Chapter 14 Urinary System & Venipuncture Flashcards
Function of the urinary system
To produce urine and eliminate from the body
Urinary system consists of:
2 kidneys
2 ureters
1 bladder
1 urethra
How are the kidneys positioned in the abdominal cavity
Posterior, below the lower portion of the liver and spleen; between iliac crest and xiphoid
What angle are kidneys in the body
30 degrees
What system are the adrenal glands part of
Endorcine
Where are adrenals located
Superior portion of the kidneys, encompassed by the fatty capsule
What is the trigone
Posterior surface of the bladder; muscular entrance where the ureters enter and the urethra leaves
What does the trigone attach to
Floor of the pelvis
Total capacity of the bladder
350-500mL; feel the urge to go at 250mL
When does urinating become involuntary
When internal bladder pressure gets too high
Function of the prostate gland
Produces fluid whcih helps make the sperm swim
Where does the urethra exit the body
Inferior to pubic symphysis
Length of female urethra
4 cm
Length of male urethra
17-20 cm
Function of urethra in females
Pass urine outside the body
Function of urethra in males
Eliminates urine and a passageway for semen
Size of kidney
4-5” long
2-3” wide
1” thick
What muscles cause the kidneys to sit at a 30 degree angle
Psoas mucles
What muscles surround the kidneys
Quadratus lumborum
Erector spinae
Posterior obliques show which kidney
Opposite kidney
What surrounds each kidney
Adipose capsule or peritoneal fat
What is nephroptisis
Downward displacement of kidneys
How much urine is produced daily
1.5 L
Function of kidneys
Make urine
Removes nitrogenous waste
Regulates H20
Regulates acid-base balance and electrolyes
How much blood goes through the kidneys every 60 seconds
1 Liter
How much blood is reabsorbed after going through the kidneys
99%
Substance which forms the peripheral or outer portion of the kidney
Cortex
What forms the renal columns
Cortex dips down between the renal pyramids
Renal columns extend to form the:
Renal sinuses
What is underneath the cortex and composed of conical masses (pyramids)
Medulla
What makes up the conical masses (pyramids)
Collection of tubes that converge at an opening of the renal papilla (apex) and drain in the minor calyx
What forms the renal pelvis
Major calyces unite
Term used to describe the total function of the kidneys
Renal parenchyma
Structural and functional unit of the kidney
Nephron
How many nephrons are in each kidney
1 million
What are glomeruli
Tiny capillary tuffs formed from small arteries in the renal cortex
Function of glomeruli
Filter blood
How does blood move around the glomeruli
Afferent arterioles supply blood
Efferent arterioles take blood away to a seconday capillary network
Each glomeruli is surrounded by a:
Glomerular capsule (Bowman’s capsule)
What is the path of filtrate from the glomerulus to the ureter
Glomerular capsule
Proximal convoluted tubule
Descending limbs
Ascending limbs
Distal convoluted tubule
Collecting tubule
Minor Calyx
Major Calyx
Renal pelvis
Arterial blood is received by the kidneys from the __________ aorta via the _________
Abdominal
Left and right renal arteries
Renal veins dump into the:
IVC
Renal veins are anterior or posterior to the heart
Anterior
Longitudinal fissure where the renal artery, vein, lymphatics, nerves and ureter exit and enter
Hilum
What two ways can contrast be introduced
IV (antegrade)
Catheter (retrograde)
In iodinated contrast, iodine is the _______ element
Opacifying
Ionic contrast has a positive charged chain element called the:
Cation (usually salt)
What does the cation (salt) do in ionic contrast
Increases the solubility of the contrast (dissolves in the bloodstream)
Ionic contrast has a negative charged element called the:
Anion
Diatrizoate and iothalamte are examples of:
Common anions
Once ionic contrast is injected, the _____ splits apart, creating two ions
Cation
When the cation splits apart, it can cause a hypertonic condition, which is what?
Increase in blood plasma osmolariy
How is non-ionic contrast different from ionic
Has no positively charged cations
In non-ionic contrast, the carboxyl group is replaced by:
Amide or glucose
Does non-ionic have low or high osmolarity?
Low (doesn’t increase blood plasma)
What is the #1 nosocomial (hosptial acquired) infection
UTI
What medications are used if a patient is allergic to contrast
Antihistamine (Benedryl)
Steroid (Decadron)
What is the best patient position for an IVU
Prone
Normal Creatinine level range
.6-1.5mg/dL
Normal BUN levels
8-25 mg/100mL
Normal GFR levels
> 60 mL/min
How to determine the folcrum point for tomos
Distance from anterior to posterior / 3
What pathology do the kidneys look like fat baby hands
Hydronephrosis
Water-soluble iodinated contrast can be administered by:
Bolus injection
Drip infusion
Is venipuncture an invasive or non-invasive procedure?
Invasive - skin is broken
Where are the ideal veins located for IVU
Antecubital fossa
The most commonly used veins are:
Medial cubital
Cephalic
Basilic
Veins should be avoided that are:
Sclerotic (hardened)
Tortuous (twisted)
Rolling
Overused
What hand is used to find the injection site
Non-dominant hand
How high should turniquet be positioned
3-4” above the site
What artery should be checked after the turniquet is on
Radial artery
How should the bevel be facing
Upward
What angle do you approach the vein
20-45 degrees
Why type of medication is heparin or coumadin
Blood thinners
What is Phlebitis
Inflammation of a vein
What type of reaction is life-threatening
Vasovagal reaction
Is an anaphylactic reaction a moderate or severe reaction?
Moderate
What is the size of a normal ureter
28-34 cm long
1mm-1cm wide
What curve does the ureter follow
Sacrococcygeal curve and lumbar
What are the 3 constriction points of the ureter
UP junction
Brim of the pelvis
UV junction (most kidney stones get stuck)
