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Rad (K)
URINARY TRACT
ANATOMY
KIDNEY :
I. Normal Size :
Right kidney smaller than left
3 3,5 lumbar vertebral body
Discrepancies of 1,5 cm or greater :
Positive factor in hypertension
RLL
SP
RK
Right Kidney
LK
Left Kidney
LK
Left Kidney
URETER
About
25 cm long
Retroperitoneal
In pelvic : Convex posteriorly and laterally
At ischial spine bend forward and medially
> lower portion of bladder
Diameter variable : more or less 6 mm
Three normal constriction :
- Ureteropelvic junction
- Cross external iliac artery
- Uretero vesical junction
URINARY BLADDER
* Lies in pelvic space
* Anterior : Pubic symphysis
* Posterior between bladder and rectum :
- Male : ductus deferens and seminal vesicles
- Female : Uterus and vagina
URETHRA
- Female
- Male
BLOOD SUPPLY
Renal artery : 1
st
RENAL FUNCTIONS :
Blood
plasma filtration
Selective tubular reabsorption
Tubular synthesis and excretion
Acid base regulation
Fluid volume regulation
Maintenance normal blood regulation
Erythropoiesis
INTRAVENOUS UROGRAPHY
Indications :
1. Elevated creatinin or BUN
2. Flank Pain
3. Pyuria
4. Microscopic / gross hematuria
5. Hypertension
6. Proteinuria
7. Dribbling
8. Frequency
9. Dysuria
DIAGNOSIS
1. Neoplasia
2. Urinary tract obstruction
3. Inflammation
4. Lithiasis
5. Cystic disease
6. Hypertension
PREPARATION
- Clear liquid diet
- Fasting after midnight
- Bowel cleansing
SKIN TEST OF CONTRAST MEDIUM
PLAIN FILM ABDOMEN
COMPRESSED OF ABDOMEN
(by rubber bag / tennis ball)
NORMAL UROGRAM :
FILMING SEQUENCE
1 minute : Nephrogram phase
Ureteral compression
5 minute : collecting system
15 30 minute : ureter
60 minute : bladder
Post voiding > - Passage of contrast agent
- Simptom of lower urinary tract
- Suspected stone
No ureteral compression :
- Suspected stone
- Acute abdomen
- Following abdominal surgery
- Large abdominal mass
- Aortic aneurysm
BNO IVP
5 MENIT
15 MENIT
30 MENIT
FULL BLAST
POST
VOIDING