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What are the 3 main parts of the kidney?

1. cortex
2. medulla
3. sinus

Which part of the kidney contains renal pyramids and minor calyces? This part is the very beginning of the collecting system

medulla

Which part of the kidney contains major calyces and the hilum and is the most echogenic? This part is surrounded by fat.

sinus

Which part of the kidney is the outer, less echogenic parenchyma and houses nephrons?

cortex

Size of kidneys?

L-9-12cm

What is the kidney surrounded by? (3 things)

true capsule, fat, Gerota's fascia

The renal hilum is located medially/laterally and contains what 3 things?

medially, a renal vein, a renal artery, and a ureter

Where do the spiral muscles that surround the pyramids live primarily? What is their function?

inside the columns of Bertin, they exert "milking" action to enhance urine flow

What is the functional unit of the kidney?

nephron

What are the bands of cortical parenchyma separating each renal pyramid, and these may extend into the renal sinus?

columns of Bertin

The kidney cleanses/filters the blood, while the spleen cleanses/filters the blood

cleanses; filters

What part of the kidney takes out the waste?

nephrons

What anterior structures cover the right kidney?

1. adrenal
2. rt lobe of liver
3. 2nd part of medial duodenum
4. hepatic flexure of the colon

What anterior structures cover the left kidney?

1. panc tail
2. adrenal
3. spleen
4. jejunum
5. stomach
6. splenic flexure of the colon

How long are the ureters?

25 cm in length

What are the 3 constrictions of the ureters?

1. at renal hilum
2. as they cross the pelvic brim
3. at bladder wall

Do we see ureters sonographically?

Not unless they are enlarged.

Ureteral orifice is seen at the bladder ____.

trigone

What do you commonly see with color on as the bladder fills?

ureteral jets

What is the path of waste products?

First to CORTEX-
then to PYRAMIDS-
then to MINOR CALYCES-
then to MAJOR CALYCES-
then to URETERS-
then to BLADDER-

What do the nephrons do?

excrete urine to eliminate waste and maintain electrolyte balance in body.

What kind of unit is a nephron?

a filtration/reabsorption unit

What kind of capsule does a nephron contain?

Bowman's capsule

What is included in the malphigian body in the nephron?

capsule + glomerulus

Explain the blood flow in the kidney.

main renal artery to the-
segmental to the-
interlobar to the-
arcuate to the-
interlobular to the-
afferent to the-
efferent

Explain the vasculature in the kidney.

1. afferent arteriole
2. glomerulus
3. efferent arteriole (bk to circ)
4. Bowman's capsule
5. descending tubule
6. loop of henle
7. ascending tubule
8. convoluted tubules
9. collecting duct
collecting duct dumps into a pyramid

What are the 3 renal functions?

1. filtration
2. reabsorption
3. tubular secretions

Where does the filtration occur in the kidney? Where do substances filter into?

glomerulus; bowman's capsule

Where does the reabsorption occur?

convoluted tubules, loop of henle, and collecting tubules

Where are body waste substances secreted into?

distal tubules

RRA runs posterior to ___. Longer/shorter course than LRA? Where does it enter kidney?

IVC; longer; hilum posterior to RRV

How do the renals run in the body?

TRV

Where does the LRA enter kidney? The LRA is easier/harder to see than the RRA?

at hilum posterior to LRV, harder

Renal veins are ____ to renal arteries

anterior

When you have doppler on a renal artery, what kind of resistance should it have?

LOW resis (lots of diastolic flow, sharp systolic peaks)

What is it called when there's no nice systolic window, and the peaks are elevated and irregular?

renal artery stenosis

What is it called when the systole doesn't go straight up anymore (it's delayed) and you get a point in your waveform, which signifies a decrease

Tardus Parvus

Which muscle near the kidney lies medially and relates to the upper pole of the kidney?

psoas

Which muscle near the kidney lies lateral and relates to the lower pole of the kidney?

quadratus lumborum

Labs related to the kidney?

BUN-blood, urea, nitrogen (getting rid of wastes)
Creatinine (hydration)

What does a neonatal kidney look like?

will be smaller, not have a prominent echogenic fat layer, looks like a choc chip cookie

What is the best reason for ultrasound on the kidneys?

to investigate solid vs. cystic masses

What 5 things do we assess the kidneys for?

1. perineal fat
2. renal size
3. parenchymal detail
4. to rule out obstruction
5. to rule out anomalies

This anomaly is excess fat in the sinus and collective tissue (makes tumor distinction more difficult).

renal sinus lipomatosis

This anomaly is a localized cortical bulge found on the lateral LK.

dromedary hump

This anomaly is a band of cortical tissue extending between renal pyramids, sometimes to the renal sinus. (will be isoechoic to the renal cortex)

hypertrophied column of bertin

Where are fetal lobulations common?

LT kidney

What do you call one or 2 fetal lobulations?

junctional defect

This anomaly has 2 separate renal sinuses, and the column of bertin goes the whole way through.

duplex collecting system

This anomaly is the absence of a kidney and ureter. What is this linked to?

Renal agenesis; absence of ovary

This anomaly is a little extra patch of renal parenchyma (like an accessory kidney)

supernumerary kidney

This anomaly occurs when the pelvis lives outside of the kidneys (you can see sonographically that nothing else has fluid in it)

extra renal pelvis

This anomaly is common when you search in the normal spot for a kidney and do not see one.

pelvic kidney

This anomaly occurs when the upper or (most commonly) lower poles fuse during fetal development.

horseshoe kidney

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