Renal and Urologic system Flashcards
primary function of the renal system
maintain a stable internal environment for optimal cell and tissue metabolism
- balance solute and water transport
- excrete metabolic waste products
- conserve nutrients
- regulate acids/bases
- have an endocrine function
- synthesize glucose (gluconeogenesis)
the renal system regulates acids and bases by reabsorbing _______ and secreting ________ into the urine
bicarbonate; hydrogen ions
the renal system has an endocrine function, name three substances it secretes
- renin (regulation of bp)
- erythropoietin (rbc production)
- vitamin D (calcium metabolism)
what is the order that the renal system works
blood filtered -> kidneys -> ureters -> urinary bladder -> urethra
functional units of the kidneys
nephrons
what main structures does a nephron contain (5)
- renal corpuscles
- renal tubules
- loop of henle
- distal convoluted tubules
- collecting duct
what structures do the renal corpuscles contain
glomerulus and bowman capsule
the renal tubules contain the _______ tubules
proximal convoluted tubules
- most of water reabsorption
- glucose reabsorption
- nutrients and electrolytes to maintain homeostasis
what is the normal pH of urine
4.5 - 8
how much blood is filtered by the kidneys every 24 hours
200 L
how much filtered fluid is converted into urine and excreted each day
1 L
how much fluid and electrolytes are reabsorbed back into the bloodstream each day
178 L/day
name the route of glomerular filtration
afferent arterioles (in) -> glomerulus -> efferent arterioles (out)
AUTOREGULATION and hormones control pressure in the glomerular capillaries by what three things
- VASOCONSTRICTION of afferent arteriole (dec pressure/filtrate)
- DILATION of afferent arteriole (inc pressure/filtrate)
- VASOCONSTRICTION of efferent arteriole (inc pressure/filtrate)
arteriolar constriction is controlled by what three factors
- internal to kidneys (autoregulation
- nervous (external regulation)
- RAAS (external regulation)
what is the normal color of urine
clear, light yellow
what does low SG and high SG mean
low - dilute urine; high - concentrated urine
cloudy urine can be due to what
infection, vaginal discharge, dehydration, high fruit/vegetable diet
turbid urine can be due to what
crystal, blood, casts
dark colored urine can be due to what
hematuria, bilirubin, highly concentrated urine, drug SE/AE
unpleasant/unusual odor of urine can be due to what
infection, diet, meds
name some abnormal constituents of urine that can be found in a urinalysis
blood, elevated protein level, bacteria, glucose and ketones
microscopic blood in the urine from a urinalysis can indicate what
infection, inflammation, tumors in the urinary tract
gross blood in the urine from a urinalysis can indicate what
increased glomerular permeability or hemorrhage
elevated protein in the urine (proteinuria, albuminuria)
nephrotic syndrome and glomerular inflammation
bacteria in the urine (bacteriuria) can indicate what
UTI
glucose and ketones in the urine can indicate what
uncontrolled diabetes mellitus
what is the best test for renal functioning
GFR > 60 ml/min
normal BUN value
10 - 20 mg/dL
normal serum creatinine levels
0.6 - 1.3 mg/dL
elevated levels of BUN and creatinine can be caused by what
decreased GFR, dehydration or renal failure
(can lead to metabolic acidosis)
laboratory tests for the renal and urologic systems (5)
- urinalysis
- blood urea nitrogen (BUN)
- creatine
- culture
- occult blood
radiographic tests and scans for the renal and urologic system (4)
x-rays, CT, MRI, ultrasound
direct observation tests for the renal and urologic system
cystoscopy, uroscopy
what is another diagnostic test that can be done for the renal and urologic system
urodynamic tests
the involuntary passage of urine
urinary incontinence
nighttime wetting
nocturnal enuresis
stress incotinence
Involuntary loss of urine during coughing, sneezing, laughing or other physical activity associated with increased abdominal pressure
(increased intra-abdominal pressure forces urine through the sphincter)
who is stress incontinence more common in
women and men who have an enlarged prostate
urge incontinence
Involuntary loss of urine associated with an abrupt and strong desire to void (urgency)
mixed incontinence
combination of stress and urge incontinence
overflow incontinence
involuntary loss of urine with overdistention of the bladder
(associated with neurologic lesions below S1, polyneuropathies, and urethral obstruction - enlarged prostate or detrusor underactivity)
functional incontinence
involuntary loss of urine caused by dementia or immobility
neurogenic bladder
general term for bladder dysfunction caused by neurological disorders
inability to empty bladder
urinary retention
(may be accompanied by overflow incontinence; can follow anesthesia; spinal cord injury at sacral level blocks micturition reflex)
name three reasons UTIs are more common in women
- Shortness of urethra
- Proximity of urethra to anus
- Congenital abnormalities (mostly children)
two causes of UTIs in men
- Prostatic hypertrophy and prostatitis
- Urine retention
where is the most common site of UTI
bladder
s/s of cystitis and urethritis are based on what
inflammation and/or infection
name some s/s of cystitis/urethritis
polyuria, increased frequency, hematuria, cloudy urine, flank pain, mental status changes
infection of one or both upper urinary tracts
pyelonephritis (lower UTI that moves up the ureter)
AKI (acute kidney injury)
sudden decline in kidney function with a decrease in GFR and urine output and an elevation in plasma creatinine and BUN levels
- abrupt onset
- potentially reversible
name the phases of an AKI
initiation phase, extension phase, maintenance/oliguric phase, recovery/polyuria phase
______ phase: acute cell injury; prevention of injury is possible but window is short
initiation
______ phase: continued hypoxia and inflammatory response
extension
_______ phase: cells undergo repair, urine output is lowest
maintenance/oliguric
oliguria is urine output of what (less than what)
less than 400mL/24 hr
______ phase: glomerular function returns; diuresis is common; may take 3-12 months; some do not gain full recovery
recovery/polyuria
