Urogenital Imaging and Anatomy

Question 1

what is the round apex of the medullary pyramids called?

Answer 1

papilla

Question 2

how many nephrons are there in the kidney?

Answer 2

1 million

Question 3

what structure looks bubbly on a CT and is located medially to the liver?

Answer 3

transverse colon

Question 4

the left renal hilum is at what vertebral level?

Answer 4

L1

Question 5

the right renal hilum is at what vertebral level?

Answer 5

L1/L2

Question 6

benefits of kidney USS?

Answer 6

can see size of kidney

can see scarring, calculi and other abnormalities

Question 7

benefits of a kidney CT?

Answer 7

vascular problems can be seen

multiphasic assessment of kidney

Question 8

what abnormality is best seen in the pre-contrast phase of a CT?

Answer 8

renal calculi

Question 9

2nd CT kidney phase?

Answer 9

corticomedullary

Question 10

when is the best CT phase to look at the ureters?

Answer 10

5-15mins after contrast injection
phase 4 (excretory phase)

Question 11

name the 4 CT phases of kidney imaging

Answer 11

pre contrast
corticomedullary
nephrographic
excretory

Question 12

name the 3 fundamental spaces in the retroperitoneum and where they lie in relation to the kidney

Answer 12

anterior pararenal (anterior)
perirenal (immediately lateral)
posterior pararenal (posterolateral)

Question 13

when would you suspect CT-contrast induced nephropathy in a patient?

Answer 13

impairment in renal function 3 days after contrast injection

serum creatinine and urea raised

Question 14

how is contrast induced nephropathy prevented?

Answer 14

give saline and bicarb prior to CT

Question 15

name the small arteries that come off of the aorta after the renal arteries and before the iliac arteries?

Answer 15

lumbar arteries

Question 16

what renal condition presents with inital skin erythema and pain which then turns the skin “wood like”

Answer 16

nephrogenic systemic sclerosis

Question 17

how long are the ureters?

Answer 17

25-30cm long

Question 18

name the 3 different divisions of the ureter

Answer 18

abdominal
pelvic
intravesical

Question 19

another way of saying “where the ureter crosses the bifurcation of the aorta”

Answer 19

pelvic brim

Question 20

go-to renal imaging test?

Answer 20

CT urogram

Question 21

name for the posterior surface of the bladder

Answer 21

base

Question 22

name for the anterior surface of the bladder

Answer 22

apex

Question 23

what muscles lie inferolaterally to the bladder?

Answer 23

levator ani

obturator internus

Question 24

commonest imaging of the bladder?

Answer 24

USS

Question 25

bladder USS requires a fully empty bladder before imaging can be done: T or F

Answer 25

F, needs to be completely full so the outlines can be seen

Question 26

gold standard test to see leak through bladder wall tear?

Answer 26

cystography

Question 27

what 2 forms of contrast imaging are used for the bladder?

Answer 27

IVU

cystography

Question 28

gold standard test for local staging of bladder wall tumours?

Answer 28

MRI

Question 29

gold standard test for nodal and metastatic bladder disease staging?

Answer 29

CT

Question 30

when would a urethrogra be used?

Answer 30

suspected strictures, trauma, diverticula

Question 31

name the different divisions of the urethra in the male

Answer 31

prostatic
membranous
bulbous
penile/spongy

Question 32

USS is the primary imaging of choice for what genital structures

Answer 32

testes, scrotum, prostate biopsy

uterus, ovaries

Question 33

when is a hysterosalpingogram used?

Answer 33

infertile patient to check tubal patency

uterine abnormalities

Question 34

MRI is the imaging of choice for what genital structures?

Answer 34

prostate for cancer staging

double check abnormalities not picked up on USS eg in uterus