Urinary system :) Flashcards
1
Q
what structures comprise the urinary system
A
kidneys
ureters
urinary baldder
urethra
2
Q
where and through what process is urine formed ?
A
kidneys
filtration and reabsorption
3
Q
how many L of blood is filtered per day ?
A
180 L
4
Q
how much urine is formed via filtration/reabsorption per day ?
A
1 - 1.5 L per day
5
Q
where is the hilum of the kidneys located?
A
medial surface
hilum (plural)
hilus (singular)
6
Q
what is the functional unit of the kidney
and what is its function
A
nephron
froming and creating urine
7
Q
what is the nephron unit composed of
A
glomerulus
bowmans capsule
convoluted tubules
8
Q
where is blood filtered in the nephron system
A
glomerulus
9
Q
were does the nepron unit terminate
A
collecting tubule
10
Q
name the structures in which urine travels through out of the body
A
collecting tubule (opening at renal papilla)- minor calyx -- major calyces --which terminate at the renal pelvis
11
Q
where do the ureters connect with the bladder
A
posteriolateral aspect in oblique angle
equidistant from the urethral orifice
(think trigone)
12
Q
what is the function of the ureters
A
drain urine from kidneys to the bladder
13
Q
orientate bladder and pubic symphysis
A
bladder is posterior to the pubic symphysis
14
Q
what repro. function does the urethra serve in males ?
A
it passes through the prostate gland receiving seminal fluid via ejaculatory ducts (which open into the urethra through the prostate)
15
Q
(3) sections of the male urethra
A
prostatic
membraneous
cavernous
16
Q
KUB
A
kidneys, ureters, bladder
radiograph
17
Q
what structure does the urethra open up into the exterior of the body ?
A
urinary meatus
18
Q
what should be assessed before administering contrast for urinary anatomy?
A
patient renal function
19
Q
urinary disorders clinical findings:
A
polyuria (lg vol of dilute) frequent urination oliguria (sm ammounts) dysuria obstructive sx flank pain
20
Q
what is GFR
what is normal GFR
what does it test
what is eGFR
A
glomular filtration rate
> 90mL per min per 1.73 m cubed _norm
measures the rate of blood flow through the kidneys
level for contraindication of contrast not established
eGFR is the estimated measurement of serum creatinine value in combo with Pt age race and gender
21
Q
individuals with low kidney function present with
A
high levels of creatinine and urea nitrogen in blood
22
Q
what is BUN
what is BUN levels determined by
contraindication for radiograph
A
blood urea nitrogen
levels influenced by urine flow and production and metab of urea
no greater than 50mg/dL
23
Q
serum creatine measure contraindicated for contrast
A
3mg/dL
24
Q
embryonic development of the urinary system occurs in how many stages?
A
3
dev. of kidneys -from growth of ureteric duct
development of metanephric tissue
25
anomalies of the kidneys and ureters are caused by _____ and classified as either ___,_____,____ or _____
errors in dev
| number, size&form, fusion, and position
26
congenital anomalies result in
impaired renal function and renal calculi
27
Number and size anomalies of the kidney:
| 4
renal aplasia
supernumerary kidney
hypoplasia
hyperplasia
28
compensatory hypertrophy
result of renal aplasia (unilateral absence of kidney) the existing kidney is larger than norm
29
in unilateral kidney aplasia which kidney is statistically more absent
left
| which is usually lower in abdom cavity -- right because of the liver
30
hypertrophic kidney is more prone to what
trauma
31
what is the absence of both kidneys refered to ?
bilateral agenesis (spell this) a-gene-sis
Potter syndrome
not conducive with life
32
renal aplasia
absence of one (unilateral) or both (bilateral) kindeys
detected via fetal US
bilateral renal aplasia is accompanied by compensatory hypertrophy (enlargement of the other kidney)
33
supernumerary kidney
presence of 3ed kidney
no paren-chy-mal attachment
prone to infection
34
hypoplasia
underdeveloped size
normal nephron development
req. renal arteriography to differentiate
hypertrophic changes from atrophy due to acquired vascular disease
usually accompanied with HTN
vol of the functioning kidney plays clinical role
35
Hyperplasia
overdevelopment of kidney
due usually to hypoplasia of the other kidney or hypertrophy
36
Fusion ano-mal-ies
how are they viewed
(2)
viewed via radiographs
horseshoe kidney
crossed ectopy
37
horseshoe kidney
lower poles of kidneys connected via band of soft tissue across the midline of the body
ureters exit anteriorly instead of medially
lower pole caylyces point medially rather than laterally
38
crossed ectopy
one kidney lies across the midline and is fused with the other kidney and usually lies inferoior to the other kidney with ureter crossing midline to conn with bladder on proper side
39
how are crossed ectopy and horseshoe kidney remided?
pyeloplastic surgery
40
Position anomalies of the kidneys:
| 2
malrotation
| ectopic kidney
41
malrotation
incomplete or excessive rotation of the kidneys as they ascend from the pelvis IN UTERO
usually not problem unless obstruction occurs
42
ectopic kidney
out of normal position
usually found in the pelvis
asymptomatic 1-800 urologic exams
ureteropelvic junction obstruction or VUR is found
interthoracic location
43
nephroptosis
drooping of the kidney
| nephro-ptosis
44
VUR
vesi-coure-teral
reflux
abnormal flow of urine from the bladder to the upper urinary tract
45
Renal pelvis and ureter anomolies
asymmetric
double renal pelvis
double ureter
impare renal dranage
infection and calculi
46
lower urinary tract anomalies
uretrocele
ureteral diverticula
bladder diverticula
uretheral valve obstruction
47
ureterocele
cystlike dialation of a ureter near opening to the bladder
result from stenosis
"cobra head"
48
ureterocele with ureteral duplication
"ectopic" ureterocele
| causes obstruction to affect of renal falure due to infection
49
ureteral diverticula
dialated branched ureteric remnant
50
ureteral diverticula is best demonstrated with what mod
retrograde urography
51
uretheral valves
mucosal folds that protrude into the posterior urethera as a congenittal condition
obstructs urine flow
52
Polycystic kidney disease
PKD
many tiny cysts within nephron
results in renal failure
US plays role in identifing cysts and obtaining biopsy
autosomal dominant is asymptomatic untill adulthood
53
polycystic kidney disease in adulthood
visualized late stage after cysts in liver and kidneys cause impared function
bilateral enlargement of kidneys
poor defined capsule
calyceal streatching
development of uremia
require dialysis or kidney Tx
54
Medullary sponge kidney
congenital dialation of the renal tubules leading to urinary stasis and increased leveles of caPHO4
55
increase levels if caPHO4 in renal tubules
nephro-cal-cin-osis
56
sx of medullary sponge
dialation of the medullary and papillary pts of the collecting ducts (bilaterally)
57
Inflammatory diseases of urinary system
| 4
UTI
pyelonephritis
acute glomerulonephritis
cystitis
58
UTI
urinary tract infection
tx approach- quantative urine culture
59
Pyelonephritis
bacterial infection of the calyces and renal pelvis
60
what is the most common renal disease
pyelonephritis
61
what predisposed pt to pyelonephritis
stagnation or obstruction of ruine flow
bacterium reach kidneys via ascending ureters or bloodstream
62
pyuria
presence of pus in the urine
63
chronic reflux of infected urine into renal pelvis may result in
chronic pyelonephritis
commonly due to anatomy obstruction or childhood VUR
64
IVU vs UVR
IVU- An intravenous urogram (IVU) is sometimes called an intravenous pyelogram (IVP). This test uses X-rays to look at the kidneys, bladder, and the tubes that connect them (the ureters). Together these are called the urinary system
UVR- Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder into the kidneys. ... Secondary VUR occurs when an obstruction in the bladder or urethra causes urine to flow backward into the kidneys.
65
chronic pyelonephritis can cause
destruction/scaring of the renal tissue
dialation of the calyces
reduction in kidney size
atrophy of renal pyramids
py-ram-ids
HTN
66
acute
| glomeronephritis
antigen-antibody rx
in glomeruli inflammatory response to renal parenchyma
begins in the cortex
67
alt name for acute glomeronephritis
Bright's disease
68
acute pyelonephritis primarly affects the:
interstitial tissue
69
acute glomeronephritis primarly affects the
nephron
70
gold standard for Dx of glomeronephritis
microscopic deposits in the glomerulus
(streptococcal)
collected with US or CT guidance
71
Cystitis
acute or chronic
inflammation of urinary bladder
72
how is VUR prevented
compression of bladder musculature on the ureters during micturition
73
congenital VUR is seen how
displaced laterall ureteric orifices
duplication of collecting systems & ureters w/ reflux into an ectopically placed ureter
neurogenic bladder
74
neurogenic bladder
bladder dysfunction
| interference w nerve impulses- urination
75
bladder trabeculae
radiograph apperance of roughening of normally smooth bladder wall
76
what prevention is paramount when dealing with cystitis
pyelonephritis
77
urinary calcifications
renal calculi
urine/precipitate crystaline materials
ca salts
78
predisposing factors to renal calculi
metabolic disorders..hyperparathyroid
excessive ca intake
high urine concentration
chronic UTI
79
non calcific stones
uric acid stones
80
most stones are formed where
calyces
| renal pelvis
81
staghorn calculus
large calculus
| in shape of pelvicalyceal junction
82
what mods used to show stones?
US
CT - no contrast
dx flank pain
appendicitis - AAA- renal calculus
83
renal colic
movement/ obstruction
of stones
severe intermittent pain
84
renal calculi may cause
```
renal colic
hematuria
fever
chills
frequent urination
secondary infection
```
85
degenerative diseases
| 3
nephrosclerosis
renal failure
hydronephrosis
86
nephrosclerosis
intimal thickening --- sm vessels of kidney
aging, HTN, diabetes
87
what causes nephrosclerosis
reduced blood flow --ateriosclerosis = atrophy of renal parenchyma
collecting sys is intact--kidney is impaired
88
how does local infarction of renal parenchyma appear?
irregularity of the cortical margin
| indentation
89
nephrosclerosis lab tests
| and associated complications
BUN increase increase creatinine levels
HTN
90
what conditions cause the kidneys to appear smaller than norm
hypoplasia
atrophy after obstruction
nephrosclerosis
91
Renal failure
norm regulatory & excretion b/c loss of glomerular filtration = loss of parenchyma
92
renal falure usually is chronic and results from
| 2
chronic glomerulonephritis
| PKD
93
uremia
characteristic of renal failure
| retention of urea in the blood
94
what is r/o to dx acute renal failure
(progressive BUN/ serum creatinine increase)
```
urinary calculi (abdom radio)
US/CT assess hydronephrosis kidney size
```
vascular abnorm -- nuc med scan or renal angiography
biopsy
95
what changes in body syst result from renal failure
anemia
HTN
heart arrhythmia
CHF
electrolyte / acid-base imbalance
96
tx for renal failure
dialysis and transplantation
97
Hydronephrosis
obstructive disorder
causes dilation of the renal pelvis and calyces with urine
98
chronic hydronephrosis causes
intrarenal preasure= ischemia
parenchymal atrophy
loss of function
flank pain
99
Neoplastic Diseases of Renal system
| 4
renal cysts
renal cell carcinoma
nephroblastoma (wilms tumor)
bladder carcinoma
100
Bladder carcinoma
3* more in men
aka transtional cell carcinoma
squamous cell carcinoma
adenocarcinoma
101
main Sx of adenocarcinoma aka bladder carcinoma
painless hematuria
tumors located in trigone
IVU/ cystography - fillilng deficite
102
why is cystoscopy the method of choice for bladder carcinoma
hard to distinguish between
| tumor, stone, blood clot
103
Nephroblastoma
aka wilms tumor
malignant tumor effecting 500 children a year
embryonal tumor
clinical dx via palpable immovable abdominnal mass
104
Renal cysts
asymptomatic
may rupture, hemorrhage, infection or obstruction
commonly forumnd in lower pole of kidney
105
how are tumors distinguished from cysts in the renal system
nephrotomography
| cysts show absence of nephrogram phase after contrast medium injection
