-
increased risk of ug malformations with
- maternal renal disease
- drug use
-
two parts of the urogenital system
-
urinary and genital systems from
mesoderm
-
excretory ducts from urinary and genital systems enter the
cloaca
-
morphologic indicationi of gender at what week
9
-
three sets of excretory organs that develop in embryo
- pronephros- 1st set of kidneys nonfunctional
- mesonephros- function for a little but are replaced
- metanephros - permanant kidneys
-
when do permanant kidneys begin to develop
-
when does urine formation begin
- 11-12th week
- end of 1st trimester
-
kidney migration complete at what week
9
-
pelvic kidney
kidney remains in pelvic cavity
- can be seen with bladder dilitation
- may look like pelvic mass in females
-
fetal bladder is derived from the hindgut derivative know as the
urogenital sinus
-
genitalia begin to develop at what week?
complete by what week?
-
testes produce
androgens that cause masculinization of external genitalia
-
scrotal raphe
- line of fusion of labioscrotal folds
- in male
-
urethra and vagina open into
urogenital sinus
-
urogenital folds become
labiosacral swellins become
phallus becomes
- labia minora
- labia majora
- clitoris
-
when do you see kidneys and bladder
14weeks
-
when do you see stomach
12 weeks
-
differentiation of parts of kidney
18 weeks
-
renal pelvis size (a/p) up to third trimester
thrid tri to term
normal up to 5, 5-10 possibly normal, >10 anomoly
-
normal fetal bladder wall
- 2mm or less
- measured at level of umb artery
-
document gender with
- presense of other anomolies
- when gentalia is not male or female
-
testes visable in scrotal sac at what week
28
-
kidney urine production contributes to amniotic fluid volume
14-16 weeks
-
posterior urethral valve
- male fetus
- presence of valve in posterior urethra
-
ureterocele
associated with duplication
anechoic cystic structure in the bladder
-
large echogenic kideys could mean
- polycystic disease
- trisomy 13
- meckel-gruber syndrome
-
infantile polycystic kidney
oligohydraminos
-
-
renal agenesis
- maternal diabetes or cocaine useage
- unilateral or bilateral
- bilatera;- hypoplastic lungs
unilateral more common- good outcome- compensates for the other
-
potters syndrome
- bilateral renal agenesis
- (flat nose, recess chin, wide set eyes)
-
hypospadias
testicular agenesis or hypoplasia
-
horse shoe kidney
- ingerior poles fuse
- more common in males
- 1-4 in 1000
- associated with other anomolies- tris 18
- hydro, uti, kidney stones
-
renal ectopia
- kidneys lie outside normal position in renal fossa
- usually area of pelvis
-
crossed ectopia
- both on same side of body
- lies on opposite side of body from ureter insertion into bladder
- can be fused and on right side of body
- rarely in thoracic cavity on the left
-
exstrophy of bladder
- protrusion of posterior wall of bladder which contains the trigone and ureteric orfices
- defective closure of inferior abd wall in 4th week
- if midline think holoprosensencephaly
- males
- 1 in 30000
low cord insertion
-
cloacal exstrophy
bladder exstropied but al so large and small intestines
-
epispadias
abnormal congenital opening of urethra on top of penis
-
urachus
- allantois regresses to become fibrous cord or urachus
- ligament from apex of bladder to umbilicus
-
urachal abnormalities
- lumen of allantois persists while urachus forms and urachal fistula develops which causes urine to drain from bladder to umbilicus
- usually in teens
- males
- assoc with prune belly and post urethral valve syn
-
urachal cyst
- aka vesicoallantoic cyst
- lumen of allantois persists when urachus forms
-
potters sequence
- diseases associated with renal failure
- oligo
-
infantile polycystic kidney disease
- autosomal recessive poly cystic kidney disease
- effects fetal liver and kidneys
- small cysts in both kidneys and liver cysts
- tubular malformation and ectasia of distal collecting ducts
can be in meckle gruber or tris 13
usually dont survive the first year of life
-
multicystic dysplastic kidney
- MCDK
- multiple noncommunicating cysts of different sizes
- no normal renal tissue
- hypoplastic or abset artery
- atretic ureter and pelvis
- early obstruction or abnormal development- nonfunctional
- 1 in 3000 births
- males
- maternal diabetes
- bilatearl- lethal
- other kidney enlarges to compensate
-
adult dominant polycystic kidney disease adpkd
- cystic dilation of nephrons and collecting tubules
- defective gene for normal epithelial cell devel
- cysts in cortex and medulla- dont form and impair until adulthood
- 1 in 1000
- most common hereditary renal cystic disease recurrance of 50%
- cysts in liver spleen and panc
-
meckel gruber synd
- bilateral renal cysts
- but also encephalocele polydactly oligo
-
obstructive cystic dysplasia
- renal dysplasia second to kidney obstruction in 1-2nd trimester
- fibrous and cystic replacement of tissue
- severe bladder outlet obst urethral atresia or post valves
- 1 in 8000
hydro or hydroureter
bilateral hypoplastic lungs
-
key hole sign
- bladder outlet obstruction
- dialted bladder and urethra
-
UPJ
- ureteropelvic junction
- where ureter enters renal pelvis
- can be from stenotic ureter - male
- usually unilateral
-
UVJ
- ureterovesicle juntion
- where ureter enters bladder
- megaureter
aperistalic segment can contract and pass urine
- ectopic ureterocele
- males
- unilateral
-
megacystitis
obstruction at the urethra
-
pyelectasis
- dilated pelvis but not calyces
- associated with downs syndrome
-
hydronephrosis
dilated pelvis and calyces inresponse to blockage of urine
most common fetal anomoly
-
posterior urethral valve obstruction PUV
- hydroneph
- hydrour
- dilated bladder
- post urethra
- abnormal membrane from wolfian duct in post urethra
- urine cant pass
- most common in males and most common obstruct
- can put shunt to drain bladder- lungs can develop
bladder/kidney can rupture
-
anterior urethral valves
- males
- cong defect obstruction of ant urethral valve
- abnormal tissue growth causes obstruction?
- rare
- hydro and dilated ureters
- bladder rupture
-
prune belly syndrome
aka eagle barrett synd
- no rectus sheath - hypoplasia of abd wall
- dilated collecting system
- cryptorchidism
- muscle defects from dilated collecting system
- rare- males
- large urethra mimicing puv obstruction
- oligo- distended abdomen- smal thoracic cavity
- undestended testis
-
ureterocele
- cystic dilation of intravesical bladder
- associated with double collecting system
- ectopic ureter- medial and caudal
- lower pole prone to reflux
- upper pole prone to obstruction
- females- double collecting
- males- normal collecting
- can remove upperpole with surgery in double collect syst
-
most common renal tumor
mesoblastic nephroma aka hamartoma (benign)
- wilms- malignant- female- after 18 months
- neuroblastoma- first 18mths- adrenal=- right side
- renal tumors more common in males
- and are benign
-
hydrocele
- common
- males
- resolve by itself
- accumulation of serous fluid around testicle from communication with periotoneal cavity
-
cryptorchidism
- undestended testis
- desend through inguinal canal to enter scrotum before birth
-
hermaphroditism
male and female tissue present
-
hydrometrocolpos
- obstructed uterus and vagina
- atresia
- imperforate hymen
- double uterus and septate vagina
- cyst like mass posterior to bladder
-
fetal ovarian cysts
- from maternal horomones
- benign
- most common cystic mass
- most regress prenatally
- may cause torsion, rupture, or intestinal obstruction
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