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CH 21 GI and Renal Emergencies > Lecture > Flashcards

Lecture Flashcards

1
Q

Gross anatomy of the renal system

A

kidney, ureters, bladder, urethra

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2
Q

3 main functions of the urinary system

A
  1. removal of waste from body fluids
  2. elimination of waste into the environment
  3. homeostatic regulation of blood plasma
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3
Q

The medial side of the kidney where the vessels and nerves after and leave is referred to as the …

A

Hilum

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4
Q

What does the renal fascia do

A

Anchors the kidney to the abdominal wall

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5
Q

Outer layer of the kidney is called?

A

Renal cortex (shell)

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6
Q

Middle layer of the kidney is called the…

and contains cone shaped structures called…

A

Renal medulla

renal pyramids

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7
Q

What is the renal pelvis

A

a cone shaped collecting are that connects the ureters to the kidney

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8
Q

Minor calyx

A

drains urine from the renal medulla to the major calyx

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9
Q

Major calyx

A

drains urine from the minor calyx to the renal pelvis

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10
Q

How much of the cardiac output flows through the kidney every minute?

A

25%

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11
Q

The afferent artery enters the kidney and becomes what structure

A

The glomerulus (the main filter)

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12
Q

The efferent arteriole forms after leaving the glomerulus and becomes …

A

peritubular capillaries that permit reabsorption from the convoluted tubules

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13
Q

What is unique about the capillary beds in the kidney

A

No other organ in the body has 2 distinct capillary beds

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14
Q

What are the structural and functional units of the kidney and where are they found

A

The nephrons

In the cortex and medulla

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15
Q

Another name for the glomerulus capsule

A

Bowmans capsule

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16
Q

What is the path that they kidney filtrate takes from the bowman capsule to the collecting ducts

A

PCT - Loop of Henle - DCT

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17
Q

How many nephrons are contained in the kidney

A

1.25 million

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18
Q

What is the function of the podocytes

A

They wrap around the glomerular capillaries and form slits that permit filtrate to pass into the glomerular capsule, but are small enough to prevent larger molecules such as protein from leaving the blood stream

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19
Q

What is the glomerular filtration rate for a normal adult

A

125ml/min

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20
Q

What does the initial filtrate in the bowman capsule contain

A

glucose, salts, mineral, water and metabolic wastes

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21
Q

Where does initial reabsorption occur

A

PCT and deposited into surrounding interstitial fluid

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22
Q

As the interstitial fluid becomes more concentrated what happens next?

A

Water moves from the filtrate by osmosis into the interstitial fluid. The interstitial fluid then moves into the peritubular capillaries to restore homeostatic balance

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23
Q

What happens in the descending portion of the loop of henle?

A

It is permeable to water but impermeable to Na+ and Cl-

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24
Q

What is the permeability of the ascending loop of henle?

A

Permeable to Na+ and Cl- but impermeable to H20

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25
Q

After leaving the loop of henle and entering the DCT how much of the initial filtrate has been reabsorbed

A

85% of the water

80% of the solutes depending upon the bodies needs

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26
Q

What is the structure at site where the efferent arteriole and the DCT meet?

A

Juxtaglomerular apparatus

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27
Q

What do the pressure sensitive cells in the juxtaglomerular apparatus do?

A

release Renin in response to low BP

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28
Q

What are the macula dense cells sensitive to?

A

Sensitive to chemical changes and monitor the filtrate concentration in the DCT

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29
Q

What does Renin do?

A

converts plasma protein angiotensinogen into angiotensin I

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30
Q

What does angiotensin I do?

A

Nothing

31
Q

When angiotensin I is converted into angiotensin II what does it do?

A

Acts as a smooth muscle constrictor (alpha 1 agonist) to increase BP and peripheral resistance and increases Na+ reabsorption in the PCT which increases water reabsorption and BP

32
Q

What does ADH do and where is it produced?

A

Antidiuretic hormone produced by the hypothalamus is released into the blood stream in response to increases in plasma solute concentration. ADH signals the DCT to become more permeable to water and thus decreasing blood solute concentration and increasing BP

33
Q

What does aldosterone do?

A

Increases the active rate of reabsorption of Na+ and Cl- in the blood which leads to an increase in water reabsorption
It also decreases K+ reabsorption which causes excess K+ to be excreted in the urine

34
Q

Male urethra is dived into what 3 regions?

A

prostatic urethra
membranous urethra
spongy or penile urethra

35
Q

Once urine enters the collecting ducts, what is its path out of the kidney?

A

minor calyx - major calyx - renal pelvis - ureters

36
Q

Most of the bladder is located in the _________, with the dome of the bladder in the _______

A

anterior abdominal cavity

retroperitoneum

37
Q

A spinal reflex that causes contraction of the bladders smooth muscle

A

micturition reflex

38
Q

Name a few reasons for urological pain

A

bacteria or viral infections, kidney stones and prostate enlargement, renal failure

39
Q

Name the 9 abdominal regions

A

R/L hypochondrial / Epigastric
R/L Lumbar / Umbilical
R/L Iliac / Hypogastric

40
Q

6 causes of urinary retention

A
  1. Renal Calculi
  2. Acute Renal Failure
  3. Urethral Obstructions
  4. Benign Prostate Hypertophy
  5. UTI
  6. Nerve Damage
41
Q

The type of pain most commonly associated with urologic problems caused by stimulation of the nerve receptors in hollow organs

A

Visceral Pain

42
Q

Classic S&Sy of UTI

A 
Urinary Triad
Painful urination
Frequent urges to urinate
Difficult urination
\_\_\_\_\_\_\_\_\_\_\_\_\_
Fever
AMS
43
Q

Where may a patient with a bladder condition experience referred pain

A

the neck and shoulder

44
Q

If a UTI move proximal it could result in…

A

pyelonephritis

45
Q

2 categories of urinary incontinence

A

Urge- sudden, intense, involuntary urge due to parkinsons, uti, stroke, CNS disorders
Overflow - constant slow flow of urine due to damaged bladder, blocked urethra or nerve damage

46
Q

Where do kidney stones originate?

A

Renal pelvis when an excess of insoluble salts crystallize

47
Q

3 types of kidney stones

A

Calcium (most common), Struvite (common in women), Uric acid

48
Q

Migration of pain with kidney stones

A

Starts in the flank and migrates downward to the front

49
Q

Treatments for kidney stones

A

hydration of 2-3 L H2o/day
Lithrotripsy
Direct Endoscopy

50
Q

What is Acute Renal Failure (ARF)

A

Sudden decrease in filtration through the glomeruli causing toxins to accumulate in the blood

51
Q

The name for urine output of less than 500ml/day

A

Oliguria

52
Q

Anuria

A

Complete cessation of urine

53
Q

S&Sy of ARF

A

generalized edema, acidosis, heart failure, hypertension

54
Q

3 classifications of ARF

A

Prerenal
Intrarenal
Postrenal

55
Q

S&Sy of Prerenal failure

A 
Caused by hypo perfusion of the kidneys
Hypotension
Tachycardia
Dizziness
Thirst
56
Q

S&Sy of Intrarenal failure

A 
Flank Px
Joint Px
Oliguria
Hypertension
Confusion
Seizure
57
Q

S&Sy of Postrenal failure

A 
Caused by blockage of flow from the kidney
Px in flank and lower abdomen
Oliguria
Distended Bladder
Hematuria
Peripheral edema
58
Q

Most common cause of Prerenal ARF

A

Hypovolemia due to CHF, trauma, shock, sepsis

59
Q

Intrarenal failure is often due to what disease process?

A

Diabetes

60
Q

What is the condition called that is characterized by the permanent loss of nephrons and scarring in the kidney

A

Chronic Renal Failure

CRF

61
Q

CRF leads to Uremia and Azotemia, what are they?

A

Uremia - increased concentration of uria and other wastes

Azotemia - increased concentration of nitrogenous wastes

62
Q

Patients with CRF can present with what S&Sy

A 
ALOC
Hypotension
Tachycardia
Pericarditis
Pulmonary Edema
63
Q

End stage renal disease presents with what S&Sy

A 
Confusion
SOB
Peripheral edema
Bruising
CPx
Seizures
Muscle twitching
Pruritis
64
Q

What are the 2 types of renal dialysis

A

Peritoneal dialysis - large amounts of fluid are infused into the abdomen allowing for diffusion to occur and then removed from the abdomen allowing waste to leave the body
Hemodialysis - blood is circulated through a machine and is cleaned in much the same way as the kidneys function

65
Q

Describe an internal shunt

A 
a fistula (artificial connection between an artery and a vein usually located in an upper extremity.
Should only be accessed in a life threatening emergency
66
Q

What is epididymitis?

A

An infection that causes inflammation of the epididymis along the posterior boarder of the testies

67
Q

What is orchitis?

A

When one or more of the testes become infected leading to increased tenderness and enlargement of the scrotum

68
Q

What is Fournier Gangrene?

A

Bacteria that enters the scrotum due to a laceration and causes necrosis of the tissue

69
Q

What is a priapism?

A

Painful, tender, persistent erection due to tumors, leukemia, spinal cord injury, cocaine or ED drugs

70
Q

What is phimosis?

A

The inability to retract the distal foreskin over the penis

71
Q

What is Paraphimosis?

A

Results when the foreskin is retracted over the glans penis and becomes entrapped

72
Q

What is benign prostate hypertrophy?

A

Noncancerous enlargement of the prostate gland typically in men over 60

73
Q

What is testicular torsion?

A

Twisting of the testicle on the spermatic cord

CH 21 GI and Renal Emergencies (1 decks)

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