OB/GYN II Chapter 26
urethral atresia, prune belly syndrome, posterior urethral valves
"Keyhole" sign would be seen with what 3 situations
d
"Lying down" adrenal sign would be seen in all EXCEPT: a. unilateral renal agenesis b. bilateral renal agenesis c. Potter syndrome d. pyelectesis
renal agenesis
"Lying down" sign describes sonographic finding for _____ _____
true
A little fluid in fetal kidneys is ok. (T-F)
inferior, superior
A pelvic kidney is located _____ to the renal fossa and _____ to the bladder.
membrane
A posterior urethral valve is an obstructing _____ in the posterior urethra in males caused by a redundant membranous fold.
simple
A single, nonseptated renal cyst with well-defined borders and no communication with the renal pelvis describes a _____ renal cyst.
duplicated collecting system
A ureterocele is mostly associated with a _____ _____ _____.
Potter sequence
AKA oligohydramnios sequence and includes renal conditions such as agenesis, obstructive processes and acquired or inherited polycystic disease
megacystitis
Abnormally enlarged urinary bladder
b
All are associated with oligohydramnios BUT: a. bilateral MCDK disease b. unilateral renal agenesis c. bilateral renal agenesis d. ARPKD
hydronephrosis
Another name for pelvocaleiectasis
common iliac
Arteries that initially supply blood to kidneys while in the pelvis
ARPKD
Associated with enlarged echogenic kidneys and microscopic renal cysts
pelvis
Before 9 weeks gestation, the kidneys are located within the _____.
ARPKD
Bilateral enlarged, echogenic fetal kidneys and oliohydramnios
Potter syndrome
Bilateral renal agenesis is _____ _____
ascites
Bladder wall thickness cannot be visualized clearly without _____.
mesoderm
Both urinary and genital systems develop from the _____.
18-20, hypoechoic
By _____ - _____ weeks kidneys are easier to see because they have a _____ texture similar to adult kidneys
urachus
Canal connecting the fetal bladder with the allantois
c
Cloacal exstrophy is associated with all BUT: a. omphalocele b. spina bifida c. encephalocele d. imperforate anus
bladder exstrophy
Condition demonstrating two commonly seen umbilical arteries in the fetal pelvis without a cystic structure between them
renal ectopia
Condition where the kidney is positioned outside the renal fossa
bladder exstrophy
Congenital anomaly where the bladder is outside the body through a ventral wall defect inferior to the umbilical cord
prune belly syndrome
Congenital disorder of the urinary system resulting in the absence of the abdominal muscles, undescended testicles and urinary tract problems
hydronephrosis
Dilation or widening of renal pelvises or calyces occurring when urine is backed up in the kidney
9, 12
Distinguishable sex characteristics begin developing by _____ weeks and external genital organs are fully differentiated by _____ weeks' gestation.
pronephros
Embryologic kidney that exists until week 4, then degenerates completely, nonfunctioning
cloaca
Embryonic structure that develops into normal rectum & urogenital sinus
compensatory hypertrophy
Enlargement of the unaffected contralateral kidney with unilateral renal agenesis or compromised renal function
cloaca
Excretory ducts of both GU systems initially enter a common cavity called the _____.
bladder exstrophy
External position of the bladder
cryptorchidism
Failure of one or both testes to complete the migratory descent into the scrotum
sirenomelia
Fetal abnormality characterized by fusion of the lower extremities, renal agenesis, and oligohydramnios; may also be referred to as mermaid syndrome
3rd
Fetal adrenals are best imaged in the _____ trimester.
hydrocele
Fluid surrounding the fetal testicle
mesonephros
Functions as "interim kidney" for 1st trimester; later contributes to male genital system
encephalocele
Herniation of brain tissue and meninges through a defect in the skull
Turner syndrome
Horseshoe kidney has the highest prevalence in fetuses with _____ _____.
renal obstruction
Hydronephrosis can be caused by _____ _____.
7 mm
In a 30-week fetus, megaureter is diagnosed when the ureter measures greater than _____ _____.
oval
In a transverse plane, fetal kidneys are _____-shaped.
isoechoic
In the first trimester, fetal kidneys appear _____ to the surrounding anatomy.
hypoplasia
Incomplete development or underdevelopment of an organ or tissue
common iliac, aorta, abdominal
Initial blood supply of kidneys Later blood supply of kidneys is distal _____ caudally and _____ aorta cranially
allantois, urachus, medial umbilical ligament
Initial fetal bladder is the _____. Obliterates into a fibrous cord called the _____. And finally becomes the _____ _____ _____.
posterior urethral valves
Irregular thin membranes of tissue located within the male posterior urethra that do not allow urine to exit the urethra
horseshoe kidney
Kidney where the upper poles fuse
neuroblastoma
Malignant tumor that can occur within the adrenal gland and anywhere within the sympathetic nervous system
polyhydramnios
Mesoblastic nephromas ( fetal renal hamartoma) are related to ______.
UPJ
Most common cause of congenital obstructive hydronephrosis ocurs in the _____ (abbr)
VUR
Most common cause of hydronephrosis in a neonate and most common form of fetal renal obstruction
hydronephrosis
Most common fetal abnormality noted during an OB sonogram
UG
Most common fetal malformation involves the _____ _____ system. (abbr.)
pelvis
Most common location of ectopic kidney
neuroblastoma
Most common malignant adrenal pediatric tumor
duplex collecting system
Most common renal anomaly
horseshoe kidney
Most common type of fusion anomaly
pronephros, mesonephros, metanephros
Name Structure A Name Structure B Name Structure C
ureterocele, VUR
Name the anomaly and what it can lead to (abbr)
unilateral renal agenesis
Name the anomaly.
MCDK
Numerous noncommunicating anechoic masses within the left renal fossa at 20 weeks' gestation What is the most likely etiology? (abbr)
renal pelvis, calices
Obstruction at the level of the UPJ would lead to the dilation of the _____ _____ and _____.
500, 5
Oligohydramnios is defined as an amniotic fluid volume of less than _____ cc, as indicated by a maximum vertical pocket (MVP) of less than 2 cm or an amniotic fluid index (AFI) of less than _____ cm on U/S.
7 mm
Pelvic dilation in the 3rd trimester means the renal pelvis is dilated over _____ _____.
vesicoureteral reflux (VUR)
Permanent or intermittent retrograde flow of urine from the bladder into the upper urinary tract. ** full name and abbreviation **
cloaca
Posterior orifice that serves as the only opening for digestive, reproductive and urinary tracts
polycystic kidneys
Predominantly female renal and/or bladder group of anomalies
c
Prognosis is poor for a fetus with all EXCEPT: a. bilateral hydronephrosis b. pulmonary hypoplasia c. isoechoic renal echogenicity d. bladder obstruction
bladder
Prune belly syndrome is cause by an enlarged _____.
5, 8, 10
Renal Pelvis Measurements 13-20 weeks = _____ mm 20-30 weeks = _____ mm 30-term weeks = _____ mm
agenesis
Renal _____ is absence of the kidney or failure of the kidney to form
ADPKD
Renal cystic disease that develops late in adulthood
7
Renal pelvis should NOT exceed _____ mm prior to 20 weeks' gestation
dysmorphism
Representing two genders
unilateral renal agenesis
Results in compensatory hypertrophy
hydrocele
Serous fluid accumulation in a saclike cavity like the scrotum
15 mm
Severe fetal hydronephrosis is an APRPD (anterior-posterior renal pelvis diameter) over _____ _____.
prune belly syndrome
Syndrome that is a consequence of the abdominal wall musculature being stretched by an extremely enlarged urinary bladder
umbilical
The _____ arteries will assist in locating the fetal bladder.
caudal, involution, disappear
The _____ branches that supply the fetal kidney undergo _____ and _____.
renal function
The amount of amniotic fluid observed has a direct correlation with _____ _____ of the fetus.
30 minutes to 1 hour
The fetal bladder fills and voids approximately once every _____ _____.
11-13
The fetal bladder should be visualized by _____ to _____ weeks.
oligohydramnios
The presence of _____ after 16 weeks' gestation raises suspicion for a malfunctioning GU system.
simple cyst, complex cyst, solid mass
Three common ovarian anomalies seen sonographically in the female fetus
medial umbilical ligament
Urachus is represented by ______ _____ _____
true
Urinary system begins to develop before the genital system. (T-F)
metanephros
What embryonic structure forms the following adult structures? • Nephrons • Kidneys
transverse
What scan plane?
keyhole, bladder, posterior urethra
What sign is this? What is dilated (2)?
pelvic
What type of kidney cause HTN?
posterior urethral valves
What would cause a bladder outlet obstruction?
color and/or power Doppler
When the 2nd trimester fetal renal are difficult to visualize, what method will assist in imaging them?
b
Which is NOT associated with prune belly syndrome: a. megacystitis b. undescended testicles c. dilated UB and urethra d. abdominal muscle hypertrophy
caliectasis
Widening and dilation of the renal calyces
13
Working fetal kidneys seen by _____ weeks of gestation but are hard to see b/c they are isoechoic to surrounding tissue
Potter syndrome
_____ _____ is a condition that a fetus has pulmonary hypoplasia secondary to oligohydramnios, typically because of renal failure.
crossed
_____ renal ectopia is a kidney located on the opposite side from which its ureter inserts into the bladder.
