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RADT 313 - Urinary
Review of the urinary system and contrast from Bontrager textbook
| Question | Answer |
|---|---|
| urinary system is comprised of what organs? | kidneys, ureters, bladder, urethra |
| kidneys and ureters lie in what abdominal space | retroperitoneal |
| which kidney is generally lower than the other | right |
| what causes one kidney to be generally lower than the other | liver |
| ureters enter the bladder at what point | posterolateral aspect |
| the bladder and urethra lie in what abdominal space | infraperitoneal |
| how many kidneys are essential for normal well-being? | one |
| what degree does the longitudinal plane of the kidneys lie compared with the MSP | 20 |
| what degree does the transverse plane of the kidneys lie compared with the MCP | 30 |
| what causes the kidneys to lie at 20 degrees longitudinally and 30 degrees transversely | psoas muscles |
| An RPO would be done to demonstrate what kidney? | left |
| An RPO would be done to demonstrate what ureter? | right |
| what landmarks can be used to center for a image of the kidney | xyphoid tip and iliac crest |
| a condition whereby the kidney moves greater than 2 inches in position when standing upright | nephroptosis |
| how much urine is produced during a normal intake of water in a 24 hour period? | 1.5 L |
| the longitudinal fissure on the medial border of the kidney where the renal artery, vein, lymphatics, nerves, and ureter enter/exit the kidney | hilum |
| what are the functions of the urinary system? | regulate water levels in tissues, removing waste, regulating electrolyte balance |
| the total functioning portion of the kidney is called what? | renal parenchyma |
| describe the direction of urine flow | nephrons to renal pyramids to renal papilla to minor calyces to major calyces to renal pelvis to ureter to bladder to urethra |
| what are the three constricted points along the ureters where stones may get stuck? | UPJ, pelvic brim, UVJ |
| the UPJ is located where? | where the ureter and kidney join |
| the UVJ is located where? | where the ureter and bladder join |
| the pelvic brim is located where? | at the brim of the pelvis where the iliac blood vessels cross over the ureters |
| what is the trigone? | muscular area formed by the entrance of the two ureters and exit of the urethra in the bladder |
| how much can the adult bladder hold? | 350 to 500 mL |
| at what point do most humans receive a signal to void? | when bladder capacity reaches 250 mL |
| what type of contrast (nonionic or ionic) is most expensive? | nonionic |
| which type of contrast decreases risks of reaction? | nonionic |
| what causes ionic contrast to react? | it disscociates in ions in the blood |
| why is diabetes of concern when doing contrasted exams? | if patient takes a metformin derivative, it should be witheld following a contrasted exam |
| how long should metformin derivative containing drugs be witheld following a contrast study? | 48 hours |
| higher osmolarity contrast agents create what type of condition within the blood plasma | hypertonic |
| A hypertonic solution injected into the blood system can cause dehydration . . . why? | it draws fluid in from surrounding structures |
| what would be an example of a side effect following contrast administration? | warm flush, metallic taste |
| what would be an example of a reaction following contrast administration? | hives (moderate to severe), angioedema, tachycardia, bradycardia, hypotension |
| normal BUN level for an adult | 8-25 |
| normal creatnine level for an adult | 0.6-1.5 |
| what methods can be taken to reduce risk of allergic reaction to contrast agents? | screen, pre-medicate, find alternative imaging |
| what might be commonly included in a premedication protocol? | benadryl & prednisone |
| at what stage would the technologist declare a medical emergency for allergic reaction | severe reactions |
| at what stage would the technologist seek medical assistance for an allergic reaction | moderate reaction |
| what should the technologist do if the patient is experiencing a side effect of contrast administration? | continue with the exam and monitor patient for other signs |
| when specific organs are affected by the contrast media injected how is the reaction classified? | organ-specific |
| true/false: contrast media is toxic to surrounding tissues | true |
| when contrast media "leaks" out of the vein it was injected into, what is this called? | extravasation |
| how would you treat extravasation? | notify nurse/physician/administrator, elevate limb, use cold compress initially followed by a warm compress, document |
| IVU stands for | intravenous urography |
| IVP stands for | intravenous pyelogram |
| VCUG stands for | voiding cystourethrogram |
| In linear tomography, as the tomographic angle decreases, slice thickness will | increase |
| name two common needle types used for venipuncture | butterfly, over the needle catheter |
| true/false: you should wash hands PRIOR to venipuncture | true |
| what angle should the needle be approached to the vein | 20-45 degrees |
| which direction should the bevel of the needle face during venipuncture | up |
| what happens if extravasated contrast does not get reabsorbed in the body? | surgical lancing |
| if patient needed an IVU and BE what exam would be scheduled first? | IVU |
| what methods can be employed to reduce radiation exposure to the patient? | high kV, lower mAs, shielding (when doing nephrotomograms), reduce need for repeats by double checking appropriate centering and positioning |
| why would ureteric compression be used? | enhances filling of the pelvicalyceal system and proximal ureters |
| when would ureteric compression be contraindicated? | possible stones, abdominal mass, AAA, recent abdominal surgery, severe abdominal pain, acute abdominal trauma |
| what is an alternative to ureteric compression? | trendelenburg |
| where should compression paddles be placed | at pelvic brim just lateral to each side of the vertebral column on the anterior surface of the patient |
| what are different methods that contrast can be introduced for a study of the urinary system | intravenous, retrograde through a catheter |
| how is contrast introduced for a nephrotomogram? | intravenous |
| how is contrast introduced for a cystogram | retrograde through catheter |
| when doing bladder imaging, you must get the bladder free of superimposition of the pubic symphysis. What is a common method for doing this? | angle caudally |
| If a nephrotomgram image demonstrates the spinous process of the vertebral column, where region is this slice of anatomy from? | posterior |
| where is the centering point for a KUB? | iliac crest and MSP |
| where is the centering point for a RPO KUB | iliac crest and 2" lateral of midline on elevated side |
| where is the centering point for an upright KUB | iliac crest and midline |
| where is the ceentering point for an AP axial bladder? | 2 inches sup;erior to pubic symphysis and MSP |
| how much angle is typically used for an AP axial bladder? | 10-15 degree caudal |
| what degree of rotation is used for a LPO KUB? | 30 |
| what degree of rotation is used for a RPO bladder? | 45 to 60 |
| where is the centering point for an RPO bladder? | 2 inches superior to symphysis pubis and 2 inches medial to ASIS |
| where is the centering point for a lateral bladder? | 2 inches superior and posterior to symphysis pubis |
| true/false: contrast media should never be injected under pressure into the bladder | true |
| what size image receptor (if available) should be used for the adult bladder? | 10x12 - 11x14 |
| what is the positioning difference between a male and female VCUG? | male = RPO 30 degree; female - supine |
| where is the centering point for the VCUG? | symphysis pubis |
| what technique is used for VCUG? | 80-85 kV |
| what technique is used for AP axial bladder? | 80-85 kV |
| what technique is used for oblique bladder | 80-85 kV |
| what technique is used for lateral bladder? | 80-85 kV |
| what technique is used for nephrotomogram? | 80-85 kV |
| what technique is used for PA KUB? | 80-85 kV |
| what technique is used for upright KUB? | 80-85 kV |
| what technique is used for RPO/LPO KUB? | 80-85 kV |
| what technique is used for AP KUB? | 80-85 kV |
| If a patient has hypertension, will it take more or less time for contrast to be picked up in the kidneys? | less |
| artifical opening between bladder and rectum | vesicorectal fistula |
| inflammation of the kidney and renal pelvis caused by pyogenic bacteria | pyelonephritis |
| distention of the renal pelvis and calyces resulting in some obstruction of the ureters or renal pelvis | hydronephrosis |
| most frequent malignant tumor of the kidney | renal cell carcinoma |
| large stone that grows to completely fill the renal pelvis | stagorn calculus |
| calcifications that occur in the luminal aspect of the urinary tract | renal calculi |
| disorder marked by cysts scattered throughout one or both kidneys | polycystic kidney disease |
| also called Bright disease | glomerulonephritis |
| inflammation of the capillary loops of the glomeruli of the kidneys | glomerulonephritis |
| inflammation of the urinary bladder caused by a bacterial or fungal infection | cystitis |
| abnormal rotation of the kidney | malrotation |
| occurs as a fusion of the kidneys during development of the fetus | horshoe kidney |
| kidney that fails to ascend into the abdomen and remains in the pelvis | ectopic kidney |
| involves two ureters and/or renal pelvis originating from the same kidney | duplication of ureter and renal pelvis |
| structural or chemical imperfections or alterations present at birth | congenital anomalies |
| tumor of the bladder that is three times more common in males than females | bladder carcinoma |
| stones formed in the bladder | bladder calculi |
| an enlargement of the prostate taht generally begins in the fifth decade of life | benign prostatic hyperplasia |
| eruption of wheals (hives) | uticaria |
| infection of urinary tract | UTI |
| backward or return flow of urine from the bladder into ureter and kidney | vesicoureteral reflux |
| involuntary passage of urine | urinary incontinence |
| excess in the blood of urea, creatnine and other nitrogenous end products | uremia |
| rapid heartbeat | tachycardia |
| loss of consciousness | syncope |
| inability to void | retention |
| inability of kidney to excrete metabolites at normal plasma levels | renal failure |
| absence of formation of a kidney | renal agenesis |
| protein in the urine | proteinuria |
| passage of a large volume of urine | polyuria |
| air or gas in urine | pneumouria |
| diminished amount of urine excretion | oliguria |
| therapy using sound waves to break apart large kidney stones | lithotripsy |
| an example of a diuretic | lasix |
| closure of the glottic aperture within the glottic opening | laryngospasm |
| low blood pressure | hypotension |
| blood in urine | hematuria |
| glucose in urine | glucosuria |
| feces in urine | fecaluria |
| agent to increase urine | diuretic |
| contraction of the bronchi and muscles making restricted air passageways | bronchospasm |
| slow heartbeat | bradycardia |
| bacteria in urine | bacteriuria |
| no urine secretion | anuria |
| subcutaneous swelling | angioedema |
Created by:
hschmuck1
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