Urinary Info Flashcards
(201 cards)
1
Q
what is the urinary system known as?
A
Excretory system
2
Q
What is included in the urinary system?
A
- Two kidneys
- Two ureters
- Bladder
- Urethra
3
Q
Whats the primary function of the urinary system?
A
The production of urine and its elimination from the body
4
Q
What shape are the kidneys?
A
Bean shaped
5
Q
What are the kidneys divided into?
A
Upper & lower poles
6
Q
What is the lateral border of the kidney?
A
Convex
7
Q
What is the medial border of the kidney?
A
Concave
8
Q
The kidneys have a slightly _____ anterior and posterior surfaces
A
Convex
9
Q
The left kidney is _______ than the right kidney
A
slightly longer and narrower
10
Q
The kidney is ______ long, _____ wide, and ____ thick
A
- 4 1/2”
- 2-3”
- 1 1/4”
11
Q
The right kidney is _____ than the left kidney
A
lower
12
Q
why is the right kidney lower than the left?
A
Due to the presence of the liver
13
Q
What does retro mean?
A
backwards
14
Q
Where are retroperitoneal structures located?
A
Behind the peritoneum
15
Q
What structures are the kidneys?
A
retroperitoneal
16
Q
What plane do the kidneys lie in?
A
Oblique
17
Q
How many degrees is the kidneys located?
A
30 degrees anteriorly toward the aorta
18
Q
What views do we perform when imaging the kidneys?
A
30 degree oblique views
19
Q
Where do the kidney lie in sthenic patients?
A
Level of superior border of T12 to the level of transverse processes of L3
20
Q
Where do the kidneys lie in hypersthenic patients?
A
Higher than the Level of superior border of T12 to the level of transverse processes of L3
21
Q
Where do the kidneys lie in asthenic patients?
A
Lower than the level of superior border of T12 to the level of transverse processes of L3
22
Q
What body habitus do patients have when their kidneys lie lower?
A
Asthenic
23
Q
What body habitus do patients have when their kidneys lie higher?
A
Hypersthenic
24
Q
What is the renal capsule?
A
Semitransparent outer covering of the kidney
25
What is the adipose capsule?
Mass of fatty tissue that the kidney is embedded in
26
What is the renal fascia?
Sheath of superficial fascia that envelops the capsule and kidney
27
What is the renal fascia attached to?
- Diaphragm
- Lumbar vertebrae
- Other adjacent structures
28
What part of the kidney is attached to the diaphragm, lumbar vertebrae, and other adjacent structures?
Renal fascia
29
What position are the kidneys supported in?
fairly fixed
30
How much do the kidneys move during respiratory movement?
1"
31
The kidneys move 1" during what type of movement?
Respiratory
32
How many inches do the kidneys drop when changing from supine to upright position?
2"
33
Why do the kidneys drop 2"?
When changing positions from supine to upright
34
What part of the kidney is the semitransparent outer covering of the kidney?
Renal capsule
35
What part of the kidney is a mass of fatty tissue that the kidney is embedded in?
Adipose capsule
36
What part of the kidney is the sheath of superficial that envelops the capsule and kidney?
Renal fascia
37
What is the hilum of the kidney?
Longitudinal slit (fissure) in the medial border of the kidney
38
What is the longitudinal slit (fissure) in the medial border of the kidney called?
Hilum
39
What is transmitted through the kidneys hilum?
- Blood vessels
- Lymphatic vessels
- Nerves
- Ureter
40
What does the hilum form when it expands into the body?
The renal sinus
41
How is the renal sinus formed?
When the hilum expands into the body
42
What is the renal sinus?
Fat-filled space surrounding the renal pelvis and vessels
43
What is the fat-filled space surrounding the renal pelvis and vessel called?
Renal sinus
44
What is the renal cortex?
The outer portion of the kidney
45
What is the outer portion of the kidney called?
Renal cortex
46
What is the renal medulla composed of?
8-15 conical masses (renal pyramids)
47
Where does the renal medulla lie under?
The renal cortex
48
What part of the kidney lies under the renal cortex?
Renal medulla
49
What part of the kidneys does the renal pyramids compose?
Renal medulla
50
What do the renal columns extend to?
The renal sinus
51
How are the renal columns formed?
When the cortex periodically dips between the renal pyramids
52
What part of the kidney extends to the renal sinus?
Renal columns
53
What part of the kidney is formed by the cortex periodically dips between the renal pyramids?
Renal columns
54
What are the renal pyramids?
A collection of tubules that converge at an opening at the renal papilla and drains into the minor calyx
55
What part of the kidney is A collection of tubules that converge at an opening at the renal papilla and drains into the minor calyx?
Renal pyramids
56
What part of the kidney drains into the minor calyx?
Renal pyramid
57
What does the renal pyramid drain into?
Minor calyx
58
What are calyces?
Cup-shaped stems arising from the sides of the renal papilla
59
What are the Cup-shaped stems arising from the sides of the renal papilla called?
Calyces
60
How many minor calyces unite to form 2-3 major calyces?
4-13
61
4-13 minor calyces can form _____ major calyces
2-3
62
What part of the kidneys unites to form the renal pelvis?
Major calyces
63
What do major calyces unite to form?
The renal pelvis
64
What is the ureteropelvic junction?
The area where the renal pelvis transitions to the ureter
65
What is the area where the renal pelvis transitions to the ureter called?
Ureteropelvic junction
66
What is a nephron?
The structural and function unit of the kidney
67
What is the structural and function unit of the kidney called?
Nephron
68
How many nephrons does the kidney contain?
1 million
69
What is the nephron composed of?
A renal corpuscle and a renal tubule
70
What part of the kidney is composed of a renal corpuscle and a renal tubule?
Nephron
71
How long are the ureters of a kidney?
10-12" long
72
What is the diameter of the kidney ureters?
1 mm-1 cm
73
What are the ureters 3 constricted points?
- Ureteropelvic junction (UPJ)
- Near the pelvic brim
- Ureterovesical junction (UVJ)
74
What is the ureterovesical junction?
Where the ureter joins the bladder
75
What is the part of the ureter where the ureter joins the bladder called?
Ureterovesical junction (UVJ)
76
Where do the ureter enter the bladder?
At the level of the ischial spine
77
The ureters descend behind the ______ and in front of the _______
- Peritoneum
- Psoas muscles
78
How do the ureters convey the urine from the renal pelvis to the bladder?
Using slow, rhythmic peristaltic contractions?
79
What is the urinary bladder?
A musculomembranous sac that serves as a resevoir for urine
80
What is the musculomembranous sac that serves as a resevoir for urine called?
Urinary bladder
81
What is the neck of the urinary bladder?
The most fixed part of the bladder
82
What is the most fixed part of the bladder called?
The neck
83
What is the apex of the urinary bladder?
The anterosuperior aspect adjacent to the superior aspect of the pubic symphysis
84
What is the anterosuperior aspect adjacent to the superior aspect of the pubic symphysis of the bladder called?
The apex
85
Where is the urinary bladder situated in males?
Posterior and superior to the pubic symphysis and anterior to the rectum
86
Where is the urinary bladder situated in females?
Posterior and superior to the pubic symphysis and anterior to the vaginal canal
87
What does the urinary bladder vary depending on content?
- Size
- Shape
- Position
88
How much fluid can the adult bladder hold when full?
500 mL
89
How much fluid is in the adult bladder when the urge for urination occurs?
250 mL
90
The urinary bladder is _____ and is held in position by the _______
- Freely moveable
- Folds of the peritoneum
91
Where is the bladder located when its empty?
The pelvic cavity
92
What happens when the bladder is full?
Expands superiorly into the abdominal cavity
93
Ureters enter the bladder on the ______ wall at the _______ margins of the _____ part of the _____
- Posterior
- Lateral
- Superior
- Base
94
How far apart are the openings of the ureterovesical junction when the bladder is empty?
1" apart
95
How far apart are the openings of the ureterovesical junction when the bladder is distended?
2" apart
96
What is the internal urethral orfice?
The opening situated at the neck of the bladder which give rise to the urethra
97
What is the opening situated at the neck of the bladder which give rise to the urethra called?
Internal urethral orfice
98
What is the trigone?
The triangular area between the three orifices of the bladder
99
What is the triangular area between the three orifices of the bladder called?
Trigone
100
Muscle remains _______ over the trigone, while the remainder of the bladder contains _____, called _____, when its _____
- Smooth
- Folds
- Rugae
- Empty
101
What is the urethra?
Narrow, musculomembranous tube that conveys urine out of the body
102
What is the narrow, musculomembranous tube that conveys urine out of the body called?
Urethra
103
Where does the urethra arise?
At the internal urethral orifice in the bladder
104
How many inches do female urethras extend?
1 1/2"
105
How many inches do male urethras extend?
7-8"
106
What does the urethra pass along in females
The anterior wall of the vagina to the external urethral orifice
107
How many parts is the male urethra divided into?
3
108
What parts is the male urethra divided into?
- Prostatic portion
- Membranous portion
- Spongy portion
109
What does the spongy portion extend to in males?
From the pelvic floor to the external urethral orifice
110
How long is the membranous portion in males?
1/2" long
111
How long is the prostatic portion in males?
1" long
112
What is the prostatic portion surrounded by in males?
The prostate gland
113
What is a urogram?
A general term to classify the radiographic imaging of the renal drainage or collecting system
114
What is the general term to classify the radiographic imaging of the renal drainage or collecting system?
Urogram
115
What is a urogram divided into?
Antegrade filling techniques and retrograde filling techniques
116
What is antegrade filling of the kidneys?
When contrast media enters the kidneys in the normal direction of blood flow
117
How is antegrade filling administered?
Intravenously through a superficial vein in the arm
118
What is the technique for antegrade filling called?
Excretory or intravenous urography (IVU)
119
What filling technique is excretory or intravenous urography (IVU) for?
Antegrade
120
What is intravenous urography?
A study of all parts of the urinary system
121
What is the study of all parts of the urinary system called?
Intravenous urography (IVU)
122
What is another term for intravenous urography (IVU)?
Intravenous pyelogram (IVP)
123
what is intravenous pyelogram (IVP) another term for?
Intravenous urography (IVU)
124
What is an intravenous pyelogram (IVP)?
The study of the renal pelvis and calyces (Pyelogram)
125
What is the study of the renal pelvis and calyces (Pyelogram) called?
Intravenous pyelogram
126
What is retrograde filling?
Contrast media thats introduced against normal flow
127
How is retrograde filling administered?
Urethral catherization
128
What is the technique for retrograde filling called?
Retrograde urography
129
What is cystography?
examination of the bladder
130
What is the examination of the bladder called?
Cystography
131
What is cystoureterography?
Exam of the bladder and the low ureters
132
What is the exam of the bladder and the low ureters called?
Cystoureterography
133
What is cystourethrography?
Exam of the bladder and urethra
134
What is the exam of the bladder and urethra called?
Cystourethrography
135
What is a voiding cystourethrogram (VCUG)?
The act of voiding the bladder is observed
136
What is the act of voiding the bladder is observed called?
Voiding cystourethrogram
137
How is the contrast for a VCUG administered?
Retrograde flow through urethral catheter, followed by withdrawal of catheter for imaging during voiding
138
What is the purpose for a VCUG?
- Study of the urethra
- Evaluates patients ability to urinate
- Indicate trauma & incontinence
- Function study
139
What is the purpose for a retrograde cystography?
- Evaluates for trauma, calculi, tumor, and inflammatory disease of the urinary bladder
- Non-function study
140
What is the purpose for a IVU?
- Visualize the collecting portion of the urinary system
- Assess function ability of kidneys
- Evaluates the urinary system for pathology or anatomic anomalies
-Function study
141
What kind of contrast is used when doing a urinary study?
Iodinated intravenous contrast
142
What kind of contrast is preferred when doing a urinary study?
Non-ionic
143
How is the contrast introduced when doing a urinary study?
Using a bolus injection
144
How much contrast is injected into the venous system? Why?
- The entire dose is injected all at once
- This provides maximum enhancement
145
What does the rate of the bolus injection depend on?
- Gauge of needle or connecting tube
- Amount of contrast media injected
- Viscosity of contrast media
- Stability of vein
- Force applied by the individual performing the injection
146
What are the characteristic reactions when introducing contrast media in urinary studies?
- Feeling of warmth
- Flushing
- Hives (sometimes)
147
How severe are can the reactions be when introducing contrast in urinary studies?
- Mild and short duration
- Severe reaction can occur but are rare
148
What are the occasional reactions when introducing contrast media in urinary studies?
- Nausea
- Vomiting
- Edema or respiratory mucous membranes
149
What should you do before and after administering contrast during a urinary study?
- Check clinical history
- Observe patient closely after contrast administration
- Emergency equipment and medication must be readily available
150
What should the patient do to prep for a retrograde urography exam?
Drink 4-5 cups of water several hours before the exam
151
What does a clear demonstration of the urinary system require?
The intestinal tract to be free of gas and fecal material
152
At what age is bowel preparation not attempted?
Infants & children
153
What does adult preparation depend on?
Patient condition
154
What should adult patients do to prep for a urinary exam?
- Low residue diet for 1-2 days before exam
- Light evening meal on day before exam
- Non-gas forming laxative, when indicated, the day before the examination
- NPO after midnight the day of the examination
155
What may be given to help prep the patient for a urinary exam?
Cleansing enema
156
What should the patient do just before the start of the exam?
Void the bladder
157
What could happen if the patients bladder is full for a urinary exam?
The bladder could rupture
158
What could happen if urine is present in the bladder during a urinary exam?
The urine could dilute the contrast that may accumulate there
159
Where is compression applied over for a urinary exam?
The distal ends of the ureters
160
What is the purpose of ureteral compression?
Slow down the flow of opacified urine into the bladder to ensure filling of the renal pelvis and calyces
161
Where is ureteral compression centered over?
Level of the anterior superior iliac spine (ASIS)
162
What is another alternative to ureteral compression?
Place patient in trendelenburg position 15 degrees
163
What do you do to the compressor when removing it and why?
Apply and remove slowly to reduce patient discomfort caused by changes in intrambdominal pressure
164
What are some contraindications for patients when doing ureteral compression?
- Urinary stones
- Abdominal mass
- Aortic aneurysm
- Colostomy
- Suprapubic catheter
- Traumatic injury
- Recent abdominal surgery
- Severe abdominal pain
165
What is the protocol for an IVU?
- Take clinical history
- Scout radiograph (KUB) is performed
- Injection of contrast media is performed
- Basic imaging routine is performed
166
What is the basic imaging routine for IVU protocol?
- 1 minute nephogram or mephrotomogram
- 5 minute AP supine
- 10-15 minute AP supine
- 10-15 minute RPO/LPO
- 20 minute AP supine (KUB or bladder shot)
- Post void (Supine, prone, or upright)
167
What do you need to note for an IVU protocol?
- The start time of the injection
- The type and mount of contrast injected
168
What is the difference between a nephrogram and nephrotomogram?
- Nephrotomogram is performed using a tomographic machine
- A nephrogram is not performed using a tomographic machine
169
When is the nephrogram/nephrotomogram taken?
In the nephron (nephrotic) phase
170
What is the purpose for doing a nephrogram/nephrotomogram?
To visualize the renal parenchyma (nephrons and collecting tubes)
171
Where should the centering be for anephrogram/nephrotomogram exam?
Halfway between the iliac crest and xiphoid process
172
What is the area of interest for a nephrogram/nephrotomogram exam?
The kidneys
173
What is the purpose for a retrograde urography study?
To evaluate the collecting system in a patient with renal insufficiency or who are allergic to iodinated contrast media
174
Why is the incidence of reactions reduced in a retrograde urography study?
Because the contrast in not introduced into the circulatory system
175
What is a retrograde urography study classified as?
An operative procedure
176
Are patients put under anesthesia for retrograde urography studies?
Yes
177
What is a ureterocystoscope?
A cystoscope that helps with insertion of catheters into the vesicoureteral orifices
178
For a retrograde urography study the urologist performs _______ of the ureters through a _______
- Catheterization
- Ureterocystoscope
179
What happens when the urologist passes a ureteral catheter into the ureters?
The scope is withdrawn and the catheters stay in place
180
What kind of contrast is injected for retrograde urography?
Iodinated contrast
181
How many mL of contrast does it take to fill the renal pelvis?
3-5 mL but may require more if the structures are dilated
182
Where is the CR for retrograde urography?
The level of the iliac crests or sometime slightly higher
183
What happens to the catheters when the retrograde urography exam is completed?
Catheters are fully removed
184
Where is the head of the table located for an AP pyelogram?
Lowered 10-15 degrees
185
Where is the head of the table located for an AP ureterogram?
Elevated 35-40 degrees
186
Why is the head of the table elevated 35-40 degrees for an AP ureterogram?
To show tortuosity of the ureters and the mobility of the kidneys
187
Why is the head of the table lowered 10-15 degrees for an AP pyelogram?
To prevent contrast from escaping the ureters
188
For a retrograde urography study, where are the catheters withdrawn to? Where is contrast injected?
- The lower ends of the ureters
- Into the canals
189
What is the purpose for a retrograde cystography exam?
Evaluate the urinary bladder
190
What kind of catheter is placed for a retrograde cystography exam?
Foley catheter
191
When is the preliminary image taken for a retrograde cystography?
When the foley catheter is placed
192
What does the physician do after the preliminary images are taken for the retrograde cystography?
Removes the bladder clamp and drains the bladder
193
What happens after the bladder is drained for a retrograde cystography?
Contrast is introduced into the catheter and the physician clamps the catheter to keep the contrast from escaping
194
Are voiding images taken for a retrograde cystography?
Yes
195
What is the purpose for a cystourethrography?
To examine the bladder and urethra
196
Why does the cystoscope do for a cystourethorgraphy?
To inspect the bladder and introduce a catheter
197
What happens after endoscopic inspection during a cystourethrography?
The bladder is drained and contrast is injected and then AP voiding images are taken
198
What degree is the patient rotated fro RPO/LPO cystourethrography voiding images?
35-45 degrees
199
When are the AP voiding images taken for a cystourethography?
While the contrast is injected
200
What is the CR for cystourethrography AP voiding images?
Perpendicular to MSP, entering at the level of the upper border of the pubic symphysis
201
What degree are females angled for an AP void cystourethrography image?
5 degrees caudal
