urinary system Flashcards
(127 cards)
1
Q
urinary system
A
eliminates organic wastes and maintains the water and electrolyte balance of the body
2
Q
urinary system consists of
A
2 kidneys
2 ureters
1 urinary bladder
1 urethra
3
Q
right kidney
A
more inferior than the left because of the liver
4
Q
adrenal glands
A
on the upper medial border of each kidney
have no functional relationships with the kidneys
5
Q
ureters
A
follow the natural curve of he vertebral column
most of each ureter lies anterior to its kidney
6
Q
the ureters enter what aspect of the bladder
A
posterolateral aspect
7
Q
urethra
A
exits the from the body inferior to the pubic symphysis
8
Q
retroperitoneal structures
A
kidneys
ureters
9
Q
infraperitoneal structures
A
distal ureters
urinary bladder
urethra
10
Q
hilum of the kidney
A
the dividing point between the upper and lower poles of the kidney
where the ureter, blood vessels, lymphatic vessels, and nerves leave the kidney
11
Q
what is the average size of the kidney
A
4-5 inches long
2-3 inches wide
1 inch thick
about the size of a bar of soap
12
Q
the kidneys form a vertical angle of what from the MSP
A
20 degree angle
13
Q
the kidneys are rotated how much from the coronal plane
A
30 degrees
14
Q
are the kidneys higher or lower in a hyperstenic patient
A
higher
15
Q
are the kidneys higher or lower in an asthenic patient
A
lower
16
Q
top of the left kidney is at what level
A
T11-T12
17
Q
bottom of the right kidney is at what level
A
L3
18
Q
what is the fatty tissue surrounding each kidney
A
adipose capsule or perirenal fat
protects from trauma and maintains its normal position
19
Q
when one inhales deeply or stands upright, the kidneys will
A
drop about one lumbar vertebrae or 2 inches
20
Q
nephroptosis
A
excessive downward movement of kidney when erect
can cause kinking or twisting of the ureters
21
Q
what is the primary function of the urinary system
A
the production of urine and its elimination from the body
22
Q
during the production of urine what do the kidneys do
A
- remove waste products from the blood
- regulate water levels in the body
- regulate acid-base balance and electrolyte levels in the blood
23
Q
uremia
A
the presence of excessive amounts of urea and other nitrogenous waste products in the blood, as occurs in renal failure
24
Q
how much of the blood is pumped from the heart with each beat that passes through the kidney?
A
25%
25
the average water intake for humans during each 24 hour period is about
2.5 L
26
the kidneys normally excrete about how many L of urine per day
1.5 L or 1500 mL
27
the outer covering of each kidney is called the
renal capsule
28
renal cortex
the outer smooth textured reddish area
29
renal medulla
the deep reddish brown region
| consists of 8-18 renal pyramids
30
the renal cortex and renal pyramids of the renal medulla make up what
the parenchyma of the kidney
31
renal parenchyma
the total functional portion of the kidneys
32
papillary ducts
urine formed by the nephrons drain into these ducts h
33
minor/major calyx
cuplike structures where the papillary ducts drain into
34
how many minor calyces in a kidney
8-18
35
how many major calyces in a kidney
2-3
36
renal pelvis
where the major calyx drains urine into
| the first major collecting area of urinary waste
37
3 basic processes the nephrons are involved in
1. filtering blood
2. returning useful substances to the blood
3. removing substances from the blood that aren't needed
38
the individual nehpron is composed of what 2 things
a renal corpuscle and a renal tubule
39
renal corpuscle consists of
double walled membranous cup called glomerular capsule/ bowmans capsule and glomerulus
40
glomerulus
cluster of blood capillaries
| serves as a filter for the blood
41
afferent arteriole
the vessel entering the glomerular capsule
42
efferent arteriole
the vessel leaving the glomerular capsule
43
3 parts of the renal tubule y
proximal convoluted tube
nephron loop (loop of henle)
distal convoluted tube
44
collecting system
nephrons - renal pyramids - renal papilla - minor calyces - major calyces - renal pelvis - ureter
45
when is the filtrate termed urine
by the time it reaches the minor calyx
46
glomerular filtrate goes from
glomerular capsule - proximal convoluted tube - loop of henle - distal convoluted tube - minor calyx
47
renal sinus
cavity within the kidney where the calyces, blood vessels and nerves lie
48
what is the size of the ureter
10-12 inches long
| 1 mm - 1 m in diameter
49
where do the ureters enter the bladder
the posterolateral part
50
what are the 3 constricted points along each ureter
| also the 3 most common spots for obstruction
1. Uretteropelvic junction UPJ
2. brim of the pelvis
3. ureterovescial junction UVJ
51
UPJ
the point the renal pelvis funnels down into small ureter
| where the renal pelvis becomes the ureter
52
UVJ
where the ureters join the bladder
53
most kidney stones passing down the ureter tend to hang up where
the UVJ
54
urinary bladder
musculomembranous sac that serves as a reservoir for urine
55
location of bladder in males
directly anterior the the rectum
56
location of bladder in females
anterior to the vagina and inferior to the ureters and posterior to pubic symphysis
57
shape of the bladder
depends on how much urine it contains
58
trigone
small triangular area in the floor of the bladder
| has a smooth appearance
59
micturition
discharge of urine
| also called urination or voiding
60
when does the desire for micturition occur
when the volume of urine reaches about 250 mL
| is voluntary
61
T or F
| normally some urine is present in the bladder at all times
TRUE
62
the total capacity of the bladder is
350 - 500 mL
63
incontinene
unable to hold urine
64
dysuria
pain in urination
65
anuria
absence of urine formation
66
polyuria
passage of large volume of urine in relation to fluid intake during a given period
67
diuresis
increased excretion of urine
68
hematuria
blood in the urine
69
urethra
musculomembranous tube with a sphincter at the neck of the bladder
70
male urethra length
7-8 inches
71
female urethra length
1 and a half inches
72
male urethra divides into 3 portions
1. prostatic
2. membranous
3. spongy
73
the kidneys in the adult are located
midway between xiphoid process and iliac crest
74
urography
radiographic examination of the urinary system in general
75
before withdrawing contents from any vial or bottle, you must confirm...
correct contents of container
route of administration
amount to be administered
expiration date
76
iodinated contrast agents may be administered in what 2 ways
bolus injection
| drip infusion
77
bolus injections
rapid introduction of contrast into the venous system at one time
for maximum contrast enhancement
78
rate of bolus injection is controlled by:
```
gauge of needle
amount of contrast
viscosity of contrast
stability of vein
force applied
```
79
drip infusion
where contrast media is introduced into venous system by connective tubing attached to an IV
controlled by a clamp
80
equipment and materials for injection
```
emergency cart stocked
sharps container
tourniquets
alcohol pads
gauze
tape
gloves
contrast
various sizes of butterfly needle
syringes
IV tubing
arm board
```
81
for most IVU's veins where are recommended
antecubital fossa
| in front of the elbow
82
other veins that may be used for injection site
cephalic vein on lateral wrist and veins on posterior hand or lower forearm
83
type and size of needle used on an adult
18 - 20 gauge butterfly needle
84
type and size of needle used for pediatrics
23 - 25 gauge needle
85
what is the expected outcome of injected contrast media
temporary hot flash
metallic taste in mouth
passes quickly
86
adult creatinine level
0.6 - 1.5 mg/dl
87
adult BUN level
8 - 25 mg/100 ml
88
metformin hydrochloride
drug given for the management of non insulin dependent diabetes
if mixed with contrast may increase risk for renal failure
89
metformin should be withheld for how long after the procedure
48 hours and only resumed if kidney function is normal
90
pre medication protocol
some pts. may be given a combo of benadryl and predinisone 12 hrs before procedure to help reduce liklihood of reaction
91
4 categories of contrast media reactions
1. mild
2. moderate
3. severe
4. organ specific
92
1. mild reaction
nonallergic reaction
does not typically require medical attention
symptoms:
anxiety, nausea, light head, metallic taste, vomiting, redness
treatment: breathe slowly, provide cold cloth, observe and monitor
93
2. moderate reaction
true allergic reaction (anaphylactic)
symptoms: urticaria, trouble breathing, bronchospasm, tachycardia, bradycardia, hypotension
may lead to life threatening
need medical assistance
94
adult creatinine level
0.6 - 1.5 mg/dl
95
adult BUN level
8 - 25 mg/100 ml
96
extravasation treatment
elevate affected extremity above heart
use cold compress followed by warm compress
document the incident
97
metformin should be withheld for how long after the procedure
48 hours and only resumed if kidney function is normal
98
pre medication protocol
some pts. may be given a combo of benadryl and predinisone 12 hrs before procedure to help reduce liklihood of reaction
99
4 categories of contrast media reactions
1. mild
2. moderate
3. severe
4. organ specific
100
1. mild reaction
nonallergic reaction
does not typically require medical attention
symptoms:
anxiety, nausea, light head, metallic taste, vomiting, redness
treatment: breathe slowly, provide cold cloth, observe and monitor
101
2. moderate reaction
true allergic reaction (anaphylactic)
symptoms: urticaria, trouble breathing, bronchospasm, tachycardia, bradycardia, hypotension
may lead to life threatening
need medical assistance
102
3. severe reaction
also known as vasovagal
fast and prompt response required
symptoms: low BP, bradycardia, convulsions, loss of concsciousness, cardiac arrest
possible hospitalization
103
4. organ specific reaction
specific organs are affected by the contrast media injection
symptoms: renal shutdown, vascular system(venous thrombosis) seizure induction, extravasation (leakage of contrast outside the vessel)
may not occur until 48 hours after the study
104
extravasation treatment
elevate affected extremity above heart
use cold compress followed by warm compress
document the incident
105
Intravenous urogram IVU
visualizes the minor and major calyces, renal pelves, ureters and urinary bladder after injection of contrast media
is a functional test
106
urinary tract infection
infection caused by bacteria/ urinary reflux
107
IVU contraindications (10)
1. hypersensitivity to contrast
2. anuria
3. multiple myeloma
4. diabetes
5. severe hepatic or renal disease
6. congestive heart failure
7. phechromocytoma
8. sickle cell anemia
9. pts. taking glucophage, metformin, etc
10. renal failure
108
diuretic
an agent that increases excretion of urine
109
lasix
brand name for a diuretic
110
lithotripsy
therapeutic technique that uses sound waves to shatter kidney stones so they can be passed
111
if you cannot use a ureteric compression what could be done instead?
put the patient in trendelenburg
112
urinary incontinence
involuntary passage of urine through urethra
113
urinary reflux
backward or return flow of urine from bladder into ureter and kidney
114
urinary tract infection
infection caused by bacteria/ urinary reflux
115
patient prep for an IVU
```
light evening meal prior
bowel cleansing laxative
NPO after midnight
enema on morning of exam
void prior to procedure
all clothing removed
```
116
prep of radiographic equipment and supplies
```
correct type and amt. of contrast
empty container of contrast media
selection of needles
alcohol wipes
gloves
tourniquet
support for elbow
shaps container
male gonadal sheild
emesis basin
eminephrine or benadryl
ureteric compression
cold towel
oxygen and suction devices
```
117
ureteric compression
allows renal collecting system to retain contrast longer
118
hydronephrosis
distention of the renal pelvis and calyces of the kidneys as a result of some obstruction of the ureters or renal pelvis
119
if you cannot use a ureteric compression what could be done instead?
put the patient in trendelenburg
120
how long does injection usually take
between 30 secs and 1 minute
121
when do most reactions occur
within the first 5 minutes following injection
122
how many mL of contrast is typically used for adults
30 - 100 mL
123
after beginning of injection how long does it take to see the contrast in the pelvicalyceal system
2-8 minutes
124
the greatest concentration of contrast medium in the kidneys normally occurs when
15 - 20 minutes after injection
125
IVU protocol basic routine
```
nephrogram / nephrotomogram (taken immediately after injection)
5 minute image
10-15 minute image
20 minute obliques
postvoid
```
126
hydronephrosis
distention of the renal pelvis and calyces of the kidneys as a result of some obstruction of the ureters or renal pelvis
127
6 exams of the urinary system
1. IVU
2. hypertensive intravenous urography
3. retrograde urography
4. retrograde cystography
5. voiding cystourethrography
6. retrograde urethrography (only for males)
