Quiz 5: Urinary/Renal, GI, Breast anatomy

Question 1

What’s the difference between the Urinary and the Renal system?

Answer 1

Renal refers to Kidneys; Urinary refers to the ureters, bladder, and urethra

Question 2

Where are the kidneys located, and what function does this position offer?

Answer 2

Just below the ribcage – held in position on either side of the vertebral column, below the diaphragm: ribs help serve a protective function

Question 3

What is the function of the kidneys?

Answer 3

Significant functions are to regulate water balance/ fluid balance which are key for the renal system; Function = getting ride (excreting) waste product;
NB for hormone secretion and management;
links to control of our blood pressure.

Question 4

What is a nephron?

Answer 4

Functioning kidney unit that serves the filtration function of the kidney

Question 5

Approximately how many nephrons are there in each kidney?

Answer 5

1 million

Question 6

In the nephron, what is the coiled knot of capillaries known as?

Answer 6

Glomerulus

Question 7

Where is the glomerulus contained?

Answer 7

In the Glomerulus/Bowman’s Capsule

Question 8

Blood enters the glomerulus in the afferent arteriole and leaves in the efferent arteriole.
Since the efferent arteriole is narrower than the afferent arteriole, what does this do to the blood pressure in the glomerulus?

Answer 8

It enforces a high blood pressure in the glomerulus, thus aiding in the filtration process

Question 9

What hormone regulates blood/plasma osmolarity?

(ie. which hormone controls water balance and blood pressure)?

Answer 9

ADH = Anti-diuretic hormone

Question 10

What is micturition?

Answer 10

The action of urinating

Question 11

By term, how much does the bladder capacity increase by?

Answer 11

It doubles to approx. 1000ml

Question 12

What causes the trigone in the bladder to become hyperplastic with muscle hypertrophy?

Answer 12

Oestrogen

Question 13

The hyperplasia of the bladder can make the bladder more XXX…?

Answer 13

prone/vulnerable to infection

Question 14

Loss of ureteral tone combined with increased urinary tract volume results in

Answer 14

urinary stasis

Question 15

What can the retention of urine lead to

Answer 15

bacteria can multiple = infection

Question 16

Which hormone has a significant effect on the ureters

Answer 16

progesterone

Question 17

During pregnancy, what happens to the capacity of the ureters

Answer 17

may contain up to 25x more urine

Question 18

Due to pregnancy, the renal and urinary systems are at a high risk of three main conditions - what are they?

Answer 18

physiological obstruction
urinary stasis
pyelonephritis

Question 19

As a result of the increased risk of infections, even in asymptomatic women; what should we as midwives do?

Answer 19

perform regular urinalysis tests to monitor and record any changes or risk factors

Question 20

What does urinary stasis refer to?

Answer 20

Urinary retention

Question 21

what does pyelonephritis refer to?

Answer 21

Kidney infection = a type of urinary tract infection (UTI)

Question 22

How severe is pyelonephritis?

Answer 22

sudden and severe kidney infection which causes the kidneys to swell and may permanently damage them, and can be life-threatening.

Question 23

What is the difference between UTI and pyelonephritis?

Answer 23

A urinary tract infection is inflammation of the bladder and/or the kidneys almost always caused by bacteria that moves up the urethra and into the bladder. If the bacteria stay in the bladder, this is a bladder infection. If the bacteria go up to the kidneys, it is called a kidney infection or pyelonephritis

Question 24

What structural changes to the kidneys occurs during pregnancy?

Answer 24

increases 1cm in length due to an increase in blood flow

Question 25

When will the changes to the renal and urinary system be noticeable from?

Answer 25

From the 1st trimester

Question 26

Renal pressure increase by ....% in early pregnancy

Answer 26

50%

Question 27

in the third trimester, what % does the renal pressure decrease to

Answer 27

15-25% above non-pregnancy levels

Question 28

What is the Glomerular Filtrate Rate (GMR) ml/min during the first trimester

Answer 28

180ml/min

Question 29

As GMR increases, what happens to the amount of protein excreted in urine

Answer 29

It increases = commonly up to 260mg/day

Question 30

What effect does the hormone aldosterone have on the body?

Answer 30

aldosterone causes an increase in salt and water reabsorption into the bloodstream from the kidney thereby increasing the blood volume, restoring salt levels and blood pressure.

Question 31

Why do we need higher sodium reabsorption?

Answer 31

More sodium that is reabsorbed = more retention of water, thus helping maintain a high overall circulating volume to support fetal demands

Question 32

Water needs to be retained, however, what happens when it does not remain in the vessels needed

Answer 32

The lymphatic system is overwhelmed, and water is retained in the lower extremities (oedema of the lower limbs)

Question 33

What hormone affects the aldosterone levels

Answer 33

Progesterone

Question 34

What hormone increases renin production

Answer 34

Oestrogen

Question 35

What is glycosuria

Answer 35

glucose in the urine; small finding is normal in pregnancy

Question 36

What is respiratory alkalosis

Answer 36

Respiratory alkalosis is by definition a disease state where the body's pH is elevated to greater than 7.45

Question 37

What function do the kidneys serve within the state of respiratory alkalosis

Answer 37

The kidney compensates in response to respiratory alkalosis by reducing the amount of new HCO3 (bicarbonate) by excreting bicarbonate and reabsorbing hydrogen ions.

Question 38

How do the kidneys compensate for respiratory acidosis?

Answer 38

Kidneys conserve bicarbonate and secrete hydrogen ions into the urine.

Question 39

What is Gingival hyperplasia, and which hormone can cause this condition?

Answer 39

Gingival hyperplasia is an overgrowth of gum tissue around the teeth = caused by oestrogen

Question 40

what is ptyalism

Answer 40

excessive salivation

Question 41

What is pica

Answer 41

craving for non-food items

Question 42

What may cause heartburn during pregnancy, and what is this causes by

Answer 42

Heartburn may be caused by a relaxation of the cardiac sphincter, as a result of progesterone

Question 43

what other effects may progesterone have on the GI tract

Answer 43

Progesterone slows peristalsis which can lead to constipation further complicated with haemorrhoids.

Question 44

What effect does Human Placental Lactogen (HPL) have on metabolism

Answer 44

HPL alters the metabolism of carbohydrates, protein, and fat.

Question 45

In which trimester is the most fat sotred during gestation

Answer 45

2nd trimester

Question 46

Is Human placental lactogen/human placental growth hormone A) an insulin antagonist B) an insulin protagonist

Answer 46

A) an insulin antagonist

Question 47

In the pancreatic cells, which cells secrete glucagon?

Answer 47

Alpha cells

Question 48

In the pancreatic cells, which cells secrete insulin?

Answer 48

Beta cells

Question 49

What effect does insulin what on the body?

Answer 49

Insulin reduces blood glucose levels by stimulating the uptake of glucose by cell membranes and muscle tissue; also promotes the storage of fat as adipose tissue

Question 50

What action does glucagon cause upon the liver?

Answer 50

causes an increase in blood glucose levels by converting glycogen to glucose.

Question 51

During pregnancy, HPL rises and insulin resistance increases. What does this result in relation to blood glucose regulation?

Answer 51

Results in a glucose load taking a longer time to reach a maximum plasma concentration, final concentration is higher than normal, remains elevated for longer.

Question 52

What hormone affect milk production

Answer 52

prolactin

Question 53

what hormone affect milk ejection

Answer 53

oxytocin

Question 54

What is the Areola

Answer 54

the pigmented area surrounding the nipple. Contains Montgomery tubercles.

Question 55

What are Alveoli

Answer 55

minute sacs of milk-secreting cells around a lumen.

Question 56

How many minutes of sucking does it take for prolactin levels to rise

Answer 56

10 minutes

Question 57

Which cells are milk-secreting

Answer 57

acini cells

Question 58

What cells surround the alveoli and contract to make milk flow

Answer 58

myoepithelial cells

Question 59

What are some positive indicators of successful breastfeeding

Answer 59

Woman feels squeezing/tingling in her breasts. Milk visible/leaking . Feels pain from uterine contractions. Sees baby taking slow deep sucks and hears swallowing

Question 60

What effect does FIL have on lactation?

Answer 60

FIL = Feedback Inhibotr of f lactation: Breast milk contains a protein that can reduce or inhibit milk production. If the breast contains a lot of milk then the inhibitor acts by slowing down milk production.

Question 61

Describe the endocrine control of lactation? | Name secretory gland, hormones, and location

Answer 61

Pituitary gland Oxytocin (milk ejection for current feed) Prolactin (milk production for next feed) Systemic (both breasts)

Question 62

Describe the autocrine control of lactation? | Name the hormone, effects and location

Answer 62

Feedback inhibitory of Lactation (FIL) Build up (inhibits prodcution) Removal (stimulates production) local (one breast)

Question 63

What does the acronym CHIN stand for?

Answer 63

``` close head free in line nose to nipple sustainable ```