Urinary Pathology Flashcards
Nephrologist
Professional who treats the kidney.
Urologist
Professional who treats the non-kidney parts of the urinary tract.
Components of the kidney
Capsule, cortex and medulla.
Parts of the medulla
Pyramids and columns.
NUmber of nephrons in a kidney
2.5 million
Renal corpuscle
Site of palsma filtration, found in the renal cortex.
Renal tubule
Tube extending from the glomerular capsule. Is divided into the proximal convoluted tubule, loop of Henle and the distal convoluted tubule.
Main function of the kidney
To form urine.
Urine formation is dependent on what?
Hydration and blood flow.
Hormones which are important to the urinary system.
Antidiuretic hormone, atrial natriuretic peptide and aldosterone.
Types of urinary dysfunction
Prerenal, intrarenal and post renal
Prerenal dysfunction
Due to some form of blood insufficiency.
Intrarenal dysfunction
True kidney failure.
Post renal dysfunction
Due to obstructions such
Hemodynamic disorders of the kidney
Acute tubular necrosis, nephroangiosclerosis and hypertension.
Acute tubular necrosis
Occurs after cardiac arrect or hypotensive shock. The cortex is affected first, then the medulla.
Nephroangiosclerosis
Artherosclerosis of the arteries relevant tot he kidney. Causes ischemia, which then causes tubular atrophy.
Effect of hypertension on the kidney
Renal ischemia due to hypertensive arteris will stimulate renin release, which then aggravates the hypertension.
Tumours of the urinary tract
Are typically malignant and originate from the epithelial cells. More common in males.
Wilm’s tumour / Nephroblastoma
Malignant tumour which is common in childhood. Immature cells resembling the fetal kidney grow. Prognosis is good.
Renal cell carcinoma
Common cancer in older adults. Often fatal due to the lack of early symptoms.
Symptoms of renal cell carcinoma
Hematuria, flank pain and sometimes a palpable mass. Non-specific symptoms such as weight loss, fever, hypertension.
Internist’s tumour
Renal cell carcinoma. Called this because it is often found accidentally by internists.
Transitional cell carcinoma
Resemble the papillary transitional carcinomas of the urinary bladder. Early diagnosis often pssobile due to symptoms.
Symptoms of transitional cell carcinoma
Hematuria, obstruction, dysuria and lower abdominal pain.
Infectious disorders of the urinary system
Bacterial infections, pyelonephritis, cystitis.
Bacterial urinary tract infections
Bacteria typically enters by ascending the urethra. Can also enter via hematogenous infection (septicemia).
Acute pyelonephritis
Bacterial invasion of the renal parenchyma. Causes fever, back pain, dysuria, hematuria and frequency.
Chronic pyelonephritis
Chronic bacterial infection of the kidney causes scarring. The kidney loses function and shrivels. Often unilateral.
Cystitis
Infection of the bladder which can be acute or chronic. Can be acute or chronic.
Acute cystitis
Caused by congestion and mucosal hemmorrhages and ulcers.
Chronic cystitis
Thickening of the bladder wall.
Developmental disorders of the kidneys
Renal agenesis and horseshoe kidney.
Autosomal polycystic kidney disease
Autosomal disorder which causes enlargement of the kidneys with cysts. The kidneys’ mass can be inflated up to 20x and causes kidney failure.
Urinary stone components
Calcium (75%), struvite (15%), uric acid (5%) or cystine (1%).
Causes of urinary stones
They may vary, but are often metabolic, endocrine, dietary or due to an absorption factor or UTI.
Urolithiasis
Urinary stones
Symptoms of urolithiasis
Severe, unrelenting pain, hematuria and spasms.
Glomerular disease
Any disease that alters the ability of the glomerulus to function.
Symptoms of nephrotic syndrome
Proteinuria, hypoalbuminemia, general bilateral edema and hyperlipidemia.
Massage in client with end-stage renal failure
Avoid adressing edema because it may overload the cardiovascular system.
Diabetic nephropathy
Kidney infections and failure due to uncontrolled diabetes.
Typical cause of urinary incontinence
Damage to the nerves.
Innervation of the smooth muscle of the bladder
Parasympathetic branches of S2 to S4.
Innervation of the inner sphincter of the bladder
Sympathetic branches of T11 to L2
Innervation of the external urinary sphincter
Somatic motor fibers.
