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NSG 2202 > A&P Test 5 > Flashcards

A&P Test 5 Flashcards

1
Q

Urine flows from

A

the kidney pelvis and is propelled through the ureters by perstalic action

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2
Q

The urge to void

A

Parasympathetic nerve response to stimulation by bladder wall stretch
-usually occurs after about 200-300 ml of urine has collected in the bladder

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3
Q

Motor nerves to external urinary sphincter

A

When activated, the sphincter remains contracted, allowing voluntary control over urination

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4
Q

Urinary retention

A
  • an inability to void due to blockage of the urethra
  • sufficient urine is being produced by kidneys but patient is unable to expel urine from the bladder
  • Causes can be mechanical, congenital or functional
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5
Q

Retention with overflow

A
  • Pt will complain of full bladder with frequent small amounts of urine
  • As the bladder overfills, the restraining capability of the sphincter is taxed
  • Small amount of urine will be released to reduce pressure to the level where the sphincter can control the flow of urine again
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6
Q

Normal Kidney Function

A
  • Electrolyte balance
  • Acid-base balance
  • Metabolic regulation
  • Body water regulation
  • Excretory regulation
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7
Q

Body water regulation:

A

Functional unit of the kidney is the nephron

  • normal GFR is 125 ml/min (180 L/day)
  • blood filtered across semipermeable membrane into Bowman’s capsule
  • 99% of water is reabsorbed
  • ADH and aldosterone help reabsorption in distal tubule-blood pressure regulation
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8
Q

Acid base balance-

A
  • Bicarb retention

* Eliminates excess H+ (acids)

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9
Q

Excretory regulation-

A
  • phosphates
  • uric acid
  • drug metabolites
  • nitrogenous waste products
  • urea
  • creatinine
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10
Q

Normal Renal BUN:

A

3-29

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11
Q

Normal Creatinine

A

0.5-1.4

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12
Q

Sodium:

A

135-148- more than 99% is reabsorbed

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13
Q

Potassium

A

3.4-5.3 Excrete >90% of total daily K intake

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14
Q

Cl

A

96-110

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15
Q

Calcium

A

8.5-10.4 activate vitamin D and assist with calcium absorption

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16
Q

Magnesium

A

1.4-2.5 excrete excess magnesium

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17
Q

Phosphorus

A

2.5- 4.5 excrete phosphorus

18
Q

Kidneys produce and release:

A

erythropoietin

19
Q

Erythropoietin stimulates

A

bone marrow to make RBC

  • vit D activation
  • RAA
20
Q

Chronic renal failure def:

A

Progressive, irreversible destruction of the nephrons of the kidneys

  • up to 80% of the GFR may be lost with few changes in the functioning of the body
  • remaining nephrons hypertrophy to compensate
  • gradual onset-months to years
21
Q

Stage 1

A

Signs of mild kidney disease with normal or better GFR- 90%

22
Q

Stage 2

A

mild kidney disease, decreased GFR 60-89%

23
Q

Stage 3

A

moderate chronic renal insufficiency- 30-59%

24
Q

Stage 4

A

severe chronic renal insufficiency 15-29%

25
Q

Stage 5

A

ESRD- less than 15%

26
Q

Gerontologic Considerations:

A
  • Physiological changes in vascular bed affect renal function
  • Arteriosclerotic changes in the renal arteries cause renovascular pathology
  • Blood pressure changes in the elderly effect renal function
  • Prostatic hypertrophy common in older males
  • Muscle tone decreases and the pelvic organs put increasing pressure on the bladder-stress incontinence
  • 20-30% decrease in size and weight between ages of 30-90 years
  • by 70 yrs, 30-50% of glomeruli have lost their function
  • Blood flow to/within kidneys decreases
  • Periurethral muscle fibers become less elastic, more prone to urethral irritation, urethral/bladder infections, urinary incontinence
27
Q

Common nephrotoxins

A
  • Anitbiotics- gentamycin, tobramycin, amphotericin, cephalosporins, vancomycin
  • Chemicals- methanol/gasoline, carbon tetrachloride, ethylene glycol, lead, lithium, mercury
  • Radiographic dye
  • Anesthetics
  • Drugs- NSAIDS, thiazides, dilantin, amphetamines, cisplatin
  • Other- transfusion reactions, crush injuries, heroin
28
Q

Urine studies-

A
  • I&O and daily weight- best information r/t fluid balance
  • Urinalysis-visual, chemo, micro
  • Creatinine clearance (urine and blood) calculation corrected for body size, appears to decrease with age
  • Bladder scan
  • Urine culture- clean catch, midstream
  • 24 urine (on ice or with preservative)
29
Q

Diagnostics:

A
  • KUB
  • Biospy (bladder or kidney)
  • Abdominal x-ray
  • Ultrasound (site)
  • CT/MRI (site)
  • Introvenous pyelogram
  • Cystoscopy
  • Urodynamics
  • IVP
  • Retrograde pyelogram
  • Cystogram/urethrogram
30
Q

Cystoscopy:

A
  • Interior inspect with a tubular lighted scope
  • general anesthesia
  • monitor bleeding post scope
31
Q

Male external genitalia

A

penis, scrotum

32
Q

Testes:

A

male reproductive organs

33
Q

Glands:

A

produce and secrete seminal fluid, seminal vesticles, prostate gland, cowper’s glands

34
Q

Ducts:

A
  • Epididmysis
  • Ductus deferens (vas deferens)
  • Ejaculatory duct
35
Q

The testes in conjunction with

A

the hypothalamus and pituitary secrete hormones which stimulate production and maturation of sperm- Follicle stimulating hormone (FSH)- interstitial cell stimulating hormone (ICSH or LH)- Testosterone- the major gonadal male hormone

36
Q

Spermatogenesis continues

A

throughout life

37
Q

Gerontologic Considerations:

A
  • Increase in prostate size
  • Decreased testosterone level and sperm production
  • Decreased scrotum muscle tone
  • decreased size and firmness of the testicles
  • erectile dysfunction and sexual dysfunction can occur as result of these changes
38
Q

Testes should feel

A

smooth and firm, oval and freely movable

39
Q

Seminiferous tubules

A

produce spermatozoa

40
Q

Epididymis

A

transport of mature sperm

41
Q

Vas deferens:

A
  • sperm are stored

* joins the ducts of the seminal vesicles at the base of the prostate gland to form the ejaculatory duct

NSG 2202 (22 decks)

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