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Flashcards in Urinary system Deck (130):
1

what kind of structures are the kidneys and ureters? retro, infra, or intrapertioneal

retroperitoneal

2

what are the most posterior part of the abdominal cavity?

kidneys

3

the urinary system has a vital excretory function that does what?

maintains homeostasis

4

what does the urinary system consist of?

2 kidneys, 2 ureters, urethra, bladder

5

what kidney is more inferior to the other? why?

right, because the presence of the liver

6

what is on the upper medial border of each kidney

suprarenal (adrenal) gland

7

what system are the adrenal glands apart of?

endocrine

8

where do the ureters lie in the body?

follow the natural curve of the vertebral column, mostly anterior

9

what aspect of the bladder to the ureters enter?

the posterolateral aspect

10

where does the urethra exit the body?

inferior to the pubic symphysis

11

what two parts are the kidney divided into?

the upper and lower pole (half)

12

what structures are infraperitoneal?

dital ureters, urinary bladder, and urethra

13

what does the hilum of the kidney refer to?

dividing point between the upper and lower poles

14

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

15

what side of the kidney is convex?

the lateral side, posterior and anterior

16

what side of the kidney is concave?

the medial side

17

the average kidney is how long? wide? thick?

4-5 inches long, 2-3 wide, and 1 in thick

18

what kidney is longer and more narrow?

left

19

how many ° from the coronal plane are the kidneys?

30°

20

what border of the kidney is more posterior?

lateral border

21

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

22

In a hypersthenic patient the kidneys are higher/lower? asthenic?

hypersthenic: higher
asthenic: lower

23

when performing intravenous urography the body is placed in what angle? and what obliques?

30° angle in the LPO/RPO position

24

a 30° LPO will place what kidney parallel to the IR

right

25

a 30° RPO will place what kidney parallel to the IR

left

26

what landmarks are the kidney situated in between?

xiphoid process and iliac crest

27

top of the left kidney usually at level of?

T11-T12

28

most abdominal radiographs are performed on what expiration?

expiration-allows kidney to lie high

29

the bottom of the right kidney lies at what level?

L3

30

what is each kidney surrounded with?

fatty tissue, adipose capsule or perirenal fat

31

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

32

when one inhales deeply or stands upright the kidneys move how much?

about 2 inches, 1 lumbar vertebra

33

what is the primary function of the urinary system?

production of urine and its elimination from the body

34

what is nephroptosis?

excessive downward movement of kidney when erect, kidney drop more than 2 inches

35

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

36

what is uremia?

the presence of excessive amounts of urea and other nitrogenous waste products in the blood, as occurs in renal failure

37

what percent of the blood pumped from the heart passes through the kidneys?

25%

38

what two waste products of the kidneys are formed during normal metabolism of proteins?

creatine and urea

39

what is the chain of arteries/veins in the kidneys?

arteries-arterioles-capillaries-veins-renal viens- IVC- heart

40

the renal vein connects with what to return the blood back to the right side of the heart?

IVC

41

what is the average water intake for humans during a 24 hour period?

2.5 L

42

how many liters of blood flows through the kidneys every minute?

1 L, more the 99% returned to the bloodstream

43

how much urine does the kidneys excrete daily?

1.5L (1500mL) daily

44

the medulla consists of how many cones shaped renal pyramids?

8-18

45

what is the outer covering of each kidney called?

renal capsule

46

what are the narrow ends of the pyramids called?

renal papilla

47

what is the portion of the renal cortex that extends between the renal pyramids are called?

renal columns

48

the renal pyramids and the renal medulla make up the functional part of what?

the parenchyma

49

how many parenchyma do each kidney have?

about 1 million

50

what is the parenchyma?

functional portion of the kidney, visualized during and early IVU

51

what are the microscopic structures of the kidney?

renal pyramids, minor calyces, major calyces, renal pelvis, ureter

52

the essential microscopic components of the parenchyma of the kidneys are called?

nephrons

53

Urine is formed by what part of the kidney?

nephrons

54

after urine is formed by the nephrons its drained into what? which then extends through the renal papillae of the pyramids

papillary ducts

55

what do the papillary ducts drain into?

minor and major calyces

56

what does the greek term pyelo mean?

pelvis

57

how many minor and major calyces does each kidney have?

minor: 8-18
major: 2-3

58

a minor calyx receives urine from the papillary ducts of one renal papilla and delivers it to what?

major calyx

59

From the major calyx, urine drains into a single large cavity called what?

renal pelvis

60

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

61

what is formed by a minute branch of the renal artery entering the capsule and dividing into capillaries?

glomerulus

62

what is the nephron composed of?

renal corpuscle and renal tubule

63

what is the glomerulus also called?

bowmans capsule

64

what is the vessel entering the glomerulus?

afferent arteriole

65

what is glomerulus termed for?

little ball

66

what is the renal corpuscle composed of?

double walled membrane (glomerulus) and a cluster of blood capillaries

67

what is the vessel leaving the glomerular capsule?

efferent arteriole

68

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

69

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

70

the renal tubule consist of 3 parts?

the proximal convoluted tubule, the nephron loop (loop of henle) and the distal convoluted tubule

71

the major calyces unite to form the what?

renal pelvis

72

the filtrate travel route..?

glomerular capsule-proximal convuluted tubule-loop of henle-distal convoluted tubule-minor calyx

73

when if the filtrate termed urine?

by the time it reaches the minor calyx

74

part of the renal pelvis, the calyces and branches of the renal blood vessels and nerves lie in a cavity within the kidney called?

renal sinus

75

what is in the renal sinus to help stabilize the position of the structures?

adipose tissue

76

how long is each ureter?

10-12 inches long

77

the renal pelvis leaves each kidney at the hilum to become what structure?

ureters

78

the ureters varies in diameter from..?

1mm-1cm

79

what are the 3 points of constriction of the ureters?

1. uteropelvic junction (UPJ)
2. brim of the pelvis
3. uterovesical junction (UVJ)

80

where do most kidney stones get stuck?

the UVJ

81

where is the bladder located in males

anterior to the rectum

82

where is the bladder located in females

anterior to vagina, inferior to uterus, and posterior and superior to the pubic symphysis

83

what are the small triangular area of the floor of the bladder called?

trigone

84

the 2 posterior corners of the trigone contain what?

2 ureteral openings

85

the inner mucosa of the bladder is called what?

rugae

86

where is the prostate gland located?

inferior to the bladder and measures about 1.5 inches in diameter and 1 inch in height

87

what is the term for the discharge of urine from the bladder

micturition

88

when does the desire for micturition to occur?

when it reaches 250 mL

89

what is the total capacity of the bladder?

350-500mL

90

what is dysuria?

pain in urination

91

what is anuria?

absence of urine formation

92

what is polyuria?

passage of large volume of urine in relation to fluid intake during a given period, common in diabetes

93

what is Diuresis?

increased excretion of urine

94

what is hematuria?

blood in urine

95

what is incontinence

unable to hold urine

96

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

97

what are the 3 parts of the male urethra?

prostatic, membranous and spongy

98

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

99

how long is the membranous portion of the urethra?

about 1/2 in long, passes through the urogenital diaphragm

100

where does the spongy portion of the urethra pass?

through the shaft of the penis, extending from floor of pelvis to external urethra orifice

101

what causes cystitis

bacteria into the urethra and up into the bladder

102

What is a general examination of the urinary system

Urography

103

What must you confirm on a bottle before injection (4)?

Correct contents of container
Route of administration
Amount to be administered
Expiration date

104

How can iodinated contrast be injected?

Bolus injection or drip infusion

105

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

106

Most common site of injection

Anticubital fossa

107

Most commonly used needle size for adults?

18-20 gauge butterfly needle

108

Needle size for pediatric?

23-35 gauge butterfly

109

What are the two expected outcomes of injected contrast media?

Hot flash, metallic taste in mouth

110

Normal ranges for creatine and bun

Creatinine: .6-1.5mg/dl
BUN: 8-35mg/100ml

111

What is metformin hydrochloride?

Drug given for the management of non insulin diabetes

112

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

48 hours

113

What is a common drug for reaction to contrast

Epinephrine

114

What is extravastation?

Contrast medium leaking from vein into surrounding tissue

115

What are the categories of contrast media reaction

Mild, moderate, severe, organ specific

116

What are some mild reactions to contrast

anxiety
lightheadedness
nausea
vomiting
metallic taste
mild erythema (redness)
warmth flushing station during injection
itching
mild scattered hives

117

What are some moderate reactions to contrast

Urticaria
possible laryngeal swelling
bronchial spasm
tachycardia
bradycardia
angioedema
hypotension

118

Severe life threatening reactions

Hypotension
bradycardia
cardiac arrhythmias
laryngeal swelling
possible conversions
loss of consciousness
cardiac arrest
respiratory arrest
no detectable Pulse

119

Organ specific contrast media reactions

Pulseless electrical activity
pulmonary Edema
venous thrombosis
seizure induction
temporary failure or complete shutdown of renal system
extravastation

120

How long can it take for organ specific reactions to take place

Up to 48 hours

121

Why is an ivu a functional test

Because contrast medium molecules are removed from the bloodstream and excreted completely by normal kidneys

122

What does an IVU visualize

Minor and major calyces, renal pelvis, ureters, urinary bladder

123

How much contrast is used in adults?

30-100ml

124

Most reactions occur within how many minutes of injection

5 min

125

What is the initial contrast blush of the kidney termed?

Nephron phase

126

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

2-8 minutes

127

How long after injection is the greatest concentration of contrast in the kidneys?

15-20 minutes

128

What is prolapse?

The slipping or falling out of place of an organ

129

What is retrograde?

Backward flow

130

What is antegrade

Allows the contrast medium to enter the kidney in the normal direction of the flown