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Ch 32 Renal

Renal and Urologic Emergencies

A spinal reflex that causes contraction of the bladder's smooth muscles, producing the urge to void as pressure is exerted on the internal urinary sphincter. Micturition Reflex
Inflammation of the kidney linings Pyelonephritis
The presence of blood in the urine Hematuria
A decrease in urine output to the extent that urine output drops below 5oo mL/day Oliguria
A complete stop in the production of urine. Anuria
A powdery buildup of uric acid, especially around the face Uremic Frost
Chemicals that increase urinary output. Diuretics
A sustained, painful erection of the penis Priapism
Main Functions of the Urinary System -Keeps track of the electrolytes, water content, and acids of the blood -Acts as the bloods sewage treatment plant, removing metabolic wastes, drug metabolites, and excess fluids. -Filters 2oo L of blood each day
Kidney (Anat + Phys) -Filter the blood and produce urine
Urinary Bladder (Anat + Phys) -Stores the urine until it is released from the body.
Ureters (Anat + Phys) -Transport the urine from kidneys to the bladder
Urethra (Anat + Phys) -Transports the urine from the bladder out of the body
Kidneys (Location) -structure(s) found in retroperitoneal space (behind the peritoneum), which extends from the 12th thoracic vertabra to the 3rd lumbar vertabra.
3 Distinct Regions of the Kidney's -The cortex -The medulla -The pelvis
Lighter-colored outer region closest to the capsule Renal Cortex
(middle layer) includes the cone-shaped renal pyramids, and inward extensions of cortical tissue that surround the pyramids Renal Medulla
Flat, funnel-shaped tube that fills the sinus at the level of the hilus Renal Pelvis
Approximately _____/________ of the bodys systemic cardiac output of blood flows through the kidney each minute. 1/4, 0.25, or 25%
Blood flows from the abdominal aorta into the kidney by way of the ______ ______ Renal Artery
Structure of the kidney that supplies blood to the glomerulus Afferent arteriole
A tuft of capillaries located in the kidney that serve as the main filter for the blood in the kidney Glomerulus
Structure of the kidney where blood drains from the glomerulus Efferent Arteriole
A set of capillaries unique to the kidney that branch off from the efferent arteriole; the site of tubular resorption Peritubular Capillaries.
The structural and functional units of the kidney that form urine; composed of the glomerulus, the glomular capsule, the proximal convoluted tubule, loop of henle, and the distal convoluted tubule. Nephrons
A double-Layered cup with the inner layer infiltrating and surrounding the capillaries of the glomerulus Glomerular (Bowmans) Capsule
One of the two complex sections of the nephron; includes an enlargement at the end called the glomerular capsule Proximal Convoluted Tubule (PCT)
The U-Shaped portion of the renal tubule that extends from the proximal convoluted tubule; concentrates the filtrate and converts it to urine. Loop of Henle
Connects with the kidney's collecting tubules Distal Convoluted Tubule (DCT)
Amount of filtrate produced Glomerular Filtration Rate (GFR)
Maintained at a relatively constant rate of 125 mL/min in healthy adult Glomerular Filtration Rate (GFR)
Filrate Contains? -Salts -Minerals -Glucose -Water -Metabolic Wastes
As the Filtrate passes through the rest of the nephron, Tubular __________ and Tubular ________ convert the filtrate into the urine. Resorption; and secretion
-Descending limb, extend toward the medulla -Ascending limb, moving toward the cortex Two sections of Loop of Henle
-Permiable to Water -Impermiable to Sodium and Chloride ions Descending limb of Loop of Henle
-Impermiable to Water -Permiable to Sodium and Chloride ions Ascending Limb of Loop of Henle
A structure formed at the site where the efferent arterioleand distal convoluted tubule meet Juxtaglomerular Apparatus
The cells in the _______ ________ ______ are sensitive to chemical changes and monitor the concentration of the filtrate in this area. Distat Convoluted Tubule
A hormone produced by cells in the juxtaglomerular apparatus when the blood pressure is low. Renin
-Renin released here -Sensitive to chemical changes -Monitor the concentration of the filtrate in DCT Juxtaglomerular Apparatus
Given that water tends to follow sodium, by ________ sodium resorption, the kidney _________ water resorption and, in turn, blood pressure. Increases; Increases
When _____ is released into the bloodstream, this hormone travels to the DCT and collecting ducts, ________ these structures _________ to water ADH; Increasing: permiability
Size of the Female Urethra 4 cm
Size of the Male Urethra 20 cm
-Painful Urination -Frequent Urges to urinate -Difficulty in Urination -Visceral Discomfort -Referred pain to shoulder or neck -foul smelling, cloudy urine Urinary Tract Infection (UTI) Signs+Symptoms
When _____ is released into the bloodstream, this hormone travels to the DCT and collecting ducts, ________ these structures _________ to water ADH; Increasing: permiability
Size of the Female Urethra 4 cm
Size of the Male Urethra 20 cm
-Painful Urination -Frequent Urges to urinate -Difficulty in Urination -Visceral Discomfort -Referred pain to shoulder or neck -foul smelling, cloudy urine Urinary Tract Infection (UTI) Signs+Symptoms
-extreme pain -Frequency and urgency of urination -Painful urination -Hematuria -Flank Pain that Migrates to groin -Like a UTI without presence of fever Renal Calculi (kidney stones)
A sudden decrease in filtration through the glomeruli Acute Renal Failure (ARF)
A progressive and irreversible inadequate kidney function due to permanent loss of nephrons. Chronic Renal Failure (CRF)
-Altered level of consciousness (elecrotlyte imbalance -Seizures and coma possible -lethargy, nause, headaches, cramps -Signs of anemia Chronic Renal Failure (CRF) Signs+Symptoms
A technique for "filtering" toxic wastes from the blood, removing excess fluid, and restoring the normal balance of electrolytes Renal Dialysis
-Large amounts of specially formulated dialysis fluid are infused into (and back out of) the abdominal cavity. -stays in the cavity for 1-2 hrs -high risk of peritonitis -aseptic technique is essential -can be performed at home Peritoneal Dialysis
A drop in BP is not uncommon after dialysis, but it can lead to _______ ______ if not promptly detected and treated. Cardiac arrest
Because dialysis alters the blood's chemistry, the patient may develop an _______ _________. For this reason, you should always monitor dialysis patients for ________ ________. Electrolyte Imbalance; Cardiac Dysrhythmias
-Peaked T-waves -Prolonged QRS complexes -Sometimes disappearence of the P waves -3rd degree heart block and asystole may occur HOw to determine Hyperkalemia on ECG reading
Concentration levels in urea lower rapidly, while solute concentration of CSF remain high, water moves from higher to lower concentration (osmosis), thus shiftiing water from blood stream into CSF causing ICP, N/V, headache and confusion; during dialysis Disequilibrium Syndrome
-Sudden dyspnea -Hypotension -Cyanosis Signs and Symptoms Air Embolism
-Place patient in left lateral recumbant postion -10 degrees of head-down tilt -Rapid transport Treatment Air Embolism
A tumor of the adrenal gland, usually in the medulla, that causes ecess release of the hormones epinephrine and norepinephrine. -less than 10% of tumors are malignant Pheochromocytoma
______ percent of all injuries to the GU system involve the Kidneys 80
Prehospital care of renal injuries relies on the basics of __________ Trauma Abdominal
-Hematomas and ecchymoses in lower pelvic area -Vaginal bleeding -lower pelvis tenderness Female Genitalia Injuries SIgns and symptoms
-use packing and compression -Administer replacement fluids to treat HoTN -DO NOT REMOVE ANY OBJECTS Femal Genitalia Injuries Treatment
Pain that originates in one area of the body but is interpreted as coming from a different area of the body Referred pain
Crampy, aching pain deep within the body, the source of which is usually hard to pinpoint; common with urologic problems Visceral Pain
_____ vital signs should be obtained and documented on the prehospital care report, at least every __ minutes in cases of possible renal failure. Serial; 5
The ______ is particularly susceptible to electrolyte changes, so ________ monitoring should be established for every renal patient. Heart; Cardiac
The management of patients with UTI's or Renal Calculi centers on ________ and ___________ comfort; support
Created by: kwiz28