Flashcards in Urinary system Deck (130):
what kind of structures are the kidneys and ureters? retro, infra, or intrapertioneal
what are the most posterior part of the abdominal cavity?
the urinary system has a vital excretory function that does what?
what does the urinary system consist of?
2 kidneys, 2 ureters, urethra, bladder
what kidney is more inferior to the other? why?
right, because the presence of the liver
what is on the upper medial border of each kidney
suprarenal (adrenal) gland
what system are the adrenal glands apart of?
where do the ureters lie in the body?
follow the natural curve of the vertebral column, mostly anterior
what aspect of the bladder to the ureters enter?
the posterolateral aspect
where does the urethra exit the body?
inferior to the pubic symphysis
what two parts are the kidney divided into?
the upper and lower pole (half)
what structures are infraperitoneal?
dital ureters, urinary bladder, and urethra
what does the hilum of the kidney refer to?
dividing point between the upper and lower poles
what is the hilum of the kidney?
the point at which the ureters leave the kidney, as do blood vessels (renal artery and view) lymphatic vessels and nerves
what side of the kidney is convex?
the lateral side, posterior and anterior
what side of the kidney is concave?
the medial side
the average kidney is how long? wide? thick?
4-5 inches long, 2-3 wide, and 1 in thick
what kidney is longer and more narrow?
how many ° from the coronal plane are the kidneys?
what border of the kidney is more posterior?
As psoas muscles get larger they cause the kidneys to form what vertical angle from the MSP? what part is closer to vertebral column?
20° from MSP with the upper pole closer to the vertebral column than the lower pole
In a hypersthenic patient the kidneys are higher/lower? asthenic?
when performing intravenous urography the body is placed in what angle? and what obliques?
30° angle in the LPO/RPO position
a 30° LPO will place what kidney parallel to the IR
a 30° RPO will place what kidney parallel to the IR
what landmarks are the kidney situated in between?
xiphoid process and iliac crest
top of the left kidney usually at level of?
most abdominal radiographs are performed on what expiration?
expiration-allows kidney to lie high
the bottom of the right kidney lies at what level?
what is each kidney surrounded with?
fatty tissue, adipose capsule or perirenal fat
what does the fatty capsule do for the kidney?
protect it from trauma and help maintain the normal position of the kidney against the psoas muscle
when one inhales deeply or stands upright the kidneys move how much?
about 2 inches, 1 lumbar vertebra
what is the primary function of the urinary system?
production of urine and its elimination from the body
what is nephroptosis?
excessive downward movement of kidney when erect, kidney drop more than 2 inches
During the production of urine the kidneys do (3) things?
1. remove waste products from blood
2. regulates water levels in the body
3. regulate acid base balance and electrolyte levels of the blood
what is uremia?
the presence of excessive amounts of urea and other nitrogenous waste products in the blood, as occurs in renal failure
what percent of the blood pumped from the heart passes through the kidneys?
what two waste products of the kidneys are formed during normal metabolism of proteins?
creatine and urea
what is the chain of arteries/veins in the kidneys?
arteries-arterioles-capillaries-veins-renal viens- IVC- heart
the renal vein connects with what to return the blood back to the right side of the heart?
what is the average water intake for humans during a 24 hour period?
how many liters of blood flows through the kidneys every minute?
1 L, more the 99% returned to the bloodstream
how much urine does the kidneys excrete daily?
1.5L (1500mL) daily
the medulla consists of how many cones shaped renal pyramids?
what is the outer covering of each kidney called?
what are the narrow ends of the pyramids called?
what is the portion of the renal cortex that extends between the renal pyramids are called?
the renal pyramids and the renal medulla make up the functional part of what?
how many parenchyma do each kidney have?
about 1 million
what is the parenchyma?
functional portion of the kidney, visualized during and early IVU
what are the microscopic structures of the kidney?
renal pyramids, minor calyces, major calyces, renal pelvis, ureter
the essential microscopic components of the parenchyma of the kidneys are called?
Urine is formed by what part of the kidney?
after urine is formed by the nephrons its drained into what? which then extends through the renal papillae of the pyramids
what do the papillary ducts drain into?
minor and major calyces
what does the greek term pyelo mean?
how many minor and major calyces does each kidney have?
a minor calyx receives urine from the papillary ducts of one renal papilla and delivers it to what?
From the major calyx, urine drains into a single large cavity called what?
what 3 things does the nephrons of the kidneys do?
1. filter blood
2. returning useful substances to the blood so they aren't lost from the body
3. removing substances from the blood that aren't needed
what is formed by a minute branch of the renal artery entering the capsule and dividing into capillaries?
what is the nephron composed of?
renal corpuscle and renal tubule
what is the glomerulus also called?
what is the vessel entering the glomerulus?
what is glomerulus termed for?
what is the renal corpuscle composed of?
double walled membrane (glomerulus) and a cluster of blood capillaries
what is the vessel leaving the glomerular capsule?
each renal tubule continues from a glomerular capsule in the cortex of the kidney and then travels in a circuitous path through the ___ and ___ substances
cortical and medullary
function of the glomerulus?
filter for the blood permitting water and finely dissolved substances to pass through the walls of the capillaries into the capsule
the renal tubule consist of 3 parts?
the proximal convoluted tubule, the nephron loop (loop of henle) and the distal convoluted tubule
the major calyces unite to form the what?
the filtrate travel route..?
glomerular capsule-proximal convuluted tubule-loop of henle-distal convoluted tubule-minor calyx
when if the filtrate termed urine?
by the time it reaches the minor calyx
part of the renal pelvis, the calyces and branches of the renal blood vessels and nerves lie in a cavity within the kidney called?
what is in the renal sinus to help stabilize the position of the structures?
how long is each ureter?
10-12 inches long
the renal pelvis leaves each kidney at the hilum to become what structure?
the ureters varies in diameter from..?
what are the 3 points of constriction of the ureters?
1. uteropelvic junction (UPJ)
2. brim of the pelvis
3. uterovesical junction (UVJ)
where do most kidney stones get stuck?
where is the bladder located in males
anterior to the rectum
where is the bladder located in females
anterior to vagina, inferior to uterus, and posterior and superior to the pubic symphysis
what are the small triangular area of the floor of the bladder called?
the 2 posterior corners of the trigone contain what?
2 ureteral openings
the inner mucosa of the bladder is called what?
where is the prostate gland located?
inferior to the bladder and measures about 1.5 inches in diameter and 1 inch in height
what is the term for the discharge of urine from the bladder
when does the desire for micturition to occur?
when it reaches 250 mL
what is the total capacity of the bladder?
what is dysuria?
pain in urination
what is anuria?
absence of urine formation
what is polyuria?
passage of large volume of urine in relation to fluid intake during a given period, common in diabetes
what is Diuresis?
increased excretion of urine
what is hematuria?
blood in urine
what is incontinence
unable to hold urine
what is the urethra?
a musculomembranous tube with a sphincter type muscle at the neck of the bladder and extends about 1.5 inches in the female and 7-8 in male
what are the 3 parts of the male urethra?
prostatic, membranous and spongy
how long is the prostatic portion of the urethra?
1 in, reaches from bladder to floor of the pelvis and is completely surrounded by prostate
how long is the membranous portion of the urethra?
about 1/2 in long, passes through the urogenital diaphragm
where does the spongy portion of the urethra pass?
through the shaft of the penis, extending from floor of pelvis to external urethra orifice
what causes cystitis
bacteria into the urethra and up into the bladder
What is a general examination of the urinary system
What must you confirm on a bottle before injection (4)?
Correct contents of container
Route of administration
Amount to be administered
How can iodinated contrast be injected?
Bolus injection or drip infusion
How is the rate of bolus injection controlled? (5)
Gauge of needle
Amount of contrast agent
Viscosity of contrast agent
Stability of vein
Force applied by individual performing injection
Most common site of injection
Most commonly used needle size for adults?
18-20 gauge butterfly needle
Needle size for pediatric?
23-35 gauge butterfly
What are the two expected outcomes of injected contrast media?
Hot flash, metallic taste in mouth
Normal ranges for creatine and bun
What is metformin hydrochloride?
Drug given for the management of non insulin diabetes
ACR recommends that metformin be withheld for how many hours after the procedure and resumed only if kidney function of determined to be within normal limits
What is a common drug for reaction to contrast
What is extravastation?
Contrast medium leaking from vein into surrounding tissue
What are the categories of contrast media reaction
Mild, moderate, severe, organ specific
What are some mild reactions to contrast
mild erythema (redness)
warmth flushing station during injection
mild scattered hives
What are some moderate reactions to contrast
possible laryngeal swelling
Severe life threatening reactions
loss of consciousness
no detectable Pulse
Organ specific contrast media reactions
Pulseless electrical activity
temporary failure or complete shutdown of renal system
How long can it take for organ specific reactions to take place
Up to 48 hours
Why is an ivu a functional test
Because contrast medium molecules are removed from the bloodstream and excreted completely by normal kidneys
What does an IVU visualize
Minor and major calyces, renal pelvis, ureters, urinary bladder
How much contrast is used in adults?
Most reactions occur within how many minutes of injection
What is the initial contrast blush of the kidney termed?
Depending on the patients hydration status and the speed of the injection, the contrast agent normally begins to appear in the pelvicalyceal system within how many minutes
How long after injection is the greatest concentration of contrast in the kidneys?
What is prolapse?
The slipping or falling out of place of an organ
What is retrograde?