Chapter 14 Urinary System & IVP(U). Urinary System 2 __________ 2 Ureters 1 __________ 1 Urethra.
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Transcript of Chapter 14 Urinary System & IVP(U). Urinary System 2 __________ 2 Ureters 1 __________ 1 Urethra.
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 __________