Flashcards in Kidneys Deck (100)
Branches of renal artery
Main renal artery, 5 segmental arteries, interlobar arteries (between pyramids), arcuate arteries (parallel to pyramids), interlobullar arteries (perpendicular to pyramids).
The main renal artery comes off of aorta. At hilum divides into 5 segmental arteries. Those divide into interlobar arteries.
Interlobar arteries are between medullary pyramids. At the base of pyramid, arcuate arteries branch off interlobar. (Arcuate are parallel to renal capsule)
Arcuate arteries branch into interlobullar arteries. (perpendicular to renal capsule)
Bilateral renal agenesis assoc with
Oligohydramnios & pulmonary hypoplasia
Unilateral renal agenesis is assoc with
Uterine duplication/bicornuate ut, and seminal vesicle agenesis in males.
Crossed renal ectopia
Kidney ascends to contralateral side
Crossed fused renal ectopia
Kidney goes to contralateral side and fuses with the other kidney
Lower poles fused. U shape. Lower poles at midline.
Partial or complete
Complete: 2 ureter, 1 is in ectopic location in the bladder. Frequent complication is ureterocele.
Ureterocele distal ureter into bladder with cystic dilatation. Causes obstruction. May cause upper pole to dilate.
MC male urinary obstruction
Posterior Ureteral Valve obstruction
Dilated bladder, hydroureter, hydronephrosis, urinoma
Most common cause of abd mass in newborns
If see renal cell carcinoma, must evaluate ____
Renal vein and IVC for lymphadenopathy and liver mets.
Prune Belly Syndrome characteristics
Absent Abd wall musculature,
large distended urinary bladder, hydronephrosis/hydroureter,
Pus in dilated pelvis secondary to infected hydronephrosis
Dependent echoes in the dilated pelvicaliceal system, debri, gas shadowing from infection.
Transitional cell carcinoma
MC cancer in renal pelvis
Squamous cell carcinoma and mucinous adenocarcinoma are also cancers in renal pelvis but not as common.
Bilateral renal masses
Malignant lymphoma/Hodgkin's lymphoma
Tumors assoc with Von Hippel Lindau
RCC, hemangioma, phenochromocytoma, panc cystadenoma, cystadenocarcinoma, Adenoma, islet cell tumors, cyst in organs.
Wilms tumor/ nephroblastoma
MC malignant mass in the Abd of children under 8 yrs
Large renal tumor, sharply marginated, compressed renal tissue, focal hemorrhage & necrosis, calcifications, tumor invasion of IVC and RT atrium, tumor may cross midline, hypervascular
Caused by atresia of uretopelvic junction during metanephric stage of intrauterine development. Week 8-10 GA. Collecting tubules enlarge and turn into cysts.
Assoc with contralateral UPJ obstruction, contralateral renal agenesis or hypoplasia
Cyst of varying shape/size, cyst don't communicate, absence of sinus and parenchyma. Usually unilateral. Echogenic tissue interfaces between cysts
ARPKD/infantile polycystic kidney
Bilateral, infants, spongy large echogenic kidneys. Tiny cysts.
Obstruction from a stone
Ureteropelvic junction: MC
Ureteric obstruction of the level of pelvic inlet
Renal artery stenosis
Kidneys < 9cm L
Peak main renal artery vel > 100 cm/s
Renal artery / aorta ratio > 3.5
Pulsus tardus waveform of segmental renal artery
Peak systolic vel of Main renal artery compared to PSV of aorta. Renal artery to aortic ratio > or = 3.5 indicate a hemodynamically significant stenosis
Round cystic structure that projects into the bladder lumen at the uretovesical junction
May obstruct & cause UTIs.
Structure that connects the apex of the bladder to the umbilicus
The median umbilical ligament (urachus)
Cystic dilatation of urachus = urachal cyst. Extends from umbilicus to bladder dome.
AIDs US findings
Hepatosplenomegaly, lymphadenopathy, hyper liver, hyper renal, liver abscess, Mets kaposi sarcoma, acute cholecystitis
3 parts of retroperitoneal
Perirenal, ant and post pararenal
Infantile polycystic kidney disease
Enlarged echogenic kidneys
Loss of cortical medullary distinction
Assoc with renal dysfunction, lung hypoplasia, periportal hepatic fibrosis, oligohydramnios in utero
Column of Bertin
Hypertrophied column of Bertin. Invagination between cortex. Should be < 3cm and continuous with no mass effect.
Renal cell carcinoma
Solid hypo mass
Assoc with adult polycystic kidney disease, acquired cystic disease, Von Hippel Lindau, and Tuberous Sclerosis
Evaluate ipsilateral renal vein and IVC for mets, contralateral renal vein, Retroperitoneum for lymphadenopathy, and liver for mets.
Fat tumor, hyperechoic, propagation speed artifact