Quiz 9 Flashcards
VOCAB:
Upper Renal/Urinary Tract or System contents
Lower Renal/Urinary Tract or System contents
Function of Kidney:
Ureters vs. Urethra:
Azotemia
(how to remember)
Urea:
Uremia
(how to remember)
Nephrotic syndrome:
Bladder cancer:
- What is the typical s/s
Chronic kidney disease
What is Dialysis:
What are the 2 types of Dialysis:
Continuous ambulatory peritoneal dialysis (CAPD)
Continuous cycling peritoneal dialysis
Cystectomy
Cystocele
(how to remember)
Cystometry
(how to remember)
Cystoscopy
Diabetic bladder NEUROpathy
Diabetic NEPHROpathy
Dyspareunia
(how to remember)
*** Dysuria
Glomerular filtration rate (GFR)
Glomerulonephritis
Hematuria
Interstitial cystitis (and the other name for this)
Intravenous pyelography
Micturition
Urinary incontinence
Stress urinary incontinence
Urgency (Urge) urinary incontinence
Mixed urinary incontinence
Overflow incontinence
Functional incontinence
Murphy sign
Nephrogenic systemic fibrosis
Nephrolithiasis
lithiasis=
Renal calculi
(how to remember)
Lithotripsy
(how to remember)
NEUROgenic bladder
Nocturia
Overactive bladder
Pessary
(how to remember)
Polycystic kidney disease
Pyelonephritis
Pyuria
Renal cell carcinoma
Renal osteodystrophy
(how to remember)
Uremic encephalopathy
(how to remember)
Uroflowmetry
Wilms tumor
(how to remember)
Urinary Tract Infection:
Upper Urinary Tract Infections vs Lower:
Glomerular disease
Upper: is kidney and ureters
Lower: is bladder and urethra
Function of Kidney: Your kidneys FILTER your blood and bodily fluids. It removes the wastes, excess fluid/water, salts, urea, nitrogen from your blood, which are then excreted in your urine. The kidney also helps to control your blood pressure and fluid levels in body.
Ureters: run from the kidneys to the bladder to remove waste/urine.
Urethra: runs from the bladder to exit the body to remove waste/urine.
Azotemia: abnormally high levels of NITROGEN-containing compounds (such as urea, CREATININE, various body waste compounds, and other nitrogen-rich compounds) in the BLOOD.
(Aztecs had a lot of nitrogen and creatinine)
Urea: WASTE product in URINE. As body breaks down (metabolizes) PROTEINS and AA’s, this is the waste product. Urea SHOULD be in urine, but NOT in the blood.
Uremia: A condition involving abnormally high levels of WASTE products in the BLOOD. Wastes should be eliminated from the blood by the kidneys through the urine (not get into the blood). If blood has high levels of uremia, it means kidneys are not working properly. Uremia is a dangerous condition that occurs when the kidneys no longer FILTER properly. It’s likely to occur when a person is in the final stage of chronic kidney disease.
Symptoms include fatigue, nausea, loss of appetite, a metallic taste in the mouth, and mental confusion.
Treatment includes dialysis or a kidney transplant.
(urea = waste, and MI is HIGH)
Nephrotic syndrome: A kidney disorder that causes the body to excrete too much PROTEIN in the urine.
Bladder Cancer: Cancer in the bladder.
- Typical s/s is blood in the urine (uremia)
Chronic Kidney Disease: The gradual loss of kidney function.
Dialysis: Dialysis is a way of cleaning your blood when your kidneys can no longer function properly and do their job. It gets rid of your body’s wastes, extra salt and water, and helps to control your blood pressure. It does what your kidneys do.
2 Types:
- HEMOdialysis: Where blood is pumped OUT of your body to an artificial kidney MACHINE, and returned to your body by tubes that connect you to the machine.
- PERITONEAL dialysis: The inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.
CAPD: A soft plastic tube (catheter) is placed in your belly by surgery. A sterile cleansing FLUID is put INTO your BELLY through this catheter. After the filtering process is finished, the fluid leaves your body through the catheter.
CAPD is “continuous,” but machine-free, and done while you go about your normal activities such as work or school. You do the treatment by placing about two quarts of cleansing fluid into your belly and later draining it. This is done by hooking up a plastic bag of cleansing fluid to the tube in your belly. Raising the plastic bag to shoulder level causes gravity to pull the fluid into your belly. When empty, the plastic bag is removed and thrown away.
When an exchange (putting in and taking out the fluid) is finished, the fluid (which now has wastes removed from your blood) is drained from your belly and thrown away. This process usually is done three, four or five times in a 24-hour period while you are awake during normal activities. Each exchange takes about 30 to 40 minutes. Some patients like to do their exchanges at mealtimes and at bedtime.
Continuous cycling peritoneal dialysis: This machine automatically fills and drains the dialysis solution from the abdomen. A typical CCPD schedule involves three to five exchanges during the NIGHT while the person SLEEPS.
Cystectomy: surgical REMOVAL of all or part of the urinary BLADDER (or a CYST in bladder). It may also be rarely used to refer to the removal of a cyst. The most common condition warranting removal of the urinary bladder is bladder cancer.
Cystocele: when the supportive tissue between a WOMAN’s BLADDER and VAGINAL WALL WEAKENS and stretches, allowing the bladder to BULGE INTO the VAGINA. Cele = herniation
(cele is the girl with a cyst … causing bladder to come
down into vagina)
Cystometry: TEST to measure URINARY FUNCTION. It measures the pressure inside of the bladder to see how well the bladder is working. Cystometry is done when a muscle or nerve problem may be causing problems with how well the bladder holds or releases urine.
(metry makes me think of a subject in school, so a test)
Cystoscopy: a procedure that allows your doctor to examine the lining of your bladder and the tube that carries urine out of your body (URETHRA). A hollow tube (cystoscope) equipped with a lens is inserted into your urethra and slowly advanced into your bladder. Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope. The urethra is the tube that carries urine from the bladder to the outside of the body. The cystoscope has lenses like a telescope or microscope.
Diabetic bladder neuropathy: A term referring to bladder problems caused by diabetic autonomic NEUROpathy. … The symptoms of a bladder or urinary tract infection (UTI) include frequent urination of only small amounts of urine, pain or burning when urinating, being unable to urinate despite feeling the urge, and cloudy or discolored urine.
Diabetic nephropathy: Diabetic NEPHROpathy is damage to your kidneys caused by diabetes. In severe cases it can lead to kidney failure. But not everyone with diabetes has kidney damage (about 40% have this).
Dyspareunia: difficult or painful sexual intercourse.
(uria is urine, but this is unia so YOU N me …
intercourse)
*** Dysuria: painful or difficult urination.
Glomerular filtration rate: describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR.
Glomerulonephritis: acute INFLAMMATION of the kidney, typically caused by an immune response.
Hematuria: the presence of blood in urine.
Interstitial cystitis: also called PAINFUL BLADDER SYNDROME — is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain.
Intravenous pyelography: An intravenous pyelogram, also called an intravenous urogram, is a RADIOLOGICAL procedure used to visualize abnormalities of the urinary system, including the kidneys, ureters, and bladder.
Micturition: act of passing urine
Urinary incontinence: the unintentional loss of urine.
Stress urinary incontinence: happens when PHYSICAL movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. Stress incontinence is NOT related to psychological stress. Stress incontinence differs from urge incontinence
Urgency urinary incontinence: OVERACTIVE BLADDER … you FEEL URGE TO PEE BUT CAN’T CONTAIN IT. It’s the unintentional loss of urine caused by the bladder muscle contracting, usually associated with a sense of urgency. Stress incontinence is much more common in women than men. If pelvic floor muscles are weak and you can’t contain the urine.
Mixed urinary incontinence: has both stress and urge urinary incontinence tendencies
Overflow incontinence: is the involuntary release of urine-due to a weak bladder muscle or to blockage-when the bladder becomes overly full, even though the person feels no urge to urinate.
Functional incontinence: YOU CAN NOT GET TO THE BATHROOM because of mobility issues. Nothing is wrong with kidney or urinary system. Functional incontinence is a form of urinary incontinence in which a person is usually aware of the need to urinate, but for one or more physical or mental reasons they are UNABLE to get to a bathroom. The loss of urine can vary, from small leakages to full emptying of the bladder.
Murphy Sign: a test for GALLBLADDER disease in which the patient is asked to inhale while the examiner’s fingers are hooked under the liver border at the bottom of the rib cage. The inspiration causes the gallbladder to descend onto the fingers, producing pain if the gallbladder is inflamed.
Nephrogenic systemic fibrosis: rare disorder that occurs in some individuals with reduced kidney function, who have been exposed to an intravenous contrast material that contains gadolinium. A contrast material is a dye that is sometimes used during magnetic resonance imaging (MRI). It is caused by gadolinium exposure used in imaging in patients who have renal insufficiency.
Nephrolithiasis = kidney stone. A small, hard deposit that forms in the kidneys and is often painful when passed.
lithiasis= Formation of … stones (in gallbladder or kidney)
Renal calculi: Another term for KIDNEY STONE
(calc = calcify, so hard kidney stone)
Lithotripsy: BREAK UP A KIDNEY STONE. A treatment, typically using ultrasound shock waves, by which a KIDNEY STONE or other calculus (hardened mass) is broken into small particles so that it can be passed out by the body.
(lipo is fat, this is litho so kidney stone … trip it so it falls
apart)
Neurogenic bladder: bladder dysfunction caused by NEUROlogic damage. Symptoms can include overflow incontinence, frequency, urgency, urge incontinence, and retention. Risk of serious complications
Nocturia: Having to urinate a lot (2+ times) at night
Overactive bladder: A problem with bladder function that causes the sudden need to urinate.
Pessary: A vaginal pessary is a soft, removable device that goes in your vagina. It supports areas that are affected by pelvic organ prolapse (POP). This happens when the bladder, rectum, or uterus drops or bulges down toward the vagina.
(think of pussy)
Polycystic kidney disease: An INHERITED disorder in which clusters of CYSTS develop in the KIDNEYS.
Pyelonephritis: INFLAMMATION of KIDNEY (nephron loops) due to a bacterial infection. Upper urinary tract infection.
Pyuria: the presence of PUS in the URINE, typically from bacterial infection.
Renal cell carcinoma: A type of KIDNEY CANCER that starts in the lining of small tubes in the kidney. Renal cell cancer is a disease in which malignant (cancer) cells are found in the lining of tubules (very small tubes) in the kidney.
Renal osteodystrophy: A BONE disease that occurs when your KIDNEYS FAIL to maintain proper levels of CALCIUM and phosphorus in the blood. It’s common in people with kidney disease and affects most dialysis patients.
(osteo = bone)
Uremic encephalopathy: is an organic BRAIN disorder. It develops in patients with acute or chronic RENAL FAILURE, usually when the estimated glomerular filtration rate (eGFR) falls and remains below 15 mL/min.
(cephalo = brain)
Uroflowmetry: Measures flow rate of urine. Urine flow rate or urinary flow rate is the volumetric flow rate of urine during urination. It is a measure of the quantity of urine excreted in a specified period of time. It is measured with uroflowmetry, a type of flowmetry
Wilms Tumor: Wilms’ tumor is a rare KIDNEY CANCER that primarily affects CHILDREN. Also known as nephroblastoma, it’s the most common cancer of the kidneys in children.
(Wilma loves children)
Urinary Tract Infection: An infection in any part of the urinary system, the kidneys, ureter, bladder, or urethra (and could lead elsewhere - into reproductive system). Urinary symptoms — such as blood in the urine and burning with urination — could result from a UTI. Urinary tract infections are more common in women. They usually occur in the bladder or urethra, but more serious infections involve the kidney. A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination, and blood in the urine. A kidney infection may cause back pain, nausea, vomiting, and fever. Treat with antibiotics
UPPER:
Pyelonephritis: INFLAMMATION of KIDNEY (nephron loops) due to a bacterial infection.
Ureteritis
LOWER:
Interstitial cystitis: also called painful bladder syndrome — is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain.
Urethritis
Glomerular disease: A number of different diseases can result in glomerular disease. It may be the direct result of an infection or a drug toxic to the kidneys, or it may result from a disease that affects the entire body, like diabetes or lupus. Many different kinds of diseases can cause swelling or scarring of the nephron or glomerulus.
1) Main differences between hemodialysis and CAPD:
2) Explain how patients will feel doing either:
3) These patients are limited to how much fluid intake per day?
1) Hemodialysis: - Uses a machine to take blood out and filter it - Has to be done at hospital, 3x a week - Extreme changes in BP - Gets nautious - Erythropoetin is injected back in
CAPD:
- Doesn’t require machine
- Patient is responsible to ensure it is done (so a patient with cognitive or functional disability can’t do this)
- Can do it yourself at home
- This is better for people with poor BP control
- Erythropoetin is injected back in
2)
- THEY WILL BE WEAK / fatigued
- VERY PRONE TO INFECTION
- Will gain weight often (so strict diet is enforced)
- Get depressed and discouraged
3)
1. 5 Liters a day
Brief review of urinary anatomy:
- Bladder, urethra, urethral opening
- Pelvic floor muscles (base to hold everything in place inferiorly)
- Sexual organs
- Sphincter muscle controls
Bladder fills at a constant rate, and we feel urge to void when it is around 150 -200 ml. Total bladder capacity can hold 400-600 mL of urine.
At 400-600 mL of fullness, signal is sent to brain to void (and pelvic floor muscles relax). You void everything except 5-50 mL
When urinary system fails it can’t contain urine.
Increased pressure of rectum during constipation puts strain on pelvic floor, so bladder capacity is limited. Constipation is when your pelvic floor muscles won’t relax.
We should drink 6-8 ounce glasses per day. WATER is best. Avoid coffee, tea, soda, smoking, alcohol, chocolate, spicy foods, etc. EVEN IF they don’t want to, or are experiencing diahrrea, they should drink water.
Urodynamic Testing = proceedures to see how bladder, sphincters, ureters function. It tests ability of bladder on how well it can hold urine and release it properly. It can see how well muscles of pelvic floor are working.
Kegal exercises help contract pelvic floor to strengthen pelvic floor muscles. And you can technically do MMT and grade from 0-5
Surgery doesn’t really help, and especially not for urge incontinence. And you should NOT have any proceedure done if you intend to have another child.
Interventions: EDUCATION, kegal exercises, HEP, Core strengthening, biofeedback
PT is much more cost effective than a surgery route to help with bladder or urinary incontinence.
Normally you should NOT get up in the middle of the night (maybe once or possibly twice). But 2+ times a night is NOT normal and it interrupts your sleep. And some can’t get back to sleep, so they either limit their fluids or just not get up. Or a patient at risk for falls who are tired but need to get up to go pee, that is a dangerous situation.
Leading cause of kidney failure
Where would a kidney stone NOT be
Would Nocturia make someone become dehydrated (Due to not drinking to reduce fluid intake)
Wetting the bed … or involuntary urination, especially by children at night.
Diabetic nephropathy
Bowman’s capsule
NO
Enuresis
