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DMIS 1105 post midterm > Urinary system :) > Flashcards

Urinary system :) Flashcards

1
Q

what structures comprise the urinary system

A

kidneys
ureters
urinary baldder
urethra

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2
Q

where and through what process is urine formed ?

A

kidneys

filtration and reabsorption

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3
Q

how many L of blood is filtered per day ?

A

180 L

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4
Q

how much urine is formed via filtration/reabsorption per day ?

A

1 - 1.5 L per day

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5
Q

where is the hilum of the kidneys located?

A

medial surface

hilum (plural)
hilus (singular)

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6
Q

what is the functional unit of the kidney

and what is its function

A

nephron

froming and creating urine

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7
Q

what is the nephron unit composed of

A

glomerulus
bowmans capsule
convoluted tubules

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8
Q

where is blood filtered in the nephron system

A

glomerulus

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9
Q

were does the nepron unit terminate

A

collecting tubule

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10
Q

name the structures in which urine travels through out of the body

A 
collecting tubule (opening at renal papilla)-
minor calyx -- major calyces --which terminate at the renal pelvis
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11
Q

where do the ureters connect with the bladder

A

posteriolateral aspect in oblique angle
equidistant from the urethral orifice
(think trigone)

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12
Q

what is the function of the ureters

A

drain urine from kidneys to the bladder

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13
Q

orientate bladder and pubic symphysis

A

bladder is posterior to the pubic symphysis

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14
Q

what repro. function does the urethra serve in males ?

A

it passes through the prostate gland receiving seminal fluid via ejaculatory ducts (which open into the urethra through the prostate)

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15
Q

(3) sections of the male urethra

A

prostatic
membraneous
cavernous

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16
Q

KUB

A

kidneys, ureters, bladder

radiograph

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17
Q

what structure does the urethra open up into the exterior of the body ?

A

urinary meatus

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18
Q

what should be assessed before administering contrast for urinary anatomy?

A

patient renal function

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19
Q

urinary disorders clinical findings:

A 
polyuria (lg vol of dilute)
frequent urination 
oliguria (sm ammounts)
dysuria
obstructive sx
flank pain
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20
Q

what is GFR
what is normal GFR
what does it test
what is eGFR

A

glomular filtration rate

> 90mL per min per 1.73 m cubed _norm

measures the rate of blood flow through the kidneys

level for contraindication of contrast not established

eGFR is the estimated measurement of serum creatinine value in combo with Pt age race and gender

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21
Q

individuals with low kidney function present with

A

high levels of creatinine and urea nitrogen in blood

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22
Q

what is BUN

what is BUN levels determined by

contraindication for radiograph

A

blood urea nitrogen

levels influenced by urine flow and production and metab of urea

no greater than 50mg/dL

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23
Q

serum creatine measure contraindicated for contrast

A

3mg/dL

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24
Q

embryonic development of the urinary system occurs in how many stages?

A

3
dev. of kidneys -from growth of ureteric duct
development of metanephric tissue

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25
Q

anomalies of the kidneys and ureters are caused by _____ and classified as either ___,_____,____ or _____

A

errors in dev

number, size&form, fusion, and position

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26
Q

congenital anomalies result in

A

impaired renal function and renal calculi

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27
Q

Number and size anomalies of the kidney:

4

A

renal aplasia
supernumerary kidney
hypoplasia
hyperplasia

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28
Q

compensatory hypertrophy

A

result of renal aplasia (unilateral absence of kidney) the existing kidney is larger than norm

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29
Q

in unilateral kidney aplasia which kidney is statistically more absent

A

left

which is usually lower in abdom cavity – right because of the liver

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30
Q

hypertrophic kidney is more prone to what

A

trauma

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31
Q

what is the absence of both kidneys refered to ?

A

bilateral agenesis (spell this) a-gene-sis
Potter syndrome
not conducive with life

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32
Q

renal aplasia

A

absence of one (unilateral) or both (bilateral) kindeys
detected via fetal US
bilateral renal aplasia is accompanied by compensatory hypertrophy (enlargement of the other kidney)

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33
Q

supernumerary kidney

A

presence of 3ed kidney
no paren-chy-mal attachment
prone to infection

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34
Q

hypoplasia

A

underdeveloped size
normal nephron development

req. renal arteriography to differentiate
hypertrophic changes from atrophy due to acquired vascular disease

usually accompanied with HTN

vol of the functioning kidney plays clinical role

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35
Q

Hyperplasia

A

overdevelopment of kidney

due usually to hypoplasia of the other kidney or hypertrophy

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36
Q

Fusion ano-mal-ies
how are they viewed
(2)

A

viewed via radiographs
horseshoe kidney
crossed ectopy

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37
Q

horseshoe kidney

A

lower poles of kidneys connected via band of soft tissue across the midline of the body

ureters exit anteriorly instead of medially
lower pole caylyces point medially rather than laterally

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38
Q

crossed ectopy

A

one kidney lies across the midline and is fused with the other kidney and usually lies inferoior to the other kidney with ureter crossing midline to conn with bladder on proper side

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39
Q

how are crossed ectopy and horseshoe kidney remided?

A

pyeloplastic surgery

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40
Q

Position anomalies of the kidneys:

2

A

malrotation

ectopic kidney

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41
Q

malrotation

A

incomplete or excessive rotation of the kidneys as they ascend from the pelvis IN UTERO
usually not problem unless obstruction occurs

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42
Q

ectopic kidney

A

out of normal position
usually found in the pelvis

asymptomatic 1-800 urologic exams

ureteropelvic junction obstruction or VUR is found

interthoracic location

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43
Q

nephroptosis

A

drooping of the kidney

nephro-ptosis

44
Q

VUR

A

vesi-coure-teral
reflux
abnormal flow of urine from the bladder to the upper urinary tract

45
Q

Renal pelvis and ureter anomolies

A

asymmetric
double renal pelvis
double ureter

impare renal dranage
infection and calculi

46
Q

lower urinary tract anomalies

A

uretrocele
ureteral diverticula
bladder diverticula
uretheral valve obstruction

47
Q

ureterocele

A

cystlike dialation of a ureter near opening to the bladder
result from stenosis

“cobra head”

48
Q

ureterocele with ureteral duplication

A

“ectopic” ureterocele

causes obstruction to affect of renal falure due to infection

49
Q

ureteral diverticula

A

dialated branched ureteric remnant

50
Q

ureteral diverticula is best demonstrated with what mod

A

retrograde urography

51
Q

uretheral valves

A

mucosal folds that protrude into the posterior urethera as a congenittal condition

obstructs urine flow

52
Q

Polycystic kidney disease

A

PKD
many tiny cysts within nephron

results in renal failure

US plays role in identifing cysts and obtaining biopsy

autosomal dominant is asymptomatic untill adulthood

53
Q

polycystic kidney disease in adulthood

A

visualized late stage after cysts in liver and kidneys cause impared function

bilateral enlargement of kidneys
poor defined capsule
calyceal streatching

development of uremia
require dialysis or kidney Tx

54
Q

Medullary sponge kidney

A

congenital dialation of the renal tubules leading to urinary stasis and increased leveles of caPHO4

55
Q

increase levels if caPHO4 in renal tubules

A

nephro-cal-cin-osis

56
Q

sx of medullary sponge

A

dialation of the medullary and papillary pts of the collecting ducts (bilaterally)

57
Q

Inflammatory diseases of urinary system

4

A

UTI
pyelonephritis
acute glomerulonephritis
cystitis

58
Q

UTI

A

urinary tract infection

tx approach- quantative urine culture

59
Q

Pyelonephritis

A

bacterial infection of the calyces and renal pelvis

60
Q

what is the most common renal disease

A

pyelonephritis

61
Q

what predisposed pt to pyelonephritis

A

stagnation or obstruction of ruine flow

bacterium reach kidneys via ascending ureters or bloodstream

62
Q

pyuria

A

presence of pus in the urine

63
Q

chronic reflux of infected urine into renal pelvis may result in

A

chronic pyelonephritis

commonly due to anatomy obstruction or childhood VUR

64
Q

IVU vs UVR

A

IVU- An intravenous urogram (IVU) is sometimes called an intravenous pyelogram (IVP). This test uses X-rays to look at the kidneys, bladder, and the tubes that connect them (the ureters). Together these are called the urinary system

UVR- Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder into the kidneys. … Secondary VUR occurs when an obstruction in the bladder or urethra causes urine to flow backward into the kidneys.

65
Q

chronic pyelonephritis can cause

A

destruction/scaring of the renal tissue

dialation of the calyces

reduction in kidney size

atrophy of renal pyramids
py-ram-ids

HTN

66
Q

acute

glomeronephritis

A

antigen-antibody rx
in glomeruli inflammatory response to renal parenchyma

begins in the cortex

67
Q

alt name for acute glomeronephritis

A

Bright’s disease

68
Q

acute pyelonephritis primarly affects the:

A

interstitial tissue

69
Q

acute glomeronephritis primarly affects the

A

nephron

70
Q

gold standard for Dx of glomeronephritis

A

microscopic deposits in the glomerulus
(streptococcal)
collected with US or CT guidance

71
Q

Cystitis

A

acute or chronic

inflammation of urinary bladder

72
Q

how is VUR prevented

A

compression of bladder musculature on the ureters during micturition

73
Q

congenital VUR is seen how

A

displaced laterall ureteric orifices

duplication of collecting systems & ureters w/ reflux into an ectopically placed ureter

neurogenic bladder

74
Q

neurogenic bladder

A

bladder dysfunction

interference w nerve impulses- urination

75
Q

bladder trabeculae

A

radiograph apperance of roughening of normally smooth bladder wall

76
Q

what prevention is paramount when dealing with cystitis

A

pyelonephritis

77
Q

urinary calcifications

A

renal calculi

urine/precipitate crystaline materials
ca salts

78
Q

predisposing factors to renal calculi

A

metabolic disorders..hyperparathyroid

excessive ca intake

high urine concentration

chronic UTI

79
Q

non calcific stones

A

uric acid stones

80
Q

most stones are formed where

A

calyces

renal pelvis

81
Q

staghorn calculus

A

large calculus

in shape of pelvicalyceal junction

82
Q

what mods used to show stones?

A

US
CT - no contrast
dx flank pain
appendicitis - AAA- renal calculus

83
Q

renal colic

A

movement/ obstruction
of stones
severe intermittent pain

84
Q

renal calculi may cause

A 
renal colic
hematuria
fever 
chills 
frequent urination 
secondary infection
85
Q

degenerative diseases

3

A

nephrosclerosis
renal failure
hydronephrosis

86
Q

nephrosclerosis

A

intimal thickening — sm vessels of kidney

aging, HTN, diabetes

87
Q

what causes nephrosclerosis

A

reduced blood flow –ateriosclerosis = atrophy of renal parenchyma

collecting sys is intact–kidney is impaired

88
Q

how does local infarction of renal parenchyma appear?

A

irregularity of the cortical margin

indentation

89
Q

nephrosclerosis lab tests

and associated complications

A

BUN increase increase creatinine levels

HTN

90
Q

what conditions cause the kidneys to appear smaller than norm

A

hypoplasia
atrophy after obstruction
nephrosclerosis

91
Q

Renal failure

A

norm regulatory & excretion b/c loss of glomerular filtration = loss of parenchyma

92
Q

renal falure usually is chronic and results from

2

A

chronic glomerulonephritis

PKD

93
Q

uremia

A

characteristic of renal failure

retention of urea in the blood

94
Q

what is r/o to dx acute renal failure

A

(progressive BUN/ serum creatinine increase)

urinary calculi (abdom radio)
US/CT assess hydronephrosis kidney size

vascular abnorm – nuc med scan or renal angiography

biopsy

95
Q

what changes in body syst result from renal failure

A

anemia
HTN
heart arrhythmia
CHF

electrolyte / acid-base imbalance

96
Q

tx for renal failure

A

dialysis and transplantation

97
Q

Hydronephrosis

A

obstructive disorder

causes dilation of the renal pelvis and calyces with urine

98
Q

chronic hydronephrosis causes

A

intrarenal preasure= ischemia

parenchymal atrophy

loss of function

flank pain

99
Q

Neoplastic Diseases of Renal system

4

A

renal cysts
renal cell carcinoma
nephroblastoma (wilms tumor)
bladder carcinoma

100
Q

Bladder carcinoma

A

3* more in men

aka transtional cell carcinoma
squamous cell carcinoma
adenocarcinoma

101
Q

main Sx of adenocarcinoma aka bladder carcinoma

A

painless hematuria

tumors located in trigone

IVU/ cystography - fillilng deficite

102
Q

why is cystoscopy the method of choice for bladder carcinoma

A

hard to distinguish between

tumor, stone, blood clot

103
Q

Nephroblastoma

A

aka wilms tumor
malignant tumor effecting 500 children a year
embryonal tumor

clinical dx via palpable immovable abdominnal mass

104
Q

Renal cysts

A

asymptomatic

may rupture, hemorrhage, infection or obstruction

commonly forumnd in lower pole of kidney

105
Q

how are tumors distinguished from cysts in the renal system

A

nephrotomography

cysts show absence of nephrogram phase after contrast medium injection

DMIS 1105 post midterm (3 decks)

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