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Questions and Answers
What is a characteristic feature of duplex kidney?
What is a characteristic feature of duplex kidney?
An ectopic kidney is located in the usual lumbar region of the body.
An ectopic kidney is located in the usual lumbar region of the body.
False
What is the main function of the renal parenchyma?
What is the main function of the renal parenchyma?
What is the purpose of intravenous urography (IVU)?
What is the purpose of intravenous urography (IVU)?
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The ureters have three narrowing levels.
The ureters have three narrowing levels.
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Name one imaging technique used for examining the urinary system.
Name one imaging technique used for examining the urinary system.
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A _____ kidney appears as an unusually large kidney that is crossed and fused.
A _____ kidney appears as an unusually large kidney that is crossed and fused.
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The hilum of the kidney transmits the renal vein, branches of the renal artery, and the ______.
The hilum of the kidney transmits the renal vein, branches of the renal artery, and the ______.
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Match the following kidney conditions with their descriptions:
Match the following kidney conditions with their descriptions:
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Which of the following is NOT a method of urinary system imaging?
Which of the following is NOT a method of urinary system imaging?
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Match the parts of the urinary system with their functions:
Match the parts of the urinary system with their functions:
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Which of the following is not a covering of the kidney?
Which of the following is not a covering of the kidney?
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The renal pelvis is found within the renal sinus.
The renal pelvis is found within the renal sinus.
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What surrounds the renal sinus?
What surrounds the renal sinus?
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The renal pyramids are found in the ______ part of the kidney.
The renal pyramids are found in the ______ part of the kidney.
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What is the average size of a normal kidney in cm?
What is the average size of a normal kidney in cm?
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Columns of Bertin can be mistaken for a mass in an ultrasound due to their appearance.
Columns of Bertin can be mistaken for a mass in an ultrasound due to their appearance.
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What imaging technique is used to assess the kidney, ureter, and bladder area for stones?
What imaging technique is used to assess the kidney, ureter, and bladder area for stones?
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The left kidney is located posterior to the ______.
The left kidney is located posterior to the ______.
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Match the following imaging techniques with their primary usage:
Match the following imaging techniques with their primary usage:
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What characteristic describes the echogenicity of a normal right kidney?
What characteristic describes the echogenicity of a normal right kidney?
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Agenesis of the kidney results in a filled renal fossa.
Agenesis of the kidney results in a filled renal fossa.
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What is the primary reason for lobulation of the kidney's external contour?
What is the primary reason for lobulation of the kidney's external contour?
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The renal sinus typically appears ______ on ultrasound.
The renal sinus typically appears ______ on ultrasound.
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In which portion of the kidney do the renal pyramids typically appear hypoechoic?
In which portion of the kidney do the renal pyramids typically appear hypoechoic?
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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.
