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GIR Test 4 > B5.077 Human Urinary System > Flashcards

B5.077 Human Urinary System Flashcards

1
Q

components of the urinary system

A

kidney x 2
ureter x 2
urinary bladder
urethra

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2
Q

differences between male and female urinary systems

A

male: has prostate and longer ureter
female: shorter ureter and lies anterior to uterus and ovaries

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3
Q

functions of the urinary system

A

waste excretion via liquid

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4
Q

normal urine specs

A

0.4-2L daily
bladder volume = 300 - 400 mL
duration of urination = 21 +/- 13 s

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5
Q

polyuria

A

> 2.5 L /day

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6
Q

oilguria

A

0.1-0.4 L/day

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7
Q

anuria

A

< 0.1 L/day

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8
Q

overview of basic renal function

A
  1. removal of waste products and drugs from the body
  2. balance the body’s fluids
  3. regulation of plasma ionic composition
  4. regulation of plasma osmolarity
  5. regulation of plasma volume
  6. regulation of plasma hydrogen ion concentration (pH)
  7. release of hormones (renin) to regulate BP
  8. control production of RBCs
  9. engaged in vit D activation
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9
Q

what is a staghorn calculi

A

whole calix filled with kidney stone structure

need to be surgically removes

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10
Q

epidemiology of kidney stones

A

occur in 1/10 people at some point in their life

exhibit “time effect” aka take about 10 years to develop

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11
Q

what are kidney stones due to

A

increased excretion of stone forming components such as calcium, oxalate, urate, or cystine

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12
Q

resolution of kidney stones

A

< 4 mm have 80% chance of spontaneous passage

> 8 mm have 20% chance of spontaneous passage, require additional treatment

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13
Q

types of calcium stones and their prevalence

A
  1. calcium oxalate 80%
  2. calcium phosphate 5-10%
  3. uric acid 5-10%
  4. struvite 10-15%
  5. cysteine 1-2%
  6. xanthine (very rare)
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14
Q

calcium oxalate findings

A

acidic urine

X ray +

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15
Q

calcium phosphate findings

A

alkaline urine

x ray +

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16
Q

uric acid findings

A

acidic urine

x ray -

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17
Q

struvite findings

A

due to infection
infectious urine
x ray +

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18
Q

cystine findings

A

genetic defect

x ray +

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19
Q

xanthine findings

A

x ray -

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20
Q

what is PKD

A

polycystic kidney disease
an inherited genetic disorder which causes clusters of cysts to develop primarily within kidneys
kidney enlargement and loss of function over time
cysts may also occur in liver, seminal vesicles, and pancreas

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21
Q

type 1 PKD

A

autosomal dominant
PKD1 85%
PKD2 15%

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22
Q

type 2 PKD

A

autosomal recessive
PKHD1 incidence 1:20,000
carrier 1:70

23
Q

examples of kidney tumors

A
  1. renal cell carcinoma, 80-90%
  2. transitional cell carcinoma 5-10%
  3. renal sarcoma, <1%
  4. wilms tumor, nephroblastoma
  5. renal adenoma
  6. oncocytoma
  7. angiomyolipoma
24
Q

describe the structure of the ureter

A

muscular tube, 25-30 cm x 3-4 mm

layers: lumen, transitional cells, lamina propria, inner muscle (longitudinal), outer muscle (circular)

25
Q

muscle contraction in the ureter

A

occurs every 10-15 s

26
Q

prevalence of ureter duplication

A

0.8-0.9%

27
Q

discuss the ureter blood supply

A

receives blood from multiple arteries spanning from renal down to the vaginal
during surgical resection, have to be careful about severing blood vessels

28
Q

physiologic narrowings of the ureter

A
  1. uretopelvic junction (UPJ)
  2. crossing over the iliac vessels
  3. uretovesical junction (insertion into bladder wall)
    stones get stuck here
29
Q

what are some sources of UPJ obstruction

A
  1. intrinsic (developmental problem in muscle)
  2. ureteral hypoplasia
  3. abnormal or high insertion of ureter into the renal pelvis (angular junction)
  4. crossing lower-pole renal vessel (usually artery)
  5. rotation of the kidney
30
Q

consequence of UPJ obstruction

A

hydronephrosis

occurs in 1:1500 live births

31
Q

what is important to know about the orientation of the bladder in females

A

right next to cervix

common site of cervical cancer metastasis

32
Q

what is the trigone

A

area of muscle between 2 ureteral openings and neck of bladder
sensitive to bladder expansion

33
Q

neuronal control of sphincters

A 
internal = involuntary
external = voluntary
34
Q

layers on bladder histology

A

lumen, transitional epithelium, lamina propria, muscular layer, adventitia with fat

35
Q

why is the transitional epithelium of the bladder important

A

contains multinucleated umbrella cells which make glycans to seal the bladder surface
blocks toxins from getting into deep tissue

36
Q

what is the most important layer of the bladder

A

muscular layer

37
Q

run through the micturition reflex

A
  1. stretch receptors detect bladder filling and transmit afferent signals to spinal cord via pelvic nerve
  2. signals return to bladder from S2 and S3 spinal cord segments via parasympathetic fibers in pelvic nerve
  3. efferent signals excite detrusor muscles (contraction)
  4. efferent signals relax internal urethral sphincter, urine is involuntarily voided if not inhibited by brain
  5. for voluntary control, micturition center in pons receives signals from stretch receptors
  6. if it is time to urinate, pons returns signals to spinal interneurons that excite detrusor and relax internal sphincter, urine is voided
  7. if it is untimely to urinate, pons excites spinal interneurons that keep the external sphincter contracted to retain urine in bladder
  8. later, pons ceases these signals and external sphincter relaxes
38
Q

hypogastric nerve function

A

sympathetic control of bladder muscle and internal sphincter
relaxes bladder via NE
contracts internal sphincter via NE

39
Q

pelvic nerve function

A

parasympathetic control of bladder muscle

contracts bladder via Ach

40
Q

pudendal nerve function

A

somatic control of external sphincter

contracts sphincter via Ach

41
Q

medical examinations of the urinary bladder

A

urinalysis
cystoscopy
urodynamic testing

42
Q

what is urodynamic testing

A

series of tests of urination, usually done in a doctors office
urine flow, pressure, bladder capacity, and other measurements can help identify bladder problems

43
Q

components of a urodynamic test

A 
post void residual volume
multichannel cytometry
uroflowmetry
bladder neck EMG
urethral pressure profilometry
fluoroscopy of the bladder and bladder neck during voiding
44
Q

2 classes of urinary bladder tumors

A

papillary

nodular

45
Q

what is the prostate

A

walnut sized gland
7-16 grams
secretes alkaline fluid in semen

46
Q

types of benign prostatic hyperplasia

A

basal < stromal < grandular
basal = non nodular
stromal = CD34+ fibroblast cells, nodular
glandular = most common, nodular

47
Q

what is TURP

A

trans urethral resection of prostate
treatment for BPH
break off pieces of prostate and suck them out
not done much anymore

48
Q

more common BPH surgery

A

laser vaporization of the prostate

less bleeding and fewer complications that TURP

49
Q

epidemiology of prostate cancer

A

1 in 9 men will develop it (lower than in past due to reduced screening and reduced false positives)
60% are over 65
1 in 41 will die from it

50
Q

treatment options for prostate cancer

A
  1. surgery
  2. radiotherapy
  3. chemotherapy
  4. hormone therapy
  5. immunotherapy
  6. targeted therapy
51
Q

posterior urethra

A

within body

52
Q

anterior urethra

A

outside of body

53
Q

urethral stricture

A

can happen in males

narrowing of the urethra resulting in difficulty passing urine through it

54
Q

what are hypospadias

A

urine exiting body at wrong place

requires surgery to reroute urine and enable standing urination, correct bend, and make penis look normal

GIR Test 4 (20 decks)

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