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68wm6 p2 intro urin
Introduction to the Urinary System
| Question | Answer |
|---|---|
| Define Anasarca: | severe, generalized edema |
| Define Anuria: | urine output < 100 ml/day |
| Define Asthenia: | a general feeling of tiredness and listlessness |
| Define Azotemia: | the build-up of nitrogenous waste products in the blood |
| Define Hydronephrosis: | dilation of the renal pelvis and calyces |
| Define Nephrotoxin: | a substance that causes destruction of the kidney |
| Define Nocturia: | excessive urination at night |
| Define Oliguria: | low urine output 500 ml/day |
| Define Pyuria: | pus in the urine |
| Define Residual Urine: | the volume of urine remaining in the bladder after a patient voids |
| What is the normal residual urine volume? | <50 ml |
| What hormone does the kidneys secrete to stimulate the production of RBCs? | Erythropoietin |
| What is the anatomic location of the kidneys? | Found in the retro-peritoneum, just below the diaphragm on each side of the vertebral column |
| What surrounds the kidneys? | Adipose tissue |
| What is the Hilus? | a notch found near the center of the medial (inside) border where the ureter blood vessels and nerves enter and exit the kidney |
| What is the renal capsule? | outer covering of the kidney made of strong connective tissue |
| What is the renal cortex? | Located just beneath the capsule and contains 1.25 million renal tubules |
| What is the renal medulla? | Portion of the kidney that lies beneath the cortex and contains the triangular pyramids and their papillae (narrow points of the pyramids that drain urine into the calyces) |
| Where do calyces drain? | Into the renal pelvis |
| What is the renal pelvis? | the upper extension of the ureters. |
| Where are the adrenal glands located? | Near the top of each kidney |
| What do the adrenal glands secrete? | Secrete hormones that help control blood pressure and heart rate |
| What is the functional unit of the kidney? | The Nephron |
| What are the two main structures of the nephron? | renal corpuscle and renal tubule |
| What does the nephron do? | *Maintains water balance *Maintains pH levels in the blood *Removes toxins from the blood stream |
| What is the glomerulus? | tightly bound network of capillaries in the nephron |
| Where does blood enter the glomerulus? | via the afferent arteriole |
| Where does blood exit the glomerulus? | via the efferent arteriole |
| What controls the rate of glomerular filtration? | The difference in diameter between the afferent and efferent arteriole |
| What is the bowmans capsule? | Cup-like structure that encapsulates the filtering system of the kidney (the glomerulus) |
| What is abnormal to find in the urine because they should not be filtrated out of the blood? | Large molecules i.e. RBCs, WBCs, protein |
| What does the renal tubule consist of? | Consists of proximal convoluted tubule, loop of Henle, distal convoluted tubule and collecting duct |
| Where are water and electrolytes reabsorbed? | The renal tubule |
| Where do reabsorbed water and electrolytes from the renal tubule re-enter the bloodstream? | the peritubular capillary network |
| What are secreted by the endocrine system to help the kidneys maintain fluid and electrolyte balance? | Anti-diuretic hormone (ADH) and aldosterone |
| Between the ages of 40 and 70 what happens to the renal filtering mechanism? | the filtering mechanism becomes 50% less efficient |
| Inadequate fluid intake (alterations in thirst center regulation), immobility and conditions that lead to urinary stasis increase the risk of what? | urinary tract infection (UTI) |
| In males, what leads to constriction of the urethra and incomplete emptying of the bladder | Enlargement of the prostate (Benign Prostate Hypertrophy - BPH) |
| Why are older males at increased risk for UTI? | Decreased bactericidal secretion from the prostate |
| What is the most commonly used urinary diagnostic test? | Routine Urinalysis |
| What does the routine urinalysis evaluate? | systemic disease, condition of the kidneys, and lower urinary tract |
| How is a routine urinalysis tested? | Various reagent test strips |
| What are the elements of a urinalysis? | *Evaluation of physical characteristics (color, clarity, and odor). *Determination of pH (normal 4.6 - 8.0). *Determination of specific gravity (normal 1.005 - 1.030) *Detection of protein, glucose, RBC/WBC, and ketones(not normally found in urine) |
| What are the normal pH ranges of urine? | 4.6 to 8.0 |
| What are the normal specific gravity ranges of urine? | 1.005 to 1.030 |
| What are the physical characteristics of urine that are evaluated in a urinalysis? | Color, Clarity, and Odor |
| Which urine test provides a better overall measure of kidney function? | 24 hour urine test, due to hourly changes in rate and secretion throughout the day |
| What is done with the first void of a 24-hour urine test? | Discard first void |
| What are the common substance measured in a 24-hour urine test? | *Total Protein *Creatinine *Urea *Uric Acid Levels *Catecholamines *Epinephrine and Norepinephrine |
| What is the purpose of Urine culture and sensitivity tests? | *Confirm suspected infections *Identify causative organisms *Determine appropriate antimicrobial therapy |
| True or False: Though urine is sterile, a small number of bacteria may be found in the urethra. | True |
| What test is used to distinguish between true urinary bacterial infection and contamination? | Urine culture and sensitivity |
| What kind of urine collection is required for a urine culture and sensitivity test? | clean catch voided midstream collection or catheter specimen in a sterile container |
| What test is an excellent indicator of renal function? | Urine creatinine clearance |
| What does a urine creatinine test determine? | how efficiently the kidneys are clearing creatinine from the blood |
| What is creatinine? | a catabolic product of creatine which is generated during muscle contraction and excreted in glomerular filtration |
| What directly influences the levels of creatinine? | Muscle mass |
| What should be avoided during a creatinine test period? | Excessive exercise |
| How is urine collected for a urine creatinine test? | 24-hour urine specimen |
| What is the normal creatinine clearance in males? | 90-139 ml/min |
| What is the normal creatinine clearance in females? | 80-125 ml/min |
| What would cause creatinine levels in the blood to rise | Kidney impairment |
| What is the normal serum creatinine levels? | 0.5 to 1.2 mg/dl |
| What is Glomerulonephritis? | Infection of the glomerulus |
| What is Polynephritis? | infection of the kidney |
| What is Acute tubular necrosis? | destruction of the tubules of the nephron |
| True or False: Creatinine is affected very little by | Dehydration, Malnutrition, and Liver Function |
| What is urea? | a non-protein waste which results from protein catabolism |
| How is urea formed? | conversion of ammonia in the liver |
| What urine test reflects protein intake and renal excretory capacity? | Blood Urea Nitrate (BUN) |
| What may elevate BUN? | congestive heart failure, catabolic state, starvation and large GI blood loss |
| What are the normal BUN ranges? | 10-20 mg/dl |
| What is prostate specific antigen? | An organ specific glycoprotein produced by normal prostate tissue |
| What may cause a false positive in a prostate specific antigen test? | Tissue manipulation. |
| What can be done to prevent a false positive prostate specific antigen test? | Draw the blood before examination. |
| What is the normal prostate specific antigen (PSA) value? | less than 4 ng/ml |
| What can cause an elevated Prostate Specific Antigen (PSA) reading? | *Prostate cancer *Benign prostatic hypertrophy *Prostatitis |
| What test measures the weight of the solvent compared with the weight of the solute. | Osmolality |
| What test is prefered over specific gravity? | Osmalality |
| What test provides information regarding the ability of the kidneys to concentrate urine? | Osmalality |
| What blood test is the most reliable indicator of kidney function? | Urine Creatinine Level (Per PPT slide... may have meant serum creatinine) |
| What Radiological procedure to evaluate the size, structure and position of the urinary tract structures? | Kidney Ureter Bladder (KUB) |
| What tests locate the site of any urinary tract obstructions and assessment of the excretory function of the kidneys via contrasting dye? | *Intravenous Pyleography (IVP) *Intravenous Urography (IVU) |
| What test consists of an Examination of the lower urinary tract (cystography - bladder or urethrography - urethra) with a sterile cystoscope? | Retrograde Pyleography |
| How is the upper urinary tract visualized in a retrograde pyleography? | Contrast injected into ureters |
| What is Used in conjunction with other diagnostic studies to detect abnormalities of the urinary bladder and urethra? | Voiding Cystourethrography |
| How is a Voiding Cystourethrography performed? | Contrast dye is injected into the bladder and PT is asked to void while radiographics are taken. |
| What test Identifies the kidney's shape, size, location, collecting systems, and adjacent tissues? | Ultrasonography |
| What is common after a Cystoscopy? | Blood-tinged urine is common due to the soft tissue trauma of the procedure |
| How long will the urine be blood dinged after a Cystoscopy? | Urine may not clear until the third void |
| What percentage of cardio output do the kidneys recieve each minute? | Up to 25% |
| What is used in a CT scan when tumors are suspected? | Contrast dye |
| What is a CT scan | *Computed Tomographic Scanning *Multiple cross-section pictures obtained at several different sites create a three dimensional "map" of the kidney structures. |
| How is the patient placed after a renal angiogram? | Bed rest with head of best flat for several hours after procedure |
| Which drug may be administered prior to a cystoscopy? | An anti-spasmodic may be administered prior to the procedure |
Created by:
Shanejqb
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