Urinary System - Radiological Anatomy
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Questions and Answers

What is a characteristic feature of duplex kidney?

  • Kidney located in the pelvis
  • Kidney fused with the other kidney
  • Kidney located in the lumbar region
  • Kidney tissue divided into two parts with separate ureters (correct)
  • An ectopic kidney is located in the usual lumbar region of the body.

    False (B)

    What is the main function of the renal parenchyma?

  • To produce urine (correct)
  • To store urine
  • To transmit blood to the kidneys
  • To collect urine from the kidneys
  • What is the purpose of intravenous urography (IVU)?

    <p>To visualize the collecting portion of the urinary system and assess the functional ability of the kidneys.</p> Signup and view all the answers

    The ureters have three narrowing levels.

    <p>True (A)</p> Signup and view all the answers

    Name one imaging technique used for examining the urinary system.

    <p>X-ray KUB</p> Signup and view all the answers

    A _____ kidney appears as an unusually large kidney that is crossed and fused.

    <p>Crossed Fused Ectopic</p> Signup and view all the answers

    The hilum of the kidney transmits the renal vein, branches of the renal artery, and the ______.

    <p>ureter</p> Signup and view all the answers

    Match the following kidney conditions with their descriptions:

    <p>Pelvic Kidney = Kidney located in the pelvis Horseshoe Kidney = Lower ends of both kidneys join in front of the abdominal aorta Agenesis of Kidney = Absence of one or both kidneys Duplex Kidney = Kidney tissue divided into two parts</p> Signup and view all the answers

    Which of the following is NOT a method of urinary system imaging?

    <p>MRI (B)</p> Signup and view all the answers

    Match the parts of the urinary system with their functions:

    <p>Kidneys = Produce urine Ureters = Transport urine to the bladder Urinary Bladder = Stores urine Urethra = Excretes urine from the body</p> Signup and view all the answers

    Which of the following is not a covering of the kidney?

    <p>Cortex (D)</p> Signup and view all the answers

    The renal pelvis is found within the renal sinus.

    <p>True (A)</p> Signup and view all the answers

    What surrounds the renal sinus?

    <p>Hilum</p> Signup and view all the answers

    The renal pyramids are found in the ______ part of the kidney.

    <p>medulla</p> Signup and view all the answers

    What is the average size of a normal kidney in cm?

    <p>11 cm (B)</p> Signup and view all the answers

    Columns of Bertin can be mistaken for a mass in an ultrasound due to their appearance.

    <p>True (A)</p> Signup and view all the answers

    What imaging technique is used to assess the kidney, ureter, and bladder area for stones?

    <p>X-RAY KUB</p> Signup and view all the answers

    The left kidney is located posterior to the ______.

    <p>spleen</p> Signup and view all the answers

    Match the following imaging techniques with their primary usage:

    <p>X-RAY = Stone location Ultrasound = Kidney location assessment CT-SCAN = Detailed imaging for pathologies Fluoroscopy = Real-time imaging</p> Signup and view all the answers

    What characteristic describes the echogenicity of a normal right kidney?

    <p>Less than or equal to that of the liver (C)</p> Signup and view all the answers

    Agenesis of the kidney results in a filled renal fossa.

    <p>False (B)</p> Signup and view all the answers

    What is the primary reason for lobulation of the kidney's external contour?

    <p>Persistent fetal lobulation</p> Signup and view all the answers

    The renal sinus typically appears ______ on ultrasound.

    <p>hyperechoic</p> Signup and view all the answers

    In which portion of the kidney do the renal pyramids typically appear hypoechoic?

    <p>Renal parenchyma (C)</p> Signup and view all the answers

    Flashcards

    Renal Cortex

    Outermost layer of the kidney, responsible for filtration and reabsorption.

    Renal Medulla

    Inner region of the kidney, containing structures responsible for concentrating urine.

    Renal Pyramids

    Triangular-shaped structures within the medulla, responsible for urine production.

    Renal Columns

    Extensions of the cortex that extend into the medulla, separating the renal pyramids.

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    Medullary Rays

    Striations within the renal cortex extending from the pyramids, contributing to urine formation.

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    Renal Pelvis

    Funnel-shaped structure that collects urine from the kidney and directs it to the ureter.

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    Major Calyces

    Smaller compartments within the renal pelvis, each receiving urine from a minor calyx.

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    Minor Calyces

    Even smaller compartments within the major calyces, directly collecting urine from the renal papilla.

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    Renal Hilum

    The opening at the medial border of the kidney where vessels, nerves, and the ureter pass through.

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    Minor Calyx

    A small tube that collects urine from the renal papilla and empties into the renal pelvis.

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    Renal Papilla

    The apex (tip) of the renal pyramid, where urine is drained.

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    Renal Sinus

    The area surrounding the renal pelvis, containing blood vessels, nerves, and fat.

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    Nephron

    The functional unit of the kidney, responsible for filtering blood and producing urine.

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    Urine Formation

    The process of filtering waste products from the blood and forming urine.

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    KUB X-ray

    An X-ray imaging technique used to visualize the kidneys, ureters, and bladder.

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    Renal Agenesis

    A condition where one kidney is absent.

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    Columns of Bertin

    A variation where a prominent band of cortical tissue protrudes into the renal sinus.

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    Duplex Kidney

    A congenital condition where kidney tissue is divided into two parts, each with its own ureter working independently.

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    Ectopic Kidney

    A kidney found outside its normal location in the lumbar region, often in the pelvis or on the opposite side of the body.

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    Pelvic Kidney

    An ectopic kidney located in the pelvis.

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    Crossed Fused Ectopic Kidneys

    A rare condition where two ectopic kidneys not only cross sides of the body but also fuse together. It can appear as a larger kidney or a mass.

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    Horseshoe Kidney

    A condition where the lower ends of both kidneys join together, appearing in front of the abdominal aorta. This creates a U-shaped structure.

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    Fluoroscopy

    A technique that uses X-rays to visualize the urinary system, often with the help of contrast material.

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    Study Notes

    Urinary System - Radiological Anatomy

    • The urinary system includes two kidneys, two ureters, one urinary bladder, and one urethra.
    • Radiographic examinations of the urinary system are commonly performed using contrast media.
    • Kidneys are located in the lumbar region.
    • The kidney has an outer fibrous capsule, perirenal fat, renal fascia, and pararenal fat.
    • The renal sinus is a cavity within the kidney, containing the renal pelvis, renal vein, branches of renal arteries, ureter and lymph vessels.
    • The kidney is divided into two main parts: the renal parenchyma (for urine production) and the renal pelvicalyceal system (collects urine).
    • The renal medulla is composed of renal pyramids with their apices (renal papillae) pointing towards the center.
    • The renal cortex extends into the medulla between the pyramids as renal columns.
    • The renal sinus contains the renal pelvis and its branches, the major and minor calyces.
    • The renal pelvis is connected to the ureter.
    • The kidney has a characteristic blood supply, with different artery and vein levels.
    • The main arteries of the kidney are renal arteries.
    • The renal blood supply consists of segments of arteries leading to interlobar, arcuate, interlobular, afferent and efferent arterioles
    • Each kidney is supplied by multiple branches from a single renal artery
    • The collecting system of the kidney consists of renal pelvis, major calyces, and minor calyces
    • Ultrasound, X-ray KUB (Kidney, Ureter, Bladder), fluoroscopy and CT scan are imaging techniques used for urinary system examination.
    • Variations in kidney structures, such as lobulation and columns of Bertin, can be normal.
    • Kidney anomalies can include agenesis (absence), duplex kidney, ectopic kidney (in unusual location), crossed fused ectopic kidneys and horseshoe kidney.

    Kidney Location

    • Right kidney-posterior to the liver.
    • Left kidney-posterior to the spleen.
    • The upper pole of the kidney is near the diaphragm.

    Kidney Poles

    • Kidneys are divided into upper, middle, and lower poles for describing pathology location.

    Sonographic Characteristics of Normal Kidney

    • Average size: 11cm (range 9-13cm).
    • Right kidney is smaller than or equal to the liver, left is smaller than the spleen.
    • Kidney parenchyma is homogeneous (except hypoechoic pyramids).
    • Renal sinus is hyperechoic.
    • External contour is smooth.

    Renal Blood Supply

    • The blood supply to the kidney is a complex system involving various arteries and veins.
    • Multiple arteries branching and connecting to form the blood supply for the filtering units (Glomeruli).
    • Different levels of vessels can be seen, including segmental, interlobar, arcuate, and interlobular.

    X-Ray KUB

    • X-ray KUB (Kidney, Ureter, Bladder) examination is used to identify stones in the urinary system.
    • An X-ray KUB image enables visualization of the kidney, ureter, and bladder.

    Ultrasound

    • Ultrasound can identify the kidneys and their location (posterior to the liver on the right, posterior to the spleen on the left).
    • Ultrasound can be used to locate kidney, spleen, and other abdominal organs.
    • It's possible to locate anatomical structures and diagnose pathological conditions using ultrasound.

    Fluoroscopy

    • Fluoroscopy is a technique used for dynamic imaging of the urinary system.
    • Types of fluoroscopic urographic examinations include: intravenous urography (IVU), cystography (cystogram), ascending urethrography, and antegrade pyelography.

    Intravenous Urography (IVU)

    • IVU is a common procedure to image the urinary tract using contrast.
    • IVU images can show the collecting system of the kidney.
    • IVU helps in assessing the functionality of the kidneys.

    I.V.U - Time to Follow

    • Immediate film: Major calyces appear typically within 2 minutes of contrast administration.
    • 10-20 min: Pelvicalyceal system and upper ureter (ureterogram phase).
    • 45 min: Lower ureter and bladder filling (cystogram phase).
    • 1½ hr: Full bladder.

    Anatomy Review on IVU

    • The IVU studies show the different parts of the renal collecting system, including: minor calyces, major calyces, renal pelvis, ureteropelvic junction, proximal ureter, distal ureter and urinary bladder

    Antegrade Pyelography

    • An antegrade pyelography involves injecting contrast directly into the kidney or ureter using a catheter to visualize these structures.
    • A method to visualize the kidney and ureter, in case the intravenous method is not possible.

    Cystography (Cystogram)

    • Cystogram is a form of fluoroscopy used to image the urinary bladder.
    • Cystography images are done using an iodinated contrast medium installed through a catheter.
    • Cystography is used to identify conditions such as trauma, calculi and tumors in the urinary bladder

    Urethrography (Terminology)

    • Urethrography is a study of the male urethra, commonly using a retrograde or ascending approach.
    • Retrograde urethrography (RUG): Introduces contrast into distal urethra.
    • Ascending urethrography (ASU): Introduces contrast into proximal urethra during micturition.
    • Voiding cystourethrography (VCUG): Studies contrast during urination.

    Ascending Urethrography

    • Ascending urethrography is a technique to visualize the length of the urethra in male patients.
    • It's used to look at the different parts of the male urethra to see whether there are any problems with it, such as blockages or abnormalities.

    Micturating Cystourethrography (MCUG)

    • MCUG is a functional study that assesses urination process in bladder and urethra.
    • It's used in situations like vesicoureteral reflux or bladder abnormalities.

    Vesicoureteral Reflux (VUR)

    • VUR presents as urine flowing from the bladder into the ureters or kidneys.
    • VUR typically appears as different grades of severity.

    Common Radiological Findings

    • Hydronephrosis-kidney swelling, caused by urine backflow.
    • Hydroureter-ureter swelling-often due to ureter blockages.

    Non-functioning Kidney

    • A non-functioning kidney might not show up in the image after 45 minutes, when contrast has had the chance to pass through it.

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    Description

    Explore the anatomy and radiological aspects of the urinary system in this quiz. Understand the structure and function of the kidneys, ureters, bladder, and urethra, as well as the techniques used in radiographic examinations. Test your knowledge about the renal anatomy and related imaging techniques.

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