Exam #3: Kidneys, Bladder, Spleen

Retroperitoneal

Posterior to diaphragm

Dark red, bean-shaped organ

9-12 cm

Outer portion of kidney tissue

1 cm or above

Inner portion of kidney tissue

Medulla

1. Anechoic pyramids

2. Renal pelvis

Renal tubules

Nephron

Where blood is filtered

Network of capillaries

1. Renal tubule

2. Bowman’s capsule

Vertical slit on medial surface of each kidney

Fibrous capsule

Renal fascia composed of areolar connective tissue

1. Perinephric fat

2. Kidneys

3. Adrenal glands

Tube that carries urine from kidney to bladder

25 cm

Large muscular structure that acts as a storage site for urine

1. Transitional epithelium

2. Stretch

Membranous tube from bladder to outside body

1. Internal sphincter

2. External sphincter

1. Involuntary (smooth muscle)

2. Voluntary (skeletal muscle)

Excretion of urine

When body pulls metabolic waste from blood stream and disposes it

1. Skin (sweat)

2. Lungs (CO2)

3. Liver (multiple toxins)

4. Large intestine (feces)

5. Kidneys (urine)

Series of lab tests performed on urine

Testing the pH of urine

Test that measures kidney’s ability to concentrate urine

Blood cells in urine (RBCs)

Extensive RBCs destruction

Yes

Glomerular apparatus malfunction

No

Renal failure

Smooth

1. Renal Capsule (echogenic)

2. Renal Pelvis/Sinus (echogenic)

3. Cortex (medium-level gray)

4. Renal Pyramids (hypoechoic)

Renal parenchyma

Outer

1. Posterior

2. IVC

1. Anterior

2. Aorta

Arcuate arteries

Renal hilum

Spleen

Liver

When kidney moves caudally with embryo axis
as it lengthens and fails to “ascend” to lumbar
position

Pelvis

When right and left areas of metanephric mesoderm are located very close to each other and fuse in midline, usually at inferior pole

Cake kidney

When ureteric bud doesn’t come into contact
with metanephric mesoderm so there is no induction of nephron formation

Complete absence of both kidneys that is not compatible with life (lethal)

When ureteric bud develops at abnormally inferior place on mesonephric duct

When ureteric bud splits and creates a second collecting system

Prominent fold of renal cortical tissue that produces down into medulla towards renal sinus

1. Clearly separated from renal sinus

2. Contiguous with renal cortex

3. Isoechoic to renal parenchyma

4. 3 cm or less

Bulge of renal cortex on lateral surface of kidney due to pressure on developing fetal kidney from spleen

1. Usually on left kidney

2. Isoechoic to renal parenchyma

Triangular indention in upper pole or renal parenchyma that results in partial fusion of two embryonic ranunculi that form kidney

Peripheral border of kidney

Fusion of ranunculi that results in part of kidney being rotated

Extra fat deposition in renal sinus that causes enlargement of renal sinus

Enlargement of proximal end of ureter

Difficult to see unless dilated

Full

Thick walls

1. Thin, smooth walls

2. Anechoic lumen

3. Should be located in midline

Duplication of collecting system that may involve complete or partial duplication of ureter

Ureters insert inferiorly on bladder

Ureters fuse before reaching bladder

Cyst-like enlargement of distal ureter

Intraperitoneal

1. LUQ

2. Near pancreatic tail

3. Superior and lateral to left kidney

Spleen

Filter foreign material from blood

When spleen removes nuclei from RBCs

When spleen filters out abnormal RBCs

Describes percentage of given volume of blood made up of RBCs

Presence of bacteria in blood stream (sepsis)

Elevated WBC count

Abnormally low WBC count

Lack of platelets caused by splenomegaly

1. Similar shape to liver

2. Isoechoic to liver

3. Homogenous to liver

4. Hilar area is similar to liver and kidneys

8-12 cm

Cranio-caudal length = more than 13 cm

Measure maximum dimension of spleen in long

1. Travels from splenic hilum to IVC

2. Runs along posterior border of pancreas

3. Joins MPV

Accessory spleen

Small round/ovoid structure of same echogenicity/texture as spleen tissue usually in splenic hilum

Spleen position is variable in abdomen/pelvic
due to laxity of splenic suspensory ligaments

Wandering spleen

Multiple small spleens in LUQ rather than a normal spleen

Left sided laterality sequence

Congenital absence of spleen

Right sided laterality sequence