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ANP 1107A > ANP 1107A Renal Lecture 4 > Flashcards

ANP 1107A Renal Lecture 4 Flashcards

1
Q

what is urinary retention?

A

inability to expel urine

  • after general anaesthesia, can also result from prostate hypertrophy
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2
Q

what is renal failure?

A

this happens when there are not enough functioning nephrons

  • filtrate formation has been reduced or stopped
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3
Q

what is stress incontinence?

A

anything that increases intra abdominal pressure, it’s a sharp push on the bladder and pushes a bit of urine out

  • an example is cough or sneeze
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4
Q

The regulation of micturition

A

3 things have to happen

  1. detruser muscle must contract
  2. Internal ureathral sphincter must open
  3. External urethral sphincter must open
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5
Q

what is incontinence?

A

inability to control urine voluntarily

  • due to a weakened pelvic floor muscles, pressure of pregnancy, nervous system problems
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6
Q

what are potential causes to renal failure?

A

repeated damaging kidney infections

physical injuries to kidneys

prolonged pressure on skeletal muscles

inadequate blood delivery to tubules

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7
Q

what is diarrhea?

A

nitrogenous wastes accumulate & blood becomes acidic

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8
Q

what is hemodialysis?

A

A technique in which an artificial kidney machine removes waste products from the blood

  • can be done in a clinic or at home – several times a week for 3-5 hr/session
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9
Q

what is peritoneal dialysis?

A

works by using the blood vessels of the peritoneal membrane

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10
Q

where can peritoneal dialysis be done at?

A

can be done at home or work

  • does not require weekly hospital visits
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11
Q

what happens in peritoneal dialysis?

A

dialysate is infused into the peritoneal cavity through a catheter

dialysatec omposed mostly of salts and sugar

encourages filtration through the peritoneum

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12
Q

what is removed?

A

extra fluid and wastes is drawn from the blood into dialysate which is then removed

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13
Q

what are the two types of peritoneal dialysis?

A

continuous ambulatory peritoneal dialysis (CAPD)

continuous cycling peritoneal dialysis (CCPD)

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14
Q

what are the two types of peritoneal dialysis?

A

continuous ambulatory peritoneal dialysis (CAPD)

continuous cycling peritoneal dialysis (CCPD)

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15
Q

what happens in continuous ambulatory peritoneal dialysis (CAPD)

A

happens usually 4-5 times/day

patient puts dialysate (about two litres) into peritoneal cavity through catheter

dialysate stays there for 4-5 hours before it is drained back into the back and thrown away.

there is a new bag of dialysate for each exchange

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16
Q

what happens in continuous cycling peritoneal dialysis (CCPD)

A

usually is done at home using a special machine called a cycler

number of cycles (exchanges) occur

each cycle is 1-1/2 long and exchanges occur during the night while the patient is asleep

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17
Q

what is the intracellular fluid compartment (ICF)

A

fluid within cells

= 60% total body fluid

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18
Q

what is the extracellular fluid compartment (ECF)

A

fluid outside of cells

= 40% body fluid

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19
Q

two components of extracellular fluid

A

plasma and interstitial fluid

plasma = 20% of ECF

Interstitial fluid = 80%

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20
Q

in ECF what is the chief cation?

A

sodium

Na+

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21
Q

in ECF what is the chief anion?

A

chloride

22
Q

water intake must equal

A

water output

23
Q

what are some examples of water intake?

A

liquids, foods, cellular metabolism

24
Q

what are some examples of water output?

A

~60% via kidneys; also lungs, skin, sweat, feces, lungs (add moisture to the air)

25
Q

what number are we trying to get plasma osmolarity?

A

usually 280-300 mOsm

26
Q

what happens if plasma osmolarity goes above 300 mOsm?

A

you feel thirsty - increase water intake

ADH stimulates renal water reabsorption

27
Q

what happens in decreased osmolarity?

A

thirst not stimulated

ADH secretion is not stimulated

28
Q

what happens in increase in osmolarity 1-2%?

A

reduce saliva production (makes you dry)

osmoreceptors of the hypothalamic thirst center lose water to the hypertonic ECG (depolarize and become irritable)

29
Q

what happens in decrease in plasma volume of 5-10%?

A

baroreceptors

  • also triggers the thirst mechanism
30
Q

what is dampening of thirst?

A

it begins once mucosa of mouth & throat moistened by water, it prevents overdrinking while water moves to ECF

31
Q

what are the obligatory water losses?

A

insensible water loss via lungs/skin

via the feces

minimal sensible urinary loss = 500 ml/day

32
Q

what is dehydration?

A

can be loss of only fluid or loss of fluid plus salts

consequence = cells swell

33
Q

what is hypotonic hydration?

A

dilutes out sodium in ECF, causing water to move into cells

34
Q

what is edema?

A

accumulation of fluid (including salts) in IF, but not inside cells

consequences = cells swell

35
Q

salt content of the body can vary due to?

A

diet, sweating, vomiting, etc.

36
Q

what does Na+ determine

A

determines both plasma osmolarity and blood volume

37
Q

sodium content of the body may change

A

but its concentration in ECF is monitored and usually remains stable due to immediate adjustments in water volume

38
Q

what happens to blood pressure after a salty meal?

A

blood pressure goes up

39
Q

what is aldosterone

A

most influential agent at level of kidney; acts slowly

40
Q

even without aldosterone what happens?

A

65% of Na+ in filtrate reabsorbed in PCT & 25% in loop of Henle; aldosterone secretion essential to life

41
Q

what is high aldosterone?

A

virtually all remaining Na+ (chloride co-transported) actively reabsorbed by DCT & collecting ducts

42
Q

2 pathways to aldosterone secretion

A

renin-angiotensin system

direct effect of high K+ or low Na+

43
Q

renin secretion in response

A

sympathetic ns

decreased filtrate osmolarity

decreased stretch bp

44
Q

what is Addison’s disease?

A

autoimmune

hyposecretion of aldosterone

  • excess loss of Na+ & water in urine
  • only pull back 90%
45
Q

water reabsorption in collecting ducts relies on?

A

relies on ADH secretion and will influence plasma sodium secretion

46
Q

what happens in low Na+?

A

excess fluid, reduced ADH secretion & dilute urine to unload water

47
Q

what happens in high Na+?

A

decreased blood volume and not enough water for correct osmolality, increased ADH secretion & reduced urine volume to move water back into bloodstream

48
Q

what is atrial natriuretic factor released by

A

released by cells in the atria of heart when bp is elevated

49
Q

what do potent diuretic & natriuretic hormone do

A

(i) inhibits Na+ reabsorption by DCT and collecting duct

(ii) decrease released of ADH, renin, and aldosterone

(iii) induces vasodilation overall effect is to reduce bp

50
Q

what is pressure diuresis

A

when blood pressure/volume increases, sympathetic output to kidney from cardiovascular centre

51
Q

what is the result of pressure diuresis

A

dilation of afferent arterioles and increase GFR

ANP 1107A (5 decks)

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