Kidneys | Nephrology and Genitourinary Flashcards
cali/o, calic/o
calyx
cyst/o
urinary bladder
glomerul/o
glomerulus
meat/o
meatus
nephr/o
kidney
pyel/o
renal pelvis
ren/o
kidney
trigon/o
trigone (region of the bladder)
ureter/o
ureter
urethr/o
urethra
vesic/o
urinary bladder
albumin/o
albumin
azot/o
nitrogen
bacteri/o
bacteria
dips/o
thirsty
kal/o
potassium
ket/o, keton/o
ketone bodies (ketoacids and acetone)
lith/o
stone
natr/o
sodium
noct/o
night
olig/o
scanty
-poietin
substance that forms
py/o
pus
-tripsy
crushing
ur/o
urine (urea)
urin/o
urine
-uria
urination; urine condition
Involuntary discharge of urine
enuresis
Frequent urination at night
nocturia
Examination of urine to determine the presence of abnormal elements that may indicate various pathologic conditions
urinalysis
Antidiuretic hormone (ADH) is not secreted, or there is a resisntance of the kidney to ADH
diabetes insipidus (DI)
Insulin is not secreted adequately or tissues are resistant to its effects
diabetes mellitus (DM)
Measurement of urea levels in blood
blood urea nitrogen (BUN)
Measurement of the rate at which creatinine is cleared from the blood by the kidney
creatinine clearance
X-ray images obtained using CT show multiple cross sectional and other views of the kidney
CT urography
X-ray examination (without contrast) of the kidneys, ureters and bladder
kidneys, ureters and bladder (KUB)
X-ray examination with contrast of the blood vessels of the kidney
renal angiography
X-ray image of the renal pelvis and ureters after injection of contrast through a urinary catheter into the ureters from the bladder
retrograde pyelogram (RP)
X-ray image (with contrast) of the urinary bladder and urethra obtained while the patient is voiding
voiding cystouretrhogram (VCUG)
Imaging of urinary tract structures using high-frequency sound waves
ultrasonography
Image of the kidney obtained after injecting a radioactive substance (radioisotope) into the bloodstream
radioisotope scan
Changing magnetic field produces images of the kidney and surrounding structures in three planes of the body
MRI urography
Direct visualization of the urethra and urinary bladder with an endoscope (cystoscope)
cystoscopy
Process of separating nitrogenous waste materials from the blood
dialysis
Uses an artificial kidney machine that receives waste-filled blood from the patient’s bloodstream and returns dialyzed blood to the patient’s body
hemodialysis (HD)
Uses a catheter to introduce fluid into the peritoneal cavity
peritoneal dialysis (PD)
Dilation of narrowed areas in renal arteries
renal angioplasty
Removal of kidney tissue for microscopic examination
renal biopsy
Surgical transfer of a kidney from a donor to a recipient
renal transplantation
Passage of a flexible, tubular intrument through the urethra into the urinary bladder
urinary catheterization
urinary tract stones are crushed
lithotripsy
ESWL
extracorporeal shock wave lithotripsy
What are the functions of the urinary system?
- removes waste from the bloodstream and excretes through urine2. regulates pH of body fluids3. regulates fluid and electrolyte balance4. stimulates the production of RBCs5. Controls blood pressure
Name the organs of the urinary system.
bladderkidneysurethraureters
Kidneys are protected by the ___, ___, and ___
abdomen, back muscles, and fat
Kidneys are surrounded by what 3 layers of tissue?
- fibrous capsule (inner layer)2. perirenal fat capsule (middle layer)3. renal fascia (outer layer)
What are the 3 regions of the kidneys?
- renal pelvis (inner region)2. renal medulla (middle region)- renal pyramids (triangular sections3. renal cortex
What does the following process describe: urine drains from the tip of renal pyramids > down to minor calices > major calices > renal pelvis > ureter
Pathway of urine
There are about _____ nephrons in each kidney
1 million
Name the parts of a nephron.
- glomerular (Bowman) capsure2. renal tubule
Name the three sections of a renal tubule.
- proximal (convoluted) tubule2. loop of Henle3. distal (convoluted) tubule
What processes are involved in urine formation?
- glomerular filtration2. tubular reabsorption
Urination can also be called ____ or ____
micturition or voiding
There are ____ receptors in the bladder wall that triggers the reflex for urinating
stretch receptors
The ____ sphincter in the bladder works involuntarily while the ____ sphincter works voluntarily (how we hold urine in)
internal and external
What other systems work with the urinary system?
circulatory system and endocrine system (see Google drive notes)
The urinary system consists of which 6 organs?
two kidneys, two ureters, urinary bladder, urethra
The urinary system ____ and ____ urine, which contains metabolic waste products.
forms and eliminates
What are the organs of excretion?
Kidneys
What are the other functions of kidneys?
- regulates body fluida. compositionb. volumec. pH2. maintains the state of internal balance known as homeostasis
Which two substances does the kidney produce?
erythropoietin (EPO) and renin
What system do erythropoietin and renin act on?
circulatory system
Hormone that stimulates the production of red blood cells in the bone marrow
erythropoietin (EPO)
Enzyme that functionsto raise blood pressure and activates angiotensin in the blood
renin
Renin activates a blood component called ____ which causes constriction of the blood vessels.
angiotensin
ACE inhibitors
angiotensin-converting enzyme inhibitors
Lower blood pressure by interfering with the production of angiotensin
ACE inhibitors
The kidneys are located behind the ____ in the ____ region.
peritoneum in the lumbar region
An ____ rests on top of each kidney.
adrenal gland
Each kidney is encased in a capsule of _____ overlaid with fat.
fibrous connective tissue
An outermost layer of ____ tissue supports the kidney and anchors it to the body wall
connective
The outer region of the kidney
renal cortex
The inner region of the kidney; contains portions of thenephrons and tubules that transport urine toward the renalpelvis
renal medulla
The medulla is divided into triangular sections each called a _____
pyramid
The pyramids have a lined appearance because they’re made up of the loops and collecting tubules of the ___
nephrons
The functional units of the kidney
nephrons
Each collecting tubule empties into a urine-collecting area called a _____
calyx
Smaller minor calyces merge to form a _____
major calyx
The major calyces unite to form the _____
renal pelvis
The upper funnel shaped portion of the ureter that receives urine fromthe kidney
renal pelvis
Microscopic structures; a single tubule coiled and folded into various shapes
nephrons
Cup-shaped capsule at the beginning of the nephron’s tubule
Bowman (glomerular) capsule
Part of the blood-filtering device of the nephron
Bowman (glomerular) capsule
After the bowman capsule, the tubule folds into the ___
proximal convoluted tubule
The proximal convoluted tubule straightens out to form the ____
loop of Henle
The loop of Henle coils again into the _____
distal convoluted tubule
The distal convoluted tubule finally straightens out to form a _____
collecting tubule
Blood enters the kidney through a ____
renal artery
A short branch of the abdominal aorta
renal artery
The renal artery subdivides into smaller vessels as it branches throughout the kidney tissue until blood is brought into the ____
Bowman’s capsule (glomerular)
A cluster of capillaries within the Bowman’s capsule
glomerulus
Blood leaves the kidney by a series of vessels that finally merge to form the _____
renal vein
The renal vein empties into the ______
inferior vena cava
____ forces materials through the glomerular wall and through the wall of the glomerular capsule
blood pressure
The fluid that enters the nephron
glomerular filtrate
Glomerular filtrate consists of ____, _____, _____, ____, and ____
water, electrolytes, soluble waste, nutrients and toxins
The main waste material
urea
Urea is the _____-containing byproduct of ______
nitrogen, protein metabolism
The filtrate shouldn’t contain any cells or proteins such as ____.
albumin
T or F. Waste material and toxins must be eliminated, but most of the water, electrolytes and nutrients must be returned to the blood or we would rapidly starve/dehydrate
True
The return process that occurs through the peritubular capillaries surrounding the nephron
tubular reabsorption
The concentration of the filtrate is adjusted under the effects of the pituitary hormone _______
antidiuretic hormone (ADH)
The filtrate is now called ____ when it flows into the collecting tubules to be eliminated
urine
Urine is drained from the ____ and carried by the ____ to the _____
renal pelvis, ureter, urinary bladder
Urine is stored in the bladder until fullness stimulates a ____ contraction of the ____ muscle
reflex, bladder
Urine is expulsed through this
urethra
T or F. Female urethra is shorter than than males’
True
The female urethra carries only urine while the male urethra carries both ____ and ____
urine and semen
The voiding of urine is regulated by two sphincters made up of ____ muscles that surround the urethra
circular
What are the two sphincters involved in regulating micturition?
the upper and lower sphincter
The ___ sphincter just below the bladder functions involuntarily
upper
The ___ sphincter is under conscious control
lower
A hormone released from the pituitary gland that causes reabsorptionof water in the kidneys, thus concentrating the urine
antidiuretic hormone (ADH)
A substance that increases blood pressure; activated in the blood by renin, an enzyme produced by the kidneys
angiotensin
A hormone produced by the kidneys that stimulates red blood cell production in the bone marrow
EPO
The cup-shaped structure at the beginning of the nephron that surrounds the glomerulus and receives material filtered out ofthe blood
glomerular capsule
The fluid and dissolved materials that filter out of the blood and enter the nephron at the Bowman capsule
glomerular filtrate
The cluster of capillaries within the glomerular capsule
glomerulus
Filter the blood and form urine, which contains the waste products ofmetabolism and other substances as needed to regulate the waterand electrolyte balance and the pH of body fluids
kidney
ren/o
kidney
nephr/o
kidney
glomerul/o
glomerulus
pyel/o
renal pelvis
cali-, calic-
calyx
ur/o
urine, urinary tract
urin/o
urine
ureter/o
ureter
cyst/o
urinary bladder
vesic/o
urinary bladder
urethr/o
urethra
Organisms that infect the urinary tract generally enter through the ___ and ascend toward the bladder
urethra
ARF
acute renal failure
ATN
acute tubular necrosis
The movement of substances across a semipermeable membrane
dialysis
dialysis where blood is cleansed by passage over a membrane surrounded by fluid that draws out unwanted substances
hemodialysis
dialysis where fluid is introduced into the peritoneal cavity which is withdrawn along with waste products
peritoneal dialysis
CAPD
continuous ambulatory peritoneal dialysis
CCPD
continuous cyclic peritoneal dialysis
Most urinary stones are formed from ____
calcium salts
hydronephrosis
collection of urine in the renal pelvis
UA
urinalysis
instrument for examining the inside of the urinary bladder
cystocope
IVP
intravenous pyelography
IVU
intravenous urography
Weight of a substance compared with the weight of an equal volume of water
specific gravity
Hormone secreted by the adrenal gland that regulates electrolyte excretion by the kidneys
aldosterone
Creatinine is the _____-containing byproduct of ______
nitrogen, muscle
diuresis
increased excretion of urine
GFR
glomerular filtration rate
The amount of filtrate formed per minute by the nephrons of both kidneys
GFR
The maximum rate at which a given substance can be transportedacross the renal tubule; tubular maximum
maximal transport capacity
Tm
maximal transport capacity
The glomerular capsule and the glomerulus considered as a unit; the filtration device of the kidney
renal corpuscle
A triangle at the base of the bladder formed by the openings of thetwo ureters and the urethra
trigone
anuresis vs anuria
anuresis = lack of urination, anuria = lack of urine formation
A condition caused by inadequate production of antidiuretic hormoneresulting in excessive excretion of dilute urine and extremethirst
diabetes insipidus
enuresis
involuntary urination
BUN
blood urea nitrogen
Nitrogen in the blood in the form of urea
BUN
A substance that increases the excretion of urine
diuretic
instrument for crushing a bladder stone
lithotrite
CMG
cystometrography
CRF
chronic renal failure
ESRD
end stage renal disease
ESWL
extracorporeal shock wave lithotripsy
GU
genitourinary
KUB
kidney-ureter-bladder
PEP
protein electrophoresis
UTI
urinary tract infection
Steps in the removal urine
urine drained from the renal pelvis > ureter > into urinary bladder > fullness > reflex contraction of the bladder muscle > expulsion through urethra
Steps in urine formation
blood pressure pushes materials through the glomerular wall > wall of glomerular capsule > glomerular filtrate and urea > nephrons > peritubular capillaries > filtrate adjusted > urine
Steps in blood supply in and out of kidney
blood enters kidney through renal artery > vessel subdivides into smaller vessels within kidney tissue > glomerular capsule > glomerulus > vessels that merge to form the renal vein > inferior vena cava
t or f. acute glomerulonephritis is both a primary or secondary disorder
t
most common form of acute glomerulonephritis
secondary
acute glomerulonephritis usually follows this type of infection
group B streptococcal infection
result of chronic glomerulonephritis is the progressive destruction of the glomeruli and eventually ____
end-stage renal disease (ESRD)
crystals of urea on the skin that result from the body trying to excrete urea through the sweat glands
uremic frost
arteriovenous fistula access
*
types of peritoneal dialysis
*
uses gravity to aid dialysate solution in filtering process, thereby draining waste into a bag worn around waist
continuous ambulatory peritoneal dialysis (CAPD)
uses a machine that continuously cycles the dialysate and extracts the waste
continuous cycling peritoneal dialysis (CCPD)
typically performed at night while patient sleeps
ccpd
75% of kidney transplants are performed on patients with these 3 things
- diabetic renal failure2. hypertensive renal disease3. glomerulonephritis
part of glomerulus affected by nephrotic syndrome
basement membrane
nephrotic syndrome can follow these 4 hings
- glomerulonephritis2. exposure to certain toxins or drugs3. pregnancy4. kidney transplant
3 main causes of acute renal failure
- diminished blood flow to the kidney2. intrarenal damage or disease3. mechanical obstruction of urine flow
CRF results from the gradual and progressive loss of this kidney component
nephrons
CRF is reversible
f
2 dietary substances that should be restricted in patients with CRF
- protein2. sodium
areas of kidney inflamed in pyelonephritis
renal pelvis and connective tissues
normal cause of pyelonephritis
infection ascending from the lower urinary tract
other 2 common causes of pyelonephritis
- pregnancy2. renal calculi
part of the kidney dilated in hydronephrosis
renal pelvis
cause of hydronephrosis: obstruction of urine flow due to these 4 factors
- renal calculi2. tumors3. inflammation4. pregnancy
excessive amounts of 2 substances in the blood leading to the formation of renal calculi
- calcium2. uric acid
large stone formed in the shape of the renal pelvis
staghorn calculus
cystitis and urethritis are common forms of this type of infection
lower utis
name for the diabetes-associated renal changes that comprise diabetic nephropathy
glomerulosclerosis
diabetic nepehropathy can be expected with this type of diabetes
type 1
normal renal tissue is replaced with this type of tissue in polycystic kidney disease
multiple grapelike cysts (causes gross enlargement of the kidney
form appears during infancy or childhood
autosomal recessive
form appears during middle age
autosomal dominant
acquired form of polycystic kidney disease is
long term kidney disease or dialysis
cause of neurogenic bladder
insult to brain, spinal cord, or nerves supplying the lower urinary tract
uncontrollable leakage of urine from the bladder during activities
stress incontinence
types of activities that can cause stress incontinence
physical exertion or actions that stress the pelvic muscle (laughing, sneezing, coughing, lifting, stretching, running)
causes of stress incontinence
weakening of the pelvic floor muscles and urethral stricture from childbirth, pregnancy and menopause, obesity and certain medicatons
Inflammation and swelling of the glomeruli of the kidneys
acute glomerulonephritis
t or f. acute glomerulonephritis can be primary or secondary to a systemic disease
t
acute glomerulonephritis usually follows a ____ of throat or skin
streptococcal bacterial infection
acute glomerulonephritis is marked by these 3 things
- proteinuria2. edema4. decreased urine volume
acute glomerulonephritis is caused by group A and B ____
hemolytic streptococcus.
acute glomerulonephritis can also result from an immune reaction that causes circulating ____ to be trapped within the ____
antigen-antibody complexes; capillaries and glomerulus
3 tests for acute glomerulonephritis that reveal bilateral enlargement of the kidneys
- high blood urea nitrogen levels2. elevated ESR3. kidney ureter bladder (KUB)
Slowly progressive noninfectious disease that can lead to irreversible renal damage and renal failure.
chronic glomerulonephritis (CGN)
advanced stage of chronic glomerulonephritis (CGN) results in inflammation followed by the progressive destruction of ____
glomeruli
in chronic glomerulonephritis (CGN), ____ lodged in the ____ trigger an inflammatory response and glomerular injury
antigen antibody complexes; glomerular capsular membrane
treatment for chronic glomerulonephritis (CGN) aims to prevent these 2 conditions
- CHF2. uremia
Disease of the basement membrane of the glomerulus
nephrotic syndrome
another term for nephrotic syndrome
nephrosis
Nephrotic syndrome is also sometimes referred to as ____
protein losing kidney
nephrotic syndrome is caused by increased ____ of the glomerulus meaning renal damage
permeability
3 conditions that can lead to nephrosis
- DM2. infections3. allergic reactions
in nephrosis, dietary intake of protein is adjusted to ___
GFR
sudden severe function in renal function
acute renal failure (ARF)
acute renal failure (ARF) is a common clinical emergency because ____ begin to accumulate in blood causing an acute ____
nitrogenous waste; uremic episode
acute renal failure (ARF) is caused by diminished ____ to the kidney and ____ to urine flow
blood flow; mechanical obstructions
treatment of ARF aims to reduce _____ damage
permanent kidney
gradual progressive loss of nephrons with irreversible loss of renal function and gradual onset uremia
chronic renal failure (CRF)
3 conditions that cause chronic renal failure (CRF)
- glomerulonephritis2. pyelonephritis3. polycystic kidneys
chronic renal failure (CRF) is often the end stage of chronic ____
renal disease; obstruction of urine flow
condition that can occur with chronic renal failure (CRF)
severe anemia
inflammation of renal pelvis and connective tissue of one or both kidneys
pyelonephritis
pyelonephritis is caused by this bacteria that ascend from the lower urinary tract to the kidneys
e.coli
drug to treat pyelonephritis
penicillin flouroquinolones
abnormal dilation of the renal pelvis caused by pressure from urine that can’t flow past an obstruction in the urinary tract
hydronephrosis
pyelonephritis is caused by a buildup of pressure in the kidneys because of an ____
obstruction
surgical removal of the obstruction to treat hydronephrosis; when surgery isn’t an option, a ____ may be inserted
nephrostomy tube
medical term for kidney stones
renal calculi
renal calculi is caused by an excessive amount of ___ or ___
calcium; uric acid
4 risk factors for renal calculi
- prolonged dehydration2. prolonged immobilization3. urinary stasis from obstruction4. crystalline inhibitors
2 main treatments for renal calculi
- extracorporeal shockwave lithotripsy2. electrohydraulic lithotripsy
Inflammation of the urinary bladder and urethritis, inflammation of the urethra most common form of lower UTI
infectious cystitis and urethritis
4 causes of infectious cystitis and urethritis
- e. coli2. klebsiella3. enterobacter4. proteus pseudomonas
renal changes from diabetes mellitus
diabetic nephropathy
term for the changes from DM
glomerulosclerosis
diabetic nephropathy occurs when lesions of the glomeruli eventually cause ____ to decrease
filtration rate
diabetic nephropathy may also be caused by insufficient control of ____ and ____
blood glucose levels; blood pressure
grape-like cyst replaces normal renal tissue
polycystic kidney disease (PKD)
t or f. polycystic kidney disease (PKD) is inherited but may not manifest until adolescence/adulthood
t
acquired polycystic kidney disease (PKD) is a sequela of ____ and/or _____
long term kidney disease; long term dialysis
recessive polycystic kidney disease (PKD) appears in ____
infants and children
dominant polycystic kidney disease (PKD) appears in ____
middle aged individuals
2 treatment options for polycystic kidney disease (PKD)
- dialysis2. kidney transplant
in polycystic kidney disease (PKD), there may be surgical removal of kidneys because of these 3 factors
- pain2. stones3. persistent infection
dysfunction of the urinary bladder that consists of difficulty in emptying the bladder or urinary incontinence
neurogenic bladder
neurogenic bladder results in insult to these 3 areas
- brain2. spinal cord3. other nerves supplying the lower urinary tract
treatment for neurogenic bladder aims to prevent ___
UTIs
neurogenic bladder is also treated by providing a means of storing urine and emptying the bladder
catheterization
uncontrolled leakage of urine from the urinary bladder during physical exertion or actions that stress the pelvic muscles (laughing, sneezing, coughing, etc)
stress incontinence
stress incontinence is caused by weakening of these 2 areas
- pelvic floor muscles2. urethral structure
3 treatments for stress incontinence
- kegel exercises2. endoscopy3. voiding cystourethrogram
