Chapter 14

Urinary System

&

IVP(U)

Urinary System

• 2 __________

• 2 Ureters

• 1 __________

• 1 Urethra

Kidneys

• Posterior Abdominal organs

• __________Organs

• Between ________and ___________ – T11/12 and L3

Kidneys• In the ____ plane kidneys angled approx.

_____

• Suprarenal __________gland

• Moves with diaphragm.

Kidney Blood Supply

• Renal artery– From abdominal aorta– At rest _____ of the blood passes through

kidneys.

• Renal vein– _________

Kidney Function

• Produce urine which:– _____________

• Removes nitrogenous waste

– Regulates ______________– Regulates __________ balance and

electrolyte levels– And more..

Kidney AnatomyMacroscopic

• __________ capsule – Outermost surface

• ___________– Under fibrous capsule

• ___________– Composed of renal pyramids

• Renal columns – Cortex between renal pyramids

Kidney Anatomy

• Minor __________– Convergence of renal pyramids opening at

renal papilla• Major _________

– Off of minors. Collecting area.• ____________

– Off of major calyces and empty into ureter.

NephronMicroscopic

• Area of Urine production.

• Approx. __________per kidney

• Within the ________ and ________

Ureter

• Transport urine from renal pelvis to bladder

• ___________diameter

Ureter Constriction • __________ (UPJ) junction

– Renal pelvis to ureter

• ________ brim – Iliac blood vessels cross ureters

• ___________ (UVJ) junction – Ureter joins bladder

Urinary Bladder• Musculomembranous sac that _______

urine for expulsion.

• 3 openings in the __________– 2 ureters– 1 urethra

• Total bladder capacity ______________

Bladder locations

• Female – Posterior to ___________and anterior to

________

• Male – Posterior to _________and extends into

_____________

IVP(U) Patient Prep

Ideal• NPO _________

• _________prep

• __________to the start of the exam

Prior to Injection

• Verify any contraindications to contrast.

• Make sure a ___________ is aware you are injecting.

• __________ based on department protocol.

Prior to Injection

• If the patient has a urinary catheter ___________

• Watch for __________

IVU Imaging

Routine• Scout• Inject• Nephrogram• Tomograms**• 10, 15, 20 min KUB• RPO• LPO• Prone• Upright Post Void

Scout and delayed films

• Position as routine __________

• Mark films to indicate _________ times

Nephrogram

• Taken ____________post injection

• Center between _________and _______ process. Mid sagittal

• Done to show the ___________of Kidneys

Nephrotomograms

• If per protocol• Center same as nephrogram• Typical cuts 8,9,10cm• Shows kidneys at various levels

RPO

• ____________• Center at iliac crest and mid line

(_______________)• Shows ______ kidney in AP• Shows ______ureter unobstructed from

spine

LPO

• ____________• Center at iliac crest and mid line

(_______________)• Shows __________ kidney in AP• Shows ________ ureter unobstructed from

spine

Prone

• Position as per Prone Abdomen

Upright Post Void

• Have the pt void (strain)• Position as per KUB but

_________________• _______________must be visualized• Shows emptying of bladder and any

residual stones.

Other Urinary System Imaging

• Retrograde Cystography (_________)

• Voiding Cystourethrogram– ____________

• Retrograde ____________– OR Procedure

Cystogram

• Done to Image the ______________• Insertion of a Urethral Catheter (Foley)• Bladder filled with Iodinated Contrast

– Usually ___________or more– Extension tube from __________ to contrast– Hung on IV pole. Allow __________bladder

do not force.

VCUG

• Images the ______________

• Following routine Cystogram

• Catheter is _____________ and the pt is instructed ___________.

VCUG

• Under fluoro __________ is evaluated and images are taken.

• Pt can be ___________________based on radiologist preference.

Retrograde Urography

• An _______________• Pt placed in modified ________ position.• Urologist will insert a scope into the

bladder. Then via a catheter contrast is injected into the ____________

• Images are taken at urologist’s discretion. Typically __________