Urinary Bladder

Question 1

What are the three different parts of the urinary bladder?

Answer 1

Apex - cranially
Body
Neck - caudally

Question 2

How many ligaments does the urinary bladder have?

What are they?

Answer 2

Two lateral
One ventral
Peritoneal reflections they are

Question 3

The uterus lays between what structures?

Answer 3

Urinary bladder - ventrally

Colon - dorsally

Question 4

Pelvic urinary bladder may indicate what?

Answer 4

Normal variation
Congenital urinary tract anomalies
Correlate with clinical signs

Question 5

Point apex may indicate?

Answer 5

Persistent urachal ligament

Question 6

Emphysematous cystitis can place gas where?

Answer 6

Luminal
Wall
Ligaments

Question 7

Emphysematous cystitis is associated with what other disease?

Answer 7

Diabetes mellitus

Question 8

What are compression views used for?

Answer 8

To push summated tissues out of the way to confirm abnormalities like calculi.

Question 9

Other differentials for mineralization in bladder?

Answer 9

Neoplasia
Chronic cystits
Calculi - MAIN ONE

Question 10

Indications for retrograde csytogram?

Answer 10

1) Clinical signs
Dysuria
Pollakiuria
Chronic hematuria

2) Radiographic signs
Changes in opacity of urinary bladder
Caudal abdominal mass
Non visualization of the bladder after trauma
Abnormal shape or location

Question 11

Retrograde Cystography prep

Answer 11

1) Fast for 24 hours

2) Enema

Question 12

What type of contrast is used in positive contrast?

Negative contrast?

Answer 12

PC = Iodides
NC = Air, carbon oxide, nitrogen oxide
*** Air can cause emboli

Question 13

Complication of pushing contrast on a maximal distended bladder?

Answer 13

Contrast intramural and subserosal which can cause ulcer or granuloma

Question 14

Amount of positive contrast for pos contrast study?

Answer 14

3.5ml - 10ml per kg should be used at 20%

Question 15

Views after contrast?

Answer 15

Lateral, DV and two obliques

Question 16

What cystic calculi cannot be see radiographically?

Answer 16

Urate

Cystine

Question 17

Positive contrast and double contrast studies are used more than negative contrast study T/F

Answer 17

True - neg contrast not used much

Question 18

Positive contrast is good for?

Answer 18

Tears
Location of bladder
Abnormal communications
Hernias

Question 19

Double contrast is performed by…

Answer 19

0.5-1ml undiluted for cats
1-6 ml undiluted for dogs
THEN
Distend bladder with neg contrast

Question 20

Double contrast study used for…

Answer 20

Filling defects - mass vs calculi

Wall lesions

Question 21

Irregular mucosa DDx

Answer 21

Ulcer
Neoplasia
Hyperplasia
Inadequate bladder distention

Question 22

Bladder wall thickeness is normally ~?

Answer 22

~1mm

Question 23

Bladder wall thickening DDX

Answer 23

Inadequate bladder distention
Inflammation
Hemorrhage
Neoplasia

Question 24

Where does cystitis like to show thickening?

Answer 24

FOCAL thickening of cranioventral… inflammation.. almost always

Question 25

Chronic cystitis can cause what to the distention properties of the bladder?

Answer 25

Fibrosis and restrictive

Question 26

Causes for non-sessile filling defects?

Answer 26

Calculi Air bubbles Blood clots

Question 27

Causes for sessile filling defects?

Answer 27

``` Neoplasia Polyps Blood clots Adherent calculi Ureteroceles ```

Question 28

Cobra-head sign associated with?

Answer 28

Ureteroceles

Question 29

Artifacts of cystogram

Answer 29

Pseudofilling defects Large air bubble Honeycombing Pseduothick wall

Question 30

Sonographic evaluation of UB is best done when...

Answer 30

The UB is moderatley full.

Question 31

Sonographic normal UB wall thickness

Answer 31

Dogs - 1.4-2.3mm | Cat - 1.7 +/- 0.6mm

Question 32

Artifact that makes pseudosludge in UB

Answer 32

Side lobe artifact

Question 33

Poster child for TCC?

Answer 33

Scottish terrier

Question 34

Layers of the Urinary bladder?

Answer 34

3 layers Muscosa - hyperechoic Submucosa - hypoechoic Serosa - hyperechoic

Question 35

Blood clots look like what on US?

Answer 35

Hyperechoic, nonshadowing, mobile

Question 36

Polypoid cystitis is usually located where?

Answer 36

Cranioventral... associated with cystitis | DDX - neoplasia - so follow up US needed or biopsy

Question 37

US characteristics of TCC?

Answer 37

Hypoechoic, sessile, board based, irregular

Question 38

Prognostic indicators of TCC?

Answer 38

Wall involvement Trigone location Heterogeneous echotexture

Question 39

Other neoplastic disease?

Answer 39

Leiomyoma - Single, round, well-defined intramural Leiomyosarcoma - Single, round, well-defined intramural Fibrosarcoma - Neck of UB of young dogs Rhadomyosarcomas - Neck of UB of young dogs Lymphoma

Question 40

Other observations that support neoplasia?

Answer 40

Ureter dilation | Lymphadenopathy

Question 41

US description of Ureteroceles

Answer 41

Cyst within a cyst... "cystception"

Question 42

What dog breed is most prone to polypoid cystic changes?

Answer 42

Springer spaniel