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Positioning Spring 2015 > urinary system > Flashcards

urinary system Flashcards

1
Q

urinary system

A

eliminates organic wastes and maintains the water and electrolyte balance of the body

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2
Q

urinary system consists of

A

2 kidneys
2 ureters
1 urinary bladder
1 urethra

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3
Q

right kidney

A

more inferior than the left because of the liver

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4
Q

adrenal glands

A

on the upper medial border of each kidney

have no functional relationships with the kidneys

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5
Q

ureters

A

follow the natural curve of he vertebral column

most of each ureter lies anterior to its kidney

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6
Q

the ureters enter what aspect of the bladder

A

posterolateral aspect

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7
Q

urethra

A

exits the from the body inferior to the pubic symphysis

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8
Q

retroperitoneal structures

A

kidneys

ureters

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9
Q

infraperitoneal structures

A

distal ureters
urinary bladder
urethra

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10
Q

hilum of the kidney

A

the dividing point between the upper and lower poles of the kidney
where the ureter, blood vessels, lymphatic vessels, and nerves leave the kidney

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11
Q

what is the average size of the kidney

A

4-5 inches long
2-3 inches wide
1 inch thick
about the size of a bar of soap

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12
Q

the kidneys form a vertical angle of what from the MSP

A

20 degree angle

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13
Q

the kidneys are rotated how much from the coronal plane

A

30 degrees

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14
Q

are the kidneys higher or lower in a hyperstenic patient

A

higher

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15
Q

are the kidneys higher or lower in an asthenic patient

A

lower

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16
Q

top of the left kidney is at what level

A

T11-T12

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17
Q

bottom of the right kidney is at what level

A

L3

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18
Q

what is the fatty tissue surrounding each kidney

A

adipose capsule or perirenal fat

protects from trauma and maintains its normal position

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19
Q

when one inhales deeply or stands upright, the kidneys will

A

drop about one lumbar vertebrae or 2 inches

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20
Q

nephroptosis

A

excessive downward movement of kidney when erect

can cause kinking or twisting of the ureters

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21
Q

what is the primary function of the urinary system

A

the production of urine and its elimination from the body

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22
Q

during the production of urine what do the kidneys do

A
  1. remove waste products from the blood
  2. regulate water levels in the body
  3. regulate acid-base balance and electrolyte levels in the blood
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23
Q

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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24
Q

how much of the blood is pumped from the heart with each beat that passes through the kidney?

A

25%

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25
Q

the average water intake for humans during each 24 hour period is about

A

2.5 L

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26
Q

the kidneys normally excrete about how many L of urine per day

A

1.5 L or 1500 mL

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27
Q

the outer covering of each kidney is called the

A

renal capsule

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28
Q

renal cortex

A

the outer smooth textured reddish area

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29
Q

renal medulla

A

the deep reddish brown region

consists of 8-18 renal pyramids

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30
Q

the renal cortex and renal pyramids of the renal medulla make up what

A

the parenchyma of the kidney

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31
Q

renal parenchyma

A

the total functional portion of the kidneys

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32
Q

papillary ducts

A

urine formed by the nephrons drain into these ducts h

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33
Q

minor/major calyx

A

cuplike structures where the papillary ducts drain into

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34
Q

how many minor calyces in a kidney

A

8-18

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35
Q

how many major calyces in a kidney

A

2-3

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36
Q

renal pelvis

A

where the major calyx drains urine into

the first major collecting area of urinary waste

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37
Q

3 basic processes the nephrons are involved in

A
  1. filtering blood
  2. returning useful substances to the blood
  3. removing substances from the blood that aren’t needed
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38
Q

the individual nehpron is composed of what 2 things

A

a renal corpuscle and a renal tubule

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39
Q

renal corpuscle consists of

A

double walled membranous cup called glomerular capsule/ bowmans capsule and glomerulus

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40
Q

glomerulus

A

cluster of blood capillaries

serves as a filter for the blood

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41
Q

afferent arteriole

A

the vessel entering the glomerular capsule

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42
Q

efferent arteriole

A

the vessel leaving the glomerular capsule

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43
Q

3 parts of the renal tubule y

A

proximal convoluted tube
nephron loop (loop of henle)
distal convoluted tube

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44
Q

collecting system

A

nephrons - renal pyramids - renal papilla - minor calyces - major calyces - renal pelvis - ureter

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45
Q

when is the filtrate termed urine

A

by the time it reaches the minor calyx

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46
Q

glomerular filtrate goes from

A

glomerular capsule - proximal convoluted tube - loop of henle - distal convoluted tube - minor calyx

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47
Q

renal sinus

A

cavity within the kidney where the calyces, blood vessels and nerves lie

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48
Q

what is the size of the ureter

A

10-12 inches long

1 mm - 1 m in diameter

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49
Q

where do the ureters enter the bladder

A

the posterolateral part

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50
Q

what are the 3 constricted points along each ureter

also the 3 most common spots for obstruction

A
  1. Uretteropelvic junction UPJ
  2. brim of the pelvis
  3. ureterovescial junction UVJ
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51
Q

UPJ

A

the point the renal pelvis funnels down into small ureter

where the renal pelvis becomes the ureter

52
Q

UVJ

A

where the ureters join the bladder

53
Q

most kidney stones passing down the ureter tend to hang up where

A

the UVJ

54
Q

urinary bladder

A

musculomembranous sac that serves as a reservoir for urine

55
Q

location of bladder in males

A

directly anterior the the rectum

56
Q

location of bladder in females

A

anterior to the vagina and inferior to the ureters and posterior to pubic symphysis

57
Q

shape of the bladder

A

depends on how much urine it contains

58
Q

trigone

A

small triangular area in the floor of the bladder

has a smooth appearance

59
Q

micturition

A

discharge of urine

also called urination or voiding

60
Q

when does the desire for micturition occur

A

when the volume of urine reaches about 250 mL

is voluntary

61
Q

T or F

normally some urine is present in the bladder at all times

A

TRUE

62
Q

the total capacity of the bladder is

A

350 - 500 mL

63
Q

incontinene

A

unable to hold urine

64
Q

dysuria

A

pain in urination

65
Q

anuria

A

absence of urine formation

66
Q

polyuria

A

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

67
Q

diuresis

A

increased excretion of urine

68
Q

hematuria

A

blood in the urine

69
Q

urethra

A

musculomembranous tube with a sphincter at the neck of the bladder

70
Q

male urethra length

A

7-8 inches

71
Q

female urethra length

A

1 and a half inches

72
Q

male urethra divides into 3 portions

A
  1. prostatic
  2. membranous
  3. spongy
73
Q

the kidneys in the adult are located

A

midway between xiphoid process and iliac crest

74
Q

urography

A

radiographic examination of the urinary system in general

75
Q

before withdrawing contents from any vial or bottle, you must confirm…

A

correct contents of container
route of administration
amount to be administered
expiration date

76
Q

iodinated contrast agents may be administered in what 2 ways

A

bolus injection

drip infusion

77
Q

bolus injections

A

rapid introduction of contrast into the venous system at one time
for maximum contrast enhancement

78
Q

rate of bolus injection is controlled by:

A 
gauge of needle 
amount of contrast 
viscosity of contrast 
stability of vein 
force applied
79
Q

drip infusion

A

where contrast media is introduced into venous system by connective tubing attached to an IV
controlled by a clamp

80
Q

equipment and materials for injection

A 
emergency cart stocked 
sharps container
tourniquets 
alcohol pads 
gauze
tape
gloves 
contrast 
various sizes of butterfly needle 
syringes
IV tubing 
arm board
81
Q

for most IVU’s veins where are recommended

A

antecubital fossa

in front of the elbow

82
Q

other veins that may be used for injection site

A

cephalic vein on lateral wrist and veins on posterior hand or lower forearm

83
Q

type and size of needle used on an adult

A

18 - 20 gauge butterfly needle

84
Q

type and size of needle used for pediatrics

A

23 - 25 gauge needle

85
Q

what is the expected outcome of injected contrast media

A

temporary hot flash
metallic taste in mouth
passes quickly

86
Q

adult creatinine level

A

0.6 - 1.5 mg/dl

87
Q

adult BUN level

A

8 - 25 mg/100 ml

88
Q

metformin hydrochloride

A

drug given for the management of non insulin dependent diabetes
if mixed with contrast may increase risk for renal failure

89
Q

metformin should be withheld for how long after the procedure

A

48 hours and only resumed if kidney function is normal

90
Q

pre medication protocol

A

some pts. may be given a combo of benadryl and predinisone 12 hrs before procedure to help reduce liklihood of reaction

91
Q

4 categories of contrast media reactions

A
  1. mild
  2. moderate
  3. severe
  4. organ specific
92
Q
  1. mild reaction
A

nonallergic reaction
does not typically require medical attention
symptoms:
anxiety, nausea, light head, metallic taste, vomiting, redness
treatment: breathe slowly, provide cold cloth, observe and monitor

93
Q
  1. moderate reaction
A

true allergic reaction (anaphylactic)
symptoms: urticaria, trouble breathing, bronchospasm, tachycardia, bradycardia, hypotension
may lead to life threatening
need medical assistance

94
Q

adult creatinine level

A

0.6 - 1.5 mg/dl

95
Q

adult BUN level

A

8 - 25 mg/100 ml

96
Q

extravasation treatment

A

elevate affected extremity above heart
use cold compress followed by warm compress
document the incident

97
Q

metformin should be withheld for how long after the procedure

A

48 hours and only resumed if kidney function is normal

98
Q

pre medication protocol

A

some pts. may be given a combo of benadryl and predinisone 12 hrs before procedure to help reduce liklihood of reaction

99
Q

4 categories of contrast media reactions

A
  1. mild
  2. moderate
  3. severe
  4. organ specific
100
Q
  1. mild reaction
A

nonallergic reaction
does not typically require medical attention
symptoms:
anxiety, nausea, light head, metallic taste, vomiting, redness
treatment: breathe slowly, provide cold cloth, observe and monitor

101
Q
  1. moderate reaction
A

true allergic reaction (anaphylactic)
symptoms: urticaria, trouble breathing, bronchospasm, tachycardia, bradycardia, hypotension
may lead to life threatening
need medical assistance

102
Q
  1. severe reaction
A

also known as vasovagal
fast and prompt response required
symptoms: low BP, bradycardia, convulsions, loss of concsciousness, cardiac arrest
possible hospitalization

103
Q
  1. organ specific reaction
A

specific organs are affected by the contrast media injection
symptoms: renal shutdown, vascular system(venous thrombosis) seizure induction, extravasation (leakage of contrast outside the vessel)
may not occur until 48 hours after the study

104
Q

extravasation treatment

A

elevate affected extremity above heart
use cold compress followed by warm compress
document the incident

105
Q

Intravenous urogram IVU

A

visualizes the minor and major calyces, renal pelves, ureters and urinary bladder after injection of contrast media
is a functional test

106
Q

urinary tract infection

A

infection caused by bacteria/ urinary reflux

107
Q

IVU contraindications (10)

A
  1. hypersensitivity to contrast
  2. anuria
  3. multiple myeloma
  4. diabetes
  5. severe hepatic or renal disease
  6. congestive heart failure
  7. phechromocytoma
  8. sickle cell anemia
  9. pts. taking glucophage, metformin, etc
  10. renal failure
108
Q

diuretic

A

an agent that increases excretion of urine

109
Q

lasix

A

brand name for a diuretic

110
Q

lithotripsy

A

therapeutic technique that uses sound waves to shatter kidney stones so they can be passed

111
Q

if you cannot use a ureteric compression what could be done instead?

A

put the patient in trendelenburg

112
Q

urinary incontinence

A

involuntary passage of urine through urethra

113
Q

urinary reflux

A

backward or return flow of urine from bladder into ureter and kidney

114
Q

urinary tract infection

A

infection caused by bacteria/ urinary reflux

115
Q

patient prep for an IVU

A 
light evening meal prior 
bowel cleansing laxative 
NPO after midnight 
enema on morning of exam 
void prior to procedure 
all clothing removed
116
Q

prep of radiographic equipment and supplies

A 
correct type and amt. of contrast
empty container of contrast media 
selection of needles
alcohol wipes
gloves
tourniquet
support for elbow
shaps container
male gonadal sheild
emesis basin 
eminephrine or benadryl
ureteric compression 
cold towel
oxygen and suction devices
117
Q

ureteric compression

A

allows renal collecting system to retain contrast longer

118
Q

hydronephrosis

A

distention of the renal pelvis and calyces of the kidneys as a result of some obstruction of the ureters or renal pelvis

119
Q

if you cannot use a ureteric compression what could be done instead?

A

put the patient in trendelenburg

120
Q

how long does injection usually take

A

between 30 secs and 1 minute

121
Q

when do most reactions occur

A

within the first 5 minutes following injection

122
Q

how many mL of contrast is typically used for adults

A

30 - 100 mL

123
Q

after beginning of injection how long does it take to see the contrast in the pelvicalyceal system

A

2-8 minutes

124
Q

the greatest concentration of contrast medium in the kidneys normally occurs when

A

15 - 20 minutes after injection

125
Q

IVU protocol basic routine

A 
nephrogram / nephrotomogram (taken immediately after injection)
5 minute image
10-15 minute image
20 minute obliques 
postvoid
126
Q

hydronephrosis

A

distention of the renal pelvis and calyces of the kidneys as a result of some obstruction of the ureters or renal pelvis

127
Q

6 exams of the urinary system

A
  1. IVU
  2. hypertensive intravenous urography
  3. retrograde urography
  4. retrograde cystography
  5. voiding cystourethrography
  6. retrograde urethrography (only for males)

Positioning Spring 2015 (6 decks)

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