Renal DSA

Question 1

SD of the occiput and C spine can result in: (2)

Answer 1

1. myofascial tension on CN X

2. inhibit parasympathetic tone to the kidneys, and proximal ureters

Question 2

Decreased parasympathetic tone to the kidneys can result in (2)

Answer 2

1. decreased GFR and urine volume –> UTI or stones

2. slow flushing of stones

Question 3

Excess Sympathetic activity to the kidneys may result in: (3)
All of which contribute to:

Answer 3

1. vasoconstriction of the afferent arterioles
2. reduced GFR
3. reduced urine volume
   - contribute to UTI formation and propagation

Question 4

Insufficient sympathetic tone to the bladder can result in: (4) all are typical in ____

Answer 4

1. excessive contraction of the detrusor mm
2. increased urinary frequency
3. hesitance
4. urgency
   - typical in UTI

Question 5

Excessive sympathetic tone to the urinary tract will contribute to the symptoms of urinary calculi by: (3)

Answer 5

1. dec GFR
2. dec ureter peristalsis
3. inc sensitivity to pain

Question 6

Excessive sympathetic tone can result in constriction of the _____ and _____ which slows the passage of _____.

Answer 6

internal urethral sphincter…urethra….stones

Question 7

excessive sympathetic tone to the bladder can result in _______ dt inappropriate relaxation of the detrusor mm and contraction of the urethral sphincter

Answer 7

incomplete emptying and urinary retention

Question 8

Treatment of SD in the ______ is intended to normalize sympathetic tone in the kidneys, bladder, detrusor mm, ureters, prostate and testes.

Answer 8

thoracolumnar area

Question 9

______ tone to the bladder can result in the inappropriate contraction of the detrusor mm and relaxation of the internal sphincter leading to _____.

Answer 9

excessive parasympathetic tone….urinary incontinence

Question 10

inhibited parasympathetic tone to the bladder can result in _____ leading to urinary retention, hypotonic bladder, overflow incontinence and increased risk of UTI.

Answer 10

decreased contraction of the detrusor mm and increased contraction of internal urethral sphincter

Question 11

Inhibition of parasympathetic tone of in the distal ureters can interfere with _____

Answer 11

passing of urinary calculi

Question 12

Inhibition of the ______ nerve can decrease control of the external urethral sphincter

Answer 12

pudendal n.

Question 13

SD in the lumbo-sacral area can adversely effect the _____ nerve causing weakness of the pelvic diaphragm and inhibiting ______.

Answer 13

perineal n. …..venous/lymphatic circulation and drainage

Question 14

Spinal region to normalize ANS tone to the Bladder and urethra:

Answer 14

T12-L2

Question 15

Spinal region to normalize ANS tone to the kidneys and ureters

Answer 15

T10 - L1

Question 16

The venous and lymph flow to all pelvic organs is dependent on the______.

Answer 16

active motion of the thoracic diaphragm and passive motion of the pelvic diaphragm

Question 17

The kidneys move ____ during inhalation allowing for easier____

Answer 17

downward….palpation

Question 18

The _____ mm courses obliquely causing _____ of each kidney.

Answer 18

Psoas….lateral displacement of the lower poles

Question 19

Psoas contracture/SD can effect:

Answer 19

fascial restriction of the ureters and kidney

Question 20

Preganglionic sympathetic fibers for the kidney and upper ureter synapse in the ____

Answer 20

superior mesenteric collateral ganglion;

Question 21

Preganglionic sympathetic fibers for the bladder and lower ureter synapse in the ____

Answer 21

inferior mesenteric collateral ganglion

Question 22

Sympathetic spinal Cord Levels for kidneys, ureters, bladder?

Answer 22

Kidney and ureter - T10 - L1

Bladder - T12 - L2

Question 23

Sympathetic stimulation of the kidney, bladder and ureter causes..(3)…and is exaggerated by___

Answer 23

• vasoconstriction of afferent arterioles
• decreased GFR
• decreased urine volume
  ….exaggerated with emotional stress

Question 24

Constant Sympathetic stimulation of kidneys (weeks) can cause ____ dt ______.

Answer 24

chronically elevated arterial pressure dt renal retention of fluid

Question 25

Parasympathetics to the kidneys and proximal portion of the ureters?

Answer 25

vagus n

Question 26

Parasympathetics to the distal part of the ureters and bladder?

Answer 26

pelvic splanchnic nn (S2-4)

Question 27

In the ureters, Parasympathetics effect _____.

Answer 27

peristaltic wave

Question 28

Visceral afferents in the bladder will transmit impulses to _____ to sense fullness; at the same time visceral afferents to _____ initiate a Parasympathetic reflex to increase bladder _____ and simultaneous relaxation of the _______.

Answer 28

L1-2....S2-4.....wall tone.....internal urethral sphincter

Question 29

Micturation takes place with the voluntary relaxation of the _____ via impulses from _____ and the simultaneous sympathetic relaxation of the ________.

Answer 29

external urethral sphincter.....pudendal n (S2-4)....external urinary sphincter.

Question 30

The ______ will cause increased tonus to the thoracolumbar junction and a positive Lloyd's punch test.

Answer 30

renal viceromotor reflex

Question 31

The ______ is usually described as an ache, and my refer only to the thoracolumbar area, flank or both,

Answer 31

renal vicerosensory reflex

Question 32

The ______ usually extends from the lumbar region and the iliac fossa over the front of the abdomen and the scrotum/labia.

Answer 32

ureteral viscerosensory reflex

Question 33

The _____ also causes the abdominal, erector spinae and the cremasteric mm to become tense.

Answer 33

the ureteromotor reflex

Question 34

As a stone passes through the ureters, palpatory changes from visceromotor reflex will progress from _______.

Answer 34

T10 into the lumbar region

Question 35

Renal lymphatics draining the capsule and parenchyma flow into the _____ nodes before traveling up the thoracic duct and the subclavian vein.

Answer 35

pre-aortic

Question 36

The synchronous motion of_____ is vital to lymphatic drainage from the urinary system.

Answer 36

thoracic and pelvic diaphragms

Question 37

Postural disorders, particularly short leg syndrome and psoas spasm frequently cause ____ and when accompanied by _______ are often misconstrued as UTIs.

Answer 37

backache.....functionally induced urinary changes

Question 38

SD of the Pubic symphysis with tension in the urogenital diaphragm, or the puboprostatic/pubovesicular ligaments may cause (2):

Answer 38

- dysuria | - urgency or frequency of urination

Question 39

Impaired lymphatic flow effects: (2)

Answer 39

1. inc oncotic interstitial pressure --> disrupted countercurrent exchange--> dec ability to concentrate urine 2. inc risk of kidney damage dt ureteral obstruction

Question 40

Pts with acute glomerulonephritis and pyelonephritis have SD in what spinal areas? Which is more responsive to treatment?

Answer 40

- T11 - L1 | - acute Glomerulonephritis

Question 41

Spinal area to treat for pts with azotemia and uremia?

Answer 41

- T10 - L2