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The kidneys are a… organ
Retroperitoneal
Where are the kidneys located?
Posterior to diaphragm
What is a kidney?
Dark red, bean-shaped organ
What is the normal length of the kidneys?
9-12 cm
What is the cortex of the kidney?
Outer portion of kidney tissue
What is the normal thickness of the cortex of the kidney?
1 cm or above
What is the medulla of the kidney?
Inner portion of kidney tissue
Which part of the kidney is folded into anechoic pyramids?
Medulla
The medulla is folded into… which empty into the…
Anechoic pyramids
Renal pelvis
What is a nephron?
Renal tubules
What is the functional unit of the kidney?
Nephron
What is the renal corpuscle?
Where blood is filtered
What is the glomerulus?
Network of capillaries
The renal tubule filtrate passes into the… from…
Renal tubule
Bowman’s capsule
What is the renal hilum?
Vertical slit on medial surface of each kidney
What does the perinephric fat cover?
Fibrous capsule
What is Gerota’s Fascia?
Renal fascia composed of areolar connective tissue
What does Gerota’s Fascia cover?
Perinephric fat
Kidneys
Adrenal glands
What is a ureter?
Tube that carries urine from kidney to bladder
What is the normal length for the ureter?
25 cm
What is the urinary bladder?
Large muscular structure that acts as a storage site for urine
The urinary bladder is lined with… that allows the bladder to…
Transitional epithelium
Stretch
What is the urethra?
Membranous tube from bladder to outside body
What two structures does the urethra consist of?
Internal sphincter
External sphincter
The internal sphincter of the urethra is… while the external sphincter is…
Involuntary (smooth muscle)
Voluntary (skeletal muscle)
What is the major function of the kidney?
Excretion of urine
What does excretion mean?
When body pulls metabolic waste from blood stream and disposes it
Which structures are able to maintain homeostasis via excretion?
Skin (sweat)
Lungs (CO2)
Liver (multiple toxins)
Large intestine (feces)
Kidneys (urine)
What is a urinalysis?
Series of lab tests performed on urine
What is a urine pH test?
Testing the pH of urine
What is a specific gravity test?
Test that measures kidney’s ability to concentrate urine
What is hematuria?
Blood cells in urine (RBCs)
When is hemoglobin found in the urine?
Extensive RBCs destruction
Is creatinine typically found in the urine?
Yes
What is indicated if there is less creatinine in urine than normal?
Glomerular apparatus malfunction
Is creatinine typically found in the blood?
No
What is indicated if there is more creatinine in blood than normal?
Renal failure
What is the normal texture of the kidney?
Smooth
What is the echogenicity of the parts of the kidney in order from most to least echogenic?
Renal Capsule (echogenic)
Renal Pelvis/Sinus (echogenic)
Cortex (medium-level gray)
Renal Pyramids (hypoechoic)
What is described as the area from renal sinus to capsule?
Renal parenchyma
The cortex is the… portion of the renal parenchyma
Outer
Right renal artery runs… to…
Posterior
IVC
Left renal vein runs… to…
Anterior
Aorta
What structures define the cortico-medullary junction?
Arcuate arteries
What structure distinguishes that a renal image taken in the trasnverse plane is at the mid-level?
Renal hilum
The left kidney is adjacent to the…
Spleen
The right kidney is adjacent to the…
Liver
What is a pelvic kidney?
When kidney moves caudally with embryo axis
as it lengthens and fails to “ascend” to lumbar
position
What is the most common location of ectopic kidneys?
Pelvis
What is a horseshoe kidney?
When right and left areas of metanephric mesoderm are located very close to each other and fuse in midline, usually at inferior pole
If fusion occurs at the mid portion of the kidney…
Cake kidney
What is renal agenisis?
When ureteric bud doesn’t come into contact
with metanephric mesoderm so there is no induction of nephron formation
What is bilateral agenesis?
Complete absence of both kidneys that is not compatible with life (lethal)
What is an ectopic ureter?
When ureteric bud develops at abnormally inferior place on mesonephric duct
What is a duplicated collecting system?
When ureteric bud splits and creates a second collecting system
What is a hypertrophied Column of Bertin?
Prominent fold of renal cortical tissue that produces down into medulla towards renal sinus
What are the defining characteristics of a hypertrophied Column of Bertin?
Clearly separated from renal sinus
Contiguous with renal cortex
Isoechoic to renal parenchyma
3 cm or less
What is a Dromedary Hump?
Bulge of renal cortex on lateral surface of kidney due to pressure on developing fetal kidney from spleen
What are the defining characteristics of a Dromedary Hump?
Usually on left kidney
Isoechoic to renal parenchyma
What is a junctional parenchymal defect?
Triangular indention in upper pole or renal parenchyma that results in partial fusion of two embryonic ranunculi that form kidney
Where are junctional parenchymal defects typically seen?
Peripheral border of kidney
What is fetal lobulation?
Fusion of ranunculi that results in part of kidney being rotated
What is sinus lipomatosis?
Extra fat deposition in renal sinus that causes enlargement of renal sinus
What is extrarenal pelvis?
Enlargement of proximal end of ureter
Are ureters easily seen on an ultrasound?
Difficult to see unless dilated
Bladder must be… to evaluate with sonography
Full
Empty bladder will have… which make it difficult to evaluate
Thick walls
What is the normal appearance of the bladder?
Thin, smooth walls
Anechoic lumen
Should be located in midline
What is duplicated ureters?
Duplication of collecting system that may involve complete or partial duplication of ureter
Complete ureter duplication is seen as…
Ureters insert inferiorly on bladder
Partial ureter duplication is seen as…
Ureters fuse before reaching bladder
What is a ureterocele?
Cyst-like enlargement of distal ureter
The spleen is an… organ
Intraperitoneal
Where is the spleen located?
LUQ
Near pancreatic tail
Superior and lateral to left kidney
What is the largest mass of lymphoid tissue in the body?
Spleen
What is the primary function of the spleen?
Filter foreign material from blood
What is pitting?
When spleen removes nuclei from RBCs
What is culling?
When spleen filters out abnormal RBCs
What is a hematocrit?
Describes percentage of given volume of blood made up of RBCs
What is bacteremia?
Presence of bacteria in blood stream (sepsis)
What is leukocytosis?
Elevated WBC count
What is leukopenia?
Abnormally low WBC count
What is thrombocytopenia?
Lack of platelets caused by splenomegaly
What is the sonographic appearance of the spleen?
Similar shape to liver
Isoechoic to liver
Homogenous to liver
Hilar area is similar to liver and kidneys
What is the normal size of the spleen?
8-12 cm
What is the abnormal size of the spleen?
Cranio-caudal length = more than 13 cm
What is the cranio to caudal measurement?
Measure maximum dimension of spleen in long
Where is the splenic vein located?
Travels from splenic hilum to IVC
Runs along posterior border of pancreas
Joins MPV
What is the most common splenic congenital variant?
Accessory spleen
What is an accessory spleen?
Small round/ovoid structure of same echogenicity/texture as spleen tissue usually in splenic hilum
What is an ectopic spleen?
Spleen position is variable in abdomen/pelvic
due to laxity of splenic suspensory ligaments
What is the nickname of the ectopic spleen?
Wandering spleen
What is polysplenia?
Multiple small spleens in LUQ rather than a normal spleen
Polysplenia is associated with…
Left sided laterality sequence
What is asplenia?
Congenital absence of spleen
Asplenia is associated with…
Right sided laterality sequence