urinary

In utero, the kidneys develop in what?

The pelvis.

1. In utero, when the kidneys develop into the pelvis, where would they ascend to after?

2. What weeks?

1. Abdomen

2. 12 - 15

What are the main functioning units of the kidneys?

Nephrons.

When do the nephrons begin functioning?

8 weeks.

When are the kidneys completely formed?

36 weeks.

What other structure forms at the same time as the kidneys?

The genitals.

Variations in fusion account for (1)___________________, (2)_______________, and other anomalies.

1. Junctional parenchymal defect

2. Column of Bertin

Where does the left kidney lie to the spleen?

• Inferior

• Medial

Where are the adrenal glands located in relation to the kidney?

• Anterior

• Medial

• Superior

Where is the right adrenal gland located in relation to the kidneys?

Superior.

Where is the left adrenal gland located in relation to the kidneys?

Medial.

Where does the tail of the pancreas lie to the upper pole of the left kidney?

Anterior.

The left renal artery goes directly into what structure?

The left kidney

The left renal vein goes to what structure?

The left kidney

The left or right renal vein is longer?

Left renal vein

Where does the right renal vein flow from?

The right kidney

What are the 2 main functions of a nephron?

• Excrete waste

• Regulate the composition of blood

The nephron consists of what 2 main structures?

• Renal corpuscle

• Renal tubule

What is another term for renal corpuscle?

Malpighian body.

What is another term for Malpighian body?

Renal corpuscle.

What does the renal corpuscle do?

Filters the blood in the glomerulus.

The glomerulus consists of a network of (1)_________ surrounded by (2)_________ capsule.

1. Capillaries

2. Bowman’s

When blood is filtered,

1. When needed substances are returned to the _______

2. Any _______ product and excess water pass into the collecting systems as ______

1. Blood

2. Waste, Urine

On the image, what is the name of the structure labeled ‘1’?

Glomerulus.

On the image, what is the name of the structure labeled ‘2’?

Renal corpuscle/Malpighian body.

On the image, what is the name of the structure labeled ‘3’?

Renal tubule.

Inside the renal tubule; once blood is filtered, where does it flow from there?

→ Proximal convoluted tubule

→ Loop of Henle

→ Distal convoluted tubule

What is another name for loop of Henle?

Nephron loop.

What is another name for nephron loop?

Loop of Henle.

On the image, what is the name of the structure labeled number 1? (The outer part, not the inner)

Renal corpuscle.

On the image, what is the name of the structure labeled number 2?

Proximal convoluted tubule.

On the image, what is the name of the structure labeled number 3?

Loop of Henle/Nephron loop.

On the image, what is the name of the structure labeled number 4?

Distal convoluted tubule.

In the distal convoluted tubule,

1. Substances needed by the body are returned to the _______

2. Waste products not needed are passed into the ducts as ______

1. Blood

2. Urine

What is the juxtaglomerular apparatus made up of?

• Proximal convoluted tubule

• Nephron loop

• Distal convoluted tubule

What does the juxtaglomerular apparatus regulate?

• Function of each nephron

• Blood pressure

What is another term for gerota’s fascia?

Renal fascia.

What is another term for renal fascia?

Gerota’s fascia.

Gerota’s fascia is a layer of (1)________ tissue that surrounds the (2)__________ and _______________.

1. Connective

2. Kidneys, Adrenal glands

Gerota’s fascia provides what 2 things?

• Support

• Protection

What is the echogenicity of the renal fascia?

Hyperechoic

Which number would be the correct structure for Gerota’s fascia?

3

The red arrows point to what area?

Morrison’s pouch

What is Morrison’s pouch?

A space that separates the liver from the right kidney

Can fluid accumulate in Morrison’s pouch?

Yes, and from a wide range of causes.

The renal capsule has what echogenicity to the cortex?

Hyperechoic

The renal cortex extends from where to where?

Renal capsule to medullary pyramids.

What is the normal measurement for the renal cortex?

Greater than 1 cm

What should the renal cortex echogenicity be to the liver?

• Isoechoic

• Slightly hypoechoic

What does the renal medulla contain?

Medullary pyramids

Medullary pyramids can be confused with what pathologies?

• Mass

• Cysts

What is the appearance of a medullary pyramid on US?

• Hypoechoic

• Equally spaced triangular or round areas

The medullary pyramids lie between which 2 structures?

• Cortex

• Sinus

On a medullary pyramid, where does the base lie?

Next to the renal cortex

On a medullary pyramid, where does the apex lie?

Towards the renal sinus

What is the echogenicity of the renal sinus?

Hyperechoic

The echogenicity of the renal sinus is hyperechoic due to what?

Various interfaces between fat, vessels, and fibrous tissue

What are the names of the layers that are numbered? (#3 is LAYER name, not the structures inside)

1. Renal capsule

2. Renal cortex

3. Renal medulla

4. Renal sinus

What is the name of the structure labeled with an * ?

Medullary pyramid

What are the names of the areas labeled with a star and heart on a medullary pyramid?

Star = base

Heart = apex

The renal hilum is the (1)______ opening for which 3 structures?

1. Medial

2. Renal vein, renal artery, and ureter

List the structures in the renal hilum from anterior to posterior.

• Renal vein

• Renal artery

• Ureter

Label these structures seen at the renal hilum.

1. Renal vein

2. Renal artery

3. Ureter

What is the mnemonic for remembering the renal hilum order from anterior to posterior?

It’s Very Annoying that it’s Unclear.

Each ureter has a renal ______.

Pelvis

The renal pelvis is the _______ shaped upper end.

Funnel

The renal pelvis branches into (1))______ calyces and then (2)______ calyces.

1. Major

2. Minor

What does the renal parenchyma consist of?

• Renal cortex

• Renal medulla

What structure is crossed out in this image?

Psoas major muscle

Where does urine go AFTER the nephrons?

(List step by step)

• Through the minor and major calyces

• Then the renal pelvis

• Then the ureter

• Into the bladder

The bladder stores (1)______ until it is passed via the (2)_________.

1. Urine

2. Urethra

1. What shape do the paired, kidneys take on?

2. They lie in the (intra/retro)peritoneal.

3. They lie against the deep muscles of the _____.

1. Bean shaped

2. Retroperitoneal

3. Back

1. What is the difference in placement of the right and left kidney?

2. Why is this?

1. The right kidney is slightly more inferior than the left kidney

2. Due to the liver

Which can sometimes be larger, left kidney or right kidney?

Left kidney

How does a normal adult kidney appear on an US?

• Heterogenous

• Smooth contour

Why does the kidney appear heterogenous?

Due to the combination of medullary pyramids and renal parenchyma

How does hydronephrosis appear on a US?

• Anechoic at renal pelvis

• Can sometimes branch into major calyces

In severe cases of hydronephrosis, fluid can branch into the…

Minor calyces

Label the ‘C’ and ‘S’ on the image.

C = Renal cortex

S = Renal sinus

Label the structures at the renal hilum.

(HINT: The structure at the 2 did not have color)

1. Right renal vein

2. Ureter

What plane/position was this image captured in?

Coronal

Out of these 3 planes/positions: Coronal, Sagittal, and Prone

Which provides the most detail?

Coronal

What plane/position was this image captured in?

Sagittal

What position could this image have been taken in?

Prone

Is the kidney imaged from an adult, child, neonate, or fetus?

Adult

Is the kidney imaged from an adult, child, neonate, or fetus?

Child

Is the kidney imaged from an adult, child, neonate, or fetus?

Neonate

Is the kidney imaged from an adult, child, neonate, or fetus?

Fetus

What do child, neonate, and fetal kidneys all have in common on US?

The medullary pyramids are more anechoic

Which renal measurement is most important to watch for?

Length

What is the normal measurement range for renal length?

9 - 12 cm

What is the normal measurement range for renal AP?

2.4 - 4 cm

What is the normal measurement range for renal width?

4 - 6 cm

In a sagittal scan of the kidney, what measurements are taken?

Length and AP (Height)

In a transverse scan of the kidney, what measurements are taken?

Width

What would consider the kidney measurements to be abnormal?

There is a difference >2 cm between 2 kidneys

What is the formula for calculating renal volume?

Length x AP x Width x .49

1. In the absence/nonfunction of one kidney, what can occur?

2. Describe what question 1’s answer is.

1. Compensatory hypertrophy

2. The other kidney increases in size

What measurements are taken here?

• Length

• Height (AP)

What measurements are taken here?

Width