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Positioning 1 > Ch. 14 Urinary System and Venipuncture > Flashcards

Ch. 14 Urinary System and Venipuncture Flashcards

1
Q

this kidney is generally lower or more inferior than the other

A

right

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2
Q

how do the ureters lie in respect to their kidney

A

anterior

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3
Q

what aspect of the bladder do the ureters enter into it

A

posterolateral aspect

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4
Q

how much does the average adult kidney weigh

A

5 1/4 oz (150 g)

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5
Q

what are the measurements of an average adult kidney

A

4-5” long, 2-3” wide, 1” thick

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6
Q

this kidney is a little longer, but more narrow than the other

A

left

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7
Q

the two psoas major muscles on either side of the vertebral column cause the longitudinal plane of the kidneys to form a vertical angle of what to the midsagittal plane

A

20 degrees

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8
Q

what pole of the kidney is closer to the midline of the body

A

upper pole

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9
Q

which aspect of the kidney is more anterior

A

medial border

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10
Q

what is the normal kidney rotation

A

30 degrees from coronal plane

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11
Q

what muscle is found on each side, just posterior to the kidneys

A

quadratus lumborum muscles

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12
Q

what is the group of deep muscles of the back called

A

erector spinae muscles

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13
Q

what body position places the kidney parallel to the IR

A

30 degree posterior oblique

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14
Q

each kidney is surrounded by a mass of fatty tissue called what

A

adipose capsule or perirenal fat

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15
Q

these permit radiographic visualization of the kidneys on plain abdominal radiographs

A

adipose capsule/ perirenal fat

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16
Q

with patient supine and taken on expiration, where do the kidneys normally lie

A

midway between xiphoid and iliac crest

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17
Q

how much higher is the left kidney compared to the right

A

1 cm higher

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18
Q

what level is top of left kidney at about

A

T11-T12 interspace

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19
Q

what level is the bottom of the right kidney at

A

superior endplate of L3

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20
Q

how far do the kidneys drop on deep inhalation

A

1”

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21
Q

how far do the kidneys drop when one stands upright

A

1 lumbar vertebrae (2”)

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22
Q

a condition when the kidneys drop farther than normal

A

nephroptosis

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23
Q

the kidneys perform these 3 functions during urine production

A
  • removes nitrogenous waste
  • regulate water levels
  • regulate acid-base balance and electrolyte levels of the blood
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24
Q

these nitrogenous waste products are formed during the normal metabolism of proteins

A

urea and creatinine

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25
Q

buildup of nitrogenous waste products, urea and creatinine, in the blood results in this clinical condition and may indicate renal dysfunction

A

uremia

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26
Q

how much blood pumped form the heart with each beat passes through the kidneys

A

at least 25%

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27
Q

what do the renal veins connect directly to

A

inferior vena cava

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28
Q

what is more anterior, the renal veins or the renal arteries

A

renal veins

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29
Q

along the medial border of each kidney is a centrally located, longitudinal fissure called what

A

hilum

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30
Q

this serves to transmit the renal artery, renal vein, lymphatics, nerves and ureters

A

hilum

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31
Q

each kidney is generally divided into these two parts

A

upper pole and lower pole

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32
Q

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

A

2.5 L

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33
Q

at rest, how much blood flows through the kidneys every 60 seconds this also results in removal of how much filtrate from the blood every 24 hours

A
  • more than 1 L
  • 180 L
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34
Q

how much of the filtrate volume is reabsorbed by the kidneys and returned to the blood stream

A

more than 99%

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35
Q

from the large amount of blood that flows through the kidneys each day, an average of how much urine is formed

A

1.5 L

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36
Q

what is the outer covering of the kidney called

A

renal (fibrous) capsule

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37
Q

directly under the renal capsule, surrounding each kidney; this forms the peripheral or outer portion of each kidney

A

cortex

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38
Q

under the cortex is this internal structure, composed of 8-18 conical masses

A

medulla

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39
Q

what are the conical masses within the medulla called

A

renal pyramids

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40
Q

the cortex periodically drips between the pyramids to form these

A

renal columns

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41
Q

what do the renal columns extend to

A

renal sinuses

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42
Q

the renal pyramids are primarily a collection of tubules that converge at an opening called what

A

renal papilla

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43
Q

what does the renal papilla drain into

A

minor calyx

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44
Q

these appear as hollowed flattened tubes

A

calyces

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45
Q

4-13 minor calyces unite to form this

A

2-3 major calyces

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46
Q

the major calyces unite to form this; which appears in the shape of a larger flattened funnel

A

renal pelvis

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47
Q

each expanded renal pelvis narrows to continue as this

A

ureter

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48
Q

this general term is used to describe the total functional portions of the kidneys, such as those visualized during an early phase of intravenous (IV) urographic procedure

A

renal parenchyma

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49
Q

what is the structural and functional unit of the kidney

A

nephron

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50
Q

how many nephrons exist within each kidney

A

1 million

51
Q

small arteries in the renal cortex form tiny capillary tufts called what

A

glomeruli

52
Q

blood initially is filtered through this

A

many glomeruli

53
Q

these supply blood to the glomeruli

A

afferent arterioles

54
Q

these take blood away to a secondary capillary network in close relation to the straight and convoluted tubules

A

efferent arterioles

55
Q

each glomerulus is surrounded by this, which is the proximal portion of each nephron collecting filtrate

A

glomerular capsule (Bowman capsule)

56
Q

what is the filtrate termed by the time it reaches the minor calyx

A

urine

57
Q

what is the order of travel of glomerular filtrate

A
  • glomerular capsule
  • proximal convoluted tubule
  • descending and ascending limbs of the loop of Henle
  • distal convoluted tubule
  • collecting tubule
  • minor calyx
58
Q

between the bowman capsule and the minor calyces how much filtrate is reabsorbed into the kidneys venous system

A

more than 99%

59
Q

what parts of the nephron are located within the cortex of the kidney

A
  • glomeruli
  • glomerular capsule
  • proximal and distal convoluted tubules
60
Q

what parts of the nephron are located primarily within the medulla

A
  • loop of Henle
  • collecting tubules
61
Q

what are the renal pyramids within the medulla primarily

A

collection of tubules

62
Q

what is the average length of ureters

A

11-13” (28-34 cm)

63
Q

what are the 3 constricted points along the ureter

A
  • ureteropelvic (UP) junction
  • brim of the pelvis (iliac blood vessels cross over ureters)
  • ureterovesical (UV) junction
64
Q

where do most kidney stones that pass down the ureter tend to hang up at

A

ureterovesical (UV) junction

65
Q

what is the triangular portion of the bladder along the inner, posterior surface called; the muscular area formed by the entrance of the two ureters from behind and the exit site of the urethra

A

trigone

66
Q

this portion of the trigone is smooth

A

mucosa

67
Q

the remaining aspect of the inner mucosa of the bladder has numerous folds called what rugae

A

as the bladder fills, how does the bladder expand

68
Q

as the bladder fills, how does the bladder expand

A

top of bladder expands upward and forward

69
Q

in males, what is the gland that surrounds the proximal urethra

A

prostate gland

70
Q

how big does the prostate gland measure

A

1.5” diameter, 1” in height

71
Q

the desire to void arises when the bladder reaches how much urine

A

250 mL

72
Q

retention of urine in the bladder is maintained through these two things

A
  • involuntarily controlled internal urethral sphincter (IUS)
  • voluntarily controlled external urethral sphincter (EUS)
73
Q

this is located at the junction of the bladder to the urethra (neck of bladder)

A

involuntarily controlled internal urethral sphincter (IUS)

74
Q

in males, where is the EUS located

A

distal to the prostate

75
Q

females EUS is more elaborate than males and is composed of these 3 areas

A
  • urethral sphincter
  • compressor urethrae
  • urethrovaginalis sphincter
76
Q

what is the total capacity of the bladder

A

350-500 mL

77
Q

weakening or damage to the EUS can lead to involuntary urination called what

A

incontinence

78
Q

the urinary bladder in females lies posterior and just superior to what

A

upper margin of symphysis pubis

79
Q

how long is the female urethra

A

1.5”

80
Q

where is the urethra embedded in females

A

anterior wall of the vagina

81
Q

what kind of sac do males have

A

closed sac

82
Q

what does most of the bladder of the male lie directly posterior to

A

superior margin of symphysis pubis

83
Q

how long is the male urethra

A

6.5-7.5”

84
Q

the female reproductive organs include what

A
  • pair of ovaries (female gonads)
  • uterine (fallopian) tubes
  • vagina
85
Q

the male reproductive organs include what

A
  • testes ( male gonads)
  • seminal vesicles and related ducts
  • ejaculatory ducts and ductus deferens (vas deferens)
  • penis
  • scrotum
86
Q

what is the single function of the female urethra

A

passage of urine to the exterior

87
Q

what are the 2 functions of the male urethra

A
  • eliminate urine
  • serve as passageway for semen
88
Q

the percutaneous puncture of a vein for withdrawal of blood or injection of a solution

A

venipuncture

89
Q

this contrast medium is used for radiographic exams of the urinary system

A

water-soluble iodinated contrast medium

90
Q

injection in which the entire dose of contrast medium is injected into the venous system at one time

A

bolus injection

91
Q

method where contrast medium is introduced into the venous system via connective tubing attached to the IV site; specified amount is introduced over a specified period

A

drip infusion

92
Q

in the event of an adverse contrast reaction what must be on hand

A
  • epinephrine
  • benadryl
93
Q

for most IV urograms what veins are ideal

A

antecubital fossa

94
Q

veins found within the antecubital fossa commonly used during venipuncture include what

A
  • median cubital
  • cephalic
  • basilic
95
Q

what are some other common IV access sites if veins in the antecubital fossa can’t be used

A
  • cephalic vein of the lateral wrist
  • cephalic or basilic veins of posterior hand/forearm
96
Q

what type of veins should the tech aboid

A
  • sclerotic (hardened)
  • tortuous (twisted)
  • rolling
  • overused
97
Q

for bolus injections of 50-100 mL what type of needle is used

A

18-22 gauge needle

98
Q

for pediatric patients what type of needle is used

A

23-25 gauge needle

99
Q

how long is the needle typically

A

1-1.5”

100
Q

what finger should the tech use when selecting the injection site

A

finger of the nondominant hand

101
Q

where should tourniquet be placed

A

3-4” above site

102
Q

how do you cleanse the selected site of injection

A

alcohol (70% isopropyl) in circular motion from center out 2-3”

103
Q

what direction does bevel of needle face

A

forward

104
Q

what angle should you approach the bein

A

20-45 degrees

105
Q

you decrease the angle of the needle once in the vein, to run parallel with it and advance the needle how much further

A

1/4”

106
Q

for over the needle catheter placement where should you apply pressure when inserting catheter

A

1.5” above insertion site on vein

107
Q

when should sharps containers be replaced

A

when half full

108
Q

general radiographic exam of the urinary system is called what

A

urography

109
Q

the opacifying element used in intravenous contrast media for urography

A

iodine

110
Q

what is the atomic number of iodine

A

53

111
Q

contrast agents containing one tri-iodinated benzene ring

A

monomer

112
Q

contrast agent containing two tri-iodinated benzene rings

A

dimer

113
Q

the number of dissolved particles in a solution

A

osmolality

114
Q

what does HOCA stand for

A

high osmolar contrast agent

115
Q

what are 2 common side effects that may occur after an IV injection of iodinated contrast medium

A
  • temporary hot flash
  • metallic taste in the mouth
116
Q

normal creatinine levels for the adult

A

0.6-1.5 mg/dL

117
Q

what is a normal BUN level range

A

8-25 mg/100mL

118
Q

what is a normal eGFR for adults

A

60 mL/min or greater

119
Q

a drug that is given for the management of non-insulin dependent diabetes mellitus

A

metformin hydrochloride

120
Q

nonfunctional examination of the urinary sustem

A

retrograde urography

121
Q

nonfunctional radiographic exam o the urinary bladder

A

retrograde cystrography

122
Q

routine positioning for a cystogram

A
  • AP 15 degree caudal angle
  • bilateral posterior obliques
123
Q

this exam provides a study of the urethra and evaluates the patients ability to urinate; functional study of the bladder and urethra

A

voiding cystourethrography (VCU)

124
Q

position of choice for retrograde urethrography

A

30 degree RPO CR pubic symphysis

Positioning 1 (50 decks)

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