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Urogenital Tract

Martin's Notes

Metanephros Term for permanent kidney
ureteric bud The _______________ gives rise to the ureter, renal pelvis, calyces, and collecting tubules.
Metanephric diverticulum or ureteric bud, Metanephric mesoderm Permanent kidneys develop from two different sources:
11 Kidneys complete migration occurs by the ____ wk of gestation.
2-4 25% of adult kidneys contain _____ renal arteries.
12-13 99% of kidneys are visible by _____ wk
1-2 Normal ureteral size: ____ mm
12-13 Bladder visible transvaginally by ____ wk
Pyelectasis Dilation of only the renal pelvis
4, 5 Dilation of the renal pelvis is considered abnormal if equal to or greater than ____ or ____ mm in 2nd trimester.
7-10 Dilation of the renal pelvis is considered abnormal if equal to or greater than ______ mm in 3rd trimester.
Hydroureters Abnormal ureters
Vertebral Anomalies V in VATER
Anal Atresia A in VATER
Trachoesophageal fistula T in VATER
Radial defects & renal anomalies R in VATER
30, 3 If renal abnormality exists with additional malformations, the increased risk for chromosomal abnormalities is times ____ for multiple and ____ for isolated.
1:4000 Bilateral Renal Agenesis (BRA) occurs in _____ births.
2.5:1 BRA has a M to F ratio of ______
Polyhydramnios (correct would be oligo) Which is NOT associated with BRA? Pulmonary hypoplasia, polyhydramnios, facial abnormalities, limb deformities?
Lying-down adrenal This appearance of the adrenal glands is seen in BRA.
1:1000 Unilateral Renal Agenesis occurs in ______ births.
Unilateral Renal Agenesis Sono findings of a normal AFV, normal bladder, and compensatory hypertrophy occur in which congenital malformation?
Unilateral Renal Agenesis This congenital malformation may be associated with SUA, genital, cardiac, skeletal, and GI abnormalities.
Bilateral Renal Agenesis This congenital malformation displays severe oligo, facial anomalies, and absent renal arteries sonographically.
Renal Ectopia Pelvic kidney
Crossed Renal Ectopia Enlarged, bilobed kidney
Horseshoe kidney Most common fusion anomaly of the kidney
1:400-500 Horseshoe kidney occurs in ________ births.
Horseshoe kidney This congenital malformation is associated with urogenital & CNS anomalies, Turner's, and T18
2 MCDK: Potter Type ____
Multicystic Renal Dysplasia MCDK aka Potter Type 2 aka ________________
MCDK Most common form of renal cystic disease in childhood
MCDK ONE of the most common abdominal masses in the neonate
13-26 Unilateral MCDK is associated with contralateral renal abnormalities in _________%
19-24 Bilateral MCDK has a lethal rate of ________%
Bilateral US findings of MCDK: severe oligo if unilateral or bilateral?
1 ARPKD aka Potter Type ____
liver ARPKD involves both the kidneys and the _______
Perinatal, Juvenile Two types of ARPKD are ________ and _________
Pulmonary hypoplasia Perinatal ARPKD results in early death due to what?
1-5 Juvenile ARPKD appears @ _______ yrs of age
Numerous tiny cysts Sono appearance of ARPKD has increased renal echogenicity due to what?
Oligo ARPKD: Polyhydramnios or Oligo?
Infantile ARPKD aka Potter Type 1 aka _________
3 ADPKD aka Potter Type ___
Adult ADPKD aka Potter Type 3 aka _________
ADPKD Most common hereditary renal cystic disease
ADPKD This renal cystic disease has a sonographically "normal" kidney appearance.
Family history What is critical in the diagnosis of ADPKD?
Meckel-Gruber Syndrome Lethal autosomal recessive disorder usually detected by sonography at 11-14 weeks.
Cystic dysplastic kidneys, Occipital encephalocele, Polydactyly Meckel-Gruber syndrome classic triad?
13, 18 Meckel-Gruber associated with Trisomy ____ and Trisomy ____
Mesoblastic nephroma Most common renal tumor in a newborn
Leiomyomatous hamartoma, hamartoma Mesoblastic nephroma is also known as "_________ _________" or "fetal renal _________"
Benign Mesoblastic nephroma is benign or malignant?
Pyramid Adrenals are ______ shaped early
hemorrhage Abnormalities of the adrenals include _______, cyst, hypertrophy, and tumor (neuroblastoma).
Adrenal Neuroblastoma Most common abdominal malignancy in neonates
Hydronephrosis Dilation of renal pelvis and calyces
Hydronephrosis This occurs in response to a blockage of urine at some junction in the urinary system
aneuploidy & postnatal uropathy Detection of fetal pyelectasis is important in consideration of __________ & __________
4 or 5 Renal pelvis diameter (RPD) is considered dilated when =/> ______ mm in 2nd trimester
7-10 Renal pelvis diameter (RPD) is considered dilated when ______ mm in 3rd trimester
Grade 0 Which grade of Hydronephrosis? Intact central renal complex
Grade 1 Which grade of Hydronephrosis? Only dilated renal pelvis; there is some fluid in the renal pelvis.
Grade 2 Which grade of Hydronephrosis? Dilated renal pelvis and a few calices are visible.
Grade 3 Which grade of Hydronephrosis? All calices are dilated.
Grade 4 Which grade of Hydronephrosis? Further dilation of renal pelvis and calices, with thin renal parenchyma.
Ureteropelvic Junction Obstruction (UPJ) Results from an obstruction at the junction of the renal pelvis and the ureter
Ureteropelvic Junction Obstruction (UPJ) Most common location for renal obstruction
Ureteropelvic Junction Obstruction (UPJ) Most common cause of fetal hydro
Ureteropelvic Junction Obstruction (UPJ) More common in males and often unilateral
Ureteropelvic Junction Obstruction (UPJ) Most cases of ________ are FUNCTIONAL (caused by muscular abnormality)
adhesions Other causes of UPJ are abnormal bends/kinks in ureter, abnormal valves in the ureter, and __________.
oligohydramnios If UPJ or UVJ are bilateral, possible ________ results
Vesicoureteral Junction Obstruction (UVJ) Results from an obstruction of ureter at level of bladder
Vesicoureteral Junction Obstruction (UVJ) This condition results from duplication of ureters, UVJ stenosis, or congenital megaloureter.
Vesicoureteral Junction Obstruction (UVJ) Sonographic findings of this can include a tortuous ureter and if unilateral, normal fluid and bladder.
Posterior Uretheral Valves (PUV) Congenital folds of the urethra act as valves and obstruct urinary outflow
Posterior Uretheral Valves (PUV) Results in hydronephrosis, hydroureters, or dilation of the bladder and prox urethra.
Posterior Uretheral Valves (PUV) This occurs in Males ONLY
Posterior Uretheral Valves (PUV) Keyhole appearance is associated with:
Keyhold appearance Dilated bladder & proximal urethra in PUV has this appearance
Urethral Atresia Most severe form of obstructive uropathy
Urethral Atresia Sonographic findings of this after 1st trimester include a markedly distended bladder and anhydramnios.
Cloaca Cavity lined with endoderm at the posterior end of the body serving as a common passageway for urinary, digestive, and reproductive ducts.
Cloacal Malformation Failure of urorectal septum to reach perineum
Cloacal Malformation Affects females 1:50,000
Cloacal Malformation Sonographic findings of this include: normal or decreased fluid, normal, distended, or non-visualized bladder, ascites, hydronephrosis, ambiguous genitalia, and vertebral anomalies.
Ambiguous genitalia (this is cloacal malformation) Which is not included in the Prune belly syndrome triad: Absent abdominal musculature, Ambiguous genitalia, Undescended testes, Urinary tract anomalies
Prune Belly Syndrome At birth, decompression of hydronephrosis causes wrinkling of anterior abdominal wall skin. What condition?
prostatic, tortuous Songraphic findings of Prune belly syndrome are: Oligohydramnios, Hydronephrosis, Massively distended bladder, Undescended testes, dilated _______ urethra, ________ dilated ureters, normal/hydro/dysplastic kidneys.
Vesicoamniotic shunting This is the shunt placement to relieve severe lower urinary tract obstruction and improving chance of survival
lungs Vesicoamniotic shunting drains urine into amniotic fluid, allowing the _______ to develop & prevent/stablize renal dysplastic change.
Bladder Exstrophy Caused by an incomplete median closure of the inferior portion of the anterior abdominal wall and anterior wall of the urinary bladder
Bladder Exstrophy Predominantly in males; exposure & protrusion of posterior wall of bladder
Bladder Exstrophy Associated with separation of pubic bones
Bladder Exstrophy Rarely, this occurs with OEIS complex.
Imperforate anus OEIS complex: Omphalocele, Exstrophy of bladder, _____________ & Spinal defects
Bladder Exstrophy Sonographic findings of this include a low umbilical cord insertion site and small penis.
12th By the ____ week of gestation the external genital organs are fully differentiated.
History of trisomal disorders (correct is x-linked disorders) All are medical implications for documentation of gender EXCEPT: History of trisomal disorders, Assignment of dizygosity in twins pregnancy, to diagnose structural abnormalities, familial syndrome
Hypospadias Defined as: Incomplete fusion of the urogenital folds may cause abnormal openings of the urethra
Hydrocele Defined as: Accumulation of serous fluid surrounding the testicle
Micropenis Small penis
Cryptorchidism Undescended Testes aka:
32 Undescended testes: after _____ weeks, both are descended in 97%
clitoris Abnormal genitalia in females: enlarged ________
Hydrometrocolpos Defined as: Collection of fluid in the vagina and uterus
Hydrometrocolpos Appears as ovoid, cystic or complex mass posterior to the bladder. May cause hydronephrosis or hydroureter.
Ovarian cyst Results from maternal stimulation and is usually benign.
adjacent Ovarian cysts are __________ to bladder
Created by: 1319517318