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Renal A&P


GFR glomerulo filtration rate
more blood floe through the kidneys = ______ more urine output
if the kidneys dont perfuse they will ______ stop
_____ of newborns are born with kidney and ureter abnormalities 3-4%
kidneys develop in the ____ week of gestation 5th week
urine formation begins the ____ week of gestation 9th-12th week
____ makes up the majority of amniotic fluid urine
fetus renal px will develop _______, which is _______ oligohydramnios, which is not enough amniotic fluid
failure of an organ to develop normally dysgenesis
complete failure of an organ to develop agenesis
renal agensis---wide set eyes, broad flat nose, epicanthic folds, low set ears, receding chin, and limb defects---usually do not live past a few minutes/hours Potter's Syndrome
kidneys do not develop to normal size---rare---usually of one kidney---usually develops into renal failure Renal hypoplasia
upper or lower poles of the kidney are fused together---common---does not always cause px horseshoe kidney
hereditary dx characterized by cyst formation and massive kidney enlargement polycystic kidney disease
mutation of PKD1 gene on chromosome 16, PKD2 on chromosome 4, or PKD3 polycystic kidney disease
what are the 2 types of polycystic kidney disease? who do they effect? Autosomal dominant: usually adults, progresses slowly-----autosomal recessive: usually affects children, no TX often die young
what happen when cysts develop in the kidneys in a polycystic kidney pt? the kidneys enlarge and the renal vessles and nephrons become obstructed
inflammatory disorder of the renal pelvis and the functional portion of the kidney pyelonephritis
____ causes ascending bladder infections, blood-borne infections, frequent calculi pyelonephritis
most common culprit of pyelonephritis e. coli
TX for pyelonephritis that causes urination to be orange color and changes the pH pyridium
most common primary neoplasms of young children around age os 3 Wilm's Tumor
mixed tumor composed of epithelial and mesenchymal embryonic elements Wilm's Tumor
associated with high BP and a solitary mass that can occur in any part of the kidney and is usually well-defined and encapsulated Wilm's Tumor
most common primary tumor Renal cell carcinoma
may produce hormone or hormone like substances and metastasizes commonly to the lung, mediastinum, bone, lymph nodes, liver, and CNS Renal Cell Carcinoma
what are the 3 classic signs of Renal Cell Carcinoma? triad-gross hematuria, flank pain, and papable abdominal mass
renal cell carcinoma is common in ____, ____, and ____ men, smoking, and obesity
______ are groups of capillaries with a basement membrane that filter the blood form urine filtrate glomeruli
what are the glomeruli selectively permeable to? (3) water, electrolytes, and dissolved particles (glucose and amino acids)
inflammation of the capillary loops of the glomeruli glomerulonephritis
leading cause of chronic renal failre in US glomerulonephritis
what are the 2 immune responses of glomerulonephritis? injury resulting from antibodies reacting with fixed glomerular antigens.......injury resulting from circulating antigen=antibody complexes (DNA in SLE, strep) that become trapped in the glomeruli membrane
what 3 cellular changes occur in glomerulonephritis? 1. proliferation- > in cellular componets....2. sclerotic- > in noncellular componets such as collagen.....3. membrane changes- > thickness
produces a proliferative inflammatory response (type of glomerulonephritis) nephritic syndrome
_____ is characterized by hematuria with red cell casts, diminished GFR, azotemia, oliguria, and HTN glomerulonephritis
usually in children...usually follows group A beta-hemolytic strep infection, but may also be a result of staph, measles, mumps, and chickpox acute nephritic syndromes (glomerulonephritis)
inflammatory response is immune related-immue cells become trapped in the glomerular membrane and proliferation of the glomerular membrane > permeability to red cells and protein acute nephritic syndromes (glomerulonephritis)
coke colored urine is a s/s because of the bl breakdown and the protein in the urine acute nephritic syndromes (glomerulonephritis)
the glomerular cell proliferate along with macrophages forming cresent-shaped lesions that obstruct the Bowman's capsule Chronic nephritic syndromes (glomerulonephritis
involves increased permeability of the glomerulus Nephrotic syndrome (glomerulonephritis)
characterized by massive proteinuria, lipiduria, hypoalbuminemia, edema, and hyperlipidemia Nephrotic syndrome (glomerulonephritis)
caused by diffused membrane thickening r/t immune cell deposits and is slow and progessive Membranous Nephrotic syndrome (glomerulonephritis)
sclerosis of some but not all of the glmeruli Focal segmental
end stage of glomerular disorders and are vague and slowly progressing Chronis glomerulonephritis
kidneys fail to remove metabolic waste products, regulate pH, fluid, and electrolyte, has an abrupt onset, and is oftern reversible Acute Renal Failure
what are the 3 categories of acute renal failure? prerenal, intrarenal, postrenal
hypovolemia and CV failure; most common acute renal failure prerenal (occurs before the kidney)
vascular diease, glomerulonephritis, nepritis (type of acute renal failure) intrarenal (occurs in the kidney)
extrarenal obstruction, intrarenal obstruction, and bladder rupture postrenal (occurs after the kidney)
what are the 3 phases of acute renal failure? initiation, maintenance, and recovery
begins with the onset of the event causing tubular necrosis; this phase ends with tubular injury initiation phase of acute renal failure
begins with in hours of the initiation ohase and typically lasts 1-2 weeks; it is characterized by persistent reduction in GFR and tubular necrosis maintenance of acute renal failure
begins with the GFR and tubular function have recovered and there is no further elevation of the BUN and creatine; renal function improves rapidly the first 5-25 days and contiunes up to 1 year recovery of acute renal failure
progressive inability over months to years of the kidneys to respond to change in body fluids and electrolytes with an ability to produce sufficient urine chronic renal failure
GFR < 20% and serum creatine > 5mg/dl chronic renal failure
what are the 3 stages of chronic renal failure? early (renal impairment)....second (renal insufficiency)...third (ESRD)
what stage of chronic renal failure do px begin to occur? second- renal insufficiency
when do you see a sharp > in BUN and creatine during chronic renal failure third ESRD stage
what is the most common cause of renal failure in children? glomerulonephritis and congenutal malformations
why is a transplant a good idea for the eldery with renal failure? b/c they do not respond well to dialysis
renal calculi kidney stones
are masses of crystals composed of minerals that are normally excreted in teh urine calculi
what is the most common type of kidney stone? Ca
stones in the UT urolithiasis
stones in the kidney nephrolithiasis
develop in the presence of alkaline urine or bacteria that posses the enzyme, urease; staghorned shaped; difficult to tx; too large to pass struvite
urine-filled dilatation of the renal pelvis and calices with atrophy of renal pelvis and is caused by a urine obstruction hydronephrosis
too much water in the kidneys hydronephrosis
_____ when urine obstruction is below the ureters bilateral
____ if obstruction is at level of ureters or above unilateral
infection of the bladder, kidney, urethra, or prostate and is classified by location UTI
second most common type of bacterial infection UTI
what are the two ways pathogens enter to cause an UTI? ascending from the mucous membrane of the perineal area to the lower tract (most common)......and hematogenoulsy from the blood (rare)
what causes 90% of UTIs? e. coli
what makes a UTI complicated? having more than 2 UTIs in 1 year or being male
what is the elderly's most common s/s for an UTI? confusion
what are the 3 main levels of neurological control for urine elimination? spinal cord reflex center....micturation center in the pons.....cortical and subcortical centers
where are the centers for reflex control of the bladder emptying or micturition located? b/t S1 - S4 and T11 - L2
what are the 2 classes of causes of urinary obstruction and stasis? congenital and aquired
what are the 2 classes of degrees of urinary obstruction and stasis? partial or complete
what are the 2 classes of duration of urinary obstruction and stasis? acute or chronic
what are the 2 classes of level of urinary obstruction and stasis? upper or lower UT
loss of nerual control of the bladder neurogenic bladder
failure to store urine d/t spasms; caused by spinal cord injury, herniated disks, vascular lesions, tumors, myelitis, stroke, multiple sclerosis, brain tumors spastic bladder
bladder dysfunction caused by spinal cord injury spinal shock
bladder atonic; requires cath; returns w/16 months; then the bladder becomes hyperactive spinal shock
mild; can develop after a stroke, in early multiple sclerosis, of as a result of lesions located in the hibitory centers of hte cortex or the pyramidal tract; senstation remains, stream is normal, no residual urine; decreased bladder capacity uninhibited spastic bladder
miscommunication in the muscles and spincter controlling unrication detrustor-spincter dyssynergia
failure to empty urine; caused by peripheral neuropathies or failure of the extrernal spincter to relax flaccid bladder
involuntary loss of urine that is sufficient to be a px urinary incontinence
urinary incontinence that occurs during increases intrathorasic pressure stress urinary incontinence
urinary incontinence that is due to an overactive bladder; frequnecy, uregency, dysuria, and nocturia urge urinary incontinence
urinary incontinence due to bladder distention overflow urinary incontinence
Created by: TayBay15
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