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Pharm > Urinary Anatomy > Flashcards

Urinary Anatomy Flashcards

1
Q

anuria

A

absence of urine formation

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2
Q

bacteriuria

A

bacteria in the urine

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3
Q

dysuria

A

painful urination

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4
Q

enuresis

A

involuntary discharge of urine (bedwetting)

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5
Q

glycosuria

A

glucose in the urine

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6
Q

hematuria

A

blood in the urine

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7
Q

incontinence

A

loss of control (urine or feces)

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8
Q

ketonuria

A

acetone bodies (ketones) in the body

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9
Q

micturition

A

the physical action involved in active urination

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10
Q

oliguria

A

urine output < 30 ml/hr or < 400 ml/day

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11
Q

polyuria

A

excessive urine output

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12
Q

proteinuria

A

protein, usually albumin, in the urine

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13
Q

pyuria

A

pus in the urine

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14
Q

urgency

A

a sudden, uncontrollable need to urinate

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15
Q

Kidney function

A

fluid and electrolyte balance, acid base balance, regulate arterial BP (RAAS), excrete waste products

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16
Q

acid base balance

A

HPO4 buffer system
NH3 buffer system

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17
Q

regulate arterial BP (RAAS)

A

renin, angiotensin 2, aldosterone

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18
Q

excrete waste products

A

urea, creatinine

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19
Q

kidney structure outer to inner

A

cortex -> medulla -> renal pelvis -> nephron

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20
Q

kidney cortex

A

outer layer, glomeruli and tubules

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21
Q

kidney medulla

A

middle layer, renal pyramids

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22
Q

kidney renal pelvis

A

inner layer, calyces

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23
Q

kidney nephron

A

functional unit. Filters (glomerulus), reabsorbs (tubule), secretes (tubule)

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24
Q

glomerulus

A

in the nephron
afferent arteriole
tuft (capillary structure)
efferent arteriole

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25
Q

tubule

A

in the nephron
Bowman capsule, proxial convoluted tubule, loop of henle, distal convoluted tubule

26
Q

where is the collecting tubule?

A

in the nephron of the kidney

27
Q

where is urine filtration?

A

glomerulus

28
Q

where is urine reabsorption?

A

proximal tubule

29
Q

where is urine secretion?

A

distal tubule

30
Q

ureters

A

conveys urine from the pelvis of the kidneys to the bladder, scant smooth muscle, gently moves by peristalsis + gravity

31
Q

bladder

A

detrusor muscle tone expels urine or stores it until it is time to void

32
Q

urethra

A

conveys urine from the bladder to the outside of the body during voiding

33
Q

Is the urinary tract sterile?

A

yes

34
Q

why does scant mucus secretion occur in the bladder?

A

to prevent incidental bacterial colonization

35
Q

neural control of the urinary system

A

external urinary sphincter is under voluntary control
increased activity of the sympathetic nervous system (adrenergic receptors) and causes the detrusor muscle to relax, bladder tone decreases and the internal urinary sphincter tightens (urinary retention occurs)
increased activity of the parasympathetic nervous system (cholinergic/muscarinic receptors), causes the detrusor muscle to contract, bladder tone increases, and the internal urinary sphincter relaxes (micturition can happen now)

36
Q

general impact of diuretic therapy

A

reduces intravascular volume, reduces mechanical strain on the heart, reduces serum potassium levels (thiazides and loop diuretics only), augments renal function

37
Q

Reduction of intravascular volume

A

lower BP, reduce interstitial fluid (dependent edema, cerebral edema)

38
Q

reduction of mechanical strain on the heart

A

can help reduce cardiac workload in heart failure, can help prevent complications of heart failure

39
Q

reduction of serum potassium levels

A

can be used therapeutically in hyperkalemia, needs to be watched as a critical side effect

40
Q

augmenting of renal function

A

can’t fix true renal function, must be used under careful supervision in renal disease states

41
Q

where do potassium sparing diuretics act in the kidneys?

A

on the terminal end of the distal convoluted tubule (DCT)

42
Q

potassium sparing diuretics

A

weakest class of diuretics

inhibit the sodium-potassium pump (sodium stays in the tubule -> flushed out, potassium is reabsorbed from the tubule -> reclaimed, spironolactone inhibits aldosterone to achieve this effect)

sodium get flushed out and water follows (more urine volume is secreted/cleared)

43
Q

where do thiazide diuretics act on the kidneys?

A

proximal end of the distal convoluted tubule (DCT)

44
Q

Thiazide diuretics on urine formation

A

moderately aggressive diuretic class

blocks sodium channels in the DCT (sodium stays in the tubule -> flushed out),

sodium gets flushed out and water follows (more urine volume is secreted/cleared)

45
Q

where do loop diuretics act on the kidney?

A

loop of henle

46
Q

Loop diuretics on urine formation

A

strong, rapid effect -> significant increase in urine output

stops activity of the sodium-potassium-chloride transporter in the thick limb of the loop of henle (significantly increases tubule clearance of sodium, potassium, and chloride. increases clearance of trance calcium and magnesium)

lots of sodium gets flushed out + water follows (much more urine volume is secreted/cleared)

47
Q

where does the CAI impact the kidneys?

A

proximal convoluted tubule (PCT)

48
Q

Carbonic anhydrase inhibitors (CAI) on urine formation

A

mild diuretic

blocks the carbonic anhydrase; normally allows for bicarbonate to be reabsorbed

bicarbonate stays in the tubule -> sodium, bicarbonate, and chloride is flushed out

sodium and bicarbonate gets flushed out + water follows (more urine volume is secreted and cleared)

watch for acidosis - less bicarbonate to act as a buffer

49
Q

osmotic diuretic impact on urine formation

A

carry water into the nephron, do not alter nephron physiology

depends on normal kidney function and nephron activity

many osmotic diuretics cross the basement membrane of the glomerulus (pulls water from tissues into vascular space)

more water is held in the tubule -> more water clears the nephron

50
Q

RAAS

A

pathway activated by a decrease in BP, usually related to decreasing circulating volume (intravascular fluid)

51
Q

RAAS start to finish

A

START - renin is secreted by the juxtaglomerular cells in the kidney, renin enzymatically converts angiotensinogen to angiotensin 1

angiotensin 1 is converted to angiotensin 2 by angiotensin converting enzyme (ACE) in the lungs (angiotensin 2 is a vasoactive peptide -> directly causes vasoconstriction) (angiotensin 2 stimulates the adrenal cortex to secrete aldosterone)

aldosterone induces sodium resorption within the distal convoluted tubule (Where salt goes, water goes)

FINISH - when BP and intravascular fluid has sufficiently increased -> renin secretion is inhibited; RAAS ‘turns off’

52
Q

electrolyte excess

A

hyperkalemia, hypernatremia, hyperphosphatemia

53
Q

hyperkalemia

A

too much potassium

54
Q

hypernatremia

A

too much sodium

55
Q

hyperphosphatemia

A

too much phosphorus

56
Q

fluid volume excess

A

increased circulatory volume (mechanical strain on the heart and blood vessels) and elevated BP (increased hydrostatic pressure)

57
Q

waste accumulation

A

elevated levels of urea (neurotoxic effects, impairs the clotting cascade)

58
Q

urinary lifespan considerations

A

older adults (>65 yrs) have more adiposity and a lower fluid mass ration (higher risk of dehydration and electrolyte derangement)

nephron function gradually decreases naturally with age (higher risk of kidney disease and elevated BP, decreased renal clearance of drugs)

59
Q

how do diuretics work?

A

shifting sodium (salt) out of the nephron and water follows

60
Q

what do thiazide and loop diuretics promote? What should you watch for?

A

potassium loss

hypokalemia

Pharm (4 decks)

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