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Flashcards in Kidneys Deck (100)
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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)

1

Bilateral renal agenesis assoc with

Oligohydramnios & pulmonary hypoplasia

2

Unilateral renal agenesis is assoc with

Uterine duplication/bicornuate ut, and seminal vesicle agenesis in males.

3

Crossed renal ectopia

Kidney ascends to contralateral side

4

Crossed fused renal ectopia

Kidney goes to contralateral side and fuses with the other kidney

5

Horseshoe kidney

Lower poles fused. U shape. Lower poles at midline.

6

Ureter duplication

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.

7

MC male urinary obstruction

Posterior Ureteral Valve obstruction

Dilated bladder, hydroureter, hydronephrosis, urinoma

8

Most common cause of abd mass in newborns

MCDK

9

If see renal cell carcinoma, must evaluate ____

Renal vein and IVC for lymphadenopathy and liver mets.

10

Prune Belly Syndrome characteristics

Absent Abd wall musculature,
large distended urinary bladder, hydronephrosis/hydroureter,
bilateral cryptorchidism

11

Pyonephrosis

Pus in dilated pelvis secondary to infected hydronephrosis

Dependent echoes in the dilated pelvicaliceal system, debri, gas shadowing from infection.

12

Transitional cell carcinoma

MC cancer in renal pelvis

Squamous cell carcinoma and mucinous adenocarcinoma are also cancers in renal pelvis but not as common.

13

Bilateral renal masses

Malignant lymphoma/Hodgkin's lymphoma

Mets

14

Tumors assoc with Von Hippel Lindau

RCC, hemangioma, phenochromocytoma, panc cystadenoma, cystadenocarcinoma, Adenoma, islet cell tumors, cyst in organs.

15

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

16

MCDK

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

17

ARPKD/infantile polycystic kidney

Bilateral, infants, spongy large echogenic kidneys. Tiny cysts.

18

Obstruction from a stone

Uretovesical junction:
Ureteropelvic junction: MC
Ureteric obstruction of the level of pelvic inlet

19

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

20

Ureterocele

Round cystic structure that projects into the bladder lumen at the uretovesical junction

May obstruct & cause UTIs.

21

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.

22

AIDs US findings

Hepatosplenomegaly, lymphadenopathy, hyper liver, hyper renal, liver abscess, Mets kaposi sarcoma, acute cholecystitis

23

3 parts of retroperitoneal

Perirenal, ant and post pararenal

24

Infantile polycystic kidney disease

Bilateral
Enlarged echogenic kidneys
Loss of cortical medullary distinction

Assoc with renal dysfunction, lung hypoplasia, periportal hepatic fibrosis, oligohydramnios in utero

25

Column of Bertin

Hypertrophied column of Bertin. Invagination between cortex. Should be < 3cm and continuous with no mass effect.

26

Dromedary Hump

Lateral bulge

27

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.

28

Angiomyolipoma

Fat tumor, hyperechoic, propagation speed artifact

29

Renal vein thrombosis

Cause: IVC or renal vein extrinsic compression, nephrotic syndrome, renal tumors, renal allografts, trauma

Dilated clotted renal vein, absence venous flow in kidney, enlg hypo kidney, high resistive artery