Chapter 6 Urinary System Flashcards
(151 cards)
1
Q
What is a horseshoe kidney?
A
A condition in which both kidneys are joined at their lower poles across the midline of the body
2
Q
What structures are affected with a horseshoe kidney?
A
Because the lower poles are pulled together, the upper pole and hilum of each kidney is anatomically affected
3
Q
How is the renal pelvis located with a horseshoe kidney?
A
More anteriorly located causing a more horizontal angle, allowing urine to sit for longer periods of time
4
Q
What happens when urine sits?
A
It stagnates and collects the heavier potassium and calcium waste products
5
Q
What are more common in horseshoe kidneys because of the change in anatomical positioning?
A
Renal Calculi
6
Q
What is renal ectopia?
A
The condition of a misplaced kidney and present in several different manner
7
Q
Where are the kidneys usually found with renal ectopia?
A
Usually the kidneys are found in the pelvis and are associated with a congenitally short ureter
8
Q
What is crossed ectopy?
A
When one kidney (usually the lower one) lies either partially or completely across the midline and is fused with the upper kidneys at its lower pole
9
Q
What do both of the kidneys demonstrate with renal ectopia?
A
Both kidneys demonstrate various anomalies of position, shape, fusion, and rotation
10
Q
What is more likely to be present with renal ectopia?
A
Stone formation and reflux
11
Q
What is a floating kidney termed?
A
Nephroptosis
12
Q
How are the kidneys situated?
A
The kidneys are retroperitoneal and only the anterior surface is attached to the peritoneum
13
Q
How much will the kidneys normally be displaced on inspiration?
A
Inferiorly about 1 inch upon deep inspiration
14
Q
When a person assumes the upright position how much can the kidneys move?
A
The kidneys can descend as much as 2 inches
15
Q
What occurs with nephroptosis?
A
The anterior surface of the kidney is not attached to the peritoneum
16
Q
When a person with nephroptosis stands upright, what happens to the kidneys?
A
The kidneys will fall quite a distance, sometimes into the pelvic region
17
Q
What is the determining factor of nephroptosis?
A
The length of the ureter
18
Q
What is Polycystic renal disease?
A
An inherited renal cystic condition
19
Q
What is another name for polycystic renal disease?
A
polycystic kidney disease
20
Q
What is the exact cause of the formation of polycystic renal disease?
A
The cause is unknown
21
Q
What is associated with polycystic renal disease?
A
Brain aneurisms and diverticula of the colon
22
Q
What happens in the early stages of polycystic renal disease?
A
The cysts multiply and enlarge, causing enlarged kidneys
23
Q
What happens in the end stages of polycystic renal disease?
A
The kidneys are small and scarred, preventing normal function
24
Q
Who does polycystic renal disease affect?
A
Both infants and adults (more common in adults)
25
What happens as the cysts continue to grow with polycystic renal disease?
As the cysts continue to grow and compress the cortex, they will push outward on the capsule of the kidney which causes the kidney to lose its smooth border as it becomes lumpy and lobulated
26
What is the cause of death with polycystic renal diseasE?
Renal failure
27
What modalities will demonstrate polycystic renal disease?
CT, MRI, and ultrasonography
| for radiographer, IVU
28
How will the kidneys appear in the early stages of polycystic renal disease when viewing with various modalities?
The kidneys will appear larger than normal with lobulated borders, elongated renal pelvis, and distortion of calyces
29
Is the normal filling time when imaging polycystic renal disease longer or shorter?
The normal filling time will be longer as the nephrons are compromised and unable to process the contrast as well as a normal kidney
30
How long may the "nephron blush" continue for someone with polycystic renal disease?
Many not occur for more than 3 to 5 minutes or longer
31
What is glomerulonephritis?
An inflammatory disease of the capillary loops of the renal glomeruli, located within in the nephrons
32
What is a more common term for glomerulonephritis?
Brights disease
33
What is brights disease the most common cause of?
Underdeveloped kidneys (hypoplasia) in young adults
34
What might Brights disease develop after?
A streptococcal infection as a result of antigen-antibody complex being deposited in the glomerulus
35
What is Brights disease characterized by?
Hypertension caused by the stimulation of the juxtaglomerular apparatus and edema of the face and ankles due to loss of protein
36
What are symptoms of Brights disease?
nausea, malaise, and arthralgia
37
What will laboratory tests indicate in someone with Brights disease?
A increase in albumin, BUN, and creatinine levels
38
What happens to the majority of patients with brights disease?
Majority will recover spontaneously but a small number of patients develop progressive renal failure and death may be cause by uremia
39
What happens to other patients with brights disease?
They experience chronic inflammation
40
What is prostatic hypertrophy?
It describes prostate gland enlargement and subsequent obstruction of urinary output
41
Who experience prostatic hypertrophy?
Almost all men over 55 years of age experience some enlargement of the prostate gland
42
What are the early symptoms of prostatic hypertrophy?
Reduced urine output but the feeling of a full bladder
43
What happens are the prostate gland enlarges?
It closes the lumen of the urethra, thus causing diminished urine output. The residual urine retained in the bladder tends to undergo decomposition and becomes infected
44
What is a common complaint of prostatic hypertrophy?
Cystitis associated with hypertrophy of the prostate gland
45
What is cystitis?
inflammation of the bladder
46
What does pyelonephritis mean?
Inflammation of the kidney and renal pelvis
47
What is the most common single type of renal disease?
Pyelonephritis
48
Who is most commonly affected by pyelonephritis?
women because of higher incidence of UTIs
49
What are the symptoms of pyelonephritis?
flank pain, bacteriuria, pyuria, dysuria, nocturia and increased frequency of urination
50
If pyelonephritis is quickly treated with antibiotics what happens to the kidney?
the kidney should heal with no scarring
51
What happens when treatment is delayed within the first several years of having pyelonephritis?
the kidneys will be damaged so as to affect renal function causing hypertension and even end-stage renal disease
52
What are renal calculi?
Solid masses that consists of a collection of tiny crystals containing calcium, calcium salts, and oxalates
53
What is the most common substance combined with calcium to form stones?
Oxalate
54
What do minerals form in regards to renal calculi?
Minerals form minute crystals that are passed out of the body along with urine flow
55
What can often happen to the minerals in regards to renal calculi?
Sometimes the minerals clump together and cling to the tissue lining the inside of the kidney. There they continue to grow as new crystals are added.
56
What does the urine show with renal calculi?
The urine shows elevated crystalline salts, pus, and blood upon examination and testing
57
What forms in the urinary tract with renal calculi?
Stones form, usually in the renal pelvis, but they are sometimes found in the bladder
58
What are common manifestation of renal calculi?
Hematuria and severe flank pain radiating to the groin or genitals
59
What are common in premature infants with renal calculi?
Kidney stones due to high concentration of their urine
60
What are the most common stones with renal calculi?
Calcium stones in men
61
What are the different types of stones associated with renal calculi?
Calcium stones, uric stones, and struvite stones
62
What are uric stones?
They are radiolucent making them difficult to see
63
Who are uric stones most common in?
Men
64
What are uric stones associated with?
Gout
65
What are struvite stones?
They are composed of magnesium ammonium phosphate that is found with UTIs
66
Who are struvite stones most common in?
Women
67
What is another name for struvite stones?
infection stones because of their composition and association to UTI
68
What happens if stones begin to form in the renal pelvis and continue to grow their?
It may take on the shape of the pelvicaliceal junction as it completely fills the renal pelvis aka staghorn calculus
69
What represent 70% of staghorn calculus?
Struvite calculi
70
What is nephrocalcinosis?
It describes numerous irregular spots of calcium contained in the renal parenchyma
71
Who are at risk for nephrocalcinosis?
Those who have increased alkali in the urine or who have chronic glomerulonephritis
72
What do bladder stones have a tendency to form from?
Stagnant urine that is unable to be passed because of some uretheral outlet obstruction or because of size
73
What position should be used to show bladder stones?
An upright position will demonstrate a filling defect at the base of the bladder and the post-void projection should show contrast outlining the stone
74
What modalities show stones or obstruction?
Kidney ultrasound, IVU, abdominal radiographs, retrograde pyelogram, abdominal CT, and abdominal/kidney MRI
75
What is nephroblastoma?
the most common malignant abdominal neoplasm occurring in children
76
What is another name for nephroblastoma?
Wilms tumor
77
What is the peak incidence of nephroblastoma?
3 years of age and the occurrence of the tumor after the age of 8 years is rare
78
What is the cause of nephroblastoma?
The exact cause is unknown but it is associated with birth defects of the urinary tract
79
Who is nephroblastoma more common in?
Siblings and twins
80
What are the symptoms of nephroblastoma?
palpable abdominal mass, blood in the urine, and fever
81
What does an IVU show with nephroblastoma?
An abdominal mass that displaces the kidney because of its location
82
What happens in stage 1 of Wilms tumor?
The kidney is intact and the tumor has not ruptured
83
What happens in stage II and III of Wilms tumor?
The tumor involvement is more extensive and mephrectomy is indicated with radiation and chemotherapy
84
What happens with stage IV of Wilms tumor?
It shows metastases to the lung, liver, bone or brain
85
What does stage V of Wilms tumor require?
Bilateral renal involvement
86
Where will bladder carcinoma usually begin?
In the epithelial tissue of the bladder
87
Who is most affected by bladder carcinoma?
Men over the age of 50 years
88
What is the cause of bladder carcinoma?
Excessive cigarette smoking, as the carcinogenic metabolites are excreted in the urine
89
Where does baldder carcinoma usually project into?
The bladder in a papillary form, causing a filling defect on the bladder film of the ureogram
90
What is hypernephroma?
The most common renal tumor in patients of any age
91
What are other names for kidney cancer?
Grawitz tumor and renal cell carcinoma
92
What has hypernephroma been linked to?
It's an idiopathic disease that has been linked to cigarette smoking and certain genetic syndromes such as Von Hippel-Lindau syndrome as well as long-term dialysis
93
Where does hypernephroma arise from?
The renal tubule cells and destroys the kidney while invading the blood vessels, particularly the renal vein and the IVC
94
What is the main symptom of hypernephroma?
Hematuria
95
Who is hypernephroma most common in?
Men after the age of 40
96
What is a renal cyst?
An acquired condition that usually occurs in the cortex of the lower pole of the kidney (benign neoplasm)
97
What is a bifid system?
a double collecting system
98
What is the most common anomaly of the urinary system?
Duplication
99
What may appear with a bifid system?
A double renal pelvis or ureter (for even both) may appear in either one or both kidneys
100
What is a cystography?
It is the study of the bladder
101
What is the process involved with a cystography?
A catheter is inserted through the urethra into the bladder and contrast media is instilled into the bladder. When the bladder is full, the catheter is removed and radiographic images are taken
102
What is it termed when images are also taken as the patient voids?
Cystourethrography
103
What is a cystography used to determine?
The cause of infections, locations of tumors or stones, and to check for reflux into the ureters
104
What is retrograde pyelography?
A study performed under mild sedation in the surgery area for cystoscopy ( visualize the inside of your bladder)
105
What position is the patient placed in for a retrograde pyelography?
Lithotomy position
106
What is inserted into the ureter with the tip placed as near the renal pelvis as possible
A ureterocystoscope
107
What is the process with a retrograde pyelography?
Contrast medium is injected into the renal pelvis and images are taken
108
What can retrograde studies study?
The anatomy but not the function
109
Where do the kidneys lie?
behind the peritoneum
110
What surface of the kidney is covered with peritoneum?
The anterior surface
111
How long are the kidneys?
4.5 inches in length
112
Around what level are the kidneys found?
T12 to L3
113
What kidney is slightly lower because of the liver?
The right kidney
114
What is the renal capsule?
The fibrous connective tissue that encloses the kidneys
115
What is the pale-colored functional tissue of the kidney that extends from the capsule to the base of the pyramids?
The parenchyma
116
Where are the renal columns found?
In the parenchyma between two minor calyces and their corresponding medullas
117
What is the medulla?
A darker-colored triangular shaped area directly above each minor calyx
118
What are inside the medulla?
8 to 12 renal pyramids that contain many collecting tubules
119
What are the rounded medial ends of each renal pyramid called?
The renal papillae
120
What do the renal papillae fit into?
Into the cup-shaped end of a minor calyx
121
What are minor calyces?
Division of the major calyx
122
How many major calyces are there per kidney?
Approx. 4
123
Where do the major calyces arise from?
The renal pelvis
124
What forms the renal pelvis?
The minor calyces unite to become major calyces, the major calyces merge together to form a sac like collection portion of the upper end of the ureter
125
Where is the renal pelvis found?
Both inside and outside the actual kidney
126
What forms the ureter?
The renal pelvis narrowing and exiting the kidney
127
What is the point of transition of the renal pelvis becoming the kidney?
The ureteropelvic junction
128
What is the hilum?
The external medial border of each kidneys is a depression
129
What enters/leaves the kidney at the hilum?
The renal artery, vein, nerves, lymphatic vessels, and renal pelvis
130
What structures are known as the renal pedicle?
The renal artery, vein, nerves, lymphatic vessels and renal pelvis
131
What is the length of the ureter?
Each ureter is a hallow tube that extends from the kidney to the urinary bladder, which is about 10 to 12 inches
132
Where does the urinary bladder lie in relation to the pubic symphysis?
Posterior
133
What are the four coats to the bladder?
The outer mucosal, submucosal, muscular, and the inner serosal
134
What are the three openings into the bladder?
Two ureteral and one urethral opening
135
What is the trigone?
A band of musculature that connects the three opening of the bladder
136
What is the urethra?
A hollow tube that is the single passage to the outside of the body from the bladder
137
How long is the female urethra?
Only about 1 to 1.5 inches
138
How long is the male urethra?
Extends approx. 8 inches through the prostate gland and penis before reaching the outside
139
What is the opening to the outside known as?
Urinary meatus
140
What are the main function of the kidney?
1. To excrete urine so that the body maintains its hemostatic state,
2. regulate the fluid content of the blood and regulate the concentration of various electrolytes
3. Maintain the pH level of the blood so that is does not become too acidic or alkaline
141
What does effective renal function depend on?
Adequate blood flow through the renal arteries
142
The speed at which the blood is filtered, reabsorbed, and secreted through the kidneys is affected by what?
Blood pressure
143
About how many mL of blood flow through the kidneys of a normal adult each minute?
1200
144
What is the functional unit of the kidney?
The nephron
145
What does the nephron contain?
The Bowman capsule, the glomerulus, and the tubules
146
Where does the filtration of waste materials from blood takes place so that these can be excreted in the urine?
Within the glomerulus of the nephrons
147
What do the tubules do?
they select substances needed by the body and reabsorb them to be returned to the blood
148
Where does secretion take place?
In the distal tubule and collecting ducts
149
After passing through the tubules, where does urine enter?
It enters the collecting ducts of the renal pyramids and then passes through the papillae into the minor and major calyces, the renal pelvis and finally the ureter
150
What is the function of the ureter?
To convey urine from the kidney to the bladder by means of peristalsis and gravity
151
How much urine can the bladder hold?
As much as 500 mL of urine, but 250 mL should be enough to cause distention and discomfort
