519459
Description
Flashcards by ecmarchese, updated more than 1 year ago
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Created by ecmarchese
almost 12 years ago
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| Question | Answer |
| May arise from aorta, above or below the main renal arteries | Accessory renal arteries |
| Where will the accessory renal arteries pass on the right side? | Anterior to the IVC |
| Is the RRV shorter than the LRV? | Yes |
| Where does the LRV course? | Between the SMA and aorta |
| What is the normal arterial flow for the renals? | Low resistant with continuous diastolic flow |
| What is the normal venous flow for renals? | Phasic, varies with respirations |
| Trace the arterial flow in the renals? | renal arteries, segmental arteries, inter lobar arteries, accurate arteries, inter lobular arteries, renal parenchyma |
| The renal arteries enter the renal hilum and divide into? | Segmental arteries |
| The segmental arteries branch into? | Inter lobar arteries |
| Inter lobar arteries course around the renal pyramids giving rise to the ? | Accurate arteries |
| The accurate arteries branch into the? | Inter lobular arteries |
| What do the inter lobular arteries supply? | Renal parenchyma |
| Trace the venous flow of the renals? | Inter lobular v, arcuate v, inter lobar v, segmental v, renal v, IVC |
| What are the indications for having a renal vascular duplex exam? | Suspected renal artery stenosis, renovascular HTN, vasospastic disease, serial exams after renal transplant. |
| What pt prep do you have to have for a renal exam? | No 4-6 hrs |
| What transducer is utilized for a renal exam? | 2.5-5 MHz |
| What is the protocol for a renal exam? | Aorta, renal |
| What do obtain when you look at the aorta? | Note any problems, obtain PSV prox mid and distal |
| What is the most important aortic PSV? | PSV distal to SMA proximal renal artery origin |
| What should the Doppler angle be in a renal duplex exam? | Less than 60 |
| What do you obtain when you look at the renals? | Document size of kidneys (lxwxh), measure cortical thickness |
| What is the average length of the kidneys? | 10-12 cm |
| Should the both kidneys measure the Same? | No, but they should be within 1 cm of each other |
| What is another name for the renal artery origin? | Ostium |
| Where do you obtain the PSV and EDV in the renal parenchyma? | Superior pole, inferior pole |
| What is the formula used to calculate the renal to aortic ratio (RAR)? | Renal PSV/ Aortic PSV (needs to be less than 3.5 and calculate for both sides) |
| RAR < 3.5 | 0-59% |
| RAR > 3.5 | 60-90% |
| Renal values with aortic disease will present with what measurements? | <180 cm/s negative for RAS, >180 cm/s positive for RAS |
| How do you calculate the Resistive Index for the renals? | calculate from renal parenchyma waveform, psv-edv/psv |
| What are the guidelines for the RI in the renals? | RI<.7= normal, RI greater than or equal to .7 abnormal |
| What is a common cause of HTN? | Renal Artery Stenosis |
| What is the most important sonographic diagnostic tool? | RAR |
| What test is used to definitively determine Renal Artery Stenosis? | Angiography |
| If you are off 2 degrees over 60, how much % of error will you have? | 10% |
| What is the purpose of evaluating parenchymal flow patterns? | helps to evaluate intrinsic renal vascular disease when the entire renal artery can not be visualized |
| What will parenchymal disease result in? | increase resistance to flow (End diastolic portion of the waveform will decrease as disease increases) |
| Where are doppler wave forms obtained for parenchymal flow? | arcuate/ interlobular arteries |
| What is the second most common cause of renovascular HTN? | Fibromuscular Dysplasia |
| What are some characterstics of fibromuscular dysplasia? | increased velocities with normal wave forms due to constrictions and dilations |
| pt presents with pain and hematuria, and they have an enlarged, hypoechoic kidney | Acute Renal Vein Thrombosis |
| pt is asymptomatic, and they have atrophic, hyperechoic kidney | Chronic Renal Vein Thrombosis |
| known as a renal transplant | Renal Allograft |
| The donor kidney is placed in the ______ anterior to the _____? | iliac fossa, psoas muscle |
| In a Renal Allograft, where is the donor artery anastomosed? | internal or external iliac artery |
| In a Renal Allograft, where is the Renal Vein anastamosed? | internal iliac vein |
| What are some non-specific signs of allograft rejection? | incease in renal size/volume, increase in cortical echogenicity and thickness, enlarged pyramids with low echogenicity, low echogenicity with renal sinus, hypoechoic areas within the renal parenchyma |
| How do you diagnose a Renal Allograft rejection? | increased RI, RI of >.9 is 100% positive for rejection, RI <.7 is likely |
| After transplant, 25% of pts develop HTN | Renal Artery Stenosis |
| Rare complication due to surgical technique | Renal Artery Stenosis |
| Rare, biopsy is usually involved | Pseudoaneurysm and AV fistula |
| What are 4 types of peritransplant fluid collections? | Hematoma, Urinoma, Lymphocyte, Abscess |
| These are generally small and regress spontaneously, and they appear sonographically different depending on the age of the bleed. | Hematoma |
| These commonly develop 1-2 weeks after transplant, and have a anechoic appearance that will increase in size | Urinoma |
| These are the most common fluid collection that cause hydronephrosis, are a anechoic mass located medial to TX, and frequently contain septations | lymphocyte |
| These take a few weeks to develop after surgery, and require drainage, and appear as irregular complex systic masses | Abscess |
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