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Pathophys final pt 3
Pathophys final- renal & reproductive system
| Question | Answer |
|---|---|
| nephron | functional unit of kidney |
| Glomerulus | enclosed capillary component; Afferent/efferent blood vessels |
| Tubule- Bowman’s capsule | filtrate; Proximal tubule → Loop of henle →Distal tubule |
| Juxta glomerular apparatus | Function- rennin production |
| Renin-angiotensin-aldosterone system | control of arterial bp; adjust filtrate based on body’s needs |
| kidneys | acid base reg, electrolyte balance, H2O excretion/regulation; autoregulation; erythropoietin; vitamin d synthesis; secretion of prostaglandins |
| Normal makeup of urine | |
| diuresis | increased urine volume |
| ADH | released in hypothalamus; works- in kidneys, prevents production of dilute urine |
| Aldosterone | released in adrenal cortex; works in kidneys |
| retention of potassium | cant be excreted (in kidney dx) life-threatening- build up of K+; HR changes, cardiac arrest potential (profound cardiac risk); ECG changes (T wave, QRS, PR, P wave, and ST segment changes); N/D/abd cramping |
| acid base balance | Control of production/reabsorption of bicarb; Reabsorb any bicarb from urinary filtrate; Bicarb= small, free movement at glomerulus; Can generate new bicarb in renal tubular cells too Excretion of some free acid in urine (small amt), other acid buffered |
| GFR | rate of creating initial filtrate which is called ”ultrafiltrate” |
| azotemia | increased urea levels in blood (increased BUN) |
| BUN | Blood Urea Nitrogen |
| Creatinine | endogenous waste product of skeletal muscle |
| Acute vs chronic renal failure | Acute- sudden kidney failure- blood loss, injury, infection- sepsis chronic- end stage renal dx; months or years of dx |
| acute vs chronic Glomerulonephritis | Acute- often associated with recent acute infection (i.e., Group A strep) Chronic- advanced stage of a group of kidney disorders, resulting in inflammation and gradual, progressive destruction of the glomeruli |
| Nephritic syndrome | collection of signs (known as a syndrome) associated with disorders affecting the kidneys, more specifically glomerular disorders |
| Nephrotic syndrome | nonspecific disorder in which the kidneys are damaged, causing them to leak large amounts of protein |
| Female Urinary tract | Ureters, bladder, urethra Increased risk of UTI |
| Male Urinary tract | Ureters, bladder, prostate, urethra |
| micturition | voiding |
| Lower UTI | Decreased emptying of bladder, increased concentration of urine, urinary stasis, obstructed urinary flow; Dysuria, frequency, nocturia, urgency, incontinence, suprapubic pain, Hematuria |
| Upper UTI | Chills, fever, leukocytosis, bacteriuria, pyuria; Flank pain, N/V, fatigue, dysuria, frequency, wgt loss, thirst |
| most common UTI bacteria | Escherichia coli |
| Uncomplicated UTI | occurs usually in young person with no other complicating factors or comorbidities and infection is not recurrent |
| Complicated UTI | occurs recurrently or in someone with other comorbidities or urologic abnormalities or diseases; often they are nosocomial |
| How do bacteria evade these defenses? | |
| What is reflux of urine? Why does it increase risk of UTI? | |
| Nephrolithiasis | calcium stones are most common UTI, pain, pyuria, hematuria, urgency, N/V, diarrhea Obstruction, retention, risk renal damage, urosepsis |
| Neurogenic bladder | dysfunction (spastic or flaccid) that results from a lesion of the nervous system → urinary incontinence; |
| Neurogenic bladder cont'd | caused by spinal cord injury, spinal tumor, herniated vertebral disks, MS, congenital disorders, infection, or DM. Risks- Urinary stasis, need for catheterization – infection, urolithiasis, vesicoureteral reflux, hydronephrosis, kidney damage |
| incontinence | Stress- involuntary loss of urine through an intact urethra as a result of sneezing, coughing, or changing position Urge- involuntary loss of urine associated w/ strong urge to void that cannot be suppressed mixed- combo of stress and urge. |
| Urinary retention | Inability to empty the bladder completely during attempts to void → residual urine |
| bladder CA | Tobacco= risk factor Hematuria= often first sign (microscopic first, then gross) |
| reproductive differentiation | If estrogen present- gonads form into ovaries; if testosterone present- gonads form into 2 testes 8th week of gestation |
| ova & sperm | Ova: Know that females born with total # of ova that mature over time and release with ovulation after puberty (continue 1/month until menopause) Sperm: Know that males produce sperm after puberty (continues lifelong) |
| puberty | sexual maturation- Gonads produce more sex hormone; Lasts 2-3 yrs; Begins age 8-12 usually (girls before boys); Complete with capability of reproduction |
| Menopause | cessation of menstrual flow |
| GnRH | increased from hypothalamus |
| Gonads | testosterone or estrogen |
| Adrenal cortex | secretes progesterone, androgens produced here |
| Anterior pituitary | secretes LH/ FSH |
| Gonadotropins | Luteinizing hormone and Follicle-stimulating hormone- secreted from pituitary |
| Testes- external male | Production of gametes (sperm) and sex hormones, Seminiferous tubules (spermatogenesis), Leydig cells |
| Penis- external male | Delivery of sperm and elimination of urine, Externally: shaft, glans (foreskin), Internally: urethra, corpora cavernosa, corpus spongiosum |
| Scrotum- external male | Thin, rugated sac, Tunica dartos |
| Vas deferens- external male | Spermatic cord, Storage and propulsion of sperm |
| Epididymis- external male | Sperm maturation, mobility, fertility, Transport sperm to vas deferens |
| internal male | Sperm via epididymis/spermatic cord mixes with semen via ejaculatory duct |
| Bulbourethral glands- internal male | Secrete mucus into urethra |
| Prostate Gland- internal male | Produces and releases prostatic fluid (thin, milky substance w/ alkaline pH); Urine prevented from entering prostatic urethra during ejaculation |
| Seminal Vesicles (behind bladder)- internal male | Produce and release semen (nutritive, glucose-rich fluid); Ejaculatory duct |
| spermatogenesis | development of mature sperm = begins @ puberty and continues lifelong; division= meiosis |
| testosterone | primary androgen Adrenal glands and Leydig cells of testes What functions? constant production |
| testosterone- growth and devel | Nervous and skeletal tissue (skeletal muscle, cartilage of larynx); Increased sebaceous gland activity- acne; |
| testosterone- growth and devel (cont'd) | Bone marrow stimulation- increased erythropoietin; Required for spermatogenesis and fluid for ejaculate; Libido; Role in cholesterol and fatty acid metabolism |
| Vaginal | Vaginal wall Lactobacillus acidophilus Disease: vaginitis, vaginal cancer |
| Uterus | Base= cervix Transformation Zone, endometrium Risk of HPV Monthly menstrual cycle |
| Function of uterus in pregnancy | |
| Endometriosis | growth of functioning endometrial tissue @ sites outside of uterus; inflammation of endometrium w/in uterus |
| dysfunctional uterine bleeding | heavy or irregular menstrual bleeding, disruption of menstrual cycle |
| uterine polyps/fibroids | benign tumors arising from the myometrium (muscle layer of uterus); overgrowth of endometrial tissue (vessels, etc), may cause abnormal vaginal bleeding |
| Fallopian Tubes | Function- Movement of ova to uterus- Cilia and peristalsis Often site of fertilization Disease: Ectopic pregnancy |
| Estrogen and progesterone | what functions?- Produced by ovaries, Cyclical production with surges, Control sexual development, ovarian-menstrual cycle, pregnancy, and lactation |
| Ovaries | female gonads Ova (separation of follicle to corpus luteum and ovum) Role of corpus luteum- secretes progesterone Disease: Ovarian cancer, Ovarian cysts, PCOS |
| Menstrual Cycle | Stages- Follicular/Proliferative → Luteal → Ischemic/Menstrual |
| Follicular/Proliferative Phase | Maturation of follicle; Proliferation of endometrium |
| Luteal/Secretory Phase | Midcycle surge of LH → ovulation (ovarian cycle)l Ovarian follicle→ corpus luteum ; LH → progesterone from corpus luteum → endometrial preparation; Conception or no conception |
| Ischemic/Menstrual Phase | No conception or implantation → ischemia → menstruation and cycle begins again |
| Hormones of menstrual cycle | FSH & LH |
| Breast- gland & tissue | sebaceous & mammary Adipose tissue + glands/ducts +fibrous (epithelial cells) |
| Functions of breast milk | Nourishment, immunoglobulins, nonspecific antimicrobial factors |
| Estrogen- effect breast tissue | promotes development of lobular ducts and breast growth |
| Oxytocin- effect breast tissue | controls milk let down (increases after delivery) |
| Prolactin- effect breast tissue | increases milk production (increases with continued breast feeding) |
| Progesterone- effect breast tissue | stimulates development of cells lining acini (milk glands) |
| Fibrocystic breast disease | Physiologic nodularity and breast tenderness that increases and decreases with menstrual and hormonal changes |
Created by:
sccrgrl159
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