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Pathophysiology > Ch 18 urinary > Flashcards

Ch 18 urinary Flashcards

1
Q

what are the seven functions of the urinary system

A

removes metabolic wastes
removes hormones from the body
removes drugs and other foreign material from the body
regulates water, electrolyte, and acid-base balance
secretes erythropoietin
activates vitamin D
regulates blood pressure through the renin-angiotensin-aldosterone system

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2
Q

what is the path of the urinary system

A

kidneys to ureters to urinary bladder to urethra

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3
Q

functional units of the kidneys

A

nephrons

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4
Q

how many nephrons does each kidney have?

A

over a million

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5
Q

what are the two parts of the renal corpuscles

A

glomerulus and Bowman capsule

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6
Q

what are the four parts of the renal tubules

A

proximal convoluted tubule, Loop of Henle, distal convoluted tubules and collecting duct

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7
Q

how does urine form

A

through filtration and reabsorption

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8
Q

where does filtration take place

A

in the renal corpuscles

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9
Q

what happens during filtration

A

large volumes of fluid passes from glomerular capillaries into the tubule or Bowman capsule

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10
Q

what are the types of fluids that are filtered

A

wastes, nutrients, electrolytes, and other dissolved substances

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11
Q

what remains in the blood during filtration

A

cells and proteins

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12
Q

what does reabsorption control

A

pH and electrolytes

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13
Q

what is reabsorbed

A

essential nutrients, water and electrolytes

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14
Q

reabsorption takes place in what

A

the peritubular capillaries

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15
Q

what are the three transport mechanisms for reabsorption

A

active transport, co-transport and osmosis of water

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16
Q

where is the most water reabsorbed

A

proximal convoluted tubules

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17
Q

what maintains homeostasis during reabsorption

A

nutrients and electrolytes

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18
Q

where is glucose reabsorbed

A

proximal convoluted tubules

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19
Q

what hormones are involved in reabsorption

A

antidiuretic hormone, aldosterone and atrial natriuretic hormone

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20
Q

Antidiuretic hormone is secreted by what

A

the posterior pituitary

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21
Q

where does reabsorption of water take place in the antidiuretic hormone

A

in distal convoluted tubules and collecting ducts

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22
Q

aldosterone is secreted by what

A

the adrenal cortex

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23
Q

during aldosterone, sodium is reabsorbed in exchange for

A

potassium or hydrogen

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24
Q

where is atrial natriuretic hormone come from

A

the heart

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25
Q

what does the atrial natriuretic hormone reduce

A

sodium and fluid reabsorption

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26
Q

how does blood flow through the kidney

A

renal artery to interlobar artery to arcuate artery to interlobular artery to afferent arteriole to glomerular capillaries to efferent arteriole to peritubular capillaries to interlobular vein to arcuate vein to interlobular vein to renal vein

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27
Q

what are the three autoregulation and hormone control pressure in the glomerular capillaries

A

vasoconstriction of afferent arteriole, dilation of afferent arteriole, and vasoconstriction of the efferent arteriole

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28
Q

what does vasoconstriction of the afferent arteriole do

A

decreases the glomerular pressure which decreases filtrate

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29
Q

what does dilation of afferent arteriole do

A

increases pressure of the glomerulus which increases filtrate

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30
Q

what does vasoconstriction of the efferent arteriole do

A

increases pressure in glomerulus which increases filtrate

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31
Q

what are the three controls of the arteriolar constriction

A

autoregulation, sympathetic nervous system and renin

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32
Q

what is autoregulation

A

local adjustment in diameter of arterioles

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33
Q

autoregulation maintains what

A

normal filtration rate

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34
Q

autoregulation is made in response to what changes

A

in blood flow in the kidneys

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35
Q

what does the sympathetic nervous system do

A

increases vasoconstriction in both arterioles

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36
Q

what is renin secreted by

A

juxtaglomerular cells

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37
Q

when is renin secreted

A

when blood flow to afferent arteriole is reduced

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38
Q

what is closely related to kidney function

A

blood pressure

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39
Q

what stimulates aldosterone secretion

A

angiotensin

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40
Q

angiotensin does what

A

increases reabsorption of sodium and water to increase blood volume and pressure

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41
Q

loss of voluntary control of the bladder

A

incontinence

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42
Q

involuntary urination by child age older than four years

A

enuresis

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43
Q

what is related to enuresis

A

developmental delay, sleep pattern, or psychosocial aspect

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44
Q

what are the four types of incontinence

A

overflow incontinence, incontinence, enuresis, and stress incontinence

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45
Q

stress incontinence is more common in who

A

women

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46
Q

stress incontinence has to do with what four things

A

coughing, lifting, laughing and multiple pregnancies

47
Q

stress incontinence does what

A

increases intra-abdominal pressure and forces urine through the sphincter

48
Q

overflow incontinence has to do with what three things

A

older adults, incompetent bladder sphincter, and spinal cord injuries or brain damage

49
Q

why do older adults have overflow incontinence problems

A

weakened detrusor muscle may prevent complete emptying the bladder

50
Q

interference with what two things controls the bladder (think spinal cord and brain)

A

CNS and ANS

51
Q

neurogenic bladder may be what

A

spastic or flaccid

52
Q

what does retention mean

A

inability to empty the bladder

53
Q

retention may be accompanied by what

A

overflow incontinence

54
Q

retention may follow what

A

anesthesia

55
Q

spinal cord injury blocks what during retention

A

micturition reflux

56
Q

lots of protein, blood, bacteria and pus has what appearance of urine

A

cloudy

57
Q

hematuria, excessive bilirubin, or highly concentrated urine has what appearance

A

dark color

58
Q

infection or result from certain dietary components or medication does what to urine

A

unpleasant or unusual odor

59
Q

what is the pH of urine

A

between 4.5 and 8

60
Q

what is the normal specific gravity of urine

A

1.010 to 1.050

61
Q

what is the normal appearance of urine

A

straw colored with mild odor

62
Q

what does hematuria mean

A

blood in the urine

63
Q

what does small amounts of blood in the urine mean

A

infection, inflammation, or tumors in urinary tract

64
Q

what does large amounts of blood in the urine mean

A

increases glomerular permeability or hemorrhage

65
Q

what does proteinuria or albuminuria mean

A

elevated protein in the urine

66
Q

what does bacteriuria mean

A

bacteria in the urine

67
Q

what does bacteria in the urine indicate

A

infection in the urinary tract

68
Q

what do urinary casts indicate

A

inflammation of the kidney tubules

69
Q

what does specific gravity indicate

A

ability of tubules to concentrate urine

70
Q

dilute urine with normal hydration

A

low specific gravity

71
Q

concentrated urine with normal hydration

A

high specific gravity

72
Q

what type of specific gravity is related to renal failure

A

high

73
Q

what are found when diabetes mellitus is not well controlled

A

glucose and ketones

74
Q

what does elevated serum urea and serum creatinine levels indicate

A

failure to excrete nitrogen wastes from protein metabolism

75
Q

what does elevated serum urea and serum creatinine levels are caused by

A

decreased GFR

76
Q

what does metabolic acidosis indicate

A

decreased GFR

77
Q

what does metabolic acidosis decrease

A

serum pH and serum bicarbonate

78
Q

metabolic acidosis has to do with what

A

failure of tubules to control acid-base balance

79
Q

anemia indicates what

A

decreased erythropoietin secretion and or bone marrow depression due to accumulated wastes

80
Q

low hemoglobin levels has to do with what

A

anemia

81
Q

electrolytes depend on what

A

related fluid balance

82
Q

used for diagnosis of post-streptococcal glomerulonephritis

A

antistreptolysin O or antistreptokinase titers

83
Q

elevated renin levels indicate what

A

kidney as a cause of hypertension

84
Q

what are the blood test that can be run on urine

A 
creatinine and BUN levels
metabolic acidosis
anemia
electrolytes
antibody level
elevated renin levels
85
Q

culture and sensitivity studies on the urine specimens help do what

A

select appropriate drug treatments

86
Q

used to visualize structures and possible abnormalities, flow patterns, and filtration rates

A

radiologic test

87
Q

visualizes lower urinary tract and may be used to perform biopsy or remove kidney stones

A

cystoscopy

88
Q

what are the tests used for clearance

A

creatinine or insulin

89
Q

used to acquire tissue specimens

A

biopsy

90
Q

used to remove excess sodium ions and water from the body

A

diuretic drugs

91
Q

increased excretion of water through the kidneys
reduces fluid volume in tissues and blood
several different mechanisms to increase urine volume
often administered in the morning

A

diuretic drugs

92
Q

what are the diseases that require a prescription for a diuretic drug

A

renal disease, hypertension, edema, congestive heart failure, liver disease, pulmonary edema

93
Q

what are the two forms of dialysis

A

hemodialysis

peritoneal dialysis

94
Q 
provides filtration and reabsorption
sustains life during kidney failure
used to treat patients with acute kidney failure
for patients in end-stage renal failure
between transplants
A

dialysis

95
Q

in hospital, dialysis center, or home with special equipment and training
patients blood moves from an implanted shunt or catheter in an artery to machines

A

hemodialysis

96
Q

exchange of wastes, fluids, and electrolytes
semipermeable membrane between blood and dialysis fluid
after exchange is completed, blood returned to patients vein

A

hemodialysis

97
Q

during dialysis what remains in the blood

A

blood cells and proteins

98
Q

what are possible complications with hemodialysis

A

shunt may become infected
blood clots may form
blood vessels may become sclerosed
increased risk of infection with hepatitis B and C and HIV

99
Q

how often is hemodialysis required

A

three times a week

100
Q

How long does a treatment of hemodialysis take

A

three to four hours

101
Q

done at dialysis unit or home
may be done at night
semipermeable membrane is the peritoneal
catheter with entry and exit points is implanted in the peritoneal cavity

A

peritoneal dialysis

102
Q

dialysate is drained from the peritoneal cavity via what

A

gravity

103
Q

what are the major complications of peritoneal dialysis

A

infection resulting in peritonitis

104
Q

which takes longer hemodialysis or peritoneal dialysis

A

peritoneal dialysis

105
Q

peritoneal dialysis requires what

A

loose clothing to accommodate the bag of fluid

106
Q

what has to do with both types of dialysis

A

prophylactic antibiotics
any additional problem occurring in patient such as infection may alter dialysis requirements
caution is required with many drugs because toxic level buildup can occur

107
Q

what type or urinary infection is the most common

A

UTI

108
Q

what has to do with lower urinary tract infections

A

cystitis

urethritis

109
Q

what has to do with upper urinary tract infections

A

pyelonephritis

110
Q

what is an excellent growth medium

A

urine

111
Q

what is the common causative agent of urinary tract infections

A

E coli

112
Q

what other species are associated with UTIs

A 
Klebsiella
Proteus
Enterobacter
Citrobacter
Serratia
Pseudomonas
Enterococcus
Coagulase-negative Staphylococcus
Chlamydia
Mycoplasma
113
Q

Why is UTIs more common in women

A

shortness of urethra

proximity to anus

Pathophysiology (4 decks)

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