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urinary Flashcards

1
Q

what does the urinary system do?

A

filters nitrogenous waste from the blood.
helps regulate water, electrolyte and acid base balances

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2
Q

how does the urinary system filter waste?

A

kidneys filter blood in nephrons and secrete or reabsorb electrolytes under the direction of hormones

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3
Q

why does the urinary system filter?

A

maintain blood pressure
filtration of waste from the blood

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4
Q

what is the kidneys 5 main functions?

A

removal of waste
water balance (in and out)
salt balance (homeostasis of blood osmolarity)
long term blood pressure homeostasis
acid/base balance of blood

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5
Q

where are the kidneys in the body?

A

in the back under the 12th rib. held in place by fat

The retroperitoneum is an anatomical space located behind the abdominal or peritoneal cavity

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6
Q

what are the main components of the urinary system?

A

kidneys,
ureters,
bladder,
prostate (in males)
urethra (longer in males)

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7
Q

what does the kidneys produce?

A

enzymes to help regulate blood pressure
hormone erythropoietin to simulate red blood cell production in bone marrow

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8
Q

what artery supplies the kidney with blood?

A

renal artery

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9
Q

what is the nephron?

A

functional unit of the kidneys:
the filter that forms urine.
each kidney contains over a million of these tiny filter

thousands of collecting ducts collects fluids from several nephrons and conveys it to the renal pelvis

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10
Q

what are the 3 main processes which result in urine formation?

A

glomerular filtration
tubular reabsorption
tubular secreation

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11
Q

what happens in glomerular filtration?

A
  1. blood enters the kidneys through the renal artery and flows into the glomerulus (network of tiny blood capillaries) locates within the bowmans capsule
  2. filtration pressure
    the blood pressure in the glomerulus forces water, ions and small molecules out of the blood and into the bowmans capsule.
  3. filtrate compostion
    the substances that pass through the filtration membrane include: water, glucose, aminio acids, urea and electrolytes. protiens and blood cells are to large so remain in the bloodstream
  4. formation of filtrate
    the filterated fluid collects in the bowmans capsule and will eventually flow into the renal tubules.
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12
Q

what happens in tubular reabsorption?

A

location:
proximal convoluted tube

mechanisms:
passive diffusion, faciliated diffusion, active transport and osmosis

key substances are reabsorbed such as:
-water about 70%
-glucose and amino acids
-electrolytes (ions like sodium, potassium and bicarbonate)

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13
Q

what happens in tubular secreation?
mechanism
location

A

substances are actively transported from the blood into the renal tubules.- helps regulate the composition of urine.

location- distal convoluted tubule and collecting duct of the nephron.

substances secreated:
-urea
-creatinine
-drugs#
- potassium and hydrogen ions

mechanism
-active transport

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14
Q

what is nephrolithiasis?

A

kidney stones
a condition characteristed by the formation of solid mineral and salt deposits in the kidney

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15
Q

what are the symptoms of nephrolithiasis?

A

severe pain in the back, side or lower abdomen, (described as renal colic pain)- results from inflammation, stretching and spasms from the urinary tract.
- hematuria (blood in the urine)
-nausea and vomiting
-frequent urination or urgent need to urinate
-painful urination

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16
Q

what is the pathophysiology of nephrolithiasis?
what are the 3 factors which contribute

A

kidney storms form when there is an imbalance in the substances that make up urine:
-factors that contribute to stone formation:
-high concentration of calcium, oxalate or uric acid in urine.
- dehydration leading to concentrated urine
- certain metabolic disorders that affect how the body processes minerals

17
Q

whats the diagnosis of kidney stones?

A
  • medical history and physical examination
  • imaging tests such as ultersound or ct
    -urinalysis dipsticks to test for blood, crystals, infection (white cells, keytones, proteins and ph.
    -blood in the urine usually indicates trauma to the urinary tract
18
Q

what are the complications and management/ treatment of kidney stones?

A

UTI,
obstruction of urine flow,
kidney damage

dietary modifications,
increased fluid intake,
medical or surgical intervention to remove stones

high fluid intake for 24 hours to flush out the stone

19
Q

what are the 4 types of kidney stones?

A

cystine stones
calcium stones
uric acid stones
stuvite stones

20
Q

what are kidney stones risk factors

A

male,
family history,
dehydration
calcium supplements,
diet high in animal protiens,
hypothyroidism,
obesity.

21
Q
A
22
Q

what is the process of kidney stones being produced?

A
  1. supersaturation of urine:
    - kidney stones begin to form when urine becomes supersaturated with certain substances (calcium, oxalate, uric acid and phosphate)
  2. nucleation-
    supersaturated urine can lead to formation of tiny crystals. nucleation.
  3. crystal growth
    ones formed they grow larger as more of the supersaturated deposit on them.
  4. aggregation
    the crystals can stick together forming larger aggregates. this happens by the presence of protiens and substances that promote or inhibate stone fornation
  5. retention
    if they become large enough they might not pass through the urinary tract and become lodged in the kidneys, ureters or bladder.

factors infulencing stone formation:
dehydration,
diet- high instake of salt, animal protien and oxaltee rich foods.
metabolic disorders- hyperparathyroidism, UTI
-genetics

23
Q

what is renal failure?

A

when kidneys unable to remove bodys metabolic waste.
unable to perform regulatory functions.

Impaired renal excretion results in accumulation of waste and toxins in body fluids
Leads to disruption in endocrine and metabolic function, fluid, electrolyte and acid-base disturbances

24
Q

what is chronic kidney disease?

A

a decrease in kidney function or damage to the kidneys lasting for 3 months or more. it is often classified into five stages based on the glomerular filtration rate, which measures how well the kidneys are filtering blood

25
Q

what are the symptoms for chronic kidney failure

A

fatigue and weakness
-swelling in the legs, ankles or feet.
- changes in urine output (more or less than usual)
- shortness of breath
-nausea and vomiting
- loss of appetite
- itching
-high blood pressure
-anemia

26
Q

what is the diagnosis of chronic kidney disease?

A

blood tests-
measuring the levels of creatinine and blood urea nitrogen to assess kidney function

urine tests-
checking for proiten, blood or other abnormalitities

imaging-
ultrasound or Ct scans may be used to visualise the kidneys

kidney biopsy-
to find the underlying cause

27
Q

what can CKD lead to?

A

cardiovascular disease, bone disease and eventual kidney failure. requires ongoing mangement to slow progression and manage symptoms

28
Q

what is the treatment for CKD?

A

lifestyle changes-
dietary modifications (reduce sodium intake, ), managing protein consumption and maintaining a healthy weight

medications:
antihypertensives- to control blood pressure
-diuretics- too help manage fluid retention

management of complications such as treating conditions like diabetes and high cholesterol to reduce the risk of cardiovascular diisease

dialysis or transplant

29
Q

whats the risk factors for CKD?

A

diabetes,
hypertension,
heart disease,
family history,
age,
obesity,
smoking,
chronic inflammation

30
Q

what is prerenal acute kidney injury?

A

occurs due to factors affecting blood flow to the kidneys. rather than the kidneys themselves.

the kidneys are still structurally normal but they are not receiving enough blood to function properly- which can lead to a decline in kidney function

31
Q

what is pre renal AKI caused by?

A

conditions that reduce renal perfusion- decrease in GFR this can occur due to:
hypovolemia- reduced blood volume from dehydration, bleeding or excessive fluid loss.

decreased cardiac output- heart failure or shock can impede blood flow to the kidneys

vasodilation- conditons like sepsis can cause blood vessels to widen, reducing blood pressure and flow to the kidneys

32
Q

what are the symptoms of post renal AKI

A

decreased urine output
fatigue or weakness
dizziness or lightheadness, especialy when standing
-thirst or dry mouth due to dehydration
-signs of fluid overload, such as swelling in the legs or shortness of breath

33
Q

what is the diagnosis of prerenal AKI?

A

history and physical examination

blood tests- checking levels of creatinine and blood urea nitrogen

urinalysis- urine osmolality may be high

imaging

34
Q

is pre renal aki reversable and how

A

yes.

fluid resuscitation

medications to improve cardiac output or blood pressure

monitoring

35
Q

what is post renal aki

A

occurs when there is an obstruction in the urinary tract that prevents urine from being excreted, leading to iincreased pressure in the kidneys and potential damage

36
Q

what is the symptoms of post renal aki

A

decreased urine output
swelling in the legs, ankles, or feet due to fluid retention
pain in the lower back or abdomen
nausea ad vomiting
fatigue and weakness

37
Q

what are the causes of postrenal AKI and the location of causes?

A

ureteral obstruction: stones or tumors blocking flow from the kidneys to the bladder

bladder obstruction-conditions such as benign prostatic hyperplasia or bladder tumors causing blockage

urethral obstruction: structures or infections affecting urine flow

the obstruction leads to increase pressure in the renal pelvis causing a devvrease in GFR and potential damage to kidney tissue

38
Q

whats the diagnosis of post renal aki

A

history and physical examination

imaging stools- ct or ultrasound

blood tests-measuring creatinine and blood urea nitrogen

urinalyssis- chevking for blood and minerals which could cause kidney stones

39
Q

what is the treatment of post renal aki

A

catheterization, surgery, dialaysis or other procedures to remove the obstruction

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