Renal/Urinary tract disorders Flashcards
where are the kidneys located?
retroperitoneal, enclosed in the renal capsule
what is the functional unit of the kidney
nephron
what has to be involved in order for pain to be present with the kidney
when renal capsule or ureter is involved–kidneys do not have pain receptors
renal pyramid function
channels output to renal pelvis for excretion
renal calyx function
channels formed urine from the renal pyramids to the renal pelvis
renal pelvis function
blood containing waste products forms urine and is channeled away
Ureter function
tube that terminates in the urethra
Cortex function
outer layer of the kidney
medulla location and what is it composed of
inner portion of kidney, composed of renal pyramids and tubular structures
Glomerulus located in nephron function
act as filter for passage of protein-free and RBC-free filtrate
Bowmans capsule located in nephron function
contains glomerulus and acts as a filter for urine
Proximal convoluted tubule (PCT) located in nephron function
site of reabsorption of glucose, amino acids, metabolites and electrolytes from filtrate
Loop of henle located in nephron function
further concentration of filtrate through reabsorption
Distal convoluted tubule (DCT) located in nephron function
site from which filtrate enters the collecting tubule
collecting tubule located in nephron function
releases urine
what kind of diffusion does Bowmans capsule operate under?
passive diffusion
Normal GFR
120ml/min
what happens to glucose when there is too much of it?
it gets dumped out in urine
efferent neurons function
artery carrying blood AWAY from glomerulus
afferent neurons function
artery carrying blood TO glomerulus
parasympathetic system does what to urinary system
contracts it
sympathetic system does what to urinary system
relaxes it
ureters function
transport urine from each kidney to bladder
how is autoregulation of renal blood flow accomplished?
changing renal vascular resistance
what happens when to renal blood flow when there is vasoconstriction of renal arteries?
decrease in renal blood flow
what happens to GFR when there is vasoconstriction
it decreases
what happens to renal blood flow when there is vasodilation?
it increases
what happens to GFR when there is vasodilation?
it increases
Angiotension II at low concentrations constricts efferent arterioles which does what to GFR?
increases it
Angiotension II at high concentrations constricts efferent arterioles which does what to GFR?
decreases it
what do ACE inhibitors do to efferent arterioles and how does it effect GFR?
dilates them which decreases GFR
which substances are not usually filtered?
large proteins, negatively charged molecules, lipid soluble hormones bound to plasma proteins
what is filtered through kidneys but NOT reabsorbed or secreted?
inulin
Oncotic pressure of Bowmans capsule allows how much protein to be filtered?
a small amount of protein
increased hydrostatic pressure of Bowmans capsule is done by the ureters by doing what?
constricting
ANP and BNP do what?
cause relaxation
why does NFP decrease with liver disease?
not making plasma proteins
what happens to BUN and serum creatinine when GRF is decreased?
they increase
if there is an increase in plasma protein what happens to GFR?
it increases
if there is a ureteral stone, what happens to GFR?
it decreases
primary active transport
Hydrogen and calcium are removed from cells
secondary active transport
sodium (or other ions)supply energy for transport
transport maximum
max rate that a substance will be reabsorbed
Urinalysis is a test for the evaluation of?
renal system and for determining renal disease
Urine culture and sensitivity is a urine test that identifies the presence of?
microorganisms and determines the specific antibiotics needed
Specific gravity is a urine test that measures?
specific gravity of urine
creatinine clearance is the most accurate when measuring what?
GFR
clearance refers to the complete removal of a substance from what?
the blood
why is creatinine clearance important?
because creatinine is filtered by glomeruli but not reabsorbed by the tubules
how is the creatinine clearance test done?
blood is drawn at start of test and morning the day that 24 hr urine specimen collection is complete
what should you tell the patient to do while doing creatinine clearance test
drink lots of fluids before and during the test, avoid teas coffee, medications during test
GFR is a function of
permeability of capillary walls
vascular pressure and filtration pressure
relationship between GFR and creatinine clearance
creatinine clearance = GFR since tubules neither reabsorb nor secrete creatinine
Creatinine clearance calculation
GFR + (quantity of urine) x (creatinine concentration in urine) / (serum creatinine)
VMA (Anillylmandelic Acid) test
24 hr urine collection to diagnose pheochromocytoma, a tumor of adrenal gland
because a VMA (Anillylmandelic Acid) test is looking for a pheochromocytoma, (a tumor of adrenal gland) what will there be lots of in the urine?
catecholamines
17-Ketosteroids test
24 hr urine that tests for endocrine imbalances
uric acid test
24 hr urine test to diagnose gout and kidney disease
KUB
looks for kidney stones
Intravenous pyelogram (IVP)
injection of dye that outlines the renal system
what should patient do after a Intravenous pyelogram (IVP)
drink at least 1 liter of fluid, monitor for bleeding
renal angiography
injection of dye to examine renal arterial supply
renal angiography pre-procedure duties
warn patient may feel burning sensation after dye injected, NPO after midnight, void right before procedure, give enema, mark peripheral pulses
renal angiography post-procedure duties
assess peripheral pulses, bedrest, sandbag insertion 4-8 hrs, give fluids
Renal scan
IV injection of dye to show renal blood flow
renal scan pre-procedure duties
patient will be motionless
renal scan post-procedure duties
radioactivity is eliminated in 24 hrs, (double bag diapers)
oliguria
urine <400ml/day, this results in renal failure if not corrected
anuria
complete cessation of urine flow
significant acute renal failure is associated with DAILY increase in?
serum creatinine and urea nitrogen
pre-renal causes of acute renal failure
hypovolemia, cardiovascular disorders, peripheral vasodilation, renovascular obstruction, severe vasoconstriction,
pre-renal causes of ARF can lead to what?
Intra-renal causes
pre-renal causes of ARF cannot lead to?
post-renal causes
Intra-renal causes of ARF
acute tubular necrosis, obstetric complications, pigment release, parenchymal disorders
parenchymal disorders
parts of an organ that are concerned with its function as opposed to its framework
parenchymal disorder example
sickle cell disease
acute tubular necrosis
something attacked nephron
post-renal causes of ARF
ureteral obstruction, bladder obstruction, urethral obstruction
1 post-renal cause of ARF
Benign Prostatic Hypertrophy
gold standard for interstitial nephritis diagnoses?
renal biopsy
when will BUN be increased?
GI bleed, renal failure
when will creatinine be increased?
renal failure
osteitis fibrosa
high bone turn over, low calcium levels
osteomalacia
low bone turnover
uremics will have high or low levels of serum calcium?
low