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Pathophys final pt 3

Pathophys final- renal & reproductive system

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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