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68wm6 p2 intro urin

Introduction to the Urinary System

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