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Positioning > Urinary system > Flashcards

Urinary system Flashcards

1
Q

what kind of structures are the kidneys and ureters? retro, infra, or intrapertioneal

A

retroperitoneal

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2
Q

what are the most posterior part of the abdominal cavity?

A

kidneys

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3
Q

the urinary system has a vital excretory function that does what?

A

maintains homeostasis

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4
Q

what does the urinary system consist of?

A

2 kidneys, 2 ureters, urethra, bladder

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5
Q

what kidney is more inferior to the other? why?

A

right, because the presence of the liver

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6
Q

what is on the upper medial border of each kidney

A

suprarenal (adrenal) gland

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7
Q

what system are the adrenal glands apart of?

A

endocrine

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8
Q

where do the ureters lie in the body?

A

follow the natural curve of the vertebral column, mostly anterior

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9
Q

what aspect of the bladder to the ureters enter?

A

the posterolateral aspect

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10
Q

where does the urethra exit the body?

A

inferior to the pubic symphysis

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11
Q

what two parts are the kidney divided into?

A

the upper and lower pole (half)

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12
Q

what structures are infraperitoneal?

A

dital ureters, urinary bladder, and urethra

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13
Q

what does the hilum of the kidney refer to?

A

dividing point between the upper and lower poles

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14
Q

what is the hilum of the kidney?

A

the point at which the ureters leave the kidney, as do blood vessels (renal artery and view) lymphatic vessels and nerves

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15
Q

what side of the kidney is convex?

A

the lateral side, posterior and anterior

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16
Q

what side of the kidney is concave?

A

the medial side

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17
Q

the average kidney is how long? wide? thick?

A

4-5 inches long, 2-3 wide, and 1 in thick

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18
Q

what kidney is longer and more narrow?

A

left

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19
Q

how many ° from the coronal plane are the kidneys?

A

30°

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20
Q

what border of the kidney is more posterior?

A

lateral border

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21
Q

As psoas muscles get larger they cause the kidneys to form what vertical angle from the MSP? what part is closer to vertebral column?

A

20° from MSP with the upper pole closer to the vertebral column than the lower pole

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22
Q

In a hypersthenic patient the kidneys are higher/lower? asthenic?

A

hypersthenic: higher
asthenic: lower

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23
Q

when performing intravenous urography the body is placed in what angle? and what obliques?

A

30° angle in the LPO/RPO position

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24
Q

a 30° LPO will place what kidney parallel to the IR

A

right

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25
Q

a 30° RPO will place what kidney parallel to the IR

A

left

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26
Q

what landmarks are the kidney situated in between?

A

xiphoid process and iliac crest

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27
Q

top of the left kidney usually at level of?

A

T11-T12

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28
Q

most abdominal radiographs are performed on what expiration?

A

expiration-allows kidney to lie high

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29
Q

the bottom of the right kidney lies at what level?

A

L3

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30
Q

what is each kidney surrounded with?

A

fatty tissue, adipose capsule or perirenal fat

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31
Q

what does the fatty capsule do for the kidney?

A

protect it from trauma and help maintain the normal position of the kidney against the psoas muscle

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32
Q

when one inhales deeply or stands upright the kidneys move how much?

A

about 2 inches, 1 lumbar vertebra

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33
Q

what is the primary function of the urinary system?

A

production of urine and its elimination from the body

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34
Q

what is nephroptosis?

A

excessive downward movement of kidney when erect, kidney drop more than 2 inches

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35
Q

During the production of urine the kidneys do (3) things?

A
  1. remove waste products from blood
  2. regulates water levels in the body
  3. regulate acid base balance and electrolyte levels of the blood
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36
Q

what is uremia?

A

the presence of excessive amounts of urea and other nitrogenous waste products in the blood, as occurs in renal failure

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37
Q

what percent of the blood pumped from the heart passes through the kidneys?

A

25%

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38
Q

what two waste products of the kidneys are formed during normal metabolism of proteins?

A

creatine and urea

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39
Q

what is the chain of arteries/veins in the kidneys?

A

arteries-arterioles-capillaries-veins-renal viens- IVC- heart

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40
Q

the renal vein connects with what to return the blood back to the right side of the heart?

A

IVC

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41
Q

what is the average water intake for humans during a 24 hour period?

A

2.5 L

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42
Q

how many liters of blood flows through the kidneys every minute?

A

1 L, more the 99% returned to the bloodstream

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43
Q

how much urine does the kidneys excrete daily?

A

1.5L (1500mL) daily

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44
Q

the medulla consists of how many cones shaped renal pyramids?

A

8-18

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45
Q

what is the outer covering of each kidney called?

A

renal capsule

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46
Q

what are the narrow ends of the pyramids called?

A

renal papilla

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47
Q

what is the portion of the renal cortex that extends between the renal pyramids are called?

A

renal columns

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48
Q

the renal pyramids and the renal medulla make up the functional part of what?

A

the parenchyma

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49
Q

how many parenchyma do each kidney have?

A

about 1 million

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50
Q

what is the parenchyma?

A

functional portion of the kidney, visualized during and early IVU

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51
Q

what are the microscopic structures of the kidney?

A

renal pyramids, minor calyces, major calyces, renal pelvis, ureter

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52
Q

the essential microscopic components of the parenchyma of the kidneys are called?

A

nephrons

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53
Q

Urine is formed by what part of the kidney?

A

nephrons

54
Q

after urine is formed by the nephrons its drained into what? which then extends through the renal papillae of the pyramids

A

papillary ducts

55
Q

what do the papillary ducts drain into?

A

minor and major calyces

56
Q

what does the greek term pyelo mean?

A

pelvis

57
Q

how many minor and major calyces does each kidney have?

A

minor: 8-18
major: 2-3

58
Q

a minor calyx receives urine from the papillary ducts of one renal papilla and delivers it to what?

A

major calyx

59
Q

From the major calyx, urine drains into a single large cavity called what?

A

renal pelvis

60
Q

what 3 things does the nephrons of the kidneys do?

A
  1. filter blood
  2. returning useful substances to the blood so they aren’t lost from the body
  3. removing substances from the blood that aren’t needed
61
Q

what is formed by a minute branch of the renal artery entering the capsule and dividing into capillaries?

A

glomerulus

62
Q

what is the nephron composed of?

A

renal corpuscle and renal tubule

63
Q

what is the glomerulus also called?

A

bowmans capsule

64
Q

what is the vessel entering the glomerulus?

A

afferent arteriole

65
Q

what is glomerulus termed for?

A

little ball

66
Q

what is the renal corpuscle composed of?

A

double walled membrane (glomerulus) and a cluster of blood capillaries

67
Q

what is the vessel leaving the glomerular capsule?

A

efferent arteriole

68
Q

each renal tubule continues from a glomerular capsule in the cortex of the kidney and then travels in a circuitous path through the ___ and ___ substances

A

cortical and medullary

69
Q

function of the glomerulus?

A

filter for the blood permitting water and finely dissolved substances to pass through the walls of the capillaries into the capsule

70
Q

the renal tubule consist of 3 parts?

A

the proximal convoluted tubule, the nephron loop (loop of henle) and the distal convoluted tubule

71
Q

the major calyces unite to form the what?

A

renal pelvis

72
Q

the filtrate travel route..?

A

glomerular capsule-proximal convuluted tubule-loop of henle-distal convoluted tubule-minor calyx

73
Q

when if the filtrate termed urine?

A

by the time it reaches the minor calyx

74
Q

part of the renal pelvis, the calyces and branches of the renal blood vessels and nerves lie in a cavity within the kidney called?

A

renal sinus

75
Q

what is in the renal sinus to help stabilize the position of the structures?

A

adipose tissue

76
Q

how long is each ureter?

A

10-12 inches long

77
Q

the renal pelvis leaves each kidney at the hilum to become what structure?

A

ureters

78
Q

the ureters varies in diameter from..?

A

1mm-1cm

79
Q

what are the 3 points of constriction of the ureters?

A
  1. uteropelvic junction (UPJ)
  2. brim of the pelvis
  3. uterovesical junction (UVJ)
80
Q

where do most kidney stones get stuck?

A

the UVJ

81
Q

where is the bladder located in males

A

anterior to the rectum

82
Q

where is the bladder located in females

A

anterior to vagina, inferior to uterus, and posterior and superior to the pubic symphysis

83
Q

what are the small triangular area of the floor of the bladder called?

A

trigone

84
Q

the 2 posterior corners of the trigone contain what?

A

2 ureteral openings

85
Q

the inner mucosa of the bladder is called what?

A

rugae

86
Q

where is the prostate gland located?

A

inferior to the bladder and measures about 1.5 inches in diameter and 1 inch in height

87
Q

what is the term for the discharge of urine from the bladder

A

micturition

88
Q

when does the desire for micturition to occur?

A

when it reaches 250 mL

89
Q

what is the total capacity of the bladder?

A

350-500mL

90
Q

what is dysuria?

A

pain in urination

91
Q

what is anuria?

A

absence of urine formation

92
Q

what is polyuria?

A

passage of large volume of urine in relation to fluid intake during a given period, common in diabetes

93
Q

what is Diuresis?

A

increased excretion of urine

94
Q

what is hematuria?

A

blood in urine

95
Q

what is incontinence

A

unable to hold urine

96
Q

what is the urethra?

A

a musculomembranous tube with a sphincter type muscle at the neck of the bladder and extends about 1.5 inches in the female and 7-8 in male

97
Q

what are the 3 parts of the male urethra?

A

prostatic, membranous and spongy

98
Q

how long is the prostatic portion of the urethra?

A

1 in, reaches from bladder to floor of the pelvis and is completely surrounded by prostate

99
Q

how long is the membranous portion of the urethra?

A

about 1/2 in long, passes through the urogenital diaphragm

100
Q

where does the spongy portion of the urethra pass?

A

through the shaft of the penis, extending from floor of pelvis to external urethra orifice

101
Q

what causes cystitis

A

bacteria into the urethra and up into the bladder

102
Q

What is a general examination of the urinary system

A

Urography

103
Q

What must you confirm on a bottle before injection (4)?

A

Correct contents of container
Route of administration
Amount to be administered
Expiration date

104
Q

How can iodinated contrast be injected?

A

Bolus injection or drip infusion

105
Q

How is the rate of bolus injection controlled? (5)

A 
Gauge of needle
Amount of contrast agent 
Viscosity of contrast agent 
Stability of vein 
Force applied by individual performing injection
106
Q

Most common site of injection

A

Anticubital fossa

107
Q

Most commonly used needle size for adults?

A

18-20 gauge butterfly needle

108
Q

Needle size for pediatric?

A

23-35 gauge butterfly

109
Q

What are the two expected outcomes of injected contrast media?

A

Hot flash, metallic taste in mouth

110
Q

Normal ranges for creatine and bun

A

Creatinine: .6-1.5mg/dl
BUN: 8-35mg/100ml

111
Q

What is metformin hydrochloride?

A

Drug given for the management of non insulin diabetes

112
Q

ACR recommends that metformin be withheld for how many hours after the procedure and resumed only if kidney function of determined to be within normal limits

A

48 hours

113
Q

What is a common drug for reaction to contrast

A

Epinephrine

114
Q

What is extravastation?

A

Contrast medium leaking from vein into surrounding tissue

115
Q

What are the categories of contrast media reaction

A

Mild, moderate, severe, organ specific

116
Q

What are some mild reactions to contrast

A 
anxiety
 lightheadedness 
nausea 
vomiting 
metallic taste 
mild erythema (redness) 
warmth flushing station during injection 
itching 
mild scattered hives
117
Q

What are some moderate reactions to contrast

A 
Urticaria 
possible laryngeal swelling
 bronchial spasm 
tachycardia 
bradycardia 
angioedema 
hypotension
118
Q

Severe life threatening reactions

A 
Hypotension
 bradycardia 
cardiac arrhythmias
 laryngeal swelling 
possible conversions 
loss of consciousness
cardiac arrest 
respiratory arrest 
no detectable Pulse
119
Q

Organ specific contrast media reactions

A 
Pulseless electrical activity 
pulmonary Edema 
venous thrombosis 
seizure induction
 temporary failure or complete shutdown of      renal system 
extravastation
120
Q

How long can it take for organ specific reactions to take place

A

Up to 48 hours

121
Q

Why is an ivu a functional test

A

Because contrast medium molecules are removed from the bloodstream and excreted completely by normal kidneys

122
Q

What does an IVU visualize

A

Minor and major calyces, renal pelvis, ureters, urinary bladder

123
Q

How much contrast is used in adults?

A

30-100ml

124
Q

Most reactions occur within how many minutes of injection

A

5 min

125
Q

What is the initial contrast blush of the kidney termed?

A

Nephron phase

126
Q

Depending on the patients hydration status and the speed of the injection, the contrast agent normally begins to appear in the pelvicalyceal system within how many minutes

A

2-8 minutes

127
Q

How long after injection is the greatest concentration of contrast in the kidneys?

A

15-20 minutes

128
Q

What is prolapse?

A

The slipping or falling out of place of an organ

129
Q

What is retrograde?

A

Backward flow

130
Q

What is antegrade

A

Allows the contrast medium to enter the kidney in the normal direction of the flown

Positioning (7 decks)

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