Pathologies related to the low back III Flashcards
What are other terms for nephrolithiasis?
kidney stones or renal calculi
What is the urinary system structure composed of?
kidneys, ureters, bladder, and urethra
What are urinary system functions?
- filter fluid from renal blood flow
- remove waste
- retain essential substances for electrolytes and pH - stimulates RBC production
- blood pressure regulation
- converts vitamin D (absorbs Ca2+ to its active form)
What is the etiology of nephrolitasis?
- disorders that lead to hyperexcretion of Ca2+ and uric acid (hyperthyroidism)
- NOT primarily drinking water
- obesity
- high animal protein intake
What is the incidence/prevalence of nephrolithiasis?
3rd MOST common urinary tract disorder behind infections and prostate conditions
What is the pathogenesis of nephrolithiasis?
Hard mass of salts composed of CA2+ > uric acid and other minerals deposited in urinary system as follows
What are clinical manifestations and S&S of nephrolithiasis?
- referred pain into T10-L1 dermatomes
> may begin with intermittent unilateral LBP
> Progress to acute/severe back and flank ( between ribs and iliac crests) and possibly abdominal pain - radiating pain to the groin and perianal regions
- bladder dysfunction
- eventually unrelenting pain
- N&V due to pain severity
-infection (kidney or urinary tract) could occur so infection S&S may be present
What are clinical manifestations and S&S of nephrolithiasis?
- Murphy percussion test over kidney determines referral
> one firm and closed fisted percussion over 12th costovertebral angle
> WNL = painless - pain also may be present with bladder palpation/percussion
What is the referral for nephrolithiasis?
Urgent but possibly emergent referral depending on pain severity
Is the skeleton metabolically active?
YES
What happens to the skeleton throughout life?
Undergoes continuous remodeling with an annual turnover of bone
Why is remodeling of the skeleton necessary?
- to maintain the structural integrity of the skeleton
- serve metabolic demands as a storehouse of Ca2+ and phosphorus
When does bone mass peak?
Between 25-35 years
What is osteoporosis?
A persistent progressive metabolic disease characterized by:
- low bone mass
- impaired bone quality
- decreased bone strength
- enhanced risk of fractures
What are the types and etiology of osteoporosis?
- PRIMARY - most common, associated with aging
- secondary - consequence of disease or medication
What is the incidence/prevalence of osteoporosis?
- 70% undiagnosed, found during investigation of other conditions
- increasing in younger individuals
- MOST COMMON METABOLIC BONE DISEASE
- expected to increase with aging population
- highest in post-menoposal biological women with estrogen deficits and Scandinavian ancestry
What is a precursor to osteoporosis?
opteopenia or low bone mass
What percentage of women and men will suffer an osteoporotic fx over 50yo?
33% women, 20% men
What are internal risk factors for osteoporosis?
- lower hormone levels (estrogen)
- genetics
- social habits; > 2 beers, > glass of wine, > 1 liquor shop or > 3 cups of caffeine per day
Why can lower estrogen effect osteoporosis?
- limits release of Ca2+ into blood and absorption
- associated with menopause and abnormal menses
What can lower testosterone do that effects osteoporosis?
limits release of Ca2+ into blood