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CH 21 GI and Renal Emergencies > Lecture > Flashcards

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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
After leaving the loop of henle and entering the DCT how much of the initial filtrate has been reabsorbed
85% of the water | 80% of the solutes depending upon the bodies needs
26
What is the structure at site where the efferent arteriole and the DCT meet?
Juxtaglomerular apparatus
27
What do the pressure sensitive cells in the juxtaglomerular apparatus do?
release Renin in response to low BP
28
What are the macula dense cells sensitive to?
Sensitive to chemical changes and monitor the filtrate concentration in the DCT
29
What does Renin do?
converts plasma protein angiotensinogen into angiotensin I
30
What does angiotensin I do?
Nothing
31
When angiotensin I is converted into angiotensin II what does it do?
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
What does ADH do and where is it produced?
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
What does aldosterone do?
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
Male urethra is dived into what 3 regions?
prostatic urethra membranous urethra spongy or penile urethra
35
Once urine enters the collecting ducts, what is its path out of the kidney?
minor calyx - major calyx - renal pelvis - ureters
36
Most of the bladder is located in the _________, with the dome of the bladder in the _______
anterior abdominal cavity | retroperitoneum
37
A spinal reflex that causes contraction of the bladders smooth muscle
micturition reflex
38
Name a few reasons for urological pain
bacteria or viral infections, kidney stones and prostate enlargement, renal failure
39
Name the 9 abdominal regions
R/L hypochondrial / Epigastric R/L Lumbar / Umbilical R/L Iliac / Hypogastric
40
6 causes of urinary retention
1. Renal Calculi 2. Acute Renal Failure 3. Urethral Obstructions 4. Benign Prostate Hypertophy 5. UTI 6. Nerve Damage
41
The type of pain most commonly associated with urologic problems caused by stimulation of the nerve receptors in hollow organs
Visceral Pain
42
Classic S&Sy of UTI
``` Urinary Triad Painful urination Frequent urges to urinate Difficult urination _____________ Fever AMS ```
43
Where may a patient with a bladder condition experience referred pain
the neck and shoulder
44
If a UTI move proximal it could result in...
pyelonephritis
45
2 categories of urinary incontinence
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
Where do kidney stones originate?
Renal pelvis when an excess of insoluble salts crystallize
47
3 types of kidney stones
Calcium (most common), Struvite (common in women), Uric acid
48
Migration of pain with kidney stones
Starts in the flank and migrates downward to the front
49
Treatments for kidney stones
hydration of 2-3 L H2o/day Lithrotripsy Direct Endoscopy
50
What is Acute Renal Failure (ARF)
Sudden decrease in filtration through the glomeruli causing toxins to accumulate in the blood
51
The name for urine output of less than 500ml/day
Oliguria
52
Anuria
Complete cessation of urine
53
S&Sy of ARF
generalized edema, acidosis, heart failure, hypertension
54
3 classifications of ARF
Prerenal Intrarenal Postrenal
55
S&Sy of Prerenal failure
``` Caused by hypo perfusion of the kidneys Hypotension Tachycardia Dizziness Thirst ```
56
S&Sy of Intrarenal failure
``` Flank Px Joint Px Oliguria Hypertension Confusion Seizure ```
57
S&Sy of Postrenal failure
``` Caused by blockage of flow from the kidney Px in flank and lower abdomen Oliguria Distended Bladder Hematuria Peripheral edema ```
58
Most common cause of Prerenal ARF
Hypovolemia due to CHF, trauma, shock, sepsis
59
Intrarenal failure is often due to what disease process?
Diabetes
60
What is the condition called that is characterized by the permanent loss of nephrons and scarring in the kidney
Chronic Renal Failure | CRF
61
CRF leads to Uremia and Azotemia, what are they?
Uremia - increased concentration of uria and other wastes | Azotemia - increased concentration of nitrogenous wastes
62
Patients with CRF can present with what S&Sy
``` ALOC Hypotension Tachycardia Pericarditis Pulmonary Edema ```
63
End stage renal disease presents with what S&Sy
``` Confusion SOB Peripheral edema Bruising CPx Seizures Muscle twitching Pruritis ```
64
What are the 2 types of renal dialysis
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
Describe an internal shunt
``` 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
What is epididymitis?
An infection that causes inflammation of the epididymis along the posterior boarder of the testies
67
What is orchitis?
When one or more of the testes become infected leading to increased tenderness and enlargement of the scrotum
68
What is Fournier Gangrene?
Bacteria that enters the scrotum due to a laceration and causes necrosis of the tissue
69
What is a priapism?
Painful, tender, persistent erection due to tumors, leukemia, spinal cord injury, cocaine or ED drugs
70
What is phimosis?
The inability to retract the distal foreskin over the penis
71
What is Paraphimosis?
Results when the foreskin is retracted over the glans penis and becomes entrapped
72
What is benign prostate hypertrophy?
Noncancerous enlargement of the prostate gland typically in men over 60
73
What is testicular torsion?
Twisting of the testicle on the spermatic cord

CH 21 GI and Renal Emergencies (1 decks)

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