Abdomen Test #3

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marie78
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246234
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Abdomen Test #3
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2013-11-12 20:59:03
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Abdomen Test #3
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  1. Gerota's Fascia
    A fibrous sheath that surrounds kidneys, perinephric fat & the adrenal glands
  2. Renal Capsule
    True capsule that covers kidney
  3. Perinephric Fat
    Fat around kidney
  4. Renal Sinus
    • Highly echogenic central area of the kidney
    • Calyces, Fat, Nerves, Lymph nodes
  5. Renal Pelvis
    • Urine reservoir (collecting system)
    • Expanded Superior (prox) portion of ureter
  6. Column of Bertin
    • Prominent cortical tissue
    • Separates Medullary Pyramids
    • Can mimic a mass
  7. Hematuria
    Blood in urine
  8. Albuminuria
    Albumin/Protein in urine
  9. Polyuria
    Increased/Excessive urine output
  10. Oliguria
    Decreased urine output
  11. Normal size of kidney? How do they develop
    • 9-12 cm (sag)
    • 2-4 cm A/P
    • 5-7 cm TRV
    • Develop in the Pelvis w/pelvic organ
    • Migrate into the flank area
  12. Is Kidney Intra or retroperitoneal?
    Retroperitoneal
  13. Which kidney is higher/larger in the body?
    Lt kidney is higher by 0.5-1 cm longer than right
  14. Parenchyma is made up of what?
    Cortex/Medulla (functional unit)
  15. Entrance to Renal sinus is referred to as?
    Hilum
  16. What structures pass through the hilum?
    • Renal arteries
    • Vein
    • Ureter
    • Nerves
    • Lymphatic vessels
  17. What are the Kidney functions?
    • Dispose metabolic waste through urine
    • Maintain bl pressure thu regulation of fl. vol.
    • Regulate Ph balance (base/acid)
    • Regulate Serum electrolytes
  18. Kidney Lab Values
    • Creatinine (most Specific)
    • BUN (Blood Urea Nitrogen Waste)
  19. Normal USA of Kidney
    • Renal Cortex: Homogenous low-level echoes
    • Hypoechoic to liver
    • Renal Pyramids: Triangular shaped, hypoechoic surround sinus
    • Renal Sinus: Highly echogenic central area
    • Smooth Contour & Jelly Bean shaped
  20. Blood flow pathway TO Kidney
    • Aorta
    • Renal A
    • Segmental A
    • Interlobar A
    • Arcuate A (smallest can be seen)
    • Interlobular A
  21. Blood flow pathway FR Kidney
    • Interlobular V
    • Arcuate V
    • Interlobar V
    • Renal V
    • IVC
  22. Which is longer? (Rt/Lt Renal Art) (Rt/Lt Renal Vn)
    • Right Renal A is longer (AO)
    • Left Renal Vn is longer (IVC)
  23. How does each course around the AO or IVC? (Rt/Lt Renal A) (Rt/Lt Renal Vn)
    • Rt Renal A courses Post to IVC
    • Lt Renal Vn courses Ant to AO & Post to SMA



  24. Diffuse Renal Parenchymal Disease
    Poorly functioning kidneys w/o obstruction (all over)
  25. USA of Diffuse Renal Parenchymal Disease
    • Echogenic Parenchyma (cortex/medulla)
    • Acute: Enlarged kidneys
    • Chronic: Small, contracted Kidneys
    • End Stage: Atrophy, small w/thin cortex
  26. Dromedary Hump
    Bulge in Capsule of Lt Kidney due to compression by spleen
  27. Pelvic Kidney
    Kidney in pelvis
  28. Horseshoe kidney
    Most common, usually fused @ lower poles
  29. Junctional Parenchymal Defect
    Echogenic Triangle on renal capsule (around periphery of kidney)
  30. Dual Collecting System
    • More common anomaly
    • 2 collecting sys.
    • Complete or incomplete
    • Has upper/lower sinus area
  31. Renal arteries flow (high/low)
    Low resistance bec. it feeds major organs
  32. Where is a transplanted kidney placed?
    • Iliac Fossa on Rt side connected to Iliac A
    • Superficial
  33. Name the Fl collections that may occur after a Renal transplant
    • Urinoma
    • Lymphocele
    • Post transplant hydronephrosis
    • Hematoma
    • Abscess
  34. 3 causes of Post-transplant kidney failure
    • Acute Tubular Necrosis (common cause) Degeneration of tissue
    • Renal Infarct
    • Rejection
    • Cyclosporine Toxicity
  35. What is the drug cyclosporine use to prevent in a transplanted kidney?
    Rejection
  36. Possible Post-biopsy complications
    • AVM: Arterio Venous Malformation (Fistula)
    • Pseudoaneurysm
    • Hematoma
  37. What is Resistive Index (RI) used for?
    Test Kidney Function
  38. RI Formula
    PSV-EDV/PSV
  39. Normal RI for the Kidney
    < 0.7
  40. Trigone
    • Area of the bladder that is triangular in shape 
    • Located on Posterior/Inferior wall
  41. Papilloma
    • Benign polyps
    • Superficial neoplasms of bladder wall
  42. Diverticula
    Outpouching of UB wall
  43. Wilm's Tumor
    • Malignant
    • aka Nephroblastoma
    • Most common solid tumor in Children
  44. Foley Catheter
    • Man made circle in UB
    • Mechanical way to drain urine
  45. Pyelonephritis
    Inflammation of the renal parenchyma & pelvis
  46. Angiomyolipoma
    Benign Renal Hamartoma composed of bl vessels, muscle & fat
  47. Hamartoma
    • Vascular tumor that can happen in other places of the body
    • A focal growth that resembles a neoplasm but results fr faulty development in an organ
  48. UPJ
    • Ureteropelvic Junction obstruction (ureter/pelvis)
    • Congenital narrowing of the ureter just below the kidney
  49. UVJ
    • Ureterovesicle Junction obstruction
    • Congenital narrowing of the ureter @ the UB
  50. PUV
    • Posterior Urethral Valves
    • Membrane obstructs post urethra causing dilation of UB, ureters and Pelvis
  51. Prune Belly Syndrome
    • AKA: Eagle Bartlett Syndrome
    • Lax Syndrome
    • Keyhole bladder
  52. Sponge Kidney
    • AKA: Nephrocalcinosis
    • Calcium deposits in Medullary pyramids
    • Becomes echogenic
  53. Ultrasonic Lithotripsy
    Non-surgical U/S vibration treatment of kidney stones
  54. Extracorporeal Shockwave Lithotripsy
    Non-surgical water-therapy treatment of Kidney stones
  55. Renal Infarct
    Renal Failure
  56. Transitional Cell Carcinoma (TCC)
    Secondary Cancer from the urinary tract
  57. Where does TCC originate?
    Transitional Cells of Urinary bladder
  58. Where does TCC go?
    • Kidney
    • Pelvis
  59. Renal Cell Carcinoma (RCC)
    Malignant cancer of the kidney
  60. Where does RCC originate?
    Kidney
  61. Where does RCC go?
    • Renal V
    • IVC
    • Contralateral Kidney
    • Adrenals
    • Paraaortic nodes
    • Lungs
    • Liver
    • Brain
    • Long Bones
  62. RCC AKA
    Hypernephroma
  63. Parapelvic Cyst (not a true cyst, so where are they derived from)?
    Renal Cyst located in the Sinus Hilum region
  64. What can parapelvic cyst be confused with?
    • Hydronephrosis
    • or Extra Renal Pelvis
  65. APKD
    • Autosomal Dominant Polycystic Kidney Disease or Adult Polycystic Kidney Disease
    • Inherited and Progressive
    • Latent until 50's
  66. APKD is associated with?
    Cyst in Spleen, Liver and Pancrease
  67. Renal Parenchymal Disease
    Poorly functioning kidneys w/o obstruction
  68. Xanthogranulomatous Pyelonephritis
    • Form of chronic pyelonephritis
    • Renal pelvis contracts around a stone
    • Shadowing fr stone
  69. Nephrolithiasis
    Kidney Stones
  70. USA of Nephrolithiasis
    • Echogenic foci
    • Possible Post shadowing (anechoic)
    • Stones in ureter may not be seen
  71. How to prove stones?
    • Use color doppler to see if stone displays "Twinkle artifact"
    • Harmonics
    • Change to a higher frequency tx
  72. Staghorn Calculi
    • Type of Infective Stone
    • Fills entire Renal pelvis w/ post. shadowing
    • Oddly shaped
  73. USA of Hydronephrosis
    Fluid in Renal Sinus/Calyces
  74. USA of Mild Hydro
    Slight separation of collecting system
  75. USA of Moderate Hydro
    Further dilation of calyces (paw print)
  76. USA of Severe Hydro
    Large anechoic area w/ thinning cortex

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