Ch 18 urinary Flashcards
(113 cards)
1
Q
what are the seven functions of the urinary system
A
removes metabolic wastes
removes hormones from the body
removes drugs and other foreign material from the body
regulates water, electrolyte, and acid-base balance
secretes erythropoietin
activates vitamin D
regulates blood pressure through the renin-angiotensin-aldosterone system
2
Q
what is the path of the urinary system
A
kidneys to ureters to urinary bladder to urethra
3
Q
functional units of the kidneys
A
nephrons
4
Q
how many nephrons does each kidney have?
A
over a million
5
Q
what are the two parts of the renal corpuscles
A
glomerulus and Bowman capsule
6
Q
what are the four parts of the renal tubules
A
proximal convoluted tubule, Loop of Henle, distal convoluted tubules and collecting duct
7
Q
how does urine form
A
through filtration and reabsorption
8
Q
where does filtration take place
A
in the renal corpuscles
9
Q
what happens during filtration
A
large volumes of fluid passes from glomerular capillaries into the tubule or Bowman capsule
10
Q
what are the types of fluids that are filtered
A
wastes, nutrients, electrolytes, and other dissolved substances
11
Q
what remains in the blood during filtration
A
cells and proteins
12
Q
what does reabsorption control
A
pH and electrolytes
13
Q
what is reabsorbed
A
essential nutrients, water and electrolytes
14
Q
reabsorption takes place in what
A
the peritubular capillaries
15
Q
what are the three transport mechanisms for reabsorption
A
active transport, co-transport and osmosis of water
16
Q
where is the most water reabsorbed
A
proximal convoluted tubules
17
Q
what maintains homeostasis during reabsorption
A
nutrients and electrolytes
18
Q
where is glucose reabsorbed
A
proximal convoluted tubules
19
Q
what hormones are involved in reabsorption
A
antidiuretic hormone, aldosterone and atrial natriuretic hormone
20
Q
Antidiuretic hormone is secreted by what
A
the posterior pituitary
21
Q
where does reabsorption of water take place in the antidiuretic hormone
A
in distal convoluted tubules and collecting ducts
22
Q
aldosterone is secreted by what
A
the adrenal cortex
23
Q
during aldosterone, sodium is reabsorbed in exchange for
A
potassium or hydrogen
24
Q
where is atrial natriuretic hormone come from
A
the heart
25
what does the atrial natriuretic hormone reduce
sodium and fluid reabsorption
26
how does blood flow through the kidney
renal artery to interlobar artery to arcuate artery to interlobular artery to afferent arteriole to glomerular capillaries to efferent arteriole to peritubular capillaries to interlobular vein to arcuate vein to interlobular vein to renal vein
27
what are the three autoregulation and hormone control pressure in the glomerular capillaries
vasoconstriction of afferent arteriole, dilation of afferent arteriole, and vasoconstriction of the efferent arteriole
28
what does vasoconstriction of the afferent arteriole do
decreases the glomerular pressure which decreases filtrate
29
what does dilation of afferent arteriole do
increases pressure of the glomerulus which increases filtrate
30
what does vasoconstriction of the efferent arteriole do
increases pressure in glomerulus which increases filtrate
31
what are the three controls of the arteriolar constriction
autoregulation, sympathetic nervous system and renin
32
what is autoregulation
local adjustment in diameter of arterioles
33
autoregulation maintains what
normal filtration rate
34
autoregulation is made in response to what changes
in blood flow in the kidneys
35
what does the sympathetic nervous system do
increases vasoconstriction in both arterioles
36
what is renin secreted by
juxtaglomerular cells
37
when is renin secreted
when blood flow to afferent arteriole is reduced
38
what is closely related to kidney function
blood pressure
39
what stimulates aldosterone secretion
angiotensin
40
angiotensin does what
increases reabsorption of sodium and water to increase blood volume and pressure
41
loss of voluntary control of the bladder
incontinence
42
involuntary urination by child age older than four years
enuresis
43
what is related to enuresis
developmental delay, sleep pattern, or psychosocial aspect
44
what are the four types of incontinence
overflow incontinence, incontinence, enuresis, and stress incontinence
45
stress incontinence is more common in who
women
46
stress incontinence has to do with what four things
coughing, lifting, laughing and multiple pregnancies
47
stress incontinence does what
increases intra-abdominal pressure and forces urine through the sphincter
48
overflow incontinence has to do with what three things
older adults, incompetent bladder sphincter, and spinal cord injuries or brain damage
49
why do older adults have overflow incontinence problems
weakened detrusor muscle may prevent complete emptying the bladder
50
interference with what two things controls the bladder (think spinal cord and brain)
CNS and ANS
51
neurogenic bladder may be what
spastic or flaccid
52
what does retention mean
inability to empty the bladder
53
retention may be accompanied by what
overflow incontinence
54
retention may follow what
anesthesia
55
spinal cord injury blocks what during retention
micturition reflux
56
lots of protein, blood, bacteria and pus has what appearance of urine
cloudy
57
hematuria, excessive bilirubin, or highly concentrated urine has what appearance
dark color
58
infection or result from certain dietary components or medication does what to urine
unpleasant or unusual odor
59
what is the pH of urine
between 4.5 and 8
60
what is the normal specific gravity of urine
1.010 to 1.050
61
what is the normal appearance of urine
straw colored with mild odor
62
what does hematuria mean
blood in the urine
63
what does small amounts of blood in the urine mean
infection, inflammation, or tumors in urinary tract
64
what does large amounts of blood in the urine mean
increases glomerular permeability or hemorrhage
65
what does proteinuria or albuminuria mean
elevated protein in the urine
66
what does bacteriuria mean
bacteria in the urine
67
what does bacteria in the urine indicate
infection in the urinary tract
68
what do urinary casts indicate
inflammation of the kidney tubules
69
what does specific gravity indicate
ability of tubules to concentrate urine
70
dilute urine with normal hydration
low specific gravity
71
concentrated urine with normal hydration
high specific gravity
72
what type of specific gravity is related to renal failure
high
73
what are found when diabetes mellitus is not well controlled
glucose and ketones
74
what does elevated serum urea and serum creatinine levels indicate
failure to excrete nitrogen wastes from protein metabolism
75
what does elevated serum urea and serum creatinine levels are caused by
decreased GFR
76
what does metabolic acidosis indicate
decreased GFR
77
what does metabolic acidosis decrease
serum pH and serum bicarbonate
78
metabolic acidosis has to do with what
failure of tubules to control acid-base balance
79
anemia indicates what
decreased erythropoietin secretion and or bone marrow depression due to accumulated wastes
80
low hemoglobin levels has to do with what
anemia
81
electrolytes depend on what
related fluid balance
82
used for diagnosis of post-streptococcal glomerulonephritis
antistreptolysin O or antistreptokinase titers
83
elevated renin levels indicate what
kidney as a cause of hypertension
84
what are the blood test that can be run on urine
```
creatinine and BUN levels
metabolic acidosis
anemia
electrolytes
antibody level
elevated renin levels
```
85
culture and sensitivity studies on the urine specimens help do what
select appropriate drug treatments
86
used to visualize structures and possible abnormalities, flow patterns, and filtration rates
radiologic test
87
visualizes lower urinary tract and may be used to perform biopsy or remove kidney stones
cystoscopy
88
what are the tests used for clearance
creatinine or insulin
89
used to acquire tissue specimens
biopsy
90
used to remove excess sodium ions and water from the body
diuretic drugs
91
increased excretion of water through the kidneys
reduces fluid volume in tissues and blood
several different mechanisms to increase urine volume
often administered in the morning
diuretic drugs
92
what are the diseases that require a prescription for a diuretic drug
renal disease, hypertension, edema, congestive heart failure, liver disease, pulmonary edema
93
what are the two forms of dialysis
hemodialysis
| peritoneal dialysis
94
```
provides filtration and reabsorption
sustains life during kidney failure
used to treat patients with acute kidney failure
for patients in end-stage renal failure
between transplants
```
dialysis
95
in hospital, dialysis center, or home with special equipment and training
patients blood moves from an implanted shunt or catheter in an artery to machines
hemodialysis
96
exchange of wastes, fluids, and electrolytes
semipermeable membrane between blood and dialysis fluid
after exchange is completed, blood returned to patients vein
hemodialysis
97
during dialysis what remains in the blood
blood cells and proteins
98
what are possible complications with hemodialysis
shunt may become infected
blood clots may form
blood vessels may become sclerosed
increased risk of infection with hepatitis B and C and HIV
99
how often is hemodialysis required
three times a week
100
How long does a treatment of hemodialysis take
three to four hours
101
done at dialysis unit or home
may be done at night
semipermeable membrane is the peritoneal
catheter with entry and exit points is implanted in the peritoneal cavity
peritoneal dialysis
102
dialysate is drained from the peritoneal cavity via what
gravity
103
what are the major complications of peritoneal dialysis
infection resulting in peritonitis
104
which takes longer hemodialysis or peritoneal dialysis
peritoneal dialysis
105
peritoneal dialysis requires what
loose clothing to accommodate the bag of fluid
106
what has to do with both types of dialysis
prophylactic antibiotics
any additional problem occurring in patient such as infection may alter dialysis requirements
caution is required with many drugs because toxic level buildup can occur
107
what type or urinary infection is the most common
UTI
108
what has to do with lower urinary tract infections
cystitis
| urethritis
109
what has to do with upper urinary tract infections
pyelonephritis
110
what is an excellent growth medium
urine
111
what is the common causative agent of urinary tract infections
E coli
112
what other species are associated with UTIs
```
Klebsiella
Proteus
Enterobacter
Citrobacter
Serratia
Pseudomonas
Enterococcus
Coagulase-negative Staphylococcus
Chlamydia
Mycoplasma
```
113
Why is UTIs more common in women
shortness of urethra
| proximity to anus
