Module 10 - Urinary System

Question 1

Where are the kidneys located in the body?

Answer 1

The kidneys are retroperitoneal structures located between T12 and L3 vertebrae, on either side of the spine.

Question 2

How long are the kidneys in vertebral length?

Answer 2

The kidneys are typically three vertebrae long.

Question 3

In the supine position during expiration, where can the kidneys be palpated?

Answer 3

Halfway between the xiphisternum and iliac crest on both sides.

Question 4

Which muscle do the kidneys lie parallel to?

Answer 4

The psoas muscle.

Question 5

Why is the superior pole of the kidney more medial than the inferior pole?

Answer 5

Because the kidneys follow the contour of the psoas muscle.

Question 6

Why is the superior pole of the kidney more posterior than the inferior pole?

Answer 6

Because the kidneys follow the curvature of the T12–L3 spine.

Question 7

How is the kidney rotated from the coronal plane?

Answer 7

About 30 degrees, with the medial edge facing more anteriorly.

Question 8

In which patient position is the left kidney best demonstrated parallel to the IR?

Answer 8

30-degree right posterior oblique (RPO) position.

Question 9

Why are knees bent during a KUB exam?

Answer 9

To reduce the lumbar lordosis and position the kidneys parallel to the IR.

Question 10

Where can lateral collimation be set for a KUB exam?

Answer 10

To the anterior superior iliac spines (ASIS).

Question 11

Why is the right kidney positioned lower than the left?

Answer 11

Because it is pushed down by the liver by 1 to 3 cm.

Question 12

What anatomical structure crosses the upper pole of the right kidney?

Answer 12

The 12th rib.

Question 13

At what vertebral level is the lower pole of the right kidney typically located?

Answer 13

At approximately L3.

Question 14

What forms the triangle in which the right kidney lies?

Answer 14

The lower liver margin and the right psoas muscle.

Question 15

What anatomical structure crosses the upper pole of the left kidney?

Answer 15

The 11th rib.

Question 16

What structures is the left kidney located near?

Answer 16

Medial to the spleen, lateral to the left psoas muscle, and posterior to the stomach.

Question 17

What structure surrounds the kidneys and provides contrast on x-ray?

Answer 17

Perirenal fat.

Question 18

What is the tough outer layer of the kidney called?

Answer 18

Renal capsule.

Question 19

What kidney structure surrounds the medulla and extends inward as columns?

Answer 19

Renal cortex.

Question 20

What lies between the renal pyramids and is highly vascular?

Answer 20

Renal columns.

Question 21

What is the inner layer of the kidney called?

Answer 21

Renal medulla.

Question 22

What are the triangular regions within the renal medulla called?

Answer 22

Renal pyramids.

Question 23

What is the apex of a renal pyramid called?

Answer 23

Renal papilla.

Question 24

What is the functional unit of the kidney?

Answer 24

Nephron.

Question 25

Where does renal filtration begin and end in the kidney?

Answer 25

Begins in the cortex and ends at the renal papilla in the medulla.

Question 26

What is the term for contrast-enhanced kidney appearance in imaging?

Answer 26

Blushed.

Question 27

How long does it take for contrast media to reach the kidneys after injection?

Answer 27

30 to 60 seconds.

Question 28

Which vessels supply blood to the kidneys?

Answer 28

Renal arteries from the abdominal aorta.

Question 29

Which vessels return blood from the kidneys?

Answer 29

Renal veins to the inferior vena cava.

Question 30

At what vertebral level do renal vessels enter/exit the kidneys?

Answer 30

L1–L2.

Question 31

How many minor calyces are in each kidney?

Answer 31

4 to 13.

Question 32

What part of the kidney do the minor calyces collect urine from?

Answer 32

Renal pyramids.

Question 33

What are the sharply defined edges of the minor calyces called?

Answer 33

Fornices (singular: fornix).

Question 34

What forms the major calyces?

Answer 34

The union of several minor calyces.

Question 35

How many major calyces are typically found in each kidney?

Answer 35

2 to 3.

Question 36

What structure receives urine from the major calyces?

Answer 36

Renal pelvis.

Question 37

What is the shape of the renal pelvis?

Answer 37

Trumpet-shaped with a lateral bend.

Question 38

What does the renal pelvis narrow into?

Answer 38

The proximal ureter at the ureteropelvic junction.

Question 39

What is the hilum of the kidney?

Answer 39

The medial opening where vessels and the ureter enter/exit the kidney.

Question 40

Why do the kidneys move with breathing and position changes?

Answer 40

Because they are only loosely attached within the abdomen.

Question 41

How much do the kidneys drop when moving from supine to upright?

Answer 41

Approximately 5 cm.

Question 42

How much can the kidneys drop during deep inspiration?

Answer 42

An additional 5–7 cm.

Question 43

When are kidney images typically taken?

Answer 43

On full expiration.

Question 44

Why is full expiration used for kidney imaging?

Answer 44

It elevates the diaphragm, reducing abdominal organ compression.

Question 45

What anatomical landmark helps locate the kidneys on an x-ray?

Answer 45

The psoas muscles, as the kidneys lie adjacent to them.

Question 46

cWhat is the function of the ureters?

Answer 46

To transport urine from the kidneys to the bladder using peristalsis.

Question 47

Are the ureters intraperitoneal or retroperitoneal structures?

Answer 47

Retroperitoneal.

Question 48

What is the average length of the ureters?

Answer 48

Approximately 22 to 32 cm.

Question 49

Which ureter is usually shorter, and why?

Answer 49

The right ureter, because the right kidney is positioned lower due to the liver.

Question 50

What is the internal diameter range of the ureters?

Answer 50

2 mm to 8 mm.

Question 51

What are the three major points of ureteral constriction?

Answer 51

Ureteropelvic junction (UPJ), pelvic brim (PB), and ureterovesical junction (UVJ).

Question 52

Where is the ureteropelvic junction (UPJ) located?

Answer 52

Where the renal pelvis meets the ureter.

Question 53

Where is the pelvic brim (PB) constriction point located?

Answer 53

Where the ureter crosses over the common iliac artery.

Question 54

Where is the ureterovesical junction (UVJ) located?

Answer 54

Where the ureter inserts into the bladder wall.

Question 55

What muscle do the ureters cross anterior to after leaving the kidney?

Answer 55

The psoas major muscle.

Question 56

What bony landmarks do the ureters pass near as they descend?

Answer 56

Lumbar transverse processes and ala of the sacrum.

Question 57

Into which part of the bladder do the ureters insert?

Answer 57

The supero-posterior bladder wall.

Question 58

What is the function of the urinary bladder?

Answer 58

To store urine until it is excreted.

Question 59

What is the typical capacity range of the bladder?

Answer 59

Approximately 250–500 mL.

Question 60

What is the shape of the bladder with minimal distention?

Answer 60

Inverted pyramidal.

Question 61

What is the shape of the bladder with moderate distention?

Answer 61

Transverse oval, with a convex top in males and concave top in females.

Question 62

How does the bladder change with full distention?

Answer 62

It expands superiorly and anteriorly and becomes round.

Question 63

What is the trigone of the bladder?

Answer 63

A smooth, triangular area on the inner posterior wall where the ureters and urethra connect.

Question 64

Where do the ureters insert into the bladder?

Answer 64

At the upper corners of the bladder base, within the trigone.

Question 65

What is the apex of the bladder?

Answer 65

The anterior point of the bladder directed toward the pubic symphysis.

Question 66

What is the neck of the bladder?

Answer 66

The most inferior part, where the bladder joins the urethra.

Question 67

What is the internal urethral orifice?

Answer 67

The opening where the urethra exits the bladder at the neck.

Question 68

Is the bladder a retroperitoneal or intraperitoneal organ?

Answer 68

Retroperitoneal.

Question 69

Where is the bladder located in the supine position?

Answer 69

At the level of the superior margin of the symphysis pubis and greater trochanters.

Question 70

Where is the bladder located in the upright position?

Answer 70

Slightly inferior to the pubic symphysis.

Question 71

What is the function of the urethra?

Answer 71

To carry urine from the bladder to the exterior of the body.

Question 72

What is the length of the male urethra?

Answer 72

Approximately 17.5 to 20 cm.

Question 73

What are the three sections of the male urethra?

Answer 73

Prostatic, membranous, and spongy (penile).

Question 74

Which part of the male urethra is surrounded by the prostate gland?

Answer 74

The prostatic urethra.

Question 75

What controls urine flow through the urethra?

Answer 75

Internal (involuntary) and external (voluntary) urethral sphincters.

Question 76

Why are males more prone to urethral strictures?

Answer 76

Because of the urethra’s longer length and its susceptibility to trauma or prostate enlargement.

Question 77

What is the length of the female urethra?

Answer 77

About 4 cm.

Question 78

Why are females more prone to urinary tract infections?

Answer 78

Because of their shorter urethra and its closer proximity to the anus.

Question 79

What are common imaging procedures requiring urethral catheterization?

Answer 79

Voiding cystourethrograms, sonography, and urethrograms.

Question 80

Why is it important for imaging technologists to identify the urethra?

Answer 80

Because catheterization may be required for certain exams.

Question 81

What allows the kidneys to be seen on a plain abdominal radiograph?

Answer 81

The surrounding perirenal fat provides contrast.

Question 82

How far do the kidneys descend when moving from supine to upright?

Answer 82

Approximately 5 cm.

Question 83

What can obscure visualization of the kidneys on a KUB radiograph?

Answer 83

Bowel gas and distended intestines.

Question 84

What does a KUB radiograph show?

Answer 84

The kidneys, ureters, and bladder.

Question 85

What imaging exam involves IV contrast to visualize the urinary system?

Answer 85

Intravenous urogram (IVU) or CT urogram.

Question 86

What is a retrograde pyelogram?

Answer 86

A study introducing contrast into the ureters or bladder via catheterization through the urethra.

Question 87

What does renal angiography demonstrate?

Answer 87

The blood perfusion of the kidneys.

Question 88

What is a nephrostogram?

Answer 88

Injection of contrast directly into the renal pelvis via a posterior puncture or catheter.

Question 89

What does a voiding cystourethrogram (VCUG) assess?

Answer 89

The bladder and urethra during voiding, often used to detect urinary reflux.

Question 90

What is indicated by contrast reflux from the bladder into the ureters during VCUG?

Answer 90

Abnormal bladder valve function.

Question 91

What is an ectopic kidney?

Answer 91

A kidney that failed to ascend from the pelvis to its normal position during development.