Genitourinary system Flashcards by sha flores

Bean-shaped paired organs found in the posterior abdominal wall, retroperitoneal

Kidney

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What are the functions of the kidneys?

Urine formation
Excretion of waste products
Regulation of electrolytes
Regulation of acid-base balance
Control of water balance
Control of blood pressure
Renal clearance
Regulation of red blood cell production
Synthesis of vitamin D to active form
Secretion prostaglandins
Regulates calcium and phosphorus balance

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What is the process of renal circulation?

Renal Artery (hilum) branches into afferent arterioles
|
(Glomerular Capillary beds)
|
Efferent Arterioles
|
Renal Vein

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Anatomic & functional unit of the kidney where using is formed

Nephron

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The three-step process of urine formation in the nephrons

Filtration – transfer of water and waste from blood to glomerulus
Reabsorption – water and necessary ions are transferred back into the blood
Excretion – excess substances and wastes are removed and transferred into urine

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What are the parts of nephrons?

Glomerulus
Bowman’s capsule
Proximal Convoluted Tubules (PCT)
Loop of Henle
Distal Convoluted Tubules (DCT)
Collecting Tubules

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It expands as it enters the kidney to form the renal pelvis (subdivided into calyces each containing renal papillae)
Collects urine secreted by the kidney & propels it to the bladder by peristaltic wave

Ureters

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Hollow, spherical, collapsible bag of smooth muscle
Behind the symphysis pubis
Reservoir for urine
Capacity of the adult bladder 300-500 mL

Urinary Bladder

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Musculo-membranous tube lined with mucosa opening to urinary meatus

Urethra

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What are the normal urine values?

Color: amber/straw (light yellow)
Odor: aromatic
Consistency: clear or slightly turbid
pH: 4.5-8
Specific gravity: 1.010-1.020
WBC/RBC: (-)
Albumin: (-)
E coli: (-)
Mucus thread: few
Amorphous urate: (-)

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It is the infection of the urinary bladder that is usually caused by an ascending bacterial infection or E. Coli

Cystitis

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Inflammation of the urethra with causative agents: E. Coli, staphylococcus, streptococci, pseudomonas

Urethritis

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It is the formation of stones at the urinary tract

Nephrolithiasis or Urolithiasis

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What are the types of stones found in the urinary tract?

Acidic and Alkaline stones

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It is the slow enlargement of the prostate gland in men > 40 years old

Benigh Prostatic Hyperplasia

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It is the infection of the kidney due to bacteria, fungus, and virus

Pyelonephritis

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What are the 2 types of pyelonephritis?

• Acute

Bacterial contamination from urethra by instrumentation (iatrogenic) or hematogenous spread
E. Coli/streptococcus

• Chronic

Idiopathic; obstruction or reflex (stone, tumor, or neurogenic bladder)
Progressive scarring of the kidney resulting in weight loss, hypertension and renal failure

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It is the inflammatory & degenerative disorder of the glomerulus. It is also the damage to both kidney from filtration of trapping of antibody-antigen complexes within the glomeruli resulting to decrease glomerular filtration rate

ACUTE GLOMERULONEPHRITIS (AGN)/NEPHRITIC SYNDROME

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What are the 2 types of Acute Glomerulonephritis?

• Acute Post-Streptococcal

After 7 - 10 days after streptococcal throat infection
Immune reaction to the presence of an infectious organism (group A beta hemolytic streptococcus/GABHS)

• Chronic Glomerulonephritis

Hypertensive nephrosclerosis
Heat failure
Chronic renal failure

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Renal pathology characterized by increased glomerular permeability and is manifested by massive proteinuria

Nephrotic Syndrome

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Acute tubular necrosis (ATN) renal parenchymal failure, Acute tubule-interstitial Nephritis

Acute Renal Failure

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What are the causes of Acute Renal Failure?

• Pre-renal

Hypoperfusion of kidney
Volume depletion
Impaired cardiac efficiency
Vasodilation

• Intra-renal

Actual damage to kidney tissue
Prolonged renal ischemia
Nephrotoxic agents
Infectious process

• Post renal

Obstruction to urine flow
Urinary tract obstruction
Calculi (stones), tumors
Benign prostatic hyperplasia
Blood clots

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What are the four phases of Acute Renal Failure?

Onset - Benign with initial insult and ends when oliguria develops
Oliguric Phase - Is accompanied by an increase in the serum concentration of substances usually excreted by the kidney
Diuretic Phase - marked by a gradual increase in urine output, which signals that glomerular filtration
has started to recover.
Recovery Phase - signals the improvement of renal function and may take 3 to 12 months

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It is the irreversible condition of progressive damage to the nephrons & glomerulus and the retention of waste product (uremia)

Chronic Renal Failure

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What are the 5 stages of CKF?

Stage 1 - Kidney damage with normal or increased GFR Stage 2 - Mild increase in GFR Stage 3 - Moderate increase in GFR Stage 4 - Severe increase in GFR Stage 5 - Kidney Failure (ESRD)

What are the 3 stages of CRF?

1. Diminished renal reserve volume 2. Renal Insufficiency 3. End-stage renal disease (ESRD)

Dialyzing solution is introduced via a catheter inserted in the peritoneal cavity

Peritoneal Dialysis

Client is attached (via a surgically created AV fistula or Graft) to a machine that pumps blood along a semi-permeable membrane, dialyzing solution is on the other side of the membrane, and osmosis, diffusion of waste, toxins, and fluid from the client occurs

Hemodialysis

What are the 3 kinds of hemodialysis access?

1. AV Fistula - Commonly in the forearm anastomosis artery to vein either side to side or end to end 2. AV Graft - Can be created by subcutaneously interposing a biologic, semibiologic, or synthetic graft material between an artery and vein 3. Vascular Access Devices - Creation of a double-lumen large core catheter into the subclavian, internal jugular or femoral vein

What are the possible vascular access complications?

* Poor blood flow * Clotting * Infection * Pseudoaneurysm / aneurysm * Ischemia of the hand * May contribute to congestive heart failure

Kidney transplantation involves transplanting a kidney from a living donor or deceased donor to a recipient who are longer has renal function

Renal Transplant

Where do organs come from for renal transplant?

* Living related donors * Living unrelated Donors * Decreased Donor

- Necessary for chemical reactions and transport | - Contained in the body in several compartments separated by semi-permeable membranes.

Body Fluids

What are the three major compartments?

* Intracellular—the area inside the cell membrane, containing 65 percent of body fluids * Extracellular—the area in the body that is outside the cell, containing 35 percent of body fluids * Tissues or interstitial area—contains 25 percent of body fluids

Charged molecules contributes to fluid concentration. Allows fluid movement from one compartment to another.

Electrolytes

What are the major electrolytes in the ICF?

Potassium and Phosphorus

What are the major electrolytes in the ECF?

Sodium and Chloride

What is the normal lab values for Sodium?

135-145 mEq/L

What is the normal lab values for Potassium?

3.5-5.5 mEq/L

What is the normal lab values for Calcium?

4.5-5.5 mEq/L or 8.5-10 mg/dL

What is the normal lab values for Phosphorus?

1.7-2.6 mEq/L

What is the normal lab values for Chloride?

98-108 mEq/L

What is the normal lab values for Magnesium?

1.5-2.5 mEq/L

What are the 3 movements of fluids and electrolytes?

1. DIFFUSION — movement of SOLUTE; high to low concentration 2. OSMOSIS — movement of SOLVENT; low to high concentration 3. HOMEOSTASIS — balance of fluid in the body

What is the normal specific gravity for urine?

1.010-1.020

Indirectly indicates fluid volume in the blood. The test measures the number of blood cells per volume of blood.

Hematocrit

Measures the concentration of particles dissolved in blood.

Serum Osmolality

Measures the concentration of particles dissolved in the urine. The test can show how well the kidneys are able to clear metabolic waste and excess electrolytes and concentrate urine.

Urine Osmolality

It is the major cation INSIDE (ICF) the cell. It is critical to neuromuscular function because it plays an important role in action potentials, nerve polarization/depolarization and excitability.

Potassium

May be caused by the use of diuretic medications that result in the excretion of potassium in the urine and by the loss of potassium through diarrhea or excessive sweating.

Hypokalemia

Results most commonly from decreased excretion of potassium owing to renal failure. May result from excessive intake or overaggressive treatment of potassium deficit with potassium supplements.

Hyperkalemia

Major cation in the extracellular fluid and spaces. Its concentration across the cellular membrane plays an important part in neuromuscular cell activity.

Sodium

Most often results from excessive fluid retention or infusion that dilutes the sodium in the blood.

Hyponatremia

Results from excessive sodium intake or sodium retention with excessive loss of water owing to diarrhea, diuretic medication use, vomiting, sweating, heavy respiration, or severe burns.

Hypernatremia

Most of the _______ in the body comes from the salt (sodium chloride) ingested and absorbed in the intestines as food is digested.

Chloride

Any condition that causes a loss of sodium owing to decreased reabsorption of sodium and chloride.

Hypochloremia

Also results from metabolic acidosis owing to the loss of base and respiratory alkalosis that occurs with hyperventilation.

Hyperchloremia

Mineral necessary for clotting (factor IV). Has a role in cardiac muscle contraction and excitability.

Calcium

Low calcium levels

Hypocalcemia

Most commonly from increased parathyroid function often owing to a tumor or from cancer in the bones that releases calcium into the bloodstream.

Hypercalcemia

It is found primarily in the intracellular environment and is bound to adenosine triphosphate (ATP). It is important in almost all the body's metabolic functions.

Magnesium

Excessive urinary loss of magnesium

Hypomagnesemia

Excessive intake of magnesium

Hypermagnesemia

Necessary to maintain acid base balance (through the buffer system)

Phosphate

True or False: High Phosphate=Low Calcium Low Phosphate=High Calcium

True

May result from poor absorption such as occurs with ingestion of antacids that bind to phosphate

Hypophosphatemia

Owing to the release of phosphate from the bones by tumors

Hyperphosphatemia

What is the normal ABG value for blood pH?

7.35-7.45

What is the normal ABG value for Partial Pressure Carbon Dioxide (PCO2)?

34-45 mmHg

What is the normal ABG value for Partial Pressure of Oxygen (PO2)?

80-100 mmHg

What is the normal ABG value for Bicarbonate?

22-26

Refers to the decreased blood pH?

Acidosis

Refers to the increased blood pH?

Alkalosis

Refers to the fluid loss without electrolyte loss

Dehydration

Occurs when loss of ECF volume exceeds the intake of fluid ratio of serum electrolytes to water remains the same.

Fluid Volume Deficit (FVD) or hypovolemia

Diagnostic findings for FVD or Hypovolemia

Diagnostic Findings: • BUN elevated out of proportion to the serum creatinine • Urine specific gravity is increased • Decreased urinary sodium and chloride. • Urine osmolality can be greater than 450 mOsm/kg

Management for FVD/Hypovolemia

Fluid replacement through: Isotonic electrolyte solutions - Lactated Ringer's solution 0.9% sodium chloride Hypotonic electrolyte solution - 0.45% sodium chloride

It refers to an isotonic expansion of the ECF caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF.

Fluid Volume Excess or Hypervolemia

What are the diagnostic findings for Hypervolemia?

Diagnostic Findings: • BUN and hematocrit are decreased because of plasma dilution • The urine sodium level is increased if the kidneys are attempting to excrete excess volume. • Chest x-ray may reveal pulmonary congestion.

What are the managements for hypervolemia?

- Diuretics - to reduce edema - Potassium supplements - to avoid hypokalemia from the use of diuretics - Hemodialysis or peritoneal dialysis may be used to remove nitrogenous wastes and control potassium and acid—base balance, and to remove sodium and fluid.

Expected blood gas changes include a low pH (less than 7.35) and a low bicarbonate level (less than 22 mEq/L)

Metabolic Acidosis

Evaluation of arterial blood gases reveals a pH greater than 7.45 and a serum bicarbonate concentration greater than 26 mEq/L.

Metabolic Alkalosis

A clinical disorder in which the pH is LESS than 7.35 and the PaCO2 is GREATER than 45 mm Hg

Respiratory Acidosis

A clinical condition in which the arterial pH is GREATER than 7.45 and the PaCO2 is LESS than 35mmHg.

Respiratory Alkalosis

Genitourinary system Flashcards

(84 cards)