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Flashcards in Exam 3 Deck (281)
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1

At what spinal level would we find innervation to the kidneys and ureters?

T8-L2

2

At what spinal level would we find innervation to the pelvic organs?

Primarily lumbosacral with some lower thoracic input

3

At what spinal level would we find innervation to the bladder?

T11-L2 (Dome), S2-S4 (Neck)

4

At what spinal level would we find innervation to the prostate?

T11-L2 and S2-S4

5

How many thoracic nerves do we have?

12

6

How many lumbar nerves do we have?

5

7

What plexus does T11 and S2 come from?

Hypogastric

8

How much of the CO does the Kidneys receive?

25%

9

What makes the kidneys an endocrine organ?

Secretion of renin, erythropoietin and 1,25-dihydroxycholecalciferol

10

Where is the medulla of the kidneys located?

Central region, located under the kidney capsule

11

Where is the papilla of the kidney located?

Inner most tip of the inner medulla

12

What is the functional unit of the kidney?

Nephron

13

Describe the renal tubules

Lined with epithelial cells which serve the functions of reabsorption and secretion

14

What does a nephron consist of?

Glomerulus and a renal tubule

15

Describe superficial cortical nephrons

Glomeruli in the outer cortex, short loops of henle which descend only into the outer medulla

16

Describe juxtamedullary nephrons

Glomeruli near the corticomedullary border, larger nephrons with higher GFR, long loops of henle that descend deep into the inner medulla and papilla

17

Where does the glomerulus emerge from?

Afferent arterioles

18

What surrounds the glomerulus?

Bowman's capsule

19

What is the goal in the OR in regards to BP and renal function?

Maintain a good BP because urine output is not a good indicator of renal fx

20

What consideration do we make with insufflation in regard to the kidneys?

Insufflation can compress blood flow to kidneys

21

3 Renal Vasoconstrictors

1. Sympathetic nerves (catecholamines)
2. Angiotensin 2
3. Endothelin (21 amino acid peptide)

22

6 Renal Vasodilators

1. PGE2
2. PGI2
3. Nitric Oxide
4. Bradykinin
5. Dopamine
6. Atrial Natruiretic Peptide

23

What are the afferent and efferent arterioles innervated by?

SNS fibers that produce vasoconstriction by activating alpha 1 receptors

24

What does increased sympathetic nerve activity cause when acting on the afferent arteriole?

Decrease in RBF and GFR

25

What does the baroreceptor response in situations like blood loss cause?

Increased SNS activity and reduced GFR

26

Describe Angiotensin 2 in regards to the kidneys (2)

1. A potent vasonstrictor of both afferent and efferent arterioles
2. Constricts both arterioles, increases resistance, and decreases blood flow

27

Describe ANP in regard to the kidneys (2)

1. Cause dilation of afferent arterioles and constriction of efferent arterioles
2. Because dilatory effects on afferent is greater than constrictor effect on efferent arterioles, there is an overall decrease in renal vascular resistant and resulting increase in RBF

28

Describe Prostaglandins in regards to the kidneys (2)

1. Several are produced locally in the kidneys (PGE2, PGI2)
2. Cause vasodilation of both afferent and efferent arterioles

29

Describe dopamine in regards to the kidneys (2)

1. Dopamine, a precursor of norepinephrine, has selective actions on arterioles
2. At low levels, dopamine dilates cerebral, cardiac, splanchic, and renal arterioles, and it constricts skeletal muscle and cutaneous arterioles

30

5 Things in the evaluation of renal function

1. Hx and physical
2. Estimates of disease duration
3. Urinalysis
4. Assessment of GFR
5. Laboratory Tests