Cross sectional midterm

Functions of the kidney

Filters blood

What are the functions of the urinary system

Excretion, Elimination, Homeostatic (Regulation of Blood Plasma)

Where is the kidney located

retroperitoneal

Anatomy of the kidney

consists of 3 distinct areas: cortex (outer), medulla (middle) and renal sinus (inner)

Capsule covering liver

Glisson's capsule

Capsule covering kidney

Gerotas fascia

length of kidney

9-12cm (TRV)

width of kidney

4-6cm (TRV)

Depth(AP) of the kidney

2.5-4cm (TRV)

flow of urine

1. Papillary duct in renal pyramid 2. Minor calyx 3. Major calyx 4. Renal pelvis 5. Ureter 6. Urinary bladder 7. Urethra

What is the outter portion of the kidney

Renal cortex

What is the mid aspect of the kidney

renal medulla

What is the inner portion of the kidney that's hyperechoic

Sinus

What is the name of the cortical tissue that separates the medulla pyramids

Columns of bertin

What is peristalsis?

Contriction or relaxation of the content of the structure

What is the trigone?

The three openings at the base of the urinary bladder (2 ureters, 1 urethra)

What is the urinary bladder?

temporary storage reservoir for urine

Is the urinary bladder retroperitoneal or intraperitoneal?

retroperitoneal

What vessels course through the medularry pyramids?

Interlobar arteries

Functional unit of the kidney?

nephron

types of nephrons in the kidney

• Cortical (85%): Cortex, Outter

• -Juxtamedullary: Medulla, Inner

Lateral aspect of kidney

convex

Medial aspect of kidney

Concave

What should the echogenicity of the kidney be in relation to the liver

Hypoechoic

The echogenicity of the medullary pyramids?

Anechoic

The echogenicity of the renal sinus?

hyperechoic

The echogenicity of the renal cortex?

Mid level gray, compared to liver is hypoechoic

Echogenicity of the Renal veins and arteries

Anechoic

Fluid seen superior to the diaphragm

Pleural effusion

Fluid seen inferior to the diaphragm

Plueral Ascites

Echogenicity of simple ascites

Anechoic

Normal Variants of Kidneys

Dromedary Hump, Hypertrophied, Column of Bertin, Renal Ectopia, Horseshoe Kidney

What is the most likely place for renal ectopia to take place

Pelvis

horshoe kidney

congenital anomaly in which kidneys are fused together at lower end

Where is the left kidney in relation to the tail of the panc

Lateral

Where is the tail of the panc in relation to the left kidney

Medial

What makes up the renal sinus

Fat, vessels, nerves, and lymphatics

Two main lab values for assesssing renal function

Blood Urea Nitrogen (BUN) and Serum Creatinine (Cr)

Which lab value for renal function is more sensitive and specific

Serum Creatinine (Cr)

Where is Morrison's Pouch located?

In the subhepatic space, hepatorenal space, hepatorenal/subhepatic recess

CBD in relation to the panc head

Posterolateral

GDA in relation to the panc head

Anterolateral

What makes up the portal splenic confluence

SMV and splenic vein

Which vessel hugs the IVC

Rt Renal Artery

Are the portal veins hepatopetal or hepatofugal?

hepatopetal

Are the hepatic veins hepatopetal or hepatofugal?

hepatofugal

What vessels make up the portal venous system?

Portal Veins, Splenic Veins, Superior, Mesenteric Vein, Inferior Mesenteric Vein

What vessels merge to form the IVC?

Common Iliac Veins

In what plane do we measure the Aorta?

Sagittal

How is the aorta measured?

outer wall to outer wall or AP : Anterior to Posterior

Measurements of Aorta

<3cm

Measurements of IVC

2.5cm <3.7cm

Measurements of Main Portal Vein

13mm (1.3cm)

Measurements of Common Bile Duct

<4mm in 98% of individuals

1-7mm in normal

Measurements of Common Bile Duct following a Cholecystectomy

Up to 10mm

Measurements of Duct of Wirsung

2mm

Measurements of Gallbladder

Length: 8-12cm and Width: 3-5cm

Measurements of Gallbladder Wall

3mm

What are the three vessels of the wall?

Tunica Intima, Tunica Media, Tunica Adventitia

Measurements of Pancreas

Total Length: 12-18cm Head: 2-3cm Neck: 1.5-2.5cm Body: 2-3cm Tail: 1-2cm

What makes up the Portal Triad?

Main Portal Vein, Common Hepatic Artery and Common Bile Duct

Where does the portal triad originate?

Porta hepatis

What cavity is the heart in?

Thoracic Cavity

Hormone that is released when food enters the duodenum?

Cholecystokinin

What does the pancreas secrete?

Pancreatic juices/enzymes

What do the pancreatic juices dump into?

Duct of Wirsung

What is the fluid that the gallbladder transport into the common bile duct?

Bile

What separates the GB from the Rt portal vein?

Main lobar fissure

What seperates the left lobe of the liver and caudate?

Ligamentum venosum