Flashcards in Kidneys Deck (75):
what lies inferior to the right and left kidney?
the right and left colic flexure
what lies anterior to the upper pole of the left kidney?
the tail of the pancreas
what lies on the posterior aspect of both kidneys?
the diaphragm, psoas muscles, and quadratus lomborum muscles.
the order of entrance at the renal hilum is what?
vein= anterior, middle= artery, posterior= ureter.
which muscle lies underneath the kidneys?
what is a nephron?
it is a system of bundled tubules that create the pyramids. it is the functional unit of the kidney. it contains many things such as the renal corpuscle and loops of henle.
what is the normal measurement of the renal cortex?
=or greater than 1 cm
what does the sinus of the kidney contain?
fat, calyces, renal pelvis, connective tissue, renal vessels, and lymphatics.
what is the funnel shaped transition from the major calyces to the ureter?
the renal pelvis
what is the purpose of the minor calyces?
to collect urine from the renal pyramids
Gerotas fascias is also known as what?
perirenal space. this is a fibrous sheath enclosing the kidney and adrenal glands
what is a malphigian body?
it is a renal corpuscle. this contains glomerulus and bowmans capsule.
what is the correct order of arteries running through the kidneys?
renal artery - 5 segmental arteries- interlobar - arcuate - interlobular.
what are some complications that are associated with congenital anomalies of the kidney?
impaired renal function, infection, and calculus formation
this results from failure of the kidneys ascending into the abdomen. this can also be referred to as a pelvic kidney.
what risks increase with an ectopic kidney?
UPJ obstruction, ureteral reflux, and multicystic renal dysplasia.
what is the most common fusion anomaly?
horseshoe kidney. when the lower poles connect across the midline anterior to the aorta.
what is the main reason for kidney function loss?
diabetes and HTN
what can be mistaken for lymphadenopathy around the aorta
horse shoe kidney
what is it called when two kidneys are seen on one side of the abdomen?
crossed fused renal ectopia- this is rare
fused pelvic kidney
aka pancake kidney. fused kidneys located in pelvis
increased cortical thickness on left lateral portion of the kidney
junctional parenchymal defect
aka embryonic kidney, with fetal lobulation. appear as divits that don't go away after birth and end up filling with fat so they appear as hyperechoic triangular areas.
what is a frequent complication of an ectopic ureter?
ureterocele, which is a prolapse of the distal ureter into the bladder. this happens in a double collecting system, and affects the ureter draining the upper pole.
what is the Weigert Meyer rule?
hydroureter and hydronephrosis of the upper collecting system of the kidney. seen in duplex kidney. this happens only in complete duplication
what is it called when you see hypertrophied renal parenchyma between two pyramids?
column of bertin
what is associated with bilateral renal agenesis?
oligohydramnios and pulmonary hypoplasia.
what is VACTERL syndrome?
vertebral defect, anal atresia, cardiovascular anomaly, Trans Esophageal fistula, renal anomaly, and limb defect.
what is associated with male neonates?
posterior urethral valves. this is when they can circulate amniotic fluid due to a flap of mucosa in the area of the prostatic urethra.
if you were to see a large bladder, hydroureter, hydronephrosis, and or a urinoma in a male neonate what would you suspect?
posterior urethral valve.
renal cysts are commonly seen over what age?
50, seen in 50%
what is the difference between a parapelvic and peripelcvic cyst?
parapelvic= cortical cyst that bulge into the central sinus, periperlvic = lymphatic cyst in central sinus typically located in the renal sinus
what is the bosniak renal cyst classification?
a classification system to determine increased chances of malignancy. the more septations and solid components, the increased chance of malignancy.
bilateral renal enlargement due to development of numerous cysts of varying sizes. this can be associated with liver, pancreatic, and spleen cysts.
what is associated with cerebral artery- Berry- aneurysms?
ADPKD- also associated with an increased risk of developing RCC
this is the infantile version. enlarged bilateral kidneys with hyperechoic parenchyma and loss of cortical medullary distinction. this is due to the multiple small cysts. this is due to hyperplasia of the interstitial portions of the ducts.
what can lead to pulmonary hypoplasia is infants?
ARPKD, due to oligohydramnios. ARPKD can also lead to potter syndrome
typically unilateral, renal dysplasia characterized by multiple noncommunicating cysts with absence of renal parenchyma.
what causes MCDK?
atresia of the uteropelvic junction during fetal development
what is the most common cause of abdominal mall is newborns?
MCDK is associated with what syndromes?
Beckwith, 18, VECTERL.
what are some causes of UPJ obstruction?
ureteral hypoplasia, high ureteral insertion into renal pelvis, and compression by segmental artery
patients undergoing long term renal dialysis are at increased risk for what?
acquired cystic disease. this predisposes the patient to RCC
sonographically, describe medullary sponge kidney
calcium deposits in the dilated tubules that appear as hyperechoic medullary pyramids. this is the subset of nephrocalcinosis. aka medullary nephrocalcinosis. this is due to tubular ectasia or dysplasia. urine stasis
in a patient with von hippel what should you focus your attention to?
kidneys, adrenals, and pancreas
retinal and central nervous system hemangioblastomas. be on the look out for RCC, pheochromocytomas, islet cell tumors, and renal/pancreatic cysts.
hyperechoic benign renal tumor that can cause prop speed artifact. made up of fat, and is more common in the right kidney. associated with patients affected with tuberous sclerosis. in this case, they are typically bilateral.
what is tuberous sclerosis?
genetic disease classified by seizures, mental retardation, and facial angiofibromas
what is the most common solid renal mass in an adult?
hypoechoic solitary, unilateral mass. seen most commonly with hematuria. associated with varicoceles. look out for tumor extension in the renal veins, and ivc. also METS to the lungs.
RCC is increased incidence associated with what abnormalities?
aquires cystic disease, von hippel, tuberous sclerosis, and ADPKD
what is hard to distinguish compared to RCC?
malignant cells from what can METS to the kidney?
lymphoma and leukemia
what is the most common childhood renal tumor?
wilms aka nephroblastoma. - 3.5 years
you wont be able to see renal parenchyma. look out for tumor extension. common place to METS = lungs, liver, bone, lymph nodes, and Retroperitoneum.
what is the most common neonatal tumor?
congenital mesoblastic nephroma. hard to distinguish from wilms. associated with polyhydramnios, premature birth, and neonatal HTN. more common than wilms.
what are the sonographic findings associate with pyelonephritis?
renal enlargement, hypoechoic parenchyma, and absence of sinus echous- aka a more hypoechoic sinus.
when acute pyelonephritis is focal it is aka...
acute focal bacterial nephritis, or lobar nephronia. this can be seen as wedge shaped area of hypoechoic renal lobe.
kidney with air?
emphysematous pyelonephritis. more common is diabetics.
sonogrpaihc findings in chronic pyelonephritis
small, hyperechoic kidney with cortical thinning. leads to ESRD. due to recurrent renal infection
what are chronic infections of the kidney due to long term obstruction?
xanthrogranulomatous pyelonephritis. staghorn calculus
what is the most common renal fungal disease?
mycetoma- fungal ball
hydronephrosis can indicate what kind of renal failure?
an abnormal resistive index can indicate what kind of renal failure?
what are the lab values associated with AKI?
urine output, urinalysis, BUN and serum creatinine.
what is the most accurate method of determining AKI?
changes in serum creatinine reflecting changes in GFR.
what is the most common association to renal vein thrombosis?
sonographically with renal vein thrombus=
edematous and large kidneys. absent venous flow, dilated thrombosed renal vein, RA will be highly resistive. increased resistive index
what is renal artery throbus?
a sudden cause of prerenal failure that presents as acute flank pain, hematuria, and sudden rise in blood pressure. hypoechoic areas of infarct. will appear similar to renal vein thrombus
what is the most common cause of AKI?
acute tubular necrosis. this is commonly seen coming out of surgery.
what is acute tubular nephrosis?
prolonged ischemia or nephrotoxins causing damage to tubular epithelium of the nephron leading to ARF.
what are the sonographic findings associated with ATN?
renal enlargement, and increased RI
what is the most common infectious cause of acute GN ?
strep species due to upper respiratory and skin infections. - hematuria, proteinuria, and red blood cell casts in urine. increased RI with renal enlargement.
an RI greater that 0.7 is suggestive of what?