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