upper urinary tract
Kidneys
Ureters
Lower urinary tract
Urinary bladder
Urethra
Removing water and waste products from the blood
Filtration
Removing wastes in the form of urine
Excretion
Maitaining the salt to water balance and help in regulating blood pressure
Maintenance
Producing hormones that are deployed through the body
Hormone production
Kidneys are located at _______ of spine
Retroperitoneum
Kidneys are at the level of
T12 and L4
Right kidneys are _____ than the left kidney
Lower
Right kidneys is posteroinferior to the
Liver and gallbladder
Left kidney is inferior and medial of
Spleen
Presents as midgray or medium to low-level homogeneous echoes
Renal cortex
Consists of medullary pyramids which appears as triangular , round or blunted anechoic areas
Renal medulla
Rebal medulla is _______ thick
1.2 - 1.5 cm
Have a distinctive and readily identifiable appearance
Anechoic pyramids
Bright echodense ovoid central portion of the kidney with irregular borders
Renal sinus
It houses the collecting system , lymphatic and renal vessels
Renal sinus
Outer cover is the
Rind / capsule
Collecting system is called
Pelvocalyceal / calicopelvic
Renal cortex of normal kidney pediatrics
Hyperechoic
Medullary pyramids in the pediatric kidney is
More visible
Transducer
3.5 mHz
Recommeded positioning
Supine
Prone
Right and left decubitus
Ptosis of the kidney is suspected at
Upright projection
Important factors to evaluate the renal parenchyma
Proper gain control
Sensitivity time control
To delineate different sections of the kidney
Longitudinal and transverse
Right kidneys are seen using the window
Right lobe of the liver
Landmark of the left kidney
Spleen
Longitudinal axis
9-10 cm
Vertical axis
4-5 cm
Neonatal
2-3 cm
Kidneys shrink due to
Atrophic changes
Atropic changes
Age
Circulatory inefficiency
Renal disease
Large kidney is larger to accomodate increase workload
Hypertrophy
Renal disease to small kidney
Chronic pyelonephritis
Chronic glumerulonephritis
Kimmelstiel wilson’s disease
Nepheosclerosis
Large kidneys disease
Renal hypertension
Acute inflammatory disease
It demostrates the tumor mass and whether the mass is solid or fluid
Ultrasound
Classification of renal masses
Fluid -filled mass
Solid mass
Complex renal masses
Round pouch of smooth , thin-walled tissue or closed pocket that is usually filled with fluid
Renal cyst
True cyst is considered
Anechoic
Smooth
Exhibit posterior acoustic enhancement
Considered benign
Cystic masses
Usually malignant
Solid masses
Most common malignant tumor
Renal cell carcinoma
Absence of a back wall tends to be irregular
Hypoechoic mass
Smooth continuous wall
Cysts
Exhibits both fluid and solid texture
Complex masses
A rare tumor
Cystic renal cell carninoma
Shows a complex pattern
Renal hematoma
Most common benign tumor of the kidney
Angiomyolipoma
Kidney stones
Nephrolithiasis
A color phenomenon visible behind a strongly reflecting interface
Twinkling artifact
Twinkling artifact is called
Scintillation artifact / twinkle artifact
Twinkling artifact is beneficial for the detection of
Urinary tract stones
Urinary calculi
Urine builds up in the kidneys and cannot drain out the bladder
Hydronephrosis
3 components of hydronephrosis
Pelviectasis
Calliectasis
Hydroureter
Lower segment of the ureter is obstructed the the urine
Pelviectasis
Dilation of the renal calyces then follows
Calliectasis
Dilation of ureter
Hydroureter
Grading of hydronephrosis
Mild
Moderate
Severe
Visualization of the collecting system w/ blurring
Mild
Dilation of the collecting system
Moderate
Severely dilated ; clubbed calyces w/ thinning of cortical parenchyma
Severe
Calcium levels in the kidneys are increased
Nephrocalcinosis
Obtain characteristics shape by forming a cast of renal pelvis and calices resembling horns
Staghorn calculus / coral calculi
Developmental renal anomaly characterized by abnormal anatomical location of one or both of the kidneys
Ectopic kidney ( renal ectopia )
The effect of urine entering the urinary bladder ureteral orifices
Ureteral jets
Described the sonographic appearanceof the urine filling bladder
Ureteral jets
Sac that receives and stores urine produced by the kidney
Urinary bladder
Urinary bladder is located at
Laterally lying psoas muscle
The bladder lumen appears
Anechoic
Insignificant
Minimal
5-20%
Moderate
21-30%
Significant
30%
Bladder stone
Urinary bladder calculi / vesical calculus / cystolith
Outpouching from the bladder wall , whereby mucosa herniates through the bladder wall
Urinary bladder diverticulum
Used to drain the bladder .
Urinary catheters
Parts of the urinary system
2 kidneys
Ureters
Urinary bladder
Urethra
