Urinary system Flashcards
(130 cards)
1
Q
what kind of structures are the kidneys and ureters? retro, infra, or intrapertioneal
A
retroperitoneal
2
Q
what are the most posterior part of the abdominal cavity?
A
kidneys
3
Q
the urinary system has a vital excretory function that does what?
A
maintains homeostasis
4
Q
what does the urinary system consist of?
A
2 kidneys, 2 ureters, urethra, bladder
5
Q
what kidney is more inferior to the other? why?
A
right, because the presence of the liver
6
Q
what is on the upper medial border of each kidney
A
suprarenal (adrenal) gland
7
Q
what system are the adrenal glands apart of?
A
endocrine
8
Q
where do the ureters lie in the body?
A
follow the natural curve of the vertebral column, mostly anterior
9
Q
what aspect of the bladder to the ureters enter?
A
the posterolateral aspect
10
Q
where does the urethra exit the body?
A
inferior to the pubic symphysis
11
Q
what two parts are the kidney divided into?
A
the upper and lower pole (half)
12
Q
what structures are infraperitoneal?
A
dital ureters, urinary bladder, and urethra
13
Q
what does the hilum of the kidney refer to?
A
dividing point between the upper and lower poles
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
15
Q
what side of the kidney is convex?
A
the lateral side, posterior and anterior
16
Q
what side of the kidney is concave?
A
the medial side
17
Q
the average kidney is how long? wide? thick?
A
4-5 inches long, 2-3 wide, and 1 in thick
18
Q
what kidney is longer and more narrow?
A
left
19
Q
how many ° from the coronal plane are the kidneys?
A
30°
20
Q
what border of the kidney is more posterior?
A
lateral border
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
22
Q
In a hypersthenic patient the kidneys are higher/lower? asthenic?
A
hypersthenic: higher
asthenic: lower
23
Q
when performing intravenous urography the body is placed in what angle? and what obliques?
A
30° angle in the LPO/RPO position
24
Q
a 30° LPO will place what kidney parallel to the IR
A
right
25
a 30° RPO will place what kidney parallel to the IR
left
26
what landmarks are the kidney situated in between?
xiphoid process and iliac crest
27
top of the left kidney usually at level of?
T11-T12
28
most abdominal radiographs are performed on what expiration?
expiration-allows kidney to lie high
29
the bottom of the right kidney lies at what level?
L3
30
what is each kidney surrounded with?
fatty tissue, adipose capsule or perirenal fat
31
what does the fatty capsule do for the kidney?
protect it from trauma and help maintain the normal position of the kidney against the psoas muscle
32
when one inhales deeply or stands upright the kidneys move how much?
about 2 inches, 1 lumbar vertebra
33
what is the primary function of the urinary system?
production of urine and its elimination from the body
34
what is nephroptosis?
excessive downward movement of kidney when erect, kidney drop more than 2 inches
35
During the production of urine the kidneys do (3) things?
1. remove waste products from blood
2. regulates water levels in the body
3. regulate acid base balance and electrolyte levels of the blood
36
what is uremia?
the presence of excessive amounts of urea and other nitrogenous waste products in the blood, as occurs in renal failure
37
what percent of the blood pumped from the heart passes through the kidneys?
25%
38
what two waste products of the kidneys are formed during normal metabolism of proteins?
creatine and urea
39
what is the chain of arteries/veins in the kidneys?
arteries-arterioles-capillaries-veins-renal viens- IVC- heart
40
the renal vein connects with what to return the blood back to the right side of the heart?
IVC
41
what is the average water intake for humans during a 24 hour period?
2.5 L
42
how many liters of blood flows through the kidneys every minute?
1 L, more the 99% returned to the bloodstream
43
how much urine does the kidneys excrete daily?
1.5L (1500mL) daily
44
the medulla consists of how many cones shaped renal pyramids?
8-18
45
what is the outer covering of each kidney called?
renal capsule
46
what are the narrow ends of the pyramids called?
renal papilla
47
what is the portion of the renal cortex that extends between the renal pyramids are called?
renal columns
48
the renal pyramids and the renal medulla make up the functional part of what?
the parenchyma
49
how many parenchyma do each kidney have?
about 1 million
50
what is the parenchyma?
functional portion of the kidney, visualized during and early IVU
51
what are the microscopic structures of the kidney?
renal pyramids, minor calyces, major calyces, renal pelvis, ureter
52
the essential microscopic components of the parenchyma of the kidneys are called?
nephrons
53
Urine is formed by what part of the kidney?
nephrons
54
after urine is formed by the nephrons its drained into what? which then extends through the renal papillae of the pyramids
papillary ducts
55
what do the papillary ducts drain into?
minor and major calyces
56
what does the greek term pyelo mean?
pelvis
57
how many minor and major calyces does each kidney have?
minor: 8-18
major: 2-3
58
a minor calyx receives urine from the papillary ducts of one renal papilla and delivers it to what?
major calyx
59
From the major calyx, urine drains into a single large cavity called what?
renal pelvis
60
what 3 things does the nephrons of the kidneys do?
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
what is formed by a minute branch of the renal artery entering the capsule and dividing into capillaries?
glomerulus
62
what is the nephron composed of?
renal corpuscle and renal tubule
63
what is the glomerulus also called?
bowmans capsule
64
what is the vessel entering the glomerulus?
afferent arteriole
65
what is glomerulus termed for?
little ball
66
what is the renal corpuscle composed of?
double walled membrane (glomerulus) and a cluster of blood capillaries
67
what is the vessel leaving the glomerular capsule?
efferent arteriole
68
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
cortical and medullary
69
function of the glomerulus?
filter for the blood permitting water and finely dissolved substances to pass through the walls of the capillaries into the capsule
70
the renal tubule consist of 3 parts?
the proximal convoluted tubule, the nephron loop (loop of henle) and the distal convoluted tubule
71
the major calyces unite to form the what?
renal pelvis
72
the filtrate travel route..?
glomerular capsule-proximal convuluted tubule-loop of henle-distal convoluted tubule-minor calyx
73
when if the filtrate termed urine?
by the time it reaches the minor calyx
74
part of the renal pelvis, the calyces and branches of the renal blood vessels and nerves lie in a cavity within the kidney called?
renal sinus
75
what is in the renal sinus to help stabilize the position of the structures?
adipose tissue
76
how long is each ureter?
10-12 inches long
77
the renal pelvis leaves each kidney at the hilum to become what structure?
ureters
78
the ureters varies in diameter from..?
1mm-1cm
79
what are the 3 points of constriction of the ureters?
1. uteropelvic junction (UPJ)
2. brim of the pelvis
3. uterovesical junction (UVJ)
80
where do most kidney stones get stuck?
the UVJ
81
where is the bladder located in males
anterior to the rectum
82
where is the bladder located in females
anterior to vagina, inferior to uterus, and posterior and superior to the pubic symphysis
83
what are the small triangular area of the floor of the bladder called?
trigone
84
the 2 posterior corners of the trigone contain what?
2 ureteral openings
85
the inner mucosa of the bladder is called what?
rugae
86
where is the prostate gland located?
inferior to the bladder and measures about 1.5 inches in diameter and 1 inch in height
87
what is the term for the discharge of urine from the bladder
micturition
88
when does the desire for micturition to occur?
when it reaches 250 mL
89
what is the total capacity of the bladder?
350-500mL
90
what is dysuria?
pain in urination
91
what is anuria?
absence of urine formation
92
what is polyuria?
passage of large volume of urine in relation to fluid intake during a given period, common in diabetes
93
what is Diuresis?
increased excretion of urine
94
what is hematuria?
blood in urine
95
what is incontinence
unable to hold urine
96
what is the urethra?
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
what are the 3 parts of the male urethra?
prostatic, membranous and spongy
98
how long is the prostatic portion of the urethra?
1 in, reaches from bladder to floor of the pelvis and is completely surrounded by prostate
99
how long is the membranous portion of the urethra?
about 1/2 in long, passes through the urogenital diaphragm
100
where does the spongy portion of the urethra pass?
through the shaft of the penis, extending from floor of pelvis to external urethra orifice
101
what causes cystitis
bacteria into the urethra and up into the bladder
102
What is a general examination of the urinary system
Urography
103
What must you confirm on a bottle before injection (4)?
Correct contents of container
Route of administration
Amount to be administered
Expiration date
104
How can iodinated contrast be injected?
Bolus injection or drip infusion
105
How is the rate of bolus injection controlled? (5)
```
Gauge of needle
Amount of contrast agent
Viscosity of contrast agent
Stability of vein
Force applied by individual performing injection
```
106
Most common site of injection
Anticubital fossa
107
Most commonly used needle size for adults?
18-20 gauge butterfly needle
108
Needle size for pediatric?
23-35 gauge butterfly
109
What are the two expected outcomes of injected contrast media?
Hot flash, metallic taste in mouth
110
Normal ranges for creatine and bun
Creatinine: .6-1.5mg/dl
BUN: 8-35mg/100ml
111
What is metformin hydrochloride?
Drug given for the management of non insulin diabetes
112
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
48 hours
113
What is a common drug for reaction to contrast
Epinephrine
114
What is extravastation?
Contrast medium leaking from vein into surrounding tissue
115
What are the categories of contrast media reaction
Mild, moderate, severe, organ specific
116
What are some mild reactions to contrast
```
anxiety
lightheadedness
nausea
vomiting
metallic taste
mild erythema (redness)
warmth flushing station during injection
itching
mild scattered hives
```
117
What are some moderate reactions to contrast
```
Urticaria
possible laryngeal swelling
bronchial spasm
tachycardia
bradycardia
angioedema
hypotension
```
118
Severe life threatening reactions
```
Hypotension
bradycardia
cardiac arrhythmias
laryngeal swelling
possible conversions
loss of consciousness
cardiac arrest
respiratory arrest
no detectable Pulse
```
119
Organ specific contrast media reactions
```
Pulseless electrical activity
pulmonary Edema
venous thrombosis
seizure induction
temporary failure or complete shutdown of renal system
extravastation
```
120
How long can it take for organ specific reactions to take place
Up to 48 hours
121
Why is an ivu a functional test
Because contrast medium molecules are removed from the bloodstream and excreted completely by normal kidneys
122
What does an IVU visualize
Minor and major calyces, renal pelvis, ureters, urinary bladder
123
How much contrast is used in adults?
30-100ml
124
Most reactions occur within how many minutes of injection
5 min
125
What is the initial contrast blush of the kidney termed?
Nephron phase
126
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
2-8 minutes
127
How long after injection is the greatest concentration of contrast in the kidneys?
15-20 minutes
128
What is prolapse?
The slipping or falling out of place of an organ
129
What is retrograde?
Backward flow
130
What is antegrade
Allows the contrast medium to enter the kidney in the normal direction of the flown
