URINARY SYTEM SCANNING PROTOCOL

Question 1

The urinary system includes two kidneys, a ureter for each kidneys, a urinary bladder and a urethra.

Answer 1

URINARY SYSTEM

Question 2

Upper Urinary Tract:

Answer 2

Kidneys and Ureter

Question 3

Lower Urinary Tract

Answer 3

Urinary Bladder and Urethra

Question 4

KIDNEY FUNCTION:

Answer 4

Filtration
Excretion
Maintenance
Hormone production

Question 5

situated lower than the left kidney.

Answer 5

right kidney

Question 6

is posteroinferior to the liver and gallbladder.

Answer 6

right kidney

Question 7

is inferior and medial to the spleen.

Answer 7

left kidney

Question 8

this represents as mid-gray or medium to low-level homogeneous echoes that are less than or equal the density of the liver or spleen.

Answer 8

Renal Cortex

Question 9

Consists of medullary pyramids which appear as triangular, round or blunted anechoic areas when urine-filled, and are otherwise not visible.

Answer 9

 Renal Medulla

Question 10

They are 1.2 to 1.5 cm thick.

Answer 10

 Renal Medulla

Question 11

have a distinctive and readily identifiable appearance, their echo-free presentations is in sharp contrast to the highly echogenic sinus and medium gray cortex.

Answer 11

Anechoic pyramids

Question 12

This presents as the bright echodense ovoid central portion of the kidney with irregular borders.

Answer 12

Renal Sinus

Question 13

The sinus is markedly echogenic due to the dense fat and fibrous tissue it contains.

Answer 13

Renal Sinus

Question 14

It houses the collecting system, lymphatic and renal vessels.

Answer 14

Renal Sinus

Question 15

The outer cover is

Answer 15

rind or capsule.

Question 16

The collecting system is also known as

Answer 16

pelvocalyceal or calicopelvic

Question 17

___ in the pediatric kidneys are more visible than the pyramids in the adult kidney.

Answer 17

medullary pyramids

Question 18

SONOGRAPHIC APPLICATIONS

Answer 18

Determination of kidney’s size
For renal masses
To determine structural deformity
Guidance for biopsy and cyst aspiration
Renal transplant evaluation
Detection of stone (nephrolithiasis/renal calculi)
Kidney disease – cancer/metastasis
Fever Unknown Origin (FUO)

Question 19

TRANSDUCER is ___MHz

Answer 19

3.5 MHz

Question 20

important factors to evaluate the renal parenchyma.

Answer 20

 Proper gain settings and sensitivity time control (STC)

Question 21

is best seen using the right lobe of the liver as an acoustic window.

Answer 21

right kidney

Question 22

is a good landmark for the left kidney.

Answer 22

spleen

Question 23

may shrink due to atrophic changes associated with age, circulatory insufficiency or renal disease.

Answer 23

kidney

Question 24

A kidney is considered SMALL when it is less than

Answer 24

9cm

Question 25

Classification of Renal Masses:

Answer 25

a. Fluid-Filled Mass b. Solid Mass c. Complex Renal Masses

Question 26

Fluid filled masses in the renal parenchyma are usually

Answer 26

RENAL CYSTS

Question 27

is a round pouch of smooth, thin-walled tissue or a closed pocket that is usually filled with fluid.

Answer 27

RENAL CYSTS

Question 28

To be considered a true cyst:

Answer 28

a. Anechoic b. Smooth, well defined borders c. Exhibit posterior acoustic enhancement

Question 29

- The most common malignant tumor is

Answer 29

renal cell carcinoma

Question 30

The ultrasound pattern of renal cell carcinoma may either be

Answer 30

hypoechoic or echogenic, depending on the degree of necrosis.

Question 31

is helpful in differentiating a renal mass with hypoechoic pattern from a renal cyst.

Answer 31

Increasing and decreasing the gain

Question 32

exhibit both fluid and solid texture and may be seen in intra-renal abscesses.

Answer 32

Complex masses

Question 33

also show a complex pattern.

Answer 33

Renal hematomas

Question 34

is the most common benign tumor of the kidney; it is composed of fat, smooth muscle, and abnormal blood vessels.

Answer 34

Angiomyolipoma

Question 35

Nephrolithiasis (kidney stone) also called as

Answer 35

Scintillation artifact or twinkle artifact.

Question 36

occurs when urine builds up in the kidneys and cannot drain out to the baldder.

Answer 36

Hydronephrosis

Question 37

Three components of hydronephrosis

Answer 37

Pelviectasis Caliectasis Hydroureter

Question 38

when the lower segment of the ureter is obstructed the urine accumulated in renal pelvis.

Answer 38

Pelviectasis

Question 39

dilation of the renal calyces then follows.

Answer 39

Caliectasis

Question 40

dilation of the ureter.

Answer 40

Hydroureter

Question 41

Grading of Hydronephrosis

Answer 41

Mild Moderate Severe

Question 42

refers to visualization of the collecting system with blurring of the fornices, still with visible sinus echoes.

Answer 42

Mild

Question 43

is dilation of the collecting system that fills the sinus w/o evidence for cortical thinning

Answer 43

Moderate

Question 44

refers to severely dilated, clubbed calyces w/ associated thinning of the cortical parenchyma.

Answer 44

Severe

Question 45

condition in which calcium levels in the kidnesys are increased.

Answer 45

Nephrocalcinosis

Question 46

Obtain their characteristic shape by forming a cast of the renal pelvis and calices thus resembling the horns of a stag.

Answer 46

Staghorn Calculus

Question 47

Staghorn Calculus also called as

Answer 47

coral calculi

Question 48

Is a developmental renal anomaly characterized by adnormal anatomical location of one or both of the kidneys.

Answer 48

Ectopic Kidney (Renal Ectopia)