BLOCK III - UNIT 2. Renal System Flashcards
What is the Outer fibrous covering of kidney?
Renal Capsule
What is a Basin‐like structure that drains urine into the kidneys.?
Renal Pelvis
What is the name of the Parenchyma containing the nephrons?
Renal Cortex
What is the Inner part of the kidney that contains the renal pyramids that empty into the renal calyx?
Renal Medulla
What are the functions of the kidneys?
• Fluid balance- the amount of water excreted through urine.
• Electrolyte imbalance- monitoring electrolytes such as potassium, sodium, magnesium,
phosphorus, and calcium
• pH balance (acid‐base)- The kidneys help maintain the acid–base balance by excreting hydrogen ions into the urine and reabsorbing bicarbonate from the urine.
• Blood pressure regulation- Healthy kidneys produce a hormone called aldosterone to help the body regulate blood pressure. Aldosterone is produced by the adrenal glands that sit on top of the kidneys.
• Elimination of metabolic wastes and other toxins
• Hormone production and activation (Renin, Erythropoietin & Vitamin D)
What does the kidneys produce to help the body regulate blood pressure?
aldosterone.
Aldosterone is produced by the adrenal glands that sit on top of the kidneys.
How do the kidneys help control the acid base balance?
by excreting hydrogen ions and generating bicarbonate that helps maintain blood plasma pH within a normal range.
What is the process by which the kidneys filter the blood, removing excess wastes and fluids.?
Glomerular Filtration
What calculation determines how well the blood is filtered by the kidneys, which is one way to measure kidney function?
Glomerular Filtration Rate (GFR)
A twitch of the face muscles that occurs when gentle tapping of a patient’s cheek in front of the ear is called?
Chvostek Sign
this is a clinical finding associated with hypocalcemia.
What is it called when a carpopedal spasm of a hand or wrist occurs when a blood pressure cuff inflated greater than their systolic blood pressure for 2 ‐3 minutes?
Trousseau Sign
What is a test of latent tetany to determine if an individual has hypocalcemia?
Trousseau Sign
What is a sign of kidney trauma?
Grey Turners Sign
a purplish discoloration present on the flank.
What should be the average UOP?
Should be at least 0.5mg/kg/hr. or average 30mL per hour.
When using a bladder scanner, what’s does a high number mean?
High number means retention (>200ml) means inadequate bladder emptying or obstruction.
What type of imaging can we do for the renal system?
Bladder Scan
Ultrasound
X‐ray (KUB)
CT Scan
CT Angiogram
MRI
Intravenous Pyelogram (IVP)
What is BUN?
Urea nitrogenous waste that forms when proteins are broken down
What is creatinine?
The product that forms when creatinine in the muscles are broken down
What’s responsible for water regulation, neurotransmission, electrical gradient positively charged ion, heart rate and rhythm control?
Sodium
A positively charged ion.
What’s the normal range for NA?
Sodium- 135-145 mEq/L
What is the Dx?
Hypernatremia
What’s the Dx?
Hyponatremia
What causes Hypernatremia?
caused by a decrease in total body water relative to electrolyte content.
What causes hyponatremia?
caused by an increase in total body water relative to electrolyte content or sodium loss.
What does potassium do?
Muscle contraction, neurotransmission, heart rate and rhythm regulation.
*T wave amplitude.
What is a normal potassium?
3-5.0 mmol/L
What’s the Dx?
Hyperkalemia
What is the Dx?
Hypokalemia
Severe hypokalemia is Potassium less than?
2.5 mmol/L
What does Calcium do?
Muscle contraction, neurotransmission, heart rate and rhythm regulation.
- bone composition.
What is a normal range for Calcium?
8.5-10.5 mg/dL
What’s the Dx?
Hypercalcemia
What’s the Dx?
Hypocalcemia
What does magnesium do?
Muscle contraction (especially cardiac), blood pressure regulation.
*Often correlates with calcium.
What is a normal range for Magnesium?
1.8-2.2 mg/dL
What’s the Dx?
Hypermagnesemia
What’s the Dx?
Hypomagnesemia
What does phosphate do?
Bone composition;
*balances/ inverse relationship with calcium.
What is a normal range for phosphate?
2.5-4.9 mg/dL
What’s the Dx?
Hyperphosphatemia
What’s the Dx?
Hypophosphatemia
What are 3 types of AKI?
Prerenal, Intrarenal and Postrenal
What is it called when a sudden reduction in blood flow to the kidney causes a loss of kidney function?
prerenal acute kidney injury
- nothing wrong with the kidney itself
What is it called when direct damage to the kidneys causes a sudden loss in kidney function?
intrinsic acute kidney injury
What is it called when an obstruction in the urinary tract below the kidneys causes waste to build up in the kidneys?
Postrenal acute kidney injury
What’s the name of a kidney disorder involving damage to the tubule cells of the kidneys, which can lead to acute kidney failure.
Acute Tubular Necrosis (ATN)
What is often caused by a lack of blood flow and oxygen to the kidney tissues and
may also occur if the kidney cells are damaged by a poison or harmful substance?
Acute Tubular Necrosis (ATN)
What is the most common cause of myoglobin release causing rhabdomyolysis?
Muscular trauma
What’s the name of Kidney failure caused by the release of creatinine and myoglobin from damaged muscle cells.?
Rhabdomyolysis
Myoglobin in large quantities causes direct damage to what?
tubular cells
You have a patient with Dark brown tea colored urine, High CK lab values, Decreased urine output, and Hyperkalemia. What is the Dx?
Rhabdomyolysis
What is Urosepsis?
Sepsis caused by infections of the urinary tract.
What is cystitis? And what causes it?
Inflammation of the bladder, can be cause by bacteria or some drugs
What is Pyelonephritis? What happens if it’s led untreated?
Inflammation of the renal pelvis, If left untreated can lead to scarring in the tissues
What is Glomerulonephritis? And what causes it?
Damage to the tiny filters inside your kidneys, Usually due to an immune response
What is Interstitial nephritis? And what causes it?
Inflammation of the spaces between tubules of the kidney
Caused by proton pump inhibitor, antibiotics, NSAIDS,
autoimmune disorders, hypokalemia, and hypocalcemia.
Kidneys are Supplied by what?
Supplied by the aorta through the renal arteries.
How do the kidneys drain?
Drain to the inferior vena cava through the renal veins.
Whats Urine Formation?
Helps the body to eliminate liquid waste called urea, and to keep chemicals, such as potassium and sodium, and water in balance.
Urea is produced when foods containing protein are broken down in the body.
What is The process that moves solutes and water out of the filtrate and back into your bloodstream?
Tubular Reabsorption
Urine is formed through processes within the kidney called what?
glomerular filtration, tubular reabsorption, and secretion.
*Urine Formation
What’s Useful for calculating FENa (Fractional Excretion of Sodium)?
Urine electrolytes
• Calculation used to estimate sodium loss in the urine, in relation to sodium in the serum (bloodstream).
What Helps to determine if renal failure is pre‐renal, intrinsic, or post renal pathology?
Urine electrolytes
What is?
• Useful in comparing to serum results.
• High and low levels can have a wide variety of differentials.
Urine electrolytes
Nephrons use 4 mechanisms to cleanse blood and make urine as a biproduct, what are they?
Filtration, Reabsorption, Secretion and Excretion