Urinary System

1
Chapter 17

• Urinary System
• IVP(U)

2
Urinary System

• ________________
• ________________
• 1 Urinary bladder
• 1 Urethra

3
Kidneys

• _______________ Abdominal organs
• ________________ Organs
• Between _________________________
• T11/12 and L3

4
Kidneys

• Angled _______________
• Right kidney ________________
• Each kidney has Suprarenal (adrenal) gland
• Moves with _______________.

5
Kidney Blood supply

• Kidneys ________________,
• ____________________branches into renal arteries
• At rest 25 of the blood the heart pumps passes
  through kidneys. 1 L. 180 L/day
• ____________empty into the ________ to return
  blood to _______________

6
Kidney Function

• To produce ________________
• Removes ________________
• Regulates water levels
• Regulates _________________________
• ________________
• Urine production

7
Kidney Anatomy

• __________________
• Outermost surface
• ________________
• Under Fibrous capsule
• ______________
• Composed of renal pyramids
• ________________
• Spaces between renal pyramids

8
Kidney Anatomy

• ________________
• Collecting area opened by renal papilla.
• ________________
• Off of minors. Collecting area.
• ________________
• Off of major calyces and empty into ureter.

9
Ureter

• Transport urine from ________________
• 1mm 1cm _______________

10
Ureter Constriction

• ____________________
• Renal pelvis to ureter
• ___________________
• Iliac blood vessels cross ureters
• ____________________
• Ureter joins bladder

11
Urinary Bladder

• Musculomembranous sac that stores urine for
  expulsion.
• 3 openings in the _____________
• _____________
• _____________
• Total bladder capacity 350 to 500 ml

12
Bladder locations

• Female
• Posterior to ________________________
• Male
• Posterior to ________________________

13
IVP Patient Prep

• Ideal
• NPO ______________
• Bowel prep
• __________prior to the start of the exam

14
Prior to Injection

• Verify any _______________________
• Make sure a ________________is aware you are
  injecting.
• Amount based on department protocol.

15
Prior to Injection

• If the patient has a urinary catheter
  ___________________
• __________________

16
IVU Imaging

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

17
Scout and delayed films

• Position as routine _______________
• Mark films to indicate ________________

18
Nephrogram

• Taken ____________________
• 11 x 14 XW
• Center between ____________________. Mid sagittal
• Done to show the ___________of Kidneys

19
Nephrotomograms

• If per protocol
• Center same as nephrogram
• Typical cuts __________________
• Shows kidneys at various levels

20
RPO

• ________________
• Center at ____________and mid line
  (_____________________)
• Shows _________________
• Shows ______________unobstructed from spine

21
LPO

• _____________
• Center at ___________and mid line
  (_______________________)
• Shows ______________
• Shows ________________unobstructed from spine

22
Prone

• Position as per Prone Abdomen

23
Upright Post Void

• Have the ________________-
• Position as per KUB but _________________
• __________________must be visualized
• Shows emptying of bladder and any ______________.

24
Other considerations

• Compression may be used
• Position on _________________

25
Other Urinary System Imaging

• _________________________
• ________________________
• VCUG
• ________________________
• OR Procedure

26
Cystogram

• Done to Image the ______________
• Insertion of a Urethral Catheter (Foley)
• Bladder filled with ___________________
• Usually 150ml or more
• Extension tube from catheter to contrast
• Hung on IV pole. ______________to fill bladder do
  not force.

27
VCUG

• Images the __________________
• Following routine Cystogram
• Catheter is removed and the pt is _______________

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 _______________.
• Urologist will insert a scope into the bladder.
  Then via a catheter contrast is injected into the
  ______________
• Images are taken at urologists discretion.
  Typically KUB.