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Chapter 14

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. _____

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Chapter 14

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  1. Chapter 14 Urinary System & IVP(U)

  2. Urinary System • 2 __________ • 2 Ureters • 1 __________ • 1 Urethra

  3. Kidneys • Posterior Abdominal organs • __________Organs • Between ________and ___________ • T11/12 and L3

  4. Kidneys • In the ____ plane kidneys angled approx. _____ • Suprarenal __________gland • Moves with diaphragm.

  5. Kidney Blood Supply • Renal artery • From abdominal aorta • At rest _____ of the blood passes through kidneys. • Renal vein • _________

  6. Kidney Function • Produce urine which: • _____________ • Removes nitrogenous waste • Regulates ______________ • Regulates __________ balance and electrolyte levels • And more..

  7. Kidney AnatomyMacroscopic • __________ capsule – Outermost surface • ___________ • Under fibrous capsule • ___________ • Composed of renal pyramids • Renal columns • Cortex between renal pyramids

  8. 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.

  9. NephronMicroscopic • Area of Urine production. • Approx. __________per kidney • Within the ________ and ________

  10. Ureter • Transport urine from renal pelvis to bladder • ___________diameter

  11. Ureter Constriction • __________ (UPJ) junction • Renal pelvis to ureter • ________ brim • Iliac blood vessels cross ureters • ___________ (UVJ) junction • Ureter joins bladder

  12. Urinary Bladder • Musculomembranous sac that _______ urine for expulsion. • 3 openings in the __________ • 2 ureters • 1 urethra • Total bladder capacity ______________

  13. Bladder locations • Female – Posterior to ___________and anterior to ________ • Male – Posterior to _________and extends into _____________

  14. IVP(U) Patient Prep Ideal • NPO _________ • _________prep • __________to the start of the exam

  15. Prior to Injection • Verify any contraindications to contrast. • Make sure a ___________ is aware you are injecting. • __________ based on department protocol.

  16. Prior to Injection • If the patient has a urinary catheter ___________ • Watch for __________

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

  18. Scout and delayed films • Position as routine __________ • Mark films to indicate _________ times

  19. Nephrogram • Taken ____________post injection • Center between _________and _______ process. Mid sagittal • Done to show the ___________of Kidneys

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

  21. RPO • ____________ • Center at iliac crest and mid line (_______________) • Shows ______ kidney in AP • Shows ______ureter unobstructed from spine

  22. LPO • ____________ • Center at iliac crest and mid line (_______________) • Shows __________ kidney in AP • Shows ________ ureter unobstructed from spine

  23. Prone • Position as per Prone Abdomen

  24. Upright Post Void • Have the pt void (strain) • Position as per KUB but _________________ • _______________must be visualized • Shows emptying of bladder and any residual stones.

  25. Other Urinary System Imaging • Retrograde Cystography (_________) • Voiding Cystourethrogram • ____________ • Retrograde ____________ • OR Procedure

  26. 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.

  27. VCUG • Images the ______________ • Following routine Cystogram • Catheter is _____________ and the pt is instructed ___________.

  28. VCUG • Under fluoro __________ is evaluated and images are taken. • Pt can be ___________________based on radiologist preference.

  29. 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 __________

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