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Patho - Module 4
Ch. 7, 9
| Question | Answer |
|---|---|
| Where are the kidneys located? | On either side of the vertebrae in retroperitoneal space. |
| What is the renal capsule? | Connective tissue surrounding the kidney. |
| What is the renal cortex? | Area immediately beneath the capsule, which contains the nephrons. |
| What is the function of the renal artery? | Supplies kidneys with blood. |
| What is the renal hilum? | The opening in the kidney through which the renal artery and nerves enter and the renal vein and ureter exit. |
| What is the renal sinus? | The cavity that forms the renal pelvis. |
| What are calyces? | Tubes through which urine drains into the renal pelvis. |
| What is the bowman's capsule? | A double membrane that surrounds the glomerulus. |
| Define glomerulus. | A cluster of capillaries. |
| Define glomerular filtration rate. | The rate of blood flow through the glomerulus; best indicator of renal function; normal value: 125 mL/min. |
| What do ureters do? | Transport urine from calyces to bladder. |
| Define bladder. | A muscular structure that serves as a reservoir for urine until it can be excreted. |
| What does the urethra do? | Transports urine from bladder to urinary meatus; approximately 1.5 inches long in women and 6–8 inches long in men. |
| True or false: Shorter urethras in women, in combination with sitting for urination, increase women’s risk for developing urinary tract infections. | True |
| What is considered normal daily urine output? | 1,500 mL. |
| Functions of the kidneys. | Remove waste products from the body (ammonia, urea, uric acid); Create hormones that help produce red blood cells, promote bone health, and regulate blood pressure (antidiuretic hormone, aldosterone, renin-angieotensin, aldosterone), Converts vit D to active form, Secretes bicarbonate; Excretes/retains hydrogen; Synthesizes ANP, epoeiten and renin. |
| What alterations of the kidneys occur with aging? | System functions less efficiently ; Exacerbated by the presence of chronic conditions ; Increased risk for waste accumulation and loss of homeostatic regulation ; Other renal-related complications (anemia, hypertension, and osteoporosis); Increased risk for drug toxicity. |
| Enuresis | Form of urinary incontinence; Involuntary urination by a child after 4–5 years of age; Nocturnal enuresis: bed-wetting; Causes may be psychological and structural; Usually resolves with or without treatment |
| Transient incontinence | Form of urinary incontinence; Resulting from a temporary condition ; Caused by: delirium, infection, atrophic vaginitis, use of certain medications (e.g., diuretics and sedatives), psychological factors, high urine output, restricted mobility, fecal impaction, alcohol, and caffeine. |
| Reflex incontinence | Form of urinary incontinence; Caused by trauma or damage to the nervous system; Detrusor hyperreflexia: increased detrusor muscle contractility that occurs even though there is no sensation to void; Urgency is generally absent. |
| Stress incontinence | Form of urinary incontinence; Loss of urine from pressure exerted on the bladder by coughing, sneezing, laughing, exercising, or lifting something heavy; Occurs when the sphincter muscle of the bladder is weakened; Contributing factors: pregnancy, childbirth, menopause, cystocele, prostate removal, obesity, and chronic coughing. |
| Urge incontinence | Form of urinary incontinence; Sudden, intense urge to urinate, followed by an involuntary loss of urine; Caused by: UTIs, bladder irritants, bowel conditions, smoking, Parkinson’s disease, Alzheimer’s disease, stroke, injury, and nervous system damage; Overactive bladder: urge incontinence with no known cause. |
| Overflow incontinence | Form of urinary incontinence; Inability to empty the bladder, or retention; Other indications include dribbling urine and a weak urine stream; Caused by: bladder damage, urethral blockage, nerve damage, and prostate conditions; Chronic overdistension occurs because of a perceived inability to interrupt work to void that results in detrusor muscle areflexia and overflow incontinence. |
| Mixed incontinence | Occurs when symptoms of more than one type of urinary incontinence are experienced. |
| Functional incontinence | Occurs in many older adults, especially people in nursing home, who have a physical or mental impairment that prevents toileting in time. |
| Gross total incontinence | A continuous leaking of urine, day and night, or the periodic uncontrollable leaking of large volumes of urine; The bladder has no storage capacity; Caused by: anatomic defects, spinal cord or urinary system injuries, and fistulas between the bladder and an adjacent structure, such as the vagina. |
| Risk factors for urinary incontinence. | Being female; Advancing age; Being overweight; Smoking. |
| Complications of urinary incontinence. | Skin problems; Recurrent urinary tract infections; Negative psychological consequences; Interruption of usual activities. |
| Neurogenic Bladder | Bladder dysfunction caused by an interruption of normal bladder nerve innervation; Symptoms of an overactive and underactive bladder. |
| True or False: Kidney development begins about the fifth week of gestation. | True |
| Urinary Tract Infections | Common infections (more in women than men) that happen when bacteria, often from the skin or rectum, enter the urethra, and infect the urinary tract. |
| Cystitis | Inflammation of the bladder; Bladder and urethra walls become red and swollen; Caused by infection and irritants. |
| Pyelonephritis | Infection in one or both kidneys; Commonly caused by E. coli ascending up ureters; Kidneys become grossly edematous and fill with exudate, compressing the renal artery. |
| Nephrolithiasis | Presence of renal calculi (hard crystals composed of minerals that the kidneys normally excrete); Commonly in men; Treatment: strain all urine, increase fluid intake to 2.5–3.5 L, extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy, ureteroscopy, surgery, pain management, dietary changes, and physical activity. |
| Hydronephrosis | Abnormal dilation of the renal pelvis and the calyces of one or both kidneys; Treatment: ureteral stents, nephrostomy tubes, and antibiotics. |
| Wilms’ Tumor aka nephroblastoma | Rare cancer of the kidneys that primarily affects children; |
| Renal Cell Carcinoma | Most frequently occurring kidney cancer in adults; Commonly found in men; |
| Bladder Cancer | Types: transitional cell carcinoma, squamous cell carcinoma, and adenocarcinoma; Metastasis is common to the pelvic lymph nodes, liver, and bone. |
| Benign Prostatic Hyperplasia (BPH) | A common, nonmalignant enlargement of the prostate gland that occurs as men age; Treatment: alpha-blockers and alpha5-reductase inhibitors, saw palmetto, partial or complete surgical removal of the prostate, and avoid alcohol. |
| Polycystic Kidney Disease (PKD) | Inherited disorder characterized by numerous grape-like clusters of fluid-filled cysts in both kidneys; Cysts enlarge the kidneys while compressing and eventually replacing the functional kidney tissue. |
| Glomerulonephritis | Bilateral inflammatory disorder of the glomeruli that typically follows a streptococcal infection; Affects more men than women; Lead cause of renal failure. |
| Gastrointestinal System: upper division | Oral cavity, pharynx, esophagus, and stomach; Begins digestion |
| Gastrointestinal System: lower division | Small intestine, large intestine, and anus; Ends digestion – absorbs nutrients and water. |
| What are the 4 layers of the gastrointestinal system? | Mucosa, submucosa, muscle, and serosa. |
| Mesentery | Double-layer peritoneum containing blood vessels and nerves that supplies the intestinal wall. |
| Peritoneum | Large serous membrane that lines the abdominal cavity. |
| Layers of the peritoneum | Parietal peritoneum: outer layer Visceral peritoneum: inner layer Peritoneal cavity: space between the two layers. |
| Parietal peritoneum | Outer layer of the peritoneum. |
| Visceral peritoneum | Inner layer of the peritoneum. |
| Hepatobiliary system | Liver, gallbladder, and pancreas. |
| Gallbladder | Stores bile produced by the liver. |
| Pancreas | Exocrine & Endocrine system. |
| Liver | Metabolize carbohydrates, protein, and fats; Synthesize glucose, protein, cholesterol, triglycerides, and clotting factors; Store glucose, fats, and micronutrients and release; Detoxify blood of potentially harmful chemicals; Maintain intravascular fluid volume; Metabolize medications to prepare them for excretion; Produce bile; Inactivate and prepare hormones for excretion; Remove damaged or old erythrocytes to recycle iron and protein; Serve as a blood reservoir; Convert fatty acids to ketones. |
| Exocrine functions | Produces enzymes, electrolytes, and water necessary for digestion |
| Endocrine function | Produces hormones to help regulate blood glucose |
| Changes associated with aging | Atrophic gastritis; Achlorhydria; B12 deficiency; Decreased digestion; Liver experiences reduced blood flow, delayed drug clearance, and diminished regeneration capacity; Changes in lactose, calcium, and iron metabolism and absorption; Decreased peristalsis |
| Impaired elimination | These conditions may be symptoms of another secondary condition, or the primary one. They may alter nutrition as well as impair elimination. |
| Altered nutrition | These conditions include issues consuming, digesting, and absorbing food. Affected individuals are often underweight and vitamin deficient. |
| Disorders of the lower GI tract | Diarrhea, constipation, intestinal obstruction, appendicitis, peritonitis, celiac disease, inflammatory bowel disease, irritable bowel syndrome, diverticular disease |
| Disorders of the upper GI tract | Congenital defects (cleft lip and palate and pyloric stenosis), dysphagia, vomiting, hiatal hernia, gastroesophageal reflux disease, gastritis, peptic ulcers, cholelithiasis. |
| Cleft Lip and Palate | Common congenital defects of the mouth and face that are apparent at birth and vary in severity; Associated with genetic mutations, drugs, toxins, viruses, vitamin deficiencies, and cigarette smoking. |
| Pyloric Stenosis | The pyloric sphincter muscle fibers become thick and stiff, making it difficult for the stomach to empty food into the small intestine. It is narrowed and obstructed. |
| Dysphagia | Difficulty swallowing. |
| Hematemesis | Blood in the vomitus; Characteristic “coffee grounds” appearance resulting from protein in the blood being partially digested; Blood is irritating to the gastric mucosa; Can occur from any conditions that cause upper GI bleeding. |
| Yellow or green vomitus. | Usually indicates the presence of bile; Can occur as a result of a GI tract obstruction. |
| A deep brown vomitus. | May indicate content from the lower intestine; Frequently results from intestinal obstruction. |
| Undigested food vomitus. | Caused by conditions that impair gastric emptying. |
| Hiatal hernia | A stomach section protrudes upward through an opening in the diaphragm toward the lung; Caused by weakening of the diaphragm muscle, frequently resulting from increased intrathoracic pressure or increased intra-abdominal pressure; trauma; and congenital defects. |
| Gastroesophageal Reflux Disease (Gerd) | Chyme periodically backs up from the stomach into the esophagus; Bile can also back up into the esophagus; These gastric secretions irritate the esophageal mucosa. |
| Gastritis | Inflammation of the stomach’s mucosal lining (may involve the entire stomach or a region). |
| Acute gastritis | Can be a mild, transient irritation, or it can be a severe ulceration with hemorrhage. Develops sudden with nausea and pain. |
| Chronic gastritis | Develops gradually; May be erosive or nonerosive; May be asymptomatic, but usually accompanied by a dull epigastric pain and a sensation of fullness after minimal intake. |
| Gastroenteritis | Inflammation of the stomach and intestines, usually because of an infection or allergic reaction. |
| Helicobacter pylori | Most common cause of chronic gastritis; Embeds itself in the mucous layer, activating toxins and enzymes that cause inflammation; Genetic vulnerability and lifestyle behaviors (e.g., smoking and stress) may increase the susceptibility. |
| Peptic Ulcer Disease | Lesions affecting the lining of the stomach (peptic / gastric) or duodenum (duodenal). |
| Cholelithiasis | Gallstones |
| Cholecystitis | Inflammation or infection in the biliary system caused by calculi. |
| Hepatitis | Inflammation of the liver. |
| Acute hepatitis | Proceeds through four phases — Asymptomatic incubation phase three symptomatic phases |
| Chronic hepatitis | Characterized by continued hepatic disease lasting longer than 6 months; Symptom severity and disease progression vary depending on degree of liver damage; Can quickly deteriorate with declining liver integrity. |
| Fulminant hepatitis | An uncommon, rapidly progressing form that can quickly lead to liver failure, hepatic encephalopathy, or death within 3 weeks. |
| Cirrhosis | Chronic, progressive, irreversible, diffuse damage to the liver resulting in decreased liver function. |
| Pancreatitis | Acute or chronic inflammation of the pancreas. |
| Diarrhea | Change in bowel pattern characterized by an increased frequency, amount, and water content of the stool; Results because of increased fluid secretion, decreased fluid absorption, or an alteration in GI peristalsis. |
| Chronic diarrhea | Lasts longer than 4 weeks; Caused by inflammatory bowel diseases, malabsorption syndromes, endocrine disorders, chemotherapy, and radiation. |
| Diarrhea originating in the small intestine. | Stools are large, loose, and provoked by eating; Usually accompanied by pain in the right lower quadrant. |
| Diarrhea originating in the large intestine. | Stools are small and frequent; Frequently accompanied by pain and cramping in the left lower quadrant. |
| Constipation | Change in bowel pattern characterized by infrequent passage of stool in reference to the individual’s typical bowel pattern; Stool remains in the large intestine longer than usual, increasing the amount of water removed. |
| Intestinal Obstruction | Blockage of intestinal contents in the small intestine or large intestine; Causes: mechanical or functional; Chyme and gas accumulate at the site of the blockage; Saliva, gastric juices, bile, and pancreatic secretions begin to collect as the blockage lingers; Serum electrolytes and protein increase, causing abdominal distension and pain; Intestinal blood flow can become impaired, leading to strangulation and necrosis; Intestinal contents can seep into the abdomen as the pressure increases. |
| Mechanical obstructions | Foreign bodies, tumors, adhesions, hernias, intussusception, volvulus, strictures, Crohn’s disease, diverticulitis, Hirschsprung’s disease, and fecal impaction. |
| Functional obstructions (also called paralytic ileuses) | Neurologic impairment; intra-abdominal surgery complications; chemical, electrolyte, and mineral disturbances; intra-abdominal infections; abdominal blood supply impairment; renal and lung disease; and use of certain medications (e.g., narcotics). |
| Appendicitis | Inflammation of the appendix; Often caused by an infection; Triggers local tissue edema, which obstructs the appendix; As fluid builds inside the appendix, microorganisms proliferate (multiply); The appendix fills with purulent exudate and area blood vessels become compressed; Ischemia and necrosis develop; The pressure inside the appendix escalates, forcing bacteria and toxins out to surrounding structures. |
| Manifestations of appendicitis. | Sharp right lower abdominal pain develops (pain can be anywhere in abdomen), gradually intensifies (over about 12–24 hours); Pain will temporarily subside if the appendix ruptures, and then the pain will return and escalate, nausea, vomiting, abdominal distention, occasional diarrhea; Rebound tenderness. |
| Peritonitis | Inflammation of the peritoneum (inside your abdomen); Caused by chemical irritation (e.g., ruptured gallbladder or spleen) or direct organism invasion (e.g., appendicitis and peritoneal dialysis). |
| Protective mechanisms are activated by the body with peritonitis. | A thick, sticky exudate that bonds nearby structures and temporarily seals them off; Abscesses may form in an attempt to wall off the infections; Peristalsis may slow down in a response to the inflammation, decreasing the spread of toxins and bacteria. |
| Celiac disease AKA celiac sprue or gluten-sensitive enteropathy | An immune reaction to eating gluten, a protein found in wheat, barley, and rye; inherited; common in Caucasian females. |
| Inflammatory Bowel Disease (Crohn’s, Ulcerative colitis) | Chronic inflammation of the GI tract, usually the intestine; Characterized by periods of exacerbations and remissions; Immune cells located in the intestinal mucosa are stimulated to release inflammatory mediators that alter the function and neural activity of the secretory and smooth muscle cells; Fluid, electrolyte, and pH imbalances develop; Can be painful, debilitating, and life-threatening. |
| Crohn’s Disease | Insidious, slow-developing, progressive condition; Patchy areas of inflammation involving the full thickness of the intestinal wall and ulcerations (skip lesions); Form fissures divided by nodules ( intestinal wall cobblestone appearance); Wall thick and rigid & intestinal lumen narrowed & potentially obstructed; Granulomas develop on intestinal wall & nearby lymph nodes; Damaged wall loses ability to digest and absorb; Inflammation stimulates intestinal motility, decreasing digestion and absorption. |
| Treatment for Crohn's disease. | Low-residue, high-calorie, high-protein diet; oral nutritional supplements; multivitamin supplements; total parenteral nutrition; antidiarrheal agents; aminosalicylates (5-ASAs); glucocorticoids; immune modulators; biologic agents; analgesics; antibiotics; surgical intestine resection; stress management; and support. |
| Ulcerative Colitis | Progressive condition of the rectum and colon mucosa; Inflammation triggered by T-cell accumulation in the colon mucosa causes epithelium loss, surface erosion, & ulceration that begins in the rectum & extends to the entire colon; Mucosa becomes inflamed, edematous, & frail; Necrosis of the epithelial tissue can result in abscesses; Granulation tissue forms that is fragile & bleeds easily; Ulcers merge, creating large areas of stripped mucosa that results in an inadequate surface area for absorption. |
| Treatment for ulcerative colitis | High-fiber, high-calorie, high-protein diet; oral nutritional supplements; multivitamin supplements; total parenteral nutrition; antidiarrheal agents; antispasmodics; anticholinergics; aminosalicylates (5-ASAs); glucocorticoids; immune modulators; biologic agents; analgesics; antibiotics; surgical intervention (e.g., ileostomy or colostomy); stress management; and support. |
| Irritable Bowel Syndrome (IBS) | Chronic, noninflammatory, GI condition characterized by exacerbations associated with stress; Alterations in bowel pattern & abdominal pain not explained by structural or biochemical abnormalities; No permanent intestinal damage; Common in women; 3 theories of etiology: altered GI motility, visceral hyperalgesia, & psychopathology; intensified response to stimuli with increased intestinal motility and contractions (may have a low tolerance for stretching and pain in the intestinal smooth muscle) |
| Diverticular Disease (Diverticulosis, diverticulitis) | Conditions related to the development of diverticula, outwardly bulging pouches of the intestinal wall that occur when mucosa sections or large intestine submucosa layers herniate through a weakened muscular layer; Congenital or acquired. |
| Diverticulosis | Asymptomatic diverticular disease, usually with multiple diverticula present. |
| Diverticulitis | Diverticula have become inflamed, usually because of retained fecal matter; Can result in potentially fatal obstructions, infection, abscess, perforation, peritonitis, hemorrhage, and shock; Often asymptomatic until the condition becomes serious. |
| Oral Cancer | Most cases involve squamous cell carcinomas of the tongue and mouth floor; Risk factors: smoked and smokeless tobacco, alcohol consumption, viral infections (especially the human papillomavirus), immunodeficiencies, inadequate nutrition, poor dental hygiene, chronic irritation, and exposure to ultraviolet light; Often metastasizes to neck lymph nodes and esophagus. |
| Esophageal Cancer | Usually a squamous cell carcinoma in the distal esophagus; Tumors grow the circumference of the esophagus, creating a stricture, or they can grow out into the lumen of the esophagus, creating an obstruction. |
| Gastric Cancer | Occurs in several forms, but adenocarcinoma (an ulcerative lesion) is the most frequent type; Strongly associated with increased intake of salted, cured, pickled, preserved, and smoked foods. |
| Liver Cancer | Most commonly occurs as a secondary tumor that has metastasized from the breast, lung, or other GI structures; Causes of primary tumors: chronic cirrhosis and hepatitis. |
| Pancreatic Cancer | Aggressive malignancy that can quickly metastasize; Usually adenocarcinoma. |
| Colorectal Cancer | Most often develops from an adenomatous polyp; Associated with excessive intake of fat, calories, red meat, processed meat, and alcohol as well as decreased fiber intake. |
| Hepatitis A | Vaccine-preventable liver infection that occurs due to the hepatitis A virus; Transmission through contact with fecal matter, which can happen as a result of consuming contaminated food or water, not washing the hands, or engaging in anal sex; Short-term infection and usually resolves within 2 months; No specific treatment. |
| Hepatitis B | Vaccine-preventable liver infection that occurs due to the hepatitis B virus (HBV); 2 types: acute, or short-term, and chronic, or long-term; Chronic can lead to cirrhosis and liver cancer; Transmits when blood, semen, or other bodily fluid from a person with HBV enters the body of someone who does not have it; Mostly acute infection that resolves on its own, but meds can be used; Sometimes leads to death due to cirrhosis and liver cancer. |
| Hepatitis C | Develops due to an infection with the hepatitis C virus (HCV); Acute or chronic; Without treatment can lead to liver damage and liver cancer; Develop through blood-to-blood contact ( blood containing HCV must enter the body of an individual who does not have the virus); Acute may resolve on its own or 8–12 weeks of oral therapy. |
| Hepatitis D (delta hepatitis) | Occurs due to an infection with the hepatitis D virus (can only get if they already have a hepatitis B infection); Can be acute or chronic; Transmission occurs through contact with blood and other bodily fluids from someone who has the infection; No cure; Med to reduce progression: pegylated interferon-alpha. |
| Hepatitis E | Develops due to an infection with the hepatitis E virus (HEV); Uncommon; Most cases are result from travel to a country where the condition is endemic (contaminated drinking water) ; rare due to consumption of undercooked pork or deer meat; Usually resolves on own. |
| What is intussusception? | A serious condition in which part of the intestine slides into an adjacent part of the intestine; this telescoping action often blocks food or fluid from passing through. |
Created by:
GChaos95
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