Renal & Urologic Systems Flashcards
Where does kidney pain radiate to?
Flank pain
- upper abdomen, from ribs to pelvis
- Can radiate to side and back
What are some general effects of aging on the renal system?
Dec blood flow to kidney & decrease number of nephrons
Tendency for renal vasoconstriction (causes edema in system)
Fluid and electrolyte imbalances (increase risk of hyponatremia)
Smaller bladder capacity
Pelvic floor disorders
Polypharmacy
What is an antidiuretic (ADH)?
Stimulated by low blood volume or increase osmolarity of blood
Causes kidneys to reabsorb water
What is an Atrial natriuretic (ANH)?
Triggered by stretching of atria.
Inhibits sodium reabsorption and renin release;
Inhibits aldosterone secretion
Causes a decrease in kidney reabsorption of water
What does aldosterone do?
Triggered by decrease in blood volume or decrease in NA
Renin is released
Convert angiotension to get aldosterone
Causes increase Na and water resoprtion
What is a UTI most commonly caused by?
E. coli bacteria
Are UTI’s more common in males or females?
More common in females (shorter urethra)
What are some common SxS of a UTI?
Urinary frequency Urinary urgency Nocturia Pain (shoulder, back, flank, pelvis, lower abdomen) Costovertebral tenderness Fever and chills Hyperesthesia of deratomes Dysuria (painful, difficult to urinate) Hematuria (blood in urine) Pyuria (pus in urine) Dysparenunia (painful sexual intercourse)
What are some things UTI’s may be associated with?
Diabetes
Larger prostate
What are some risk factors for UTIs?
Age Immobility/inactivity Instrumenation and urinary catheterization Atonic bladder (spinal cord injury) Increased sexual activity Spermicide use with diaphragm or condom Uncircumcised Obstruction Constipation Kidney transplantation DM Partner of viagra user STD
How do you diagnose and treat UTI’s?
Dx: Urinalysis, Ultrasound, x-ray, CT, postvoid residual, voiding cystourethrography
Treatment: Antibiotics
What are special implications to the PT for a UTI?
Look for SxS of infection
Careful with low back pain
Important to monitor in patients with a spinal cord injury
If patient with fever greater than 102 and complains of vomiting notify clients physician
Therapy is similar to incontinence therapy
Where are the common sites for renal stones?
Pelvis and calyces
What are the common types of stones?
Calcium (most common)
Struvite, (related to bacterial UTI’s)
Uric acid (gout)
Cystine (hereditary)
Where are the 3 most common sites of urinary obstruction secondary to renal stones?
Ureteropelvic junction (just as it's leaving the kidney) Where ureter crosses over the iliac vessels Ureterovesical junction (right before bladder)
