Chapter 14 – Urinary System & Venipuncture

Flashcards reviewing urinary anatomy, physiology, imaging procedures, terminology, and venipuncture techniques for Chapter 14.

Which urinary structures are retroperitoneal?

Kidneys and ureters

What is retroperitoneal?

Which urinary structures are infraperitoneal?

Urinary bladder, distal ureter, and urethra

What does 'renal' or the prefix 'ren-' mean?

Pertaining to the kidney

What is the location difference between the right and left kidney?

Left kidney sits slightly higher; right kidney is lower because of the liver

At rest, what percentage of cardiac output passes through the kidneys?

About 25 % of the blood pumped by the heart

Normal kidney position spans which vertebral levels in the supine, expiratory position?

From T11–T12 (upper pole) to L3 (lower pole)

Average size of an adult kidney (length × width × thickness)?

4–5 in long, 2–3 in wide, ~1 in thick

What is nephroptosis?

Abnormal dropping of a kidney more than 2 inches when standing

How many degrees laterally are the kidneys angled from the midsagittal plane?

≈ 20° lateral (due to psoas muscles)

How many degrees posteriorly are the kidneys rotated from the mid-coronal plane?

≈ 30° posterior

Name the fatty tissue surrounding each kidney that often outlines it on plain radiographs.

Perirenal (adipose) capsule

Name the thin outer covering of the kidney itself.

Fibrous (renal) capsule

List the structures urine passes through inside a kidney, in order.

Renal cortex → medulla → renal pyramids → renal papilla → minor calyx → major calyx → renal pelvis → ureter

What is the renal parenchyma?

The total functional portion of the kidney (all nephrons + collecting structures)

What is the single functional unit of the kidney?

The nephron

Where are the glomerulus, Bowman's capsule, and proximal/distal convoluted tubules located?

In the renal cortex

Which nephron parts lie inside the medulla?

Loop of Henle and collecting duct

Main nitrogenous waste products removed by the kidneys?

Urea and creatinine

Blood tests used to evaluate kidney function before contrast studies?

BUN (Blood Urea Nitrogen) and serum creatinine

Excess nitrogenous waste in the bloodstream is called .

Uremia

Average daily filtrate volume versus urine volume?

≈ 180 L of filtrate produced; ≈ 1.5 L of urine excreted

Normal water intake per 24 h on average?

≈ 2.5 L (from liquids, food, metabolism)

Length and diameter of a typical ureter?

11–13 in long; ≈ 1 cm in diameter

Three normal ureter constrictions (stone trap sites) from superior to inferior?

1) Ureteropelvic junction (UPJ) 2) Pelvic brim 3) Ureterovesical junction (UVJ)

Most common site where a kidney stone lodges?

Ureterovesical junction (UVJ)

How does urine move down the ureters?

Peristalsis plus gravity

Define the trigone of the bladder.

Smooth triangular area between the two ureter openings and the urethral opening

Bladder capacity range and volume that triggers urge to void?

Holds 350–500 mL; urge begins ≈ 250 mL

Terms that mean the act of urination.

Micturition or voiding

Inability to hold urine (involuntary leakage) is called .

Incontinence

Retention refers to .

Inability to void despite a full bladder (often from enlarged prostate)

Length and functions of the male urethra?

6.5–7.5 in; conveys urine and semen

Length and function of the female urethra?

≈ 1.5 in; conveys urine only

Which gland surrounds the proximal male urethra?

Prostate gland

Contrast-enhanced study of the entire urinary tract is called an .

IVU (Intravenous Urogram)

Retrograde contrast study of renal pelvis and calyces is termed .

Retrograde pyelogram

Fluoroscopic study during urination to assess bladder/urethra?

Voiding cystourethrogram (VCUG)

Most common contrast type for IVU procedures?

Water-soluble iodinated contrast

Define bolus injection.

Entire contrast dose injected rapidly at once

Minimum needle gauge for adult bolus IV contrast injection?

18–22 gauge (smaller number = larger bore)

Common antecubital fossa veins used for venipuncture (3)?

Median cubital, basilic, and cephalic veins

What is extravasation?

Contrast leaking out of the vein into surrounding tissue

Immediate care steps if extravasation occurs?

Stop injection, remove needle, elevate limb, apply cold then warm compresses, document incident

Name two main contrast reaction emergency drugs kept on hand.

Epinephrine and Benadryl (diphenhydramine)

General angle of needle entry for IV placement?

Approximately 20°–45° to the skin; lower angle once vein entered

Why keep the IV catheter in place after injecting contrast?

Provides access for emergency drugs if a reaction occurs

What cleaning pattern is used before inserting an IV needle?

Circular motion from center outward, for about 2–3 inches

Pediatric IV contrast injections generally use what needle gauge?

23–25 gauge

Two main IV delivery methods for contrast?

Bolus (hand or power injector) and drip infusion

Define nephroptosis and state a possible consequence.

Dropping of kidney; may kink ureter and obstruct urine flow

What imaging position best demonstrates the right kidney parallel to the IR, and why?

30° LPO (left posterior oblique); because kidneys are rotated 30° posteriorly and the kidney farthest from the table becomes parallel

How much do kidneys move with deep inspiration versus standing?

≈ 1 in (2.5 cm) with inspiration; ≈ 2 in (5 cm) lower when erect

Which capsule/fat layer outlines the kidney on a non-contrast abdominal radiograph?

Perirenal (adipose) fat capsule

The abnormal presence of blood plus jagged pain during stone passage is due to .

Sharp kidney stone edges lacerating urethral mucosa

What is the significance of a BUN or creatinine value that is high?

Indicates impaired renal function and higher risk for contrast-induced complications