week 11 Flashcards
Renal and Urinary functions helps
maintain the body’s state of homeostasis
Regulating fluid and electrolytes (excretion/re-absorption):
Fluid balance
Acid-base balance
Electrolyte balance
Removing wastes
Providing hormones:
Red blood cell production Erythropoietin Bone metabolism Assists in conversion of Vitamin D to maintain calcium balance Blood pressure regulation Renin/Prostaglandins
Nephron
Blood flows in via afferent arteriole
Filtered in glomerulus
Filtrate enters tubules (~ 180L/day)
Depends on blood pressure
Reabsorption – substance moves back into blood stream
Secretion – substance moves from blood stream into tubule
Influenced by anti-diuretic hormone (ADH)
Age (developmental) changes
Your kidneys shrink as you age, male & female:
GFR
Loss of thirst stimulation (decreased osmotic stimulation)
Various health problems such as diabetes, hypertension and atherosclerosis accelerate these renal changes:
But if in otherwise good health your kidneys function well into old age, maintaining homeostasis (despite the shrinkage)
In women, (especially after child birth) the female bladder, urethra, vagina and pelvic floor lose tone and vascularity (increased UTIs/incontinence)
In men, the prostate enlarges, (retention/frequency/UTIs/ incontinence)
Physical examination:
Especially abdominal and kidney palpation
Presence of oedema
Bladder percussion
Digital (rectal) prostatic palpation (DRE)
Inspection of genitalia/urinary meatus
Abnormal anatomy (female circumcision/”whistle-cock”)
Diagnostic studies (specific):
Urinalysis - baseline information – 1st am spec.
24 hr urine collection - creatinine/protein/specific components
Empty bladder at designated time
MSU/catheter spec.
Residual urine – left in bladder after urination (< 50-150mls)
Blood tests – specifically creatinine & urea
Radiological – x-rays/IVP/ultrasound/CT Scan/MRI/’scopes
Radionuclide Imaging/biopsy/cystoscopy
Renal function tests
Patient preparation
? Full bladder/? Encourage fluids/? fasting
