Midterm 2 Flashcards
(153 cards)
1
Q
What layers of kidneys accommodate movement during respiration
A
Peri
Para
2
Q
Anterior pararenal
A
Posterior peritoneum to gerotas fascia
Holds panc colon CBD SMV
3
Q
Perirenal space
A
Space between gerotas fascia and posterior pararenal
Contains kidneys aorta ivc
4
Q
Posterior pararenal
A
Space between gerotas fascia and post abdo wall
Psoas and QL
5
Q
What comes out of hilum
A
Blood vessels and ureter
6
Q
Kidney vascularity
A
Renal Segmental Lobar Interlobar Arcuate Interlobular
7
Q
Kidney average size
A
11 cm
8
Q
What aspect of the kidney decreases with age. What is it called?
A
Cortex
Parenchymal reduction
9
Q
Parts of kidney hypo to hyper
A
Medullary pyramids
Cortex
Sinus & capsule
10
Q
Hypo to hyper abdo organs
A
Kidney
Liver
Spleen
11
Q
Mid sag kidney you’ll see mostly what
A
Most pyramids
12
Q
Sag kidney layer will see
A
Kidney lateral cortex a bit of sinus
13
Q
Renal function (3)
A
Urine formation
Homeostasis
Endocrine
14
Q
Nephron is located in the
A
Cortex and medulla
15
Q
Two types of nephrons
A
Cortical nephron - shorter LoH
Juxtamedullary nephron - longer LoH
16
Q
Three sets of kidneys in embryo
A
Pronephroni
Mesonsphori
Metanephori - permanent kidneys
17
Q
Ureter size
A
25-30 cm
18
Q
Three layers of ureters
A
- Inner mucosal
- Medial smooth
- Fibrous outer
19
Q
Proximal ureter
A
UPJ
Uteropelvic junction
20
Q
Distal ureter
A
UVJ
ureterovesicle junction
21
Q
Kidney normal variants
A
Dromedary hump Hypertrophied column of Bertin Double collecting system Horseshoe kidney Renal ectopia
22
Q
In trans the bladder is what shaped
A
Square with curved edges
23
Q
In sag the bladder is what shaped
A
Triangular
24
Q
Specular reflector occurs with what organ
A
Bladder
25
How to calculate volume of kidneys
(L * w * h) * 0.523
26
How to measure length of kidney
In sag, diagonally
27
How to measure the height of the kidney
In trans, AP
28
How to measure width of kidney
In trans, right to left
29
Most common artifact in bladder
Reverberation
| Mostly in near field (anterior)
30
How do you fix reverberation artifact in the bladder
Fix gains
31
Congenital anomalies of urinary tract related to growth (3)
Hypoplasia
Fetal lobulation
Compensatory hypertrophy
32
Congenital anomalies of urinary tract related to ascent (3)
Ectopia
Crossed renal ectopia
Horseshoe
33
Congenital anomalies of urinary tract related to Ureteral bud (6)
```
Agenesis
UPJ obstruction
Supernumerary kidney
Duplex collecting system
Congenital megacalices
Congenital megaureter
```
34
Congenital anomalies of urinary tract related to vascular development (2)
Retrocaval ureter
| Aberrant vessels
35
Congenital anomalies of urinary tract related to bladder development
Bladder agenesis
Bladder duplication
Bladder exstrophy
Urachal anomalies
36
Congenital anomalies of urinary tract related to urethral development (1)
Diverticula
37
The displacement of one kidney to the other side - name and type of anomaly
Crossed renal ectopia
| Ascent
38
Fetal lobulation - what is it and type of anomaly
Smooth indentations
| Growth
39
An extra, small kidney - name and type of anomaly
Supernumerary kidney, ureteral bud
40
True or false :
| Left kidney moving to right is more common
True
41
Three types of bladder duplication
Peritoneal fold
Internal septum
Transverse band
42
Name when bladder is outside the body, inside out
Bladder extrophy
43
Urethral diverticulum - what is it and what anomaly is it assoc with
Pocket out pouching forms next to urethra and connects to urethra
Anomalies related to urethral development
44
Urachal anomalies - what is it, name 4 and what type of anomaly is it related to
Remnant is the channel between bladder and umbilicus
1. Patent urachus
2. Urachal cyst
3. Urachal sinus
4. Diverticulum
45
True or false:
Congenital megaureter is most common in males and left more common
What anomaly is congenital megaureter associated with
True
Ureteral bud
46
What anomaly looks like a bear paw
Ureteropelvic junction obstruction
47
Congenital abnormality found is distal ureter that balloons at UVJ forming sac
Ureterocele
48
Compensatory hypertrophy
One kidney gets larger to compensate for the other which is smaller
49
Ectopia is related to what type of anomaly
Ascent
50
Horseshoe kidney is what type of anomaly
Ascent
51
Ureter behind ivc before entering pelvis - name and type of anomaly
Retrocaval and vascular development
52
Fill bladder how much before US
24-32 oz
53
Women’s bladder location
Anterior to vag
| Anterior / inferior to uterus
54
Trigone
Two ureters
| Urethral opening
55
The adrenal cortex is what kind of tissue
Endocrine (corticosteroids)
56
The adrenal medulla is what kind of tissue
Neurosecretory (catecholamines)
57
Function of adrenal glands (3)
Homeostasis
Salt water balance
Fight or flight
58
Lab tests for adrenal (2)
Aldosterone
| Cortisol
59
What lab test may indicate problems with adrenal glands
Cortisol
60
Normal Sono appearance of adrenal gland
Thin hypoechoic layers separated by hyperechoic layers
61
Spleen location
LUQ
| left hypochondrium
62
Is the spleen intra or retroperitoneal
Intraperitoneal
63
The kidneys and adrenal glands are intra or retroperitoneal
Retroperitoneal
64
Is the bladder retro or intraperitoneal
Retroperitoneal
65
The spleen has smooth borders where ?
Superior
Posterior
Lateral
(Where contacts the diaphragm)
66
Where does the spleen have gentle indentations
Medial
67
What is the spleen composed of
White and red pulp
68
What are the spleen ligaments (3)
Gastrosplenic ligament
Phrenicocolic ligament
Splenorenal ligaments
Ligaments not normally seen unless ascites
69
Spleen function
```
Immunity
Tissue repair
Hematopoiesis
Blood cell destruction
Blood reservoir
```
70
Spleen average size
8 to 13 cm length
5 cm width
7 cm AP
71
Spleen volume
60 to 200 ml
72
True or false
| It is normal to see calcified splenic artery as patient ages
True
73
Difficulty scanning spleen
Lung
| Intercostal
74
Other helpful imaging modalities for spleen
CT/MRI
75
The spleen arises from what kind of cells
Mesenchymal cells
76
Spleen embryology : base of the dorsal mesentery fused with the _____
Base of dorsal mesentery fuses with posterior peritoneum
77
Normal variants of spleen associated with number (3)
Accessory spleen (splenule)
Asplenia
Polysplenia
78
Normal variants of spleen associated with location (2)
Wandering spleen
| Ectopic
79
Most common normal variant of spleen, describe
Splenule / accessory spleen
Isoechoic homogenous mass similar to spleen typically found at hilum or inferior border of the spleen
80
How many lymph nodes
500-600 LN
81
Typical locations find clusters of LN
```
Axillary
Neck
Inguinal
Thorax
Abdo
```
82
LN function (3)
Fluid from interstitial to venous
Absorb fat from SI to liver
Immune response
83
What are the only abdo LN locations you can see if small patient and a good scan (2)
Panc liver
84
Abdo LN sites
```
Great vessels
Panc
Liver
Kidney
Mesenteric region
```
(Order we learned structures)
85
LN size
<1 cm in abdo
86
Is the width, length or AP smallest in a LN
AP
87
LN sono appearance what is hypo what is hyper
Cortex is hypo
| hilum is hyper
88
Hypertrophied column of bertin - what is it, where is it typically located
Prominent renal column extending into the sinus. Upper 2/3 of the kidney
89
Junctional cortical defect is what organ variant, explain, where is it located
Site of failed fusion in the kidney
| Anteriorly and superiorly
90
Junctional cortical defect- Best seen in which plane and which kidney
Sag right kidney
91
Extra renal pelvis - explain anomaly and best seen
Dilated UPJ, medial to hilum
| Best seen in transverse
92
Dromedary hump usually _____ kidney, best seen in _____
Dromedary hump usually left kidney, best in sagittal
93
The renal sinus is what to the renal cortex
Hyperechoic
94
What is the name of the parenchyma located between the pyramids
Renal column
95
What normal variant is best seen is Sag and most often affects the left kidney
Dromedary hump
96
What is the name of the permanent kidneys
Metanephori
97
Name two causes of bladder duplication
Septation
| Fold in rugae wall
98
Name the two junctions of the ureters and what they stand for
UPJ ureteropelvic junction
| UVJ ureterovesical junction
99
At what level and aspect do the ureters insert into the plaster
Trigone posteriorly
100
What anomaly is seen as a sac like structure in the bladder and what renal variant is it associated with
Ureterocele, duplex collecting system
101
What are the two features of a normal LN
Oval, fatty hilum
102
Two challenges when scanning the spleen
Ribs
| Lung
103
What would cause a hypoechoic structure superior to the spleen in sag
Long left lobe liver
104
What two tests are most commonly done for the prostate
DRE
| PSA
105
Average volume of prostate
24 cc
106
Zone with least clinical significance
Fibromuscular region
107
Which two zones cannot be differentiated using TRUS
Central and transitional
108
At which zone and level do the ejaculatory ducts enter the prostate
Central, base
109
One variant associated with growth of kidney
Hypoplasia
Lobulation
Hypertrophy
110
Name two variants associated with ascent of kidney
Ectopia
Cross renal ectopia
Horseshoe
111
Name three variants associated with number of spleens
Asplenia
Accessory spleen (splenule)
Polysplenia
112
Name three variants associated with bladder development
Bladder agenesis
Bladder duplication
Bladder exstrophy
Urachal anomalies
113
Name four variants associated with Ureteral bud
```
Renal agenesis
UPJ obstruction
Supernumerary kidney
Duplex collecting system
Congenital megaxixes
Congenital megaureter
```
114
Kidney lab tests
Creatinine
| BUN
115
Transient pyelectasus what is it ? When is it not normal
Considered normal
Patient is well hydrated
Resolve by emptying bladder
Calyces and pyramids more anechoic
116
Ureterocele
Distal ureter balloons at UVJ assoc with duplex collecting system
117
Causes of bladder duplication (3)
Peritoneal fold
Internal septum
Transverse band
118
Urachal anomalies (4)
Patent urachus
Urachal cyst
Urachal sinus
Diverticulum
119
The seminal vesicles are ______ to the vas d/ureter and ______ to prostate
Seminal vesicles are inferior to vas def and ureter
And superior to prostate
120
The base of the prostate is positioned ______, while the apex is ______
Superior - base
| Inferior - apex
121
Semen transport
```
Epididymus
Vas deferens
Seminal vesicles
Ejaculatory duct
Urethra
```
122
Urethra travels
Bladder prostate penis
123
Prostate blood supply
Prostaticovesical arteries
Inferior vesical artery
Prostatic artery
124
Two regions of prostate and where
1. Fibromuscular - anterior
| 2. Glandular - posterior
125
Cancer location most to least likely
Peripheral (70%)
Transitional (20%)
Central (5%)
126
What zone do the seminal vesicles and vas def enter
Central
127
Seminal vesicles are located at the ______ of the prostate
Base
128
Name the structure that divides the prostate into prox /distal or anterior/posterior
Verumontanum
129
What zone lines the proximal prostatic urethra
Periurethral glandular zone
130
Two main methods to screen for prostate cancer
DRE
| PSA
131
Why is using PSA as a marker for cancer not ideal. What can help?
Normal PSA does not necessarily exclude cancer and increased PSA does not mean cancer
PSA density may help with confusion
PSA/volume (PSAd)
132
Normal PSA level
<1.5 ng/mL
133
What anatomy is assessed for male pelvis US
Prostate
Seminal vesicles
Bladder
134
Transabdominal US is good for / is limited to
Gross prostate + bladder eval
| Limited to prostate size weight shape
135
Almost all cancer is _____ aspect of prostate - can you visualize?
Posterior aspect, not visualized
136
TRUS is imaged through
| What’s the patient prep?
Full bladder
| Pt drinks 20-32 oz water
137
At what level do the ejaculatory ducts meet the urethra in the prostate
Verumontam
138
Protocol for bladder volumes
Pre and post void volumes
139
Major reasons for TRUS (3)
Prostate evaluation
Biopsy
Guidance therapeutic procedures
140
TRUS patient position
Left lateral decubitus
| Legs together bent up
141
Transrectal probe frequency
7-11 MHz
142
Urethra located where (apex or base)
Apex
143
Are you able to distinguish the 4 zones of the prostate? Why/why not
No
| Similar echotexthre
144
Prostate anatomy is divided into two “glands” what are they and what’s another name for them
Inner gland “central”
| Outer gland “peripheral”
145
What is the central/inner gland comprised of (3)
Transitional zone
Anterior fibromuscular galndular
Internal urethra sphincter
146
What is the outer gland /peripheral comprised of (2)
Central and peripheral zone
147
Sonographic appearance of the central/inner
Hypoechoic
| Heterogeneous
148
Sonographic appearance of the peripheral/outer
Hyperechoic
| Homogenous
149
Prostate volume can be converted to weight
True
150
Structure that separates outer and inner gland
Surgical capsule
151
The interface between prostate and periprostatic fat
Prostate capsule
152
Sono appearance of seminal v and vas d
Seminal v are hypoechoic and multi septated
Vas d are more hypoechoic to seminal v and more medial
153
Normal variants for prostate (3)
Benign ductal ectasia
Prostatic calcification
Corpora amylacea
