Flashcards in Chapter 6 Urinary Deck (104):
Begins in the glomerulus, higher blood pressure in the glomerulus helps filtration of fluids into the Bowman’s capsule. Initial urine goes to the convoluted tubule.
Filtration phase of urine formation
At the proximal convoluted tubule, large amounts of water and all nutrients are reabsorbed into the blood capillaries that surround the tubules.
Reabsorption phase of urine formation
What two hormones influence reabsorption in urine formation?
Anti-Diuretic Hormone and Aldosterone
Once water and nutrients are reabsorbed into the blood capillaries surrounding the tubules, where do those fluids travel to?
To the loop of Henle where salt and water are reabsorbed
What happens during the secretion phase of urine formation?
Once water and h2o are reabsorbed, the distal convoluted tubules permit excretion of concentrated urine by active secretion of potassium and hydrogen and some drugs.
What happens when urine passes from the collecting tubules?
It drains into the calyces and then to the renal pelvis and ureters where it then gets sent to the bladder and out.
X-rays of the kidney, ureters and bladder
-looking for stones; initial images
Looking at function of the kidney; contrast given intravenously and excreted through the urinary tract
Helps to look for blockage
Procedure used to visualize the urinary bladder; urinary catheter is placed and radiocontrast is instilled in the bladder and X-rays are taken.
Can be used to look for prostate hypertrophy, reflux, polyps w/in bladder or diverticula
Procedure where a radiocontrast agent is injected into the ureter to visualize the ureter and kidney with fluoroscopy and radiography
What is ultrasound good for when looking at the urinary system?
It’s used to assess the size, location, and shape of the kidneys and related structures
Can detect cysts, tumors, abscesses, obstructions, fluid collection and infection within or around the kidneys
What is CT good for when imaging the urinary system?
Can help to identify stones in the urinary tract, infections, cysts, tumors, and traumatic injury to the kidneys and ureters.
Imaging of the blood vessels of the kidney
What does renal angiography look for?
Aneurysm, stenosis, or blockage in a blood vessel
What is MRI good for when imaging the urinary system?
Best to detect kidney stones or tumors
Done with interventional radiography/surgical procedure in which the renal pelvis is punctured and contrast is injected
Usually used to drain an abscess
Treatment using US shock waves, by which a kidney stone or other calculus is broken into small particles that can be passed naturally
Thin catheter, placed through the skin into the kidney to drain urine from where it collects in the kidney
Done for patient experiencing hydronephrosis
Thin tube inserted into the ureter to prevent or treat obstruction of urine flow from the kidney
Flexible tube placed into the urethra to the bladder to drain urine
Urine output below normal; scanty
Passing abnormally large amounts of urine
What can cause polyuria?
Due to lack of ADH
Could also be associated with diabetes or UTI
No urine production, no urine output
What are the causes of anuria?
Kidney improperly functioning
Incomplete emptying of the bladder
What causes urinary retention?
Could be due to a blockage or enlargement of the prostate
Urine secretion stops
Presence of blood in the urine
What can hematuria indicate?
Can mean infection on low end or cancer on the high end
Condition involving abnormally high levels of waste products in the blood (urea and nitrogen)
What causes uremia?
Inflammation of the bladder
What causes cystitis?
Usually causes by a bacterial infection, i.e. UTI
Inflammation of the renal pelvis
What cause pyelitis?
Usually caused by bacterial infection
What procedure is done to look for cystitis and pyelitis?
Solitary kidney; rare anomaly that may be associated with a variety of other congenital malformations
Unilateral Renal Agenesis
What causes unilateral renal agenesis?
Results from failure of the embryonic renal bud or renal vascular system to form
Often appears as a miniature replica of a normal kidney with good function and a normal relationship between the amount of parenchyma and the size of the collecting system
Acquired condition that develops when one kidney is forced to performed the function normal carried out by two kidneys
Most common in children
What modality is best to demonstrate hyperplasia in a kidney?
Rare anomaly; formation of a third kidney; this kidney is usually small and rudimentary
Possesses a separate pelvis, ureter, and blood supply
Produces bizarre appearance of the renal parenchyma, calyces, and pelvis that suggests pathologic condition when the kidney is otherwise normal.
Birth defect in which a kidney is located in an abnormal normal
May create urinary problems, such as blockage, infection, or urinary stones
Fetal; condition that results when the kidney fails to ascend to their normal position above the waist and remain in the pelvis because they are blocked by blood vessels in the aorta
When a kidney is transplanted, where can it usually be found?
Rare form of ectopic kidney where the kidney moves up above the diaphragm
Most common type of fusion anomaly
In this condition, both kidneys are malrotated and their lower poles are joined by a band of normal renal parenchyma or connective tissue
Common anomaly that may vary from a simple bifid pelvis to a completely double pelvis, ureter, and ureterovesical orifice
Ureter draining the upper renal segment enters the bladder below the ureter draining the lower renal segment
A cystic dilation of the distal urethra near it’s insertion into the bladder
What radiographic signs are present with a ureterocele?
Cobra head sign
If filled, lesion appears as round/oval density surrounded by a thin radiolucent halo
Thin, transverse membranes found almost exclusively in males, that cause bladder outlet obstruction and may lead to sever hydronephrosis, hydroureter, and renal damage
Works as reverse valve, meaning the catheterization is normal but valve prevents antegrade flow
Posterior Urethral Valves
Anomaly where the kidneys are fused and located on the same side of the midline
Also called floating kidney, abnormal condition in which the kidney drops down into the pelvis when the patient stands up
Localized outpouching of the urethra into the anterior vaginal wall
Most often present in the mid or distal urethra
What causes ureteral diverticula?
Results from enlargement of obstructed periurethral glands
Pouch in the bladder wall that can be congenital or acquired
Forms when some of the bladder lining pokes through a weak part in the bladder wall
Congenital bladder diverticula
Genetic disorder characterized by the development of innumerable cysts in the kidneys
Cysts are filled with fluid and replace much of the mass of the kidneys which reduces kidney function, leading to kidney failure
Polycystic kidney disease
At what age can adult polycystic kidney disease manifest?
An infection of the kidney, ureter, bladder, or urethra.
Urinary Tract Infection
A nonsuppurative inflammatory process involving the tufts of capillaries (glomeruli) that filter the blood within the kidney.
What’s another name for glomerulonephritis?
Causes by strep infection
Affects young adults
A suppurative inflammation of the kidney and renal pelvis caused by pyogenic (pus-forming) bacteria
Affects the interstitial tissue between the tubules
Often involves one kidney
Severe form of acute parenchymal and perirenal infection with gas-forming bacteria that occurs virtually only in diabetic patients and causes an acute necrosis of the entire kidney.
Kidney basically looks filled with air.
Occurs as secondary infection from lung involvement but can evolve from other sites
Via hematogenous spread, may lead to development of small granulomas scattered in the cortical portion of the kidneys
Refers to a destructive process involving a varying amount of the medullary papillae and the terminal portion of the renal pyramids
What can papillary necrosis cause?
Causes cavitation of the central portion of the papillae or complete sloughing of the papillary tip
Inflammation of the urinary bladder is more common in women because urethra is shorter
What does cystitis cause?
Inadvertent spread of bacteria present in fecal material, which reaches then urinary opening and travels upward to the bladder
What can be visually seen with cystitis?
Decrease in bladder size
Causes lobulated filling defects
Bladder dysfunction (flaccid/spastic) causes by neurologic damage
Disrupt control of bladder
No compliant, hypotonic bladder resulting from hypertrophy of the muscular coat, usually caused by obstruction of the urethra
Hardening of the kidney, specifically: a condition that is characterized by sclerosis of the renal arteries with reduced blood flow and contraction of the kidney that is usually associated with hypertension
Calcium deposits within the substance of the kidney
Deterioration in kidney function
Refers to rapid deterioration in kidney function, that is sufficient to result in the accumulation of nitrogen-containing wastes in the blood and a characteristic odor of urine-like or “fishy” breath
Acute renal failure
Gradual loss of kidney function
Chronic renal failure
What occurs in advanced stage chronic renal failure?
Dangerous levels of fluid, electrolytes and wastes can build up in the body
Process of purifying the blood by filtering wastes and water from the blood (acts as a kidney)
Involves a tube permanently inserted through the abdomen to allow dialysis to be emptied and replaced everyday
“Do it yourself” option that doesn’t require a machine
Continuous ambulatory peritoneal dialysis
Small hardened deposit that forms in the kidneys that can become lodged in the ureter, causing partial obstruction
What can the presence of calculi lead to?
Hydronephrosis because the kidney is still producing urine but it can not drain properly due to blockage
What can blockages due to calculi at the level of the bladder lead to?
Stone that completely fills the renal pelvis, blocking the flow of urine
Pain caused by a urinary tract stone (urolithiasis)
Produced a atomic and functional changes that vary with regard to rapidity if onset, degree of occlusion, and distance between the kidney and obstructing lesion
Distinction of the pelvis and calyces of the kidney
Can lead to loss of function
Most common unifocal masses of the kidney; fluid filled and usually unilocular; vary in size, and mag occur at single or multiple sites in one or both kidneys
Presents with a beak sign on a nephrotogram
Also know as hypernephroma
Most common renal neoplasm, occurring predominantly in patients older than 40 years and often with painless hematuria.
Tumor usually originated in the tubular epithelium of the renal cortex
Presents with urographic evidence of localized bulging or generalized enlargement of the kidney
A malignant epithelial tumor resulted from proliferation of tubule cells
Most common abdominal neoplasm of infancy and childhood
Lesion arises from embryonic renal tissue, may be bilateral, and tends to become very large and appear as a palpable mass
Wilm’s tumor (nephroblastoma)
Most commonly originated in the epithelium
Usually seen in men older than 50 yrs
In bladder, may produce finger-like projections into the lumen, or may infiltrate the bladder wall
Common also in cigarette smokers
Transitional carcinoma of the bladder
What is another name for transitional carcinoma of the bladder?
Occurs most frequently in children who are severely dehydrated; formation of a clot in the vein that drains from the kidneys, ultimately leading to a reduction in the drainage of one or both kidneys and the possible migration of the clot to other parts of the body
Renal vein thrombosis
What causes renal vein thrombosis in adults?
Complication of another renal disease, trauma, the extension of a thrombus from the inferior vena cava or direct invasion or extrinsic pressure resulting from renal tumors
Age associated prostate gland enlargement that can cause urination difficulty
A narrowing of arteries that carry blood to one or both of the kidneys
Renal artery stenosis/renal hypertension