Question 1

Urinary System:

Accepted Answer

- Kidneys (2).
- Ureters (2).
- Urinary bladder.
- Urethra.

Question 2

Retroperitoneal structures:

Accepted Answer

Kidneys and ureters.

Question 3

Infraperitoneal structures:

Accepted Answer

- Distal ureters.
- Urinary bladder.
- Urethra.

Question 4

Kidney Location

Accepted Answer

- Halfway between xiphoid process and iliac crest.
- Between T11-T12 and L3.

Question 5

Nephroptosis

Accepted Answer

Excess inferior displacement of the kidney when erect.

Question 6

Nephron

Accepted Answer

- Structural and functional unit.
- Over 1 million per kidney.
- Blood filtered.

Question 7

Ureters

Accepted Answer

28-34 cm long, 1 mm to 1 cm in diameter.
Lie on psoas muscles.
Enter posterolateral bladder.
Points of constriction.
1. Ureteropelvic junction (UPJ).
2. Pelvic brim.
3. Ureterovesical junction (UVJ).

Question 8

Micturition

Accepted Answer

The act of voiding or urination.

Question 9

Anuria

Accepted Answer

Complete cessation of the urinary secretion of the kidneys also called anuresis.

Question 10

Bacteriuria

Accepted Answer

Presence of bacteria in urine.

Question 11

Diuretic

Accepted Answer

An agent that increases its secretion of urine.

Question 12

Fecaluria

Accepted Answer

Fecal matter in the urine.

Question 13

Glucosuria

Accepted Answer

Glucose in the urine.

Question 14

Hematuria

Accepted Answer

Blood in the urine.

Question 15

Lasix

Accepted Answer

Brand name for a diuretic.

Question 16

Lithotripsy

Accepted Answer

A therapeutic technique that uses acoustic waves to shatter large kidney stones into small particles until they can be passed.

Question 17

Micturition

Accepted Answer

The act of voiding or urination.

Question 18

Oliguria

Accepted Answer

Excretion of a diminished amount of urine in relation to fluid intake usually defined as less than 400mL/24hr.

Question 19

Pneumouria

Accepted Answer

Presence of gas in the urine usually as the result of a fistula b/w the bladder and the intestine.

Question 20

Polyuria

Accepted Answer

Passage of a large volume of urine in relation to fluid intake during a given period; a common symptom of diabetes.

Question 21

Proteinuria

Accepted Answer

The presence of excessive serum protein levels in the urine; also termed albuminuria.

Question 22

Renal failure

Accepted Answer

The inability of a kidney to excrete metabolites at normal plasma levels; or the inability to retain electrolytes under conditions of normal intake.

Question 23

Acute Renal Failure

Accepted Answer

Marked by uremia oliguria or anuria with hyperkalemia and pulmonary edema; IVU demonstrates little or no contrast medium filtering through the kidney possible exacerbation of patients conditions following use of iodinated contrast media.

Question 24

Chronic Renal Failure

Accepted Answer

Results in a wide variety of conditions a may require hemodialysis or transplantation.

Question 25

Uremia

Accepted Answer

An excess in the blood of urea, creatinine and other nitrogenous end products of protein and amino acid metabolism often present with chronic renal failure, also known as azotemia.

Question 26

Urinary Reflux

Accepted Answer

Backward or return flow of urine from the bladder into the ureter and kidney.

Question 27

Retention

Accepted Answer

The inability to void which may be due to obstruction in the urethra or lack of sensation to urinate.

Question 28

Urinary Tract Infection (UTI)

Accepted Answer

Infection that frequently occurs in adults and children caused by bacteria, viruses, fungi, or certain parasites; commonly caused by vesicoureteral reflux.

Question 29

Urinary Incontinence

Accepted Answer

Involuntary passage of urine through the urethra, commonly caused by failure of the involuntary control of the vesical and urethral sphincters.

Question 30

Urography and Contrast Media:

Accepted Answer

- Water-soluble, iodinated contrast media.
- Ionic or nonionic.
- Injected intravenously or through a catheter.

Question 31

Side Effect of Venipuncture:

Accepted Answer

- Temporary hot flash.
- Metallic taste in mouth.

Question 32

Reaction

Accepted Answer

An unexpected outcome of injected contrast media.

Question 33

Side effects

Accepted Answer

Expected outcome of injected contrast media.

Question 34

Technologist Responsibilities

Accepted Answer

1) Clinical complaints?
2) Food or drug allergies?
3) Previous contrast media reaction?
4) Asthma, hay fever, or hives?

Question 35

Patient History

Accepted Answer

- Management of non-insulin-dependent diabetes: Glucophage (metformin hydrochloride).
- Check chart and/or ask patient the following:
"Are you currently taking glucophage or other medication for diabetes mellitus?

Question 36

Patient History:

Accepted Answer

- To be withheld 48 hours following iodinated contrast media procedure.
- Must verify normal kidney function before resuming medication.

Question 37

Creatinine level (adult)

Accepted Answer

0.6 -1.5 mg/dL.

Question 38

BUN levels (adult)

Accepted Answer

8-25 mg/100 mL.

Question 39

Premedication Protocol

Accepted Answer

Give combination of Benadryl and prednisone over period of 12 or more hours before procedure. Patients who have history of hay fever, asthma, food allergies, or previous contrast media reaction may be candidates for premedication procedure

Question 40

Local

Accepted Answer

Reactions that affect only a specific region of the body.

Question 41

Systemic

Accepted Answer

Reactions that affect the entire body or a specific organ system.

Question 42

Extravasation

Accepted Answer

Leakage of iodinated contrast media outside the vessel and into surrounding soft tissues (also referred to as infiltration).

Question 43

Extravasation:

Accepted Answer

May be toxic to skin
* Notify department nurse and/or physician.
* Elevate affected extremity above heart.
* Cold compress followed by warm compresses first to relieve pain and then to improve resorption.

Question 44

Phlebitis

Accepted Answer

- Inflammation of a vein
* Signs include pain, redness, and possibly swelling surrounding the venous access site.
* Discontinue the venous access at this site.
* Notify department nurse and/or physician.

Question 45

Purpose of IVU (twofold)

Accepted Answer

1. Visualize the collecting portion of the urinary system.
2. Assess the functional ability of the kidneys (a timed procedure).

Question 46

Patient Preparation for IVU:

Accepted Answer

- Light evening meal prior to procedure.
- Bowel-cleansing laxative.
- NPO after midnight (minimum of 8 hours).
- Enema on the morning of examination.
- Voiding prior to procedure.

Question 47

Contraindiactions to Ureteric Compression

Accepted Answer

1. Possible ureteric stones.
2. Abdominal mass.
3. Abdominal aortic aneurysm.
4. Recent abdominal surgery.
5. Severe abdominal pain.
6. Acute abdominal trauma.

Question 48

Alternative to Ureteric Compression.....

Accepted Answer

Trendelenburg position.

Question 49

IVU—Basic Routine:

Accepted Answer

- Scout radiograph.
- Injection.
- Note time at beginning of injection.
- Sample imaging routine.
* 1 min nephrogram or nephrotomography.
* 5 min AP supine.
* 10-15 min AP supine.
* 20 min posterior obliques.
* Postvoid (prone or erect).

Question 50

Nephrogram & Nephrotomogram

Accepted Answer

Radiographs taken early in study to demonstrate renal parenchyma or functional portion of kidney.

Question 51

Retrograde Urography:

Accepted Answer

- Performed in surgery.
- Contrast media delivered retrograde through catheter.

Question 52

Retrograde Urography Procedure

Accepted Answer

- Scout radiograph taken.
- Series of radiographs taken as requested.
- Ureterogram taken once catheter has been removed.

Question 53

Retrograde Cystography

Accepted Answer

- Contrast media delivered through catheter.
- Gravity flow of contrast media.
- 150-500 mL.
- Fluoro.
- AP and posterior oblique projections.

Question 54

Voiding Cystourethrography

Accepted Answer

Functional study of the bladder and urethra:
- Performed after routine cystogram.
- Catheter removed and imaged while voiding.
*FEMALE- AP.
*MALE- 30° RPO.

Question 55

Retrograde Urethrography

Accepted Answer

Nonfunctional radiographic study of the male urethra:
- Retrograde injection of contrast media.
- Use of Brodney clamp.
- Patient in 30° RPO position.
- Rarely performed.

Question 56

IVU

Accepted Answer

Routine
- AP scout.
- Nephrotomography (1 min following injection).
- AP.
- RPO and LPO.
- AP postvoid (recumbent or erect)
Special.
- AP ureteric compression.

Question 57

IVU—AP Projection

Accepted Answer

- No rotation.
- CR to level of iliac crest (include symphysis pubis).

Question 58

Nephrogram & Nephrotomogram

Accepted Answer

- No rotation.
- CR midway between xiphoid and iliac crest.
- Three exposures taken (generally).

Question 59

IVU—Posterior Obliques

Accepted Answer

- CR to the level of iliac crest.
- 30° RPO.
- 30° LPO.

Question 60

AP (PA) Postvoid

Accepted Answer

- CR at level of iliac crest.
- Include symphysis pubis.

Question 61

AP with Ureteric Compression

Accepted Answer

- CR at level of iliac crest, or alternate centering to kidneys.
- Compression device medial to ASISs.

Question 62

Cystogram

Accepted Answer

- CR 2 inches (5 cm) superior to symphysis pubis.
- AP: 10° to 15° caudad.
- Posterior oblique: 45° to 60°.

Question 63

Voiding Cystourethrography (VCUG)- FEMALE

Accepted Answer

- AP, supine or erect.
- Extend and slightly separate legs.

Question 64

Voiding Cystourethrography (VCUG)- MALE

Accepted Answer

- Recumbent or 30° RPO.
- Superimpose urethra over right thigh.

Question	Answer
Urinary System:	- Kidneys (2). - Ureters (2). - Urinary bladder. - Urethra.
Retroperitoneal structures:	Kidneys and ureters.
Infraperitoneal structures:	- Distal ureters. - Urinary bladder. - Urethra.
Kidney Location	- Halfway between xiphoid process and iliac crest. - Between T11-T12 and L3.
Nephroptosis	Excess inferior displacement of the kidney when erect.
Nephron	- Structural and functional unit. - Over 1 million per kidney. - Blood filtered.
Ureters	28-34 cm long, 1 mm to 1 cm in diameter. Lie on psoas muscles. Enter posterolateral bladder. Points of constriction. 1. Ureteropelvic junction (UPJ). 2. Pelvic brim. 3. Ureterovesical junction (UVJ).
Micturition	The act of voiding or urination.
Anuria	Complete cessation of the urinary secretion of the kidneys also called anuresis.
Bacteriuria	Presence of bacteria in urine.
Diuretic	An agent that increases its secretion of urine.
Fecaluria	Fecal matter in the urine.
Glucosuria	Glucose in the urine.
Hematuria	Blood in the urine.
Lasix	Brand name for a diuretic.
Lithotripsy	A therapeutic technique that uses acoustic waves to shatter large kidney stones into small particles until they can be passed.
Micturition	The act of voiding or urination.
Oliguria	Excretion of a diminished amount of urine in relation to fluid intake usually defined as less than 400mL/24hr.
Pneumouria	Presence of gas in the urine usually as the result of a fistula b/w the bladder and the intestine.
Polyuria	Passage of a large volume of urine in relation to fluid intake during a given period; a common symptom of diabetes.
Proteinuria	The presence of excessive serum protein levels in the urine; also termed albuminuria.
Renal failure	The inability of a kidney to excrete metabolites at normal plasma levels; or the inability to retain electrolytes under conditions of normal intake.
Acute Renal Failure	Marked by uremia oliguria or anuria with hyperkalemia and pulmonary edema; IVU demonstrates little or no contrast medium filtering through the kidney possible exacerbation of patients conditions following use of iodinated contrast media.
Chronic Renal Failure	Results in a wide variety of conditions a may require hemodialysis or transplantation.
Uremia	An excess in the blood of urea, creatinine and other nitrogenous end products of protein and amino acid metabolism often present with chronic renal failure, also known as azotemia.
Urinary Reflux	Backward or return flow of urine from the bladder into the ureter and kidney.
Retention	The inability to void which may be due to obstruction in the urethra or lack of sensation to urinate.
Urinary Tract Infection (UTI)	Infection that frequently occurs in adults and children caused by bacteria, viruses, fungi, or certain parasites; commonly caused by vesicoureteral reflux.
Urinary Incontinence	Involuntary passage of urine through the urethra, commonly caused by failure of the involuntary control of the vesical and urethral sphincters.
Urography and Contrast Media:	- Water-soluble, iodinated contrast media. - Ionic or nonionic. - Injected intravenously or through a catheter.
Side Effect of Venipuncture:	- Temporary hot flash. - Metallic taste in mouth.
Reaction	An unexpected outcome of injected contrast media.
Side effects	Expected outcome of injected contrast media.
Technologist Responsibilities	1) Clinical complaints? 2) Food or drug allergies? 3) Previous contrast media reaction? 4) Asthma, hay fever, or hives?
Patient History	- Management of non-insulin-dependent diabetes: Glucophage (metformin hydrochloride). - Check chart and/or ask patient the following: "Are you currently taking glucophage or other medication for diabetes mellitus?
Patient History:	- To be withheld 48 hours following iodinated contrast media procedure. - Must verify normal kidney function before resuming medication.
Creatinine level (adult)	0.6 -1.5 mg/dL.
BUN levels (adult)	8-25 mg/100 mL.
Premedication Protocol	Give combination of Benadryl and prednisone over period of 12 or more hours before procedure. Patients who have history of hay fever, asthma, food allergies, or previous contrast media reaction may be candidates for premedication procedure
Local	Reactions that affect only a specific region of the body.
Systemic	Reactions that affect the entire body or a specific organ system.
Extravasation	Leakage of iodinated contrast media outside the vessel and into surrounding soft tissues (also referred to as infiltration).
Extravasation:	May be toxic to skin * Notify department nurse and/or physician. * Elevate affected extremity above heart. * Cold compress followed by warm compresses first to relieve pain and then to improve resorption.
Phlebitis	- Inflammation of a vein * Signs include pain, redness, and possibly swelling surrounding the venous access site. * Discontinue the venous access at this site. * Notify department nurse and/or physician.
Purpose of IVU (twofold)	1. Visualize the collecting portion of the urinary system. 2. Assess the functional ability of the kidneys (a timed procedure).
Patient Preparation for IVU:	- Light evening meal prior to procedure. - Bowel-cleansing laxative. - NPO after midnight (minimum of 8 hours). - Enema on the morning of examination. - Voiding prior to procedure.
Contraindiactions to Ureteric Compression	1. Possible ureteric stones. 2. Abdominal mass. 3. Abdominal aortic aneurysm. 4. Recent abdominal surgery. 5. Severe abdominal pain. 6. Acute abdominal trauma.
Alternative to Ureteric Compression.....	Trendelenburg position.
IVU—Basic Routine:	- Scout radiograph. - Injection. - Note time at beginning of injection. - Sample imaging routine. * 1 min nephrogram or nephrotomography. * 5 min AP supine. * 10-15 min AP supine. * 20 min posterior obliques. * Postvoid (prone or erect).
Nephrogram & Nephrotomogram	Radiographs taken early in study to demonstrate renal parenchyma or functional portion of kidney.
Retrograde Urography:	- Performed in surgery. - Contrast media delivered retrograde through catheter.
Retrograde Urography Procedure	- Scout radiograph taken. - Series of radiographs taken as requested. - Ureterogram taken once catheter has been removed.
Retrograde Cystography	- Contrast media delivered through catheter. - Gravity flow of contrast media. - 150-500 mL. - Fluoro. - AP and posterior oblique projections.
Voiding Cystourethrography	Functional study of the bladder and urethra: - Performed after routine cystogram. - Catheter removed and imaged while voiding. FEMALE- AP. MALE- 30° RPO.
Retrograde Urethrography	Nonfunctional radiographic study of the male urethra: - Retrograde injection of contrast media. - Use of Brodney clamp. - Patient in 30° RPO position. - Rarely performed.
IVU	Routine - AP scout. - Nephrotomography (1 min following injection). - AP. - RPO and LPO. - AP postvoid (recumbent or erect) Special. - AP ureteric compression.
IVU—AP Projection	- No rotation. - CR to level of iliac crest (include symphysis pubis).
Nephrogram & Nephrotomogram	- No rotation. - CR midway between xiphoid and iliac crest. - Three exposures taken (generally).
IVU—Posterior Obliques	- CR to the level of iliac crest. - 30° RPO. - 30° LPO.
AP (PA) Postvoid	- CR at level of iliac crest. - Include symphysis pubis.
AP with Ureteric Compression	- CR at level of iliac crest, or alternate centering to kidneys. - Compression device medial to ASISs.
Cystogram	- CR 2 inches (5 cm) superior to symphysis pubis. - AP: 10° to 15° caudad. - Posterior oblique: 45° to 60°.
Voiding Cystourethrography (VCUG)- FEMALE	- AP, supine or erect. - Extend and slightly separate legs.
Voiding Cystourethrography (VCUG)- MALE	- Recumbent or 30° RPO. - Superimpose urethra over right thigh.
Total Capacity	350-500 mL.
Urge to Urinate	250 mL.
Urinary System Functions	1. Remove nitrogenous wastes. 2. Regulate water levels in body. 3. Regulate acid-base balance and electrolyte levels of the blood.
Urine=	1.5 L/day.
H2O intake=	2.5 L/day.
Types of Needles:	Butterfly Needle, Over-the-Needle, Straight-through-the-Needle.
Inflammation of a vein:	- Signs include pain, redness, and possibly swelling surrounding the venous access site. - Discontinue the venous access at this site. - Notify department nurse and/or physician.

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Rad Pro Ch.14

Urinary System