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32 Cards in this Set
- Front
- Back
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What are the parts of the urinary system? |
Adrenal gland, right and left kidney, renal vein, renal artery, vena cava, uriter, urethra, urinary bladder, urethral spincter and urethra, and dorsal aorta. |
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What are the five main structures of the kidney and what does each part do? |
1) Renal capsule - a tough fibrous connective tissue which provides protection 2) Cortex - the lighter coloured area sourrounding the medulla with projections running between the pyramids 3)Mudella - darder coloured inner part of the kedney where the renal pyramids are found which house the nephrons. 4) Calyces - collecting ducts which carry the urine from the medull to the renal pelvis 5) Renal pelvis - funnel shaped part of the right kidney which moves urine from the kidney into the ureter for exretion. |
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What are the four parts of the nephrons and what does each part do? |
1) glomerulus - tight capillary network which recieves blood from the afferent arteriole mintaining a high pressure to llow for filtration 2) bowmans capsule - sorounds the glomerulus with podocytes (specialised cells) which allows for diffusion of the glomerular filtrate 3) relap corpuscle - filtering component containing the Bowmans capsule and glomerulus 4) Renal tubules - a network of tubules - proxmial convoluted tubule, loop of henle and distal convoluted tubule. |
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What is the function of the kidneys? |
To remove waste products form the blood. It works in conjunction with other systems to maintain homeostasis. It regulates.. 1) acid-base balence 2) Electrolytes 3) blood pressure - Regulate the volume and composition of body fluids - the main function of teh kidney is not to produce uring - this is a product of the filtration. |
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What are the mechansims of urine formation? |
1 - 1.2L of blood flows through the glomeruli each minite. The kidneys process about 180L of blood every day. About 1.5L leaves the body as urine and the rest is returned to the circulation. |
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What is urine and what are the three stages in the process of its formation? |
Its metabolic wastes and unneeded substances. The three stage process 1) Glomerular filtration 2) Tubular reabsorption 3) Secretion |
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What is glomerulr filtration and what is the equation to work out the GFR? |
Its hydrostatic pressure causing fliods and solutes to be forces through a membrane. - The glomerular filtration rate = Is the toatl amount of filtrate formedd per minute by the kidneys. Its goverened by 1) Total surface are available for filtraiton 2) Filtration membrane permeability 3) Net filtration pressure. . GFR = (urine concentration x urine flow) / plasma consentration |
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What is micturition? |
Micturition is the normal discharge of urine. The average person has a 200mL threshold when stretch receptors respond. |
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What is incontience? . What is urinary retention? |
Its the inability to control micturition voluntarily. . Is the inability of the bladder to expel the contents of the bladder. Commonly in men with hypertrophy of the prostate gland. |
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How is urine formed? |
The posterior pituitary gland releases Anti Diuretic Hormone (ADH). Its a parasympathetic response. ADH inhibits urine output. - ADH release inhibits diuresis/urine output. - causes water to pass easily from the cells into the interstitul space. - in the presence of high levels of ADH nearly all of the water in filtrate is reabsorded into the blood stream and highly concentrated minimal amount of urine is excreted. - Concentrated urine is inextricably correlated to a person abillty to survive with minimal hydration. |
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What are some genitourinary condition? |
- acute renal failure/acute kidney injury - haemodialysis/renal transplnt patient - haematuria/uraemia/protienuria - urinary tract infection/ bacterial infections - renal calculi/colic - urinary retention - testicular torsion |
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What are the characteristics of urine? |
- Colour - from clear to straw like fliod to keep yellow in colour. The yellow colour is caused by the body breaking down haemoglobin/bilirubin/bile pigments. Certian fools, medications and vitamin supplements can aso affect the colour of urine. Cloudy urine may indicate infection. - Odour - ammonia - drugs/vegetables/diseases - pH - normally acidic, protein produces acidic, vegetarial/vomiting/bacterial infection produces alkali urine. |
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What are the three different types of acute renal failure and what are the the potential causes? |
1) Pre-renal - (most seen in QAS) - hypovolaemia, haemorrhagic shock, burns, severe D and V/interstitinal obstruction/uncontrolled diabetes. 2) Intrarenal/ intrinsic - acute tubular necrosis, coagulation defects 3) Post-renal - enlarged prostate, ureteral obstruction (tumors/stones/clots) |
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What are some presentations of prerenal ARF? |
- Dizziness - Dry mouth/thurst - hypotension - tachycardia - weight loss |
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What are some presontations for intrarenal ARF? |
- fever - fland pain - joint pain - headache - hypertension - oliguria - rhabdomyolysis |
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What are some presontations for post renal ARF? |
- urine retention - distended bladder - gross haematuria - non - traumatic lower back pain - pain - abdomen, goinn, genitals - preipheral oedma. |
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What are the two types of renal dialysis? |
1) Haemodialysis (3 times a wk for 6 hours) 2) peritoneal dialysis (greater movement and increased infetion) |
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What do you have to be cautious with when taking a blood pressure on a patient undergoing haemodyalisis? |
Most hemodialysis patients will have a fistula. |
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What are some associated problems associated with the dialysis patient? |
- vascular access problems - haemorrhge - hypotension - chest pain - severe hyperkalaemia - disequilibrium syndrome - air embolism |
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What are some causes of haematuria? |
- infections - neoplasia - prostatic hyperplasia - nephrolithiasis - glomerulonephritis - schistosomiasis - ezpanding abdominal aortic aneurysms - renal vein thrombosis (RVT) - pregnancy (preeclampsia), dehydration, nephortic syndme. - Trauma to - kidneys, ureters, urinary bladder, urethra. |
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What are urinary tract infections and what are some causes? |
Upper tract infection ssociated with kidney infection - PYELONEPHRITIS . Lower tract infection associated with urethritis (urethra) and cyctitis (bladder). Causes: - catherterisation - reflux - obstruction - sexual activity/contraceltives/ STIs/STDs - pregnancy - aging |
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What is renal calculi/colic? |
Stone formation (nephrolithiasis) within the kidneys is a common disorder which is encountered regularly by pramedics in the feild. The common complaint is a sudden onset of intermittent and often unbearable pain. Stones (calculi) are most commonly fromed wintin the collecting system of the kidney - renal calyces and renal pelvis. Calculi will then pass int othe ureter before being passed through the rest of the body. |
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What are some presontations expected to be seen from a patient with a UTI? |
Dysuria Urinary frequency Haematuria Abdominal pain History of current infection Chills Fever - more likely in a upper tract infection Loin pin Confusion |
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What are renal Calculi/colic? |
Its calcium deposits in the collecting ducts, its extreemly painfull. Calculi formation: super saturation of stone forming crystals within the collecting ducts, commonly calcium, phosphate, oxilate, cystine and urate. Decreased urine volume. Lack of inhibitory chemicals - magnesium, citrate and pyrophosphate. . Infection can also assist in the formation of renal calculi. . DONT GIVE THESE PATIENT MORPHINE. SOME PTS WILL HVE CONSTRICTION OF RENL DUCTS WHEN GIVVEN MORPHINE, MAKING THE PAIN WORSE. |
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What are some causes of renal calculi/colic? |
Gout (too much uricacid, maybe uria) Hormonal disorders Heritable Diet chronic UTIs Repeated catherterisation some midication Summer Lifestyle factors - sedentry lifestyles - university lectures. - people who live and work in - mountainous, dessert and tropical regions. |
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How can you prevent renal calculi/colic? |
Prevenion is better than cure. - consume adequate amounts of water. - minimise (chocolate/celery/grapes/strawberries/beans/aspasparagus) - supplement diet with vitamin B6 and magnesium. - avoid anchovies ans sardines - raise uric acid levels - consume low-protien diet - limit salt intake |
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What is the presontation of renal calculi/colic? |
- severe pain origination in the flank with radiation to the groin or abdomen - pain may be intermittent or constant - associated nausea, vomiting, anziety and diaphoresis - haematuria - urinary urgency, frequent voiding and urge incontience may be present. - inability to find a position of comfort - writhing of renal colic - a useful point in the construction of a differentil diagnosis. |
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What is the management of renal calculi/colic? |
General management pain relief pain relief more pain relief anti-emitics fluid therapy and .. ... pain refief
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What are some risk factors associated with renal calculi/colic? |
- prolonged immobilisation and sedentary lifestype - hyperparathyriodism - peptic ulcer disease' - small bowel disease - gout - medictions - prolonged or recurrent dehydration - UITs |
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What are some differential diagnosis of renal calculi/colic? |
- appendicitis - AAA - Hernia - testicular torsion - musculoskeletal injury - renal infaction - biliary colic - ectopic pregnancy - ovarian cyst - diverticulotis - UIT - Renal failure |
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What are some causes of Urinary retention? . What is are the common presontations of urinary retention? |
Causes - urtehral stricture. enlarged prostate, CNS dysfunction, foring body obstruction and certial drugs . Presontation - dysuria, severe abdo pain, urgent need but inability to urinte, distended bladder, history of not voiding bladder in one continous stream, gross haematuria dependent on chronic distension of bladdder following cathertrisation of urethra. |
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What is testicular torsion? |
Sudden onset pain. Precipitated by vigerour activity or athletic event. Testuculr torstion must be treated within 4-6 hours to prevent loss of the testis from ischemic infarction. rapid transport and early recognition is vital. Its where the testi does a flip in the scrotum and doesnt go back without surgery. |
