Renal DSA Flashcards
SD of the occiput and C spine can result in: (2)
- myofascial tension on CN X
2. inhibit parasympathetic tone to the kidneys, and proximal ureters
Decreased parasympathetic tone to the kidneys can result in (2)
- decreased GFR and urine volume –> UTI or stones
2. slow flushing of stones
Excess Sympathetic activity to the kidneys may result in: (3)
All of which contribute to:
- vasoconstriction of the afferent arterioles
- reduced GFR
- reduced urine volume
- contribute to UTI formation and propagation
Insufficient sympathetic tone to the bladder can result in: (4) all are typical in ____
- excessive contraction of the detrusor mm
- increased urinary frequency
- hesitance
- urgency
- typical in UTI
Excessive sympathetic tone to the urinary tract will contribute to the symptoms of urinary calculi by: (3)
- dec GFR
- dec ureter peristalsis
- inc sensitivity to pain
Excessive sympathetic tone can result in constriction of the _____ and _____ which slows the passage of _____.
internal urethral sphincter…urethra….stones
excessive sympathetic tone to the bladder can result in _______ dt inappropriate relaxation of the detrusor mm and contraction of the urethral sphincter
incomplete emptying and urinary retention
Treatment of SD in the ______ is intended to normalize sympathetic tone in the kidneys, bladder, detrusor mm, ureters, prostate and testes.
thoracolumnar area
______ tone to the bladder can result in the inappropriate contraction of the detrusor mm and relaxation of the internal sphincter leading to _____.
excessive parasympathetic tone….urinary incontinence
inhibited parasympathetic tone to the bladder can result in _____ leading to urinary retention, hypotonic bladder, overflow incontinence and increased risk of UTI.
decreased contraction of the detrusor mm and increased contraction of internal urethral sphincter
Inhibition of parasympathetic tone of in the distal ureters can interfere with _____
passing of urinary calculi
Inhibition of the ______ nerve can decrease control of the external urethral sphincter
pudendal n.
SD in the lumbo-sacral area can adversely effect the _____ nerve causing weakness of the pelvic diaphragm and inhibiting ______.
perineal n. …..venous/lymphatic circulation and drainage
Spinal region to normalize ANS tone to the Bladder and urethra:
T12-L2
Spinal region to normalize ANS tone to the kidneys and ureters
T10 - L1
The venous and lymph flow to all pelvic organs is dependent on the______.
active motion of the thoracic diaphragm and passive motion of the pelvic diaphragm
The kidneys move ____ during inhalation allowing for easier____
downward….palpation
The _____ mm courses obliquely causing _____ of each kidney.
Psoas….lateral displacement of the lower poles
Psoas contracture/SD can effect:
fascial restriction of the ureters and kidney
Preganglionic sympathetic fibers for the kidney and upper ureter synapse in the ____
superior mesenteric collateral ganglion;
Preganglionic sympathetic fibers for the bladder and lower ureter synapse in the ____
inferior mesenteric collateral ganglion
Sympathetic spinal Cord Levels for kidneys, ureters, bladder?
Kidney and ureter - T10 - L1
Bladder - T12 - L2
Sympathetic stimulation of the kidney, bladder and ureter causes..(3)…and is exaggerated by___
- vasoconstriction of afferent arterioles
- decreased GFR
- decreased urine volume
….exaggerated with emotional stress
Constant Sympathetic stimulation of kidneys (weeks) can cause ____ dt ______.
chronically elevated arterial pressure dt renal retention of fluid
Parasympathetics to the kidneys and proximal portion of the ureters?
vagus n
Parasympathetics to the distal part of the ureters and bladder?
pelvic splanchnic nn (S2-4)
In the ureters, Parasympathetics effect _____.
peristaltic wave
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 _______.
L1-2….S2-4…..wall tone…..internal urethral sphincter
Micturation takes place with the voluntary relaxation of the _____ via impulses from _____ and the simultaneous sympathetic relaxation of the ________.
external urethral sphincter…..pudendal n (S2-4)….external urinary sphincter.
The ______ will cause increased tonus to the thoracolumbar junction and a positive Lloyd’s punch test.
renal viceromotor reflex
The ______ is usually described as an ache, and my refer only to the thoracolumbar area, flank or both,
renal vicerosensory reflex
The ______ usually extends from the lumbar region and the iliac fossa over the front of the abdomen and the scrotum/labia.
ureteral viscerosensory reflex
The _____ also causes the abdominal, erector spinae and the cremasteric mm to become tense.
the ureteromotor reflex
As a stone passes through the ureters, palpatory changes from visceromotor reflex will progress from _______.
T10 into the lumbar region
Renal lymphatics draining the capsule and parenchyma flow into the _____ nodes before traveling up the thoracic duct and the subclavian vein.
pre-aortic
The synchronous motion of_____ is vital to lymphatic drainage from the urinary system.
thoracic and pelvic diaphragms
Postural disorders, particularly short leg syndrome and psoas spasm frequently cause ____ and when accompanied by _______ are often misconstrued as UTIs.
backache…..functionally induced urinary changes
SD of the Pubic symphysis with tension in the urogenital diaphragm, or the puboprostatic/pubovesicular ligaments may cause (2):
- dysuria
- urgency or frequency of urination
Impaired lymphatic flow effects: (2)
- inc oncotic interstitial pressure –> disrupted countercurrent exchange–> dec ability to concentrate urine
- inc risk of kidney damage dt ureteral obstruction
Pts with acute glomerulonephritis and pyelonephritis have SD in what spinal areas? Which is more responsive to treatment?
- T11 - L1
- acute Glomerulonephritis
Spinal area to treat for pts with azotemia and uremia?
- T10 - L2
