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SOM Quiz 1 > Quiz 5: Urinary/Renal, GI, Breast anatomy > Flashcards

Quiz 5: Urinary/Renal, GI, Breast anatomy Flashcards

1
Q

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

A

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

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2
Q

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

A

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

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3
Q

What is the function of the kidneys?

A

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.

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4
Q

What is a nephron?

A

Functioning kidney unit that serves the filtration function of the kidney

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5
Q

Approximately how many nephrons are there in each kidney?

A

1 million

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6
Q

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

A

Glomerulus

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7
Q

Where is the glomerulus contained?

A

In the Glomerulus/Bowman’s Capsule

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8
Q

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?

A

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

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9
Q

What hormone regulates blood/plasma osmolarity?

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

A

ADH = Anti-diuretic hormone

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10
Q

What is micturition?

A

The action of urinating

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11
Q

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

A

It doubles to approx. 1000ml

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12
Q

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

A

Oestrogen

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13
Q

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

A

prone/vulnerable to infection

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14
Q

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

A

urinary stasis

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15
Q

What can the retention of urine lead to

A

bacteria can multiple = infection

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16
Q

Which hormone has a significant effect on the ureters

A

progesterone

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17
Q

During pregnancy, what happens to the capacity of the ureters

A

may contain up to 25x more urine

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18
Q

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

A

physiological obstruction
urinary stasis
pyelonephritis

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19
Q

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

A

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

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20
Q

What does urinary stasis refer to?

A

Urinary retention

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21
Q

what does pyelonephritis refer to?

A

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

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22
Q

How severe is pyelonephritis?

A

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

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23
Q

What is the difference between UTI and pyelonephritis?

A

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

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24
Q

What structural changes to the kidneys occurs during pregnancy?

A

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

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25
Q

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

A

From the 1st trimester

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26
Q

Renal pressure increase by ….% in early pregnancy

A

50%

27
Q

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

A

15-25% above non-pregnancy levels

28
Q

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

A

180ml/min

29
Q

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

A

It increases = commonly up to 260mg/day

30
Q

What effect does the hormone aldosterone have on the body?

A

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.

31
Q

Why do we need higher sodium reabsorption?

A

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

32
Q

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

A

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

33
Q

What hormone affects the aldosterone levels

A

Progesterone

34
Q

What hormone increases renin production

A

Oestrogen

35
Q

What is glycosuria

A

glucose in the urine; small finding is normal in pregnancy

36
Q

What is respiratory alkalosis

A

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

37
Q

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

A

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

38
Q

How do the kidneys compensate for respiratory acidosis?

A

Kidneys conserve bicarbonate and secrete hydrogen ions into the urine.

39
Q

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

A

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

40
Q

what is ptyalism

A

excessive salivation

41
Q

What is pica

A

craving for non-food items

42
Q

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

A

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

43
Q

what other effects may progesterone have on the GI tract

A

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

44
Q

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

A

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

45
Q

In which trimester is the most fat sotred during gestation

A

2nd trimester

46
Q

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

A

A) an insulin antagonist

47
Q

In the pancreatic cells, which cells secrete glucagon?

A

Alpha cells

48
Q

In the pancreatic cells, which cells secrete insulin?

A

Beta cells

49
Q

What effect does insulin what on the body?

A

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

50
Q

What action does glucagon cause upon the liver?

A

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

51
Q

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

A

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.

52
Q

What hormone affect milk production

A

prolactin

53
Q

what hormone affect milk ejection

A

oxytocin

54
Q

What is the Areola

A

the pigmented area surrounding the nipple. Contains Montgomery tubercles.

55
Q

What are Alveoli

A

minute sacs of milk-secreting cells around a lumen.

56
Q

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

A

10 minutes

57
Q

Which cells are milk-secreting

A

acini cells

58
Q

What cells surround the alveoli and contract to make milk flow

A

myoepithelial cells

59
Q

What are some positive indicators of successful breastfeeding

A

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

60
Q

What effect does FIL have on lactation?

A

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.

61
Q

Describe the endocrine control of lactation?

Name secretory gland, hormones, and location

A

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

62
Q

Describe the autocrine control of lactation?

Name the hormone, effects and location

A

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

63
Q

What does the acronym CHIN stand for?

A 
close
head free
in line
nose to nipple
sustainable

SOM Quiz 1 (5 decks)

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