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54 terms

Renals-Normal-4/2/12

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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