Urinary System study guide – Flashcards
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What does the urinary (excretory) system consist of?
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2 kidneys, 2 ureters, bladder, and urethra
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What is the function of the kidney?
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removing waste from blood, maintain fluid and electrolyte balance, and secreting substances that affect blood pressure and other body functions.
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How much urine do the kidneys secrete in one day?
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1-2 L
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Urine is expelled through the ___ system.
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Excretory system
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What is the urinary system also known as?
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Excretory system
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Suprarenal glands are also called ___?
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Adrenal glands
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What significance do adrenal glands have in relationship to the urinary system?
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None other than anatomical position
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What do the adrenal glands consist of?
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Medullary portion and cortical portion
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What 2 things do the adrenal glands secrete?
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epinephrine and cortical hormones.
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What part of the adrenal gland secretes epinephrine?
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medulla
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What part of the adrenal gland secretes the cortical hormone?
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cortex
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Which border of the kidney is concave? Convex?
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medial is concave, lateral is convex
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The kidneys are arbitrarily divided into an upper and lower portion called what?
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upper and lower poles
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About how long, wide, and thick are the kidneys?
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4.5" long, 2-3" wide, 1.25" thick
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Which kidney left or right is slightly longer and narrower than the right?
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Left
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Where are the kidneys located in relation to the peritoneum?
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posterior (it's in the retroperitoneal cavity)
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At what vertebral level do the kidneys lie?
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T12-L3
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At what angle do the kidneys lie in relation to the aorta?
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Each kidney lies in an oblique plane 30* anterior towards the aorta
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In What body habitus do the kidneys sit higher?
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hypersthenic
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Which kidney sits higher right or left?
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left because of the position of the liver
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What is the outer covering of the kidney called?
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renal capsule
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The kidneys have a respiratory movement of approximately how much?
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1"
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How much do the kidneys move when going from the supine to upright position?
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2"
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The medial side of the kidney has a slit for transmission of blood and lymphatic vessels, nerves, and ureters, what is it called?
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Hilum
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The hilum extends into the body to form a central cavity called what?
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Renal sinus
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What is the outer and inner portion of the kidney called?
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medulla is the inner portion and the cortex is the outer portion
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What does the renal medulla mainly consists of segments called what?
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renal pyramids
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An average sized medulla will consist of how many renal pyramids?
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8-15
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What are the pyramids made of?
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Collecting tubules
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Extensions of the renal pyramids are called what?
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Renal columns
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The functional unit of the kidney is what?
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Nephrons
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The essential microscopic components of the parenchyma of the kidney are called ___?
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Nephrons
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About how many nephrons are there in one kidney?
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1 million
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The individual nephron is composed of what two things?
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Renal corpuscle and a renal tubule
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The renal corpuscle consists of a double- walled serous membrane cup called ___?
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Bowman's capsule and the glomerulus
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The glomerular capsule is also known as what?
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Bowman's capsule
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What is the cluster of capillaries called that occupies Bowman's capsule?
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Glomerulus
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Which arteriole (afferent/efferent) enters the glomerular capsule, and which one exits it?
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Afferent enters, efferent exits
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The glomerulus serves as a filter for ___, permitting only water and finely dissolved substances to pass?
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Blood
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What is the tube called as it leaves the glomerular capsule?
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Convoluted tubule
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The ___ are cup shaped stems arising at the sides of the papilla of each renal pyramid.
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Calyces
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The ___ unite to form the major calyx.
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Minor calyx
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The ___ unite to form the renal pelvis.
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Major calyx
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How long are ureters?
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10-12"
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Where are the ureters located?
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Behind the peritoneum
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Where do the ureters attach to the bladder?
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The posterolateral side of the bladder (approx the level of ischial spine)
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What transports urine from the kidney to the bladder?
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Ureters
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The ___ is a musculomembranous sac that serves as a reservoir for urine.
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Urinary bladder
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The bladder is located posterior/anterior in both males and females.
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Anterior
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What is the most fixed part of the bladder?
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Neck
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How much urine can the adult bladder hold?
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500 mL
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When does the desire to urinate (micturition) occur?
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250 mL
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Where is the internal urethral orifice located in the bladder?
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The neck
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What is the triangular area between the ureteral and urethral openings called?
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Trigone
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What are the folds in the bladder called when the bladder is empty?
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Rugae
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What is the tube called that conveys urine out of the body?
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Urethra
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How long is the urethra in men?
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7-8"
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How long is the urethra in women?
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1.5"
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The male urethra is divided into what 3 sections?
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Prostatic, membranous, and spongy
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What is the gland called that surrounds the proximal part of the male urethra?
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Prostate
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What system does the prostate technically belong to?
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Reproductive
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About how long is the prostate?
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About 1 inch
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What does the prostate secrete?
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A milky fluid that combines with semen
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What is Benign Prostatic Hyperplasia (BPH)?
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Enlargement of the prostate
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What is a calculus?
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Abnormal concretion of mineraled salt, often a stone
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What is a Duplicating Collecting system?
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2 renal pelvi and/or ureters at the lower poles
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What is a horseshoe kidney?
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Fusion of the 2 kidneys, usually at the lower poles
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What is a pelvic kidney?
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Kidney that fails to ascend and remains in the pelvis
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What is cystitis?
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Inflammation of the bladder
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What is a fistula?
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Abnormal connection between 2 internal organs or between an organ and the body surface
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What is glomerulonephritis?
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Inflammation of the capillary loops in the glomeruli of the kidney
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What is hypernephrosis?
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Distension of the renal pelvis and calyces with urine
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What is a polycystic kidney?
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Massive enlargement of the kidney with the formation of many cysts
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What is pyelonephritis?
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Inflammation of the kidney and renal pelvis
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What is renal hypertension?
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increased blood pressure to the kidneys
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What is renal obstruction?
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Condition preventing the normal flow of urine through the urinary system
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What is a Wilm' tumor?
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Most common childhood abdominal neoplasm affecting the kidney
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What is an ureterocele?
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ballooning of the lower end of the ureter into the bladder
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What is vesicoureteral reflux?
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Backward flow of urine from the bladder into the ureters
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What does BPH stand for?
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Benign prostatic hyperplasia
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What position will demonstrate the mobility of the kidneys?
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AP upright
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How would you demonstrate the collecting system (calyces, pelves, ureters, bladder, and urethra)?
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Canals must be filled with contrast
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What procedure is used to investigate the blood vessels of the kidneys and suprarenal glands?
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angiography
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What is the radiologic investigation of the collecting system is called what?
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urography
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What are the 2 techniques used for filled the uninary canals with contrast medium?
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antegrade and retrograde
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Which filling technique allows the contrast to enter the kidney in the normal direction of blood flow?
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Antegrade
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What is percutaneous antegrade urography?
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introducing contrast medium directly into the kidney through percutaneous puncture.
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What is the technique called when the contrast agent is administered through an IV?
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Intravenous urography (IVU) or excretory.
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When would you use IVU?
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Upper urinary tract in infants and children and it is the preferred method for adults unless the retrograde technique is definitely indicated
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What does the term pyelography refer to?
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Radiographic demonstration of the renal pelves and calyces.
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True or False: IVP and IVU are the same things?
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True but IVU is more accurate
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Which technique uses a technique where the contrast in introduced directly into the ureter by means of catheterization?
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retrograde
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Investigations of the lower urinary tract- bladder, lower ureters, and urethra- are usually made by which technique?
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retrograde
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What is another term for bladder exam?
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cystrography
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What is another term for an exam of the bladder and urethra?
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cystourethrography
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What contrast medium is used for a cystogram?
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iodinated salts of 30% concentration or less
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Name the characteristic adverse reactions to iodinated contrast.
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warm, flush, sometimes hives.
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Name all adverse reactions that could occur from iodinated contrast but are rare.
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nausea, vomiting, and edema of respiratory mucous membrane.
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Most reactions to contrast media occur within the first _ minutes.
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5 minutes
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What is the one thing that usually interferes with exams of the urinary tract?
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gas
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What did Hope and Campoy recommend giving to small children and infants to distend the stomach with gas?
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carbonated soft drinks
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What is accomplished by giving small children and infants carbonated drinks?
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intestinal loops are pushed inferiorly and the upper urinary tract especially the left side is clearly seen through the gas filled stomach
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What position would resolve the problem of obscuring gas in majority of patients?
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prone
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What is the patient prep for exams of the urinary tract?
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low residue diet for 1-2 days to prevent gas formation, light evening meal night before exam, non-gas forming laxative evening before, NPO after midnight with the exception of water for patients with multiple myeloma, high uric acid levels, and diabetes.
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What additional patient prep of necessary for patients scheduled for retrograde urography?
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drink a large amount of water (4-5 cups) several hours before
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What is the patient prep for the lower urinary tract?
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none
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In excretory urography (IVU) where is the compression band applied?
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over the distal ends of the ureters centered at ASIS
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How much pressure is applied with a compression band?
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as much as the patient can handle.
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When is a compression band contraindicated?
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urinary stones, abdominal mass or aneurysm, a colostomy, a suprapubic catheter, or a traumatic injury.
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What is the respiration phase for all radiographs taken of the urinary system?
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suspend on respiration.
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What is another name for a preliminary radiograph taken before contrast is introduced?
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scout
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What position is the patient in when taking a scout of the kidneys?
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AP recumbent
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Can you shield women for urinary exams?
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no, unless you are specifically looking at the kidneys then you can shield the pelvis
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The most common contraindications for IVU relate to what?
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1) the ability of the kidneys to filter contrast medium from blood, and 2) the patients allergic history
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What are some examples of contraindications of IVU?
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asthma, previous reaction, cardiovascular disease, elevated creatinine level, sickle cell disease, diabetes mellitus, or multiple myeloma.
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What is a normal creatinine level?
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0.60- 1.5 mg/100mL
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How long does it take contrast to appear in the pelvicaliceal cavity?
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2-8 minutes
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The initial contrast "blush" of the kidney is termed the what?
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nephrogram phase
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How long does it take to have the greatest concentration of contrast media appear in the kidney?
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15-20 minutes after injection
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What are the most commonly recommended position and time intervals for an IVU?
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AP @ 3-20 minute time intervals
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How is excess contrast filtered from the body after the exam?
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filtered from blood by the kidney and eventually excreted in the urine
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For the AP Projection of the urinary system, how is the patient positioned?
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supine for scout and then upright or semi-upright to demonstrate opacified bladder and he mobility of the kidneys
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What position would you place the patient in when trying to obtain an AP projection of the lower ureters?
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Trendelenburg 15-20*
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When using the Trendelenburg method to demonstrate the lower ureters, how is the CR angled?
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Perpendicular @ level of crest
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Where/How is the CR directed for the AP projection of the urinary system?
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Perp to IR @ crest
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What 3 structures should be shown on the AP view? And if not all 3 are on there what projection should you take?
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Kidneys, ureters, and bladder. If not all 3 are on there you may need to do a bladder shot
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Why might you need to place the patient in the prone position rather than supine for an AP projection?
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Ureters fill better in the prone position. So, if the patient is suspected to have an obstructed ureter in the presence of hyrdonephritis prone would be better.
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What positions do you place the patient in for an AP oblique radiography of the urinary tract?
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RPO or LPO
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How much do you rotate the patient for a radiograph of the urinary tract?
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30*
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When performing an AP oblique which kidney will be perpendicular to the IR and which will be parallel?
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Closer kidney will be perp and kidney farther (elevated side) will be parallel
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Where should the IR be centered for an AP oblique of the urinary system?
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MSP @ level of crest
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Where should the CR be directed for an AP oblique of the urinary system?
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Perp @ level of crest entering 2" lateral to midline on elevated side
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What plane is centered to the grid for the lateral projection of the urinary system?
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MCP
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Where is the CR directed for the lateral proj of the urinary system?
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Perp to IR @ level of crest entering MCP
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What scale of contrast should a lateral projection of the urinary system have?
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Short scale- a distinct difference b/w contrast media and anatomy
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What is another name for renal parenchyma?
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the nephrons and collecting tubes
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Why do we use nephrotomography?
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to evaluate renal hypertension
