyma

is made up of the renal cortex and the renal medulla (where the filtration of blood occurs)

renal sinus

is the central/hilar portion of the kidney and is made up of infundibulum and the renal pelvis (where the byproducts of blood filtration collect for waste removal (where urine collects))

renal cortex

column of Bertin

renal medulla(renal pyramids)

renal papilla

what makes up the peripheral parenchyma

renal cortex

outer portion of the parenchyma; contains the renal corpuscle, proc and dist convoluted tubule

column of Bertin

band of corticle tissue separating the medullary pyramids from each other

renal medulla

inner, cone-shapedd portion of the peripheral parenchyma that drain into the minor calyces; consists of 8-18 medullary pyramids; contains loops of Henle

renal papilla AKA apex of the medullary pyramid

indents into each minor calyx

infundibulum

renal cortex

renal calyx

renal pelvis

renal hilum

what makes up the renal sinus

infundibulum

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

renal calyx

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

renal pelvis

upper basin or expanded end of the proximal ureter; receives urine from the infundibulum

renal hilum

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

inner-mucosal layer

middle-smooth muscle layer

outer-fibrous layer

ureters are composed of 3 layers

retroperitoneum

ureters sit in the ___________

above/behind the public bone

the urinary bladder sits

posterior/laterally

the ureters drain the kidneys and enter the bladder

ureteral orifices in the trigone of the bladder

the ureters enter the bladder through the

inner mucosal/transitional epithelium layer

submucosal

muscularis layer (detrusor)

outer serosal layer

4 layers to the bladder wall

anterior/inferiorly

the urethra exits the bladder

neck of the bladder

the most proximal portion of the urethra is the

the complex sympathetic and parasympathetic nervous system

_______ and _______ operation signals the bladder is full and specific muscle coordination allows the bladder to empty when it’s full

trigone

inferior/posterior portion of the bladder defined by imaginary lines between the ureters insertion and the internal urethral oriface

prostate portion

membranous portion

penile portion

male urethra has 3 parts

renal artery

supplies blood to the kidney

inferior

the RAs are lateral branches of the AO just ________ to the SMA

RVs

the ______ drain cleansed blood back into circulation

RAs

gonadal arts

superior vesical artery

arterial supply to the ureters is via the

superior vesical arterty

arterial supply to the bladder is from the

urine and maintain homeostasis in the body

the primary function of the kidneys is to create

nephron

the functional unit of the kidneys is the

uremia (a toxic and fatal condition if untreated)

failure of both kidneys leads to _________-

cortical nephron

juxtamedullary nephron

2 different types of nephron units within the kidney

high concentration to an area of low concentration

Nephrons function by moving metabolic products from an area of

RA

blood reaches the nephron from the

99 & 1

____% goes back into circulation and ____% is excreted as waste AKA urine

vasa recta

a capillary network that brings nutrients/oxygen to the kidney AND drain filtered nutrients back into vascular circulation

afferent arteriole

blood enters the glomerulus through the

efferent arteriole

exits the glomerulus through the

nephron

is responsible for filtering the blood and producing urine from the waste products

glomerular filtration

tubular reabsorption

tubular secretion

the formation of urine involves three processes

renal corpuscle

renal tubule

the nephron unit has two main structures

filters blood (bowman’s capsule and glomerulus)

renal corpuscle

renal tubule

filtered fluid moves through and substances the body needs get reabsorbed or excreted here

glomerulus

Bowman’s capsule

Bowman’s space

the renal corpuscle consists of

the renal corpuscle (&glomerulus)

_______ functions as the filter portion of the nephron

proximal tubule

nephron loop

distal tubule (straight and convoluted)

the renal tubule consists of

column of Bertin

are pieces of cortex in varying depths between the medullary pyramids

prominent columns of Bertin

are hypertrophied extensions of the normal columns and are exaggerated in patients with a duplex collecting system