Chapter 7: Urinary Tract (Penny)

____ kidney sits lower than the ____ due to the size of the liver that occupies most of the RUQ

Right Left

Increase in BUN or creatinine indicates

Some form of renal disease

Kidneys develop in ____

The pelvis

Renal hypoplasia

Undervelopment Too few nephrons Smaller

Arcuate arteries travel

at the base of the renal pyramids

Kidneys are retroperitoneal in location and are ______ shaped

bean

Hypertrophic column of bertin is actually a

double layer of cortex

Adult kidneys measure

elliptical shape 8-13cm long 2-3cm AP 4-5cm wide

The kidneys are vital for ________

homeostasis (maintain equilibrium)

Junctional parenchymal defect is

hyperechoic wedge shaped structure on the anterior portion of the kidney Located between the upper and middle sections of the kidney

Junctional parenchymal defect results from

incomplete fusion of 2 embryologic components of the kidneys

With a duplicated collecting system, the kidney will

measure longer than normal

other causes of ARF

renal artery stenosis -renal infection -urinary tract obstruction -polycystic kidney disease -metabolic disorders

Order of renal artery branches

-Segmental -Interlobar -Arcuate -Interlobular -Afferent arterioles (SeInAr, InAff)

Supernumery kidney

3rd, smaller kidney

Kidneys ascend into their normal position by

9wks gestation

Cortex should measure _____ from ____ to _____

> 1cm from the Outer margin of the renal pyramids to the Outer margin of the kidney

Medulla (inner part of parenchyma) is responsible for

Absorption

Sudden decrease in renal function

Acute renal failure (ARF)

BUN measures

Amount of urea nitrogen

Afferent arterioles

Carry blood into the glomerulus for filtration

LDH increases as a result of

Cell death

Renal sinus is located

Centrally in the kidney

Gradual decrease in kidney function over time

Chronic renal failure (CRF)

Extension of the cortex located between the pyramids

Column of bertin

Renal agenesis

Congenital absence of kidneys Fatal if bilateral

Kidney parenchyma consists of

Cortex and medulla

Renal sinus appears

Echogenic

CRF leads to

End stage renal disease (ESRD)

Renal sinus lipomatosis

Excessive fat in the renal pelvis

Renal pelvis is located outside of the hilum

Extrarenal pelvis

Renal capsule appears as

Highly reflective hyperechoic line surrounding the kidney

Renal arteries are located

Just below the level of the SMA

_____ renal artery is shorter than the _____

Left Right

_____ renal vein is longer than the _____

Left Right

Decreased BUN is associated with (5)

Liver disease and failure Malnutrition Overhydration Smoking Pregnancy

Renal pyramids are located in the

Medulla

______ are seperated by columns of bertin

Medullary pyramids

What is the functional unit of the kidney?

Nephron

4 coverings of the kidneys (Outer to inner)

Pararenal fat Gerota's Fascia Perirenal fascia Renal capsule

What is the innermost covering of the kidney?

Renal capsule

Renal sinus contains

Renal collecting system

Clinical findings of acute renal failure (8)

-Increased BUN -Increased creatinine -HTN -Leukocytosis -Hematuria -Edema -Hypovolemia

Renal collecting system is composed of

-Minor and major calyces -Renal pelvis -Infundibula

Sono findings of ARF

-Normal -May be more echogenic

urinalysis for renal function includes an evaluation for

-bacteruria -pyuria (pus) -hematuria (blood) -proteinuria (protein)

other causes of CRF

-glomerulonephritis -chronic pyelonephritis -metabolic disorders -chronic urinary tract obstruction -tuberculosis

Kidney suffers from ischemic damage and cell destruction

Acute tubular necrosis

Most common cause of ARF

Acute tubular necrosis

Interlobar arteries travel

Between the renal pyramids

Lower urinary tract consists of

Bladder and urethra

Decreased WBC is associated with (3)

Chemo Radiation therapy Toxic reaction

High specific gravity is associated with (1)

Dehydration

most common cause of CRF

Diabetes mellitus

Bulge on the lateral border of the kidney

Dromedary hump

What is the Most common congenital anomaly of the urinary tract?

Duplicated collecting system

Renal sinus lipomatosis is AKA

Fibrolipomatosis

Cortex is responsible for

Filtration

Pararenal fat covers

Gerotas fascia

Enlargement of a renal column seen as an indention of the renal sinus

Hypertrophic column of bertin

Echogenicity of renal cortex

Hypo or isoechoic to the liver and spleen

Increased WBC is associated with (2)

Infection Inflammation

Increased echogenicity of the renal cortex suggests

Intrinsic renal disease

Malrotated kidney

Kidney is in the renal fossa but positioned off the normal axis

Upper urinary tract consists of

Kidneys and ureters

_____ travels between the SMA & aorta

LRV

Dromedary hump is common on the ____ kidney

Left

____ kidney is higher than the _____

Left Right

_____ kidney is longer than the _____

Left Right

What is the outermost covering of the kidney?

Pararenal fat

What is the most common location of an ectopic kidney?

Pelvic

RRA travels

Posterior to the IVC

______ travels posterior to the IVC

RRA

Increased creatinine is associated with (5)

Renal failure Chronic nephritis Renal obstruction Diabetes Reduced renal blood flow

Increased BUN is associated with (6)

Renal failure Parenchymal disease Renal obstruction Dehydration Diabetes Hemorrhage

Low specific gravity is associated with (2)

Renal failure Pyelonephritis

Increased LDH is associated with (2)

Renal infarct Chronic renal disease

Funnel shaped structure that collects urine before it moves into the ureter

Renal pelvis

Medulla includes

Renal pyramids

Renal sinus lipomatosis appears as

Renal sinus will be large and echogenic

_____ renal artery is longer than the _____

Right Left

_____ renal vein is shorter than the _____

Right Left

____ kidney is shorter than the _____

Right Left

LRV travels between

SMA and aorta

Echogenicity of a dromedary hump

Same as cortex

Abnormal urine pH is associated with (1)

Urinary calculi

Clinical finding of a simple renal cyst

asymptomatic

_______ is responsible for filtration of the blood and is the outer part of the renal parenchyma

cortex

______ that is also excreted by the kidneys measures the amount of creatinine phosphate found in skeletal muscles

creatinine

Neonatal and pediatric kidneys will be

lobulated with prominent renal pyramids

Horseshoe kidneys are connected at

lower poles

______ _____ is a byproduct of protein metabolism that occurs within the liver and is excreted by the kidney

urea nitrogen

Blood tests analyze the levels of

-BUN -creatinine -lactacte dehydrogenase (LDH)

Functions of kidneys

-Detox blood -Regulate BP -maintain normal pH, iron and salt levels