DMS Final Exam (Kwisten) Questions With Complete
Solutions
Correct Answers kidney
- develop in pelvis together
-at 12-15 weeks gestation, kidneys ascend to flanks and split
-at ascent, urine production begins Correct Answers
embryology of kidney
- rare
- on transverse images tail may appear enlarged Correct
Answers partial duplication of tail
-both should be similar in size and appearance
-urine production
-regulation on acid base balance
-regulation of serum electrolytes
-production of erythropoietin
-renin angiotensin system Correct Answers renal physiology
-cortex is homogeneous, hypoechoic to liver or spleen,
hyperechoic to medulla
- sinus is the most echogenic structure within kidney due to fat
content
-medulla is anechoic at pyramids
-true capsule is the only layer seen on ultrasound, appears as
echogenic line outlining kidney Correct Answers sonographic
appearance of kidney
,-cortical medullary differentiation (clear cortex and clear
medullary)
- cortex should be hypoechoic to liver
-pyramids should be hypoechoic to cortex
-no hydronephrosis
- no renal masses or calculi Correct Answers what are we
looking for in renal exam
-flank pain
-hematuria
- follow up on previously identified pathology
- classification of mass (cystic or solid)
- post surgical complication (transplants)
- interventional guidance (aspiration or biopsy)
- post traumatic injury Correct Answers indications for renal
ultrasound
-hollow, muscular organ (contracts and expands)
- located between rectum and pubic symphysis (bone) Correct
Answers bladder anatomy
-paired, retroperitoneal structures
- bean shaped
-positioned between 1st and 3rd lumbar vertebra
-right kidney slightly lower than left Correct Answers Renal
anatomy
-right/left subphrenic spaces
-posterior cul-de-sac
-subhepatic space
-lesser sac
,-right/left paracolic gutters Correct Answers peritoneal spaces
*synthesize blood proteins
filter and reservoir blood products
destruction of RBC's
destruction of microorganisms Correct Answers main function
of spleen
< 50 mL
measure length in sag
measure width, AP in trans Correct Answers normal post void
residual (PVR)
<2mm Correct Answers size of main pancreatic duct
<3mm Correct Answers what is the average wall thickness of
the gallbladder
<4mm
most likely wont see CHD unless abnormality Correct Answers
CHD measurement
1 cm Correct Answers both kidney's should measure to be
within ____ of each other
1 cm Correct Answers cortical thickness should be greater than
1. arterioles communicate with the capillaries to transfer blood
to venules
, 2. venules travel via interlobular veins to acuate veins to
interlobar veins
3. interlobar veins merge to form the main renal vein at the
hilum which exits the kidney
4. main renal vein drains into IVC Correct Answers kidney
drainage
1. supplied by renal artery (aorta branch)
2. renal artery divides into 4-5 segmental arteries within the
kidney at the hilum (which travel through sinus)
3. segmental arteries divide into interlobar arteries that travel
alongside pyramids
4. interlobar arteries travel beyond the pyramids into the cortex
to become arcuate arteries
5. arcuate arteries become even smaller to enter renal glomeruli
to become interlobular arteries which supply the arterioles
Correct Answers kidney supply
1. true capsule
2. perirenal fat
3. Gerota's capsule Correct Answers 3 outer layers of the
kidney
12-15cm Correct Answers pancreas length
1200-1600g or 3.5lb Correct Answers how much does the liver
weigh?
15-17cm Correct Answers what is the length of the liver?
150-200g Correct Answers spleen weight
Solutions
Correct Answers kidney
- develop in pelvis together
-at 12-15 weeks gestation, kidneys ascend to flanks and split
-at ascent, urine production begins Correct Answers
embryology of kidney
- rare
- on transverse images tail may appear enlarged Correct
Answers partial duplication of tail
-both should be similar in size and appearance
-urine production
-regulation on acid base balance
-regulation of serum electrolytes
-production of erythropoietin
-renin angiotensin system Correct Answers renal physiology
-cortex is homogeneous, hypoechoic to liver or spleen,
hyperechoic to medulla
- sinus is the most echogenic structure within kidney due to fat
content
-medulla is anechoic at pyramids
-true capsule is the only layer seen on ultrasound, appears as
echogenic line outlining kidney Correct Answers sonographic
appearance of kidney
,-cortical medullary differentiation (clear cortex and clear
medullary)
- cortex should be hypoechoic to liver
-pyramids should be hypoechoic to cortex
-no hydronephrosis
- no renal masses or calculi Correct Answers what are we
looking for in renal exam
-flank pain
-hematuria
- follow up on previously identified pathology
- classification of mass (cystic or solid)
- post surgical complication (transplants)
- interventional guidance (aspiration or biopsy)
- post traumatic injury Correct Answers indications for renal
ultrasound
-hollow, muscular organ (contracts and expands)
- located between rectum and pubic symphysis (bone) Correct
Answers bladder anatomy
-paired, retroperitoneal structures
- bean shaped
-positioned between 1st and 3rd lumbar vertebra
-right kidney slightly lower than left Correct Answers Renal
anatomy
-right/left subphrenic spaces
-posterior cul-de-sac
-subhepatic space
-lesser sac
,-right/left paracolic gutters Correct Answers peritoneal spaces
*synthesize blood proteins
filter and reservoir blood products
destruction of RBC's
destruction of microorganisms Correct Answers main function
of spleen
< 50 mL
measure length in sag
measure width, AP in trans Correct Answers normal post void
residual (PVR)
<2mm Correct Answers size of main pancreatic duct
<3mm Correct Answers what is the average wall thickness of
the gallbladder
<4mm
most likely wont see CHD unless abnormality Correct Answers
CHD measurement
1 cm Correct Answers both kidney's should measure to be
within ____ of each other
1 cm Correct Answers cortical thickness should be greater than
1. arterioles communicate with the capillaries to transfer blood
to venules
, 2. venules travel via interlobular veins to acuate veins to
interlobar veins
3. interlobar veins merge to form the main renal vein at the
hilum which exits the kidney
4. main renal vein drains into IVC Correct Answers kidney
drainage
1. supplied by renal artery (aorta branch)
2. renal artery divides into 4-5 segmental arteries within the
kidney at the hilum (which travel through sinus)
3. segmental arteries divide into interlobar arteries that travel
alongside pyramids
4. interlobar arteries travel beyond the pyramids into the cortex
to become arcuate arteries
5. arcuate arteries become even smaller to enter renal glomeruli
to become interlobular arteries which supply the arterioles
Correct Answers kidney supply
1. true capsule
2. perirenal fat
3. Gerota's capsule Correct Answers 3 outer layers of the
kidney
12-15cm Correct Answers pancreas length
1200-1600g or 3.5lb Correct Answers how much does the liver
weigh?
15-17cm Correct Answers what is the length of the liver?
150-200g Correct Answers spleen weight
