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185 Cards in this Set
- Front
- Back
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List the organs included in the urinary system
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Kidneys
Ureters Bladder Urethra |
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Nephron
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The functional unit of the kidney, forms the urine. Nephron is composed of the glomerulus, Bowman's capsule, proximal convoluted tubule, loop of Henle, distal tubule, and collecting duct.
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Proteinuria
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Presence of large proteins in urine -- sign of glomerular injury
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Erythropoietin
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Functions within bone marrow to stimulate red blood cell production and maturation and prolongs life of mature RBCs
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Renal calculus
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Kidney stone
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Characteristics of uremic syndrome
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Increase in nitrogenous wastes in blood, marked fluid and electrolyte abnormalities, nausea, vomiting, headache, coma, convulsions - Aggressive treatrements called renal replacement therapies are needed for survival.
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2 methods of renal replacement therapies
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Dialysis and organ transplantation
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Reflex Incontinence
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Urination occurring without sensation of the need to void
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Stoma
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Artificial opening
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Urinary retention
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An accumulation of urine resulting from an inability of the bladder to empty properly.
Causes: urethral obstruction, surgical or childbirth trauma, alterations in motor and sensory innervation of bladder, medication side effects, anxiety |
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Bacteruria
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Bacteria in the urine (leads of spread of MOs to kidneys and possibly leads to bacteremia or urosepsis.
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Bacteremia
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Bacteria in the bloodstream
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Dysuria
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Painful urination
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Urinary incontinence
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Involuntary leakage of urine that is sufficient to be a problem. Either temporary or permanent. Leakage is either continuous or intermittent.
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Urgency
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Feeling of need to void immediately. Causes: Full bladder, bladder irritation or inflammation from infection, overactive bladder, psychological stress
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Dysuria
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Painful or difficult urination
Cause: Bladder inflammation, trauma or inflammation of urethral sphincter |
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Frequency
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Voiding at frequent intervals (<2 hr)
Cause: Increased fluid intake, bladder inflammation, increased pressure on bladder (pregnancy)j, diuretic therapy |
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Hesitancy
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Difficulty initiating urination
Cause: Prostate enlargement, anxiety, urethral edema |
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Polyuria
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Voiding large amounts of urine
Cause: Excess fluid intake, diabetes mellitus, insipidus, use of diuretics, postobstructive diuresis |
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Oliguria
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Diminished urinary output relative to intake (usu. 400 mL/24 hr)
Cause: Dehydration, renal failure, UTI, increased ADH secretion, congestive heart failure |
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Nocturia
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Voiding one or more times at night
Cause: Excessive fluid intake prior to bed, renal disease, aging process, prostate enlargement |
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Dribbling
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Leakage of urine despite voluntary control of urination
Cause: Stress incontinence, overflow from urinary retention (i.e. BPH) |
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Incontinence
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Involuntary loss of urine
Cause: unstable urethra, loss of pelvic muscle tone, fecal impaction, neuro impairment, overactive bladder |
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Hematuria
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Blood in the urine
Cause: Neoplasms of kidney or bladder, glomerular disease, infection of kidney or bladder, trauma to urinary structures, calculi, bleeding disorders |
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Retention
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Accumulation of urine in the bladder w/ inability to empty fully
Cause: Urethral obstruction (stricture), decreased sensory activity, neurogenic bladder, prostate enlargement, postanesthesia effects, SE of meds (anticholinergics, opioid narcotics) |
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Residual urine
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Volume of urine remaining after voiding (>100 mL)
Cause: Inflammation or irritation of bladder mucosa from infection, neurogenic bladder, prostate enlargement, trauma, or inflammation of urethra |
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Assess urine characteristics--what would you look at?
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Color - normal from pale, straw color to amber depending on concentration
Clarity - normal appears transparent. Cloudy-has it set awhile in container? Possible renal disease. Foamy - high protein concentration. Thick and cloudy-bacteria and WBCs Odor-Stagnant has ammonia odor. Sweet or fruity - acetone or acetoacetic acid (by-products of incomplete fat metabolism) seen in diabetes mellitus or starvation |
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Methods of urine collection
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Random - collect during normal voiding, indwelling cath, or urinary diversion bag
Clean-void Midstream Sterile |
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Common urine tests
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Urinalysis -pH, protein, glucose, ketones, blood, specific gravity (weight or degree of concentration of a substance compared w/ an equal volume of water)
Urine culture-requires sterile or clean-void |
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How much urine does the bladder hold?
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Adult = 600 mL up to ? 1200 mL is NOT comfortable
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What gives urine its color
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Urochrome from bile breakdown
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pH level range of urine
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4.6 - 8.0
6.5 - a little acidic - deters growth of organism. |
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Protein (in urine)
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Normal - none or up to 8 mg/100 mL
Common in renal disease from damage to glomeruli or tubules allows protein to enter urine |
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Ketones (in urine)
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Normal - None - Poorly controlled DM due to breakdown of fatty acids
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Specific Gravity (in urine)
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Normal (1.0053-1.030) Measures concentration of particles in urine. High reflects concentrated urine, low reflects diluted urine. Dehydration, reduced renal blood flow and increased ADH elevate specific gravity. Overhydration, early renal disease and inadequate ADH secretion reduce specific gravity.
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Microsocpic Urine exam
RBCs |
(up to 2) Damage to glomeruli or tubules allows RBCs to enter urine. Trauma, disease, or surgery to lower urinary tract cause blood to be present
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Microscopic urine exam
WBCs |
(0-4 per low-power field)
Greater numbers indicate urinary tract infection (UTI) |
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Microscopic urine exam
Bacteria |
Normal - None
Bacteria indicate urinary tract infection (UTI) |
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Microscopic urine exam
Casts |
Normal - None
Indicate renal alterations |
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Microscopic urine exam
Crystals |
Normal - None
Result of food metabolilsm. Excess crystals such as uric acid or calcium phosphate result in renal stone formation |
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Bilirubin
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End product of breakdown of hemoglobin from liver.
Liver dysfunction |
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Urobilinogen
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Breakdown from bilirubin
Liver dysfunction |
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What are some factors affecting urinary elimination?
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Lifestyle factors, sociocultural, developmental factors, psychological, physiological factors, surgical procedures, medications
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Prerenal
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Before the kidney - circulating blood. To and through the kidneys. Decreased blood flow decreases urinary output
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Renal
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Injury to renal tubules or glomerulus - filtration problem. End stage renal disease
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Postrenal
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Ureters, bladder, urethra, kidney stones, ruptures, protate.
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What conditions impair muscle tone related to urinary elimination?
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Multiple childbirths
Weak abdominal & pelvic floor muscles Menopausal atrophy Trauma/surgery Indwelling catheters |
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How is urine output affected by surgery?
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Anesthetics and narcotics decrease sensation , slows glomeruar filtration rate
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What classification of medications make you retain water?
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Anticholinergics, antihistamines, antihypertensives
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What medications help you get rid of fluids?
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Diuretics
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Retention
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Accumulation of urine in bladder r/t inability to empty bladder. Bladder unable to respond to micturition reflex (about 25-60mL). Could lead to overflow.
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What is the most acquired nosocomial infection r/t catheterization or surgical manipulation
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Urinary tract infection (UTI)
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What factors contribute to UTI?
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decreased immunity - very young and very old
Poor hygiene Residual urine Stricture |
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Pyelonephritis
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Upper UTI - flank pain, fever, chills, nausea, vomiting
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Functional Urinary Incontinence
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Loss of urine caused by factors outside the urinary tract that interfere with ability to respond in a socially appropriate way to the urge to void. (Environmental barriers, sensory, cognitive, mobility issues) - low-set chairs, high-set beds --they can't get in and out of. Clothing restrictions-get elastic wasted pants, low energy levels
S/S: Urge to void causes loss of urine before reaching appropriate receptacle. Interventions: Clothing modifications, Environmental modifications, scheduled toileting, absorbent products |
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Stress Urinary Incontinence
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Involuntary leakage of urine during increased abdominal pressue in absence of bladder muscle contraction
S/S: Loss of urine w/ increased intraabdominal pressure (cough, sneeze, laugh, lifting with full bladder) Intervention: Pelvic floor exercises (Kegel), Surgical interventions, biofeedback, electrical stimulation, absorbent products |
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Urge Urinary Incontinence
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Involuntary passage of urine after strong sense of urgency to void.
S/S: Urinary urgency, often with frequency (>2hrs), bladder spasm or contraction. Interventions: Antimuscarinic agents, behavioral interventions, biofeedback, bladder retraining, pelvic floor exercises, lifestyle modifications, absorbent products |
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Mixed Urinary Incontinence
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Combination of urge and stress incontinence signs and symptoms.
S/S: Combination of urge and stress incontinence Interventions: Treatment usu. based on symptoms that are bothersome to client. |
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Relfex Urinary Incontinence
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Involuntary loss of urine at intervals w/o sensation of urge to void (spinal cord dysfunction--loss of cerebral awareness or impairment of reflex arc)
S/S: lack of urge to void, unawareness of bladder filling, reflex emptying when certain volume reached Interventions: Intermittent cath, Condom cath - male |
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Indications for using Intermittent Catheterization
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Relief of discomfort of bladder distention, provision of decompression; obtaining sterile specimen, assessment of residual urine after urination; long-term management of client with spinal cord injury, neuromuscular degeneration, incompetent bladders
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Indications for using Short-Term Indwelling Catheterization
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Obstruction to urine outflow (prostate enlargement); surgical repair of bladder, urethra, and surrounding structures; prevention of urethral obstruction from blood clots after genitourinary surgery; measurement of urinary output in critically ill; continuous intermittent bladder irrigations
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Indications for using Long-Term Indwelling Catheterization
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Severe urinary retention w/ recurrent UTIs; skin rashes, ulcers or wounds irritated by contact with urine; terminal illness when bed linen changes are painful for client.
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What infection control and hygiene practices for elimination can be applied?
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Wear gloves, med-surg asepsis, wash hands, proper pericare
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Urinary Diagnostic Tests
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Urinalysis - physical, chemical, microscopic - spun to look at sediment
Urine culture & sensitivity -catheter UA Postvoid residual |
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IVP (intravenous pyelogram)
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View the collecting ducts and renal pelvis and outline the ureters, bladder and urethra
Assess client for shellfish allergy before test |
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Renal Ultrasound
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Idenify gross renal structures and structural abnormalities in kidney using high-frequency, inaudible sound waves.
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Bladder Ultrasound
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Identify structureal abnormalities of bladder or lower urinary tract. Also used to estimate volume of urine in bladder.
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Urodynamic testing (uroflowmetry)
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Determine bladder muscle funtion and evaluate causes of urinary incontinence.
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Abdominal roentgenogram (plain film, kidney, ureter, bladder (KUB), or flat plate)
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Determine the size, shape, symmetry and location of the kidneys
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CT scan
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Obtain detailed images of structures within selected plain of the body. Reconstructs cross-sectional image..To view tumors obstructions
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Urinary antiseptics/antiinfectives
nitrofurantoin (Furalan, Macrodantin) |
nitrofurantoin (Furalan, Macrodantin)
Indications: Acute or chronic UTI SE: turn urine brown, GI upset Teaching: Take w/ food, not w/ antacids Prevent growth in kidney and bladder |
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Urinary antiseptics/antiinfectives
methenamine (Hiprex, Mandelamine) |
Indications: Chronic UTIs
SE-Crystals in urine, GI upset, pH to 5.5 Teaching: Drink cranberry juice, take w/ meals, push fluids |
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Pruritis
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Itching
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Urinary antiseptics/antiinfectives
trimethoprim (Prolomprim, Trimpex) trimethoprim-sulfamethoxoazole (Bactrim, Septra) |
Indications: Prevent acute & chronic UTI
SE: GI upset, rash, pruritis (itching) Teaching: Report signs of skin problems, DO NOT TAKE IF ALLERGIC TO SULFA |
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Urinary antiseptics/antiinfectives
fluoroquinolones (quinolones) Noraxin, Cipro, floxin |
Urinary antiseptics/antiinfectives
fluoroquinolones (quinolones) Noraxin, Cipro, floxin Indications: Lower UTIs SE: Headache, rash, nausea, vomiting, diarrhea, photosensitivity Teaching: Take w/ food but NOT with antacids, urine will turn brown, no excessive sun |
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Urinary antispasmodics
Oxybutynin (Ditropan) |
Urinary antispasmodics
Oxybutynin (Ditropan) Indications: Spasms SE: Anticholinergic (slows things down), dry mouth, dizziness, constipation, blurred vision Teaching: fluids, dizzy upon arising, good oral hygiene, may take 5-7 days to work. Do NOT take if glaucoma or GI obstruction |
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Urinary cholinergics (stimulants)
bethanechol (Urecholine) |
Indications: postop urinary retention, nonobstructive retention by neurogenic bladder
SE: headache, bronchospasm, GI upset, flushing, sweating, hypothermia, decreased BP Teaching: Push fluids, change position slowly, report salivation, sweating, flushing |
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Urinary anticholinergics (slows things down)
propantheline bromide (Pro-Banthine) |
Indications: Incontinence, overactive bladder
SE-Dry mouth, dizziness, constipation Teaching: push fluids, can cause urinary retention, may take 3-5 days to work |
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Urinary analgesic
phenazopyridine hydrochloride (Pyridium) |
Indications: Relieves pain, burning, frequency of UTI
SE: GI disturbance, turns urine fire engine red Teaching: Turns urine fire engine red, flushing, drinking, good hygiene |
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Bowel System
What are the components of the small intestine? |
Duodenum, jejunum, ileum
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Bowel System
What are the components of the large intestine or colon? |
Ascending, transverse, descending, sigmoid
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Fecal Characteristics
Narrow or ribbon like |
Spastic colon or obstruction
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Fecal Characteristics
Diarrhea |
Inflamed bowel, parasitets, lactose intolerant, viral or bacterial infection
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Fecal Characteristics
Blood or pus |
Inflamed bowel from bacterial infection
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Fecal Characteristics
Blood or mucus |
Inflammatory bowel, Crohn's and colitis
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Fecal Characteristics
Yellow or Green |
Severe prolonged diarrhea
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Fecal Characteristics
Tarry black stool |
Upper GI bleeding or intake of iron supplements
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Fecal Characteristics
Tan clay color |
Liver or gallbladder
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Fecal Characteristics
Red stool |
Lower GI bleeding, medication or food coloring
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Fecal Characteristics
Fatty, pasty, greasy |
Intestinal malabsorptioin, pancreatic disease, cystic fibrosis
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Steatorrhea
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fatty stool
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Diarrhea
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Many loose watery stools
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Endosocpy-Cystoscopy
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Direct visualization, specimen collection and/or treatment of the interior of bladder and urethra. Surgery on prostate performed with special endoscope
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Arteriogram (angiography)
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Visualizes the renal arteries and/or their branches to detect narrowing or occlusion.
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Common causes of constipation
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*Irregular bowel habits, ignoring urge to defecate
*Chronic illness (Parkinson's, MS, rheumatoid arthritis, chronic bowel dieses, depression, diabetic neuropathy, eating disorders) *Low-fiber diet high in animal fats (dairy, eggs)..Low fluid slows peristalsis *Anxiety, depression, cognitive impairment *Lengthy bed rest, lack of exercise *Laxative misuse *Older adults-slowed peristalsis *Neuro conditions *Hypothyroidism, hypocalcemia, hypokalemia *Medications-anticholinergics, antispasmodics, anticonvulsants, antidepressants, antihistamines, antihypertensives, antiparkinsonism, diuretics, antacids, iron and calcium supplements, opioids |
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Medications on GI system
Dicyclomine HCl (Bentyl) |
Supresses peristalsis and decreases gastric emptying
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Medications on GI system
Anticholinergic |
Inhibit gastric acid secretion and depress GI motility
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Medications on GI system
Antibiotics |
Produce diarrhea by disrupting normal bacterial flora in GI tract.
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Medications on GI system
NSAIDs |
Cause GI irritation that increases incidence of bleeding w/ serious consequences to older adults
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Medications on GI system
aspirin |
A prostoglandin inhibitor, it interferes with the formation and production of protective mucus and causes GI b leeding
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Medications on GI system
histamine antagonists |
Suppress the secretion of hydrochloric acid and interferes with digestion of some foods
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Medications on GI system
iron |
Causes discoloration of stool (black), nausea, vomiting, constipation,abdominal cramps
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Bristol Stool Form Scale
Type 1 |
Bristol Stool Form Scale
Type 1 Separate hard lumps like nuts (difficult to pass) |
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Bristol Stool Form Scale
Type 2 |
Sausage shaped but lumpy
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Bristol Stool Form Scale
Type 3 |
Bristol Stool Form Scale
Type 3 Like a sausage but with cracks on surface |
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Bristol Stool Form Scale
Type 4 |
Like a sausage or snake, smooth and soft
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Bristol Stool Form Scale
Type 5 |
Soft blobs with clear-cut edges (passed easily)
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Bristol Stool Form Scale
Type 6 |
Fluffy pieces with ragged edges, a mushy stool
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Bristol Stool Form Scale
Type 7 |
Watery, no solid pieces (entirely liquid)
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Clostridium difficile (C. difficile)
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Symptoms: mild diarrhea to severe colitis.
Causes: Factors that cause an overgrowth (antibiotics), chemotherapy, invasive bowel procedures, poor hand hygiene and irratic disinfection practices |
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Fecal incontinence
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Inability to control passage of feces and gas from the anus
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Flatulence
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gas accumulates in the lumen of the intestines, the bowel wall stretches and distends. Common cause of fullness, pain, cramping.
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Hemorrhoids
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Dilated, engorged veins in the lining of the rectum
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Factors affecting bowel elimination?
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Mobility
Hemorrhoid surgery Childbirth Narcotics Surgery Stress Personal habits Comfort level |
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Lab tests for bowel function
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Total bilirubin
Alkaline phosphatase Amylase CEA |
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Diagnostic tests for direct visualization of bowel function
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Endoscopy, colonoscoy
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Diagnostic tests for indirect visualization of bowel function
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X-ray film w/ contrast medium
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Risk factors for colon cancer
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Age - >50
Family hx of colorectal cancer Personal hx of colorectal cancer, colorectal polyps, chronic inflammatory bowel disease, ulcerative colitis, Crohn's disease Ethnic-Jews of Eastern Europe descent Race: African Americans Diet: High animal fat, low fruit and vegetables Obesity and inactivity Smoking and alcohol intake Diabetes |
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Warnings signs for colon cancer
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Change in bowel habits
Rectal bleeding Sensation of incomplete bowel evacuation |
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Fecal characteristics
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Color, odor, consistency, frequency, amount, shape, constituents
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Antidiarrheals
Opiates and opiate-related agents Lomotil |
slows things down
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Adsorbents
Pepto-Bismol, Kaopectate |
(bind and remove irritant from GI tract)
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Laxatives
Osmotic (Saline) Examples: glycerin, lactulose, magnesium, citrate, MOM |
For acute emptying of bowel (e.g. endoscopic exam, suspected poisoning, acute constipation)
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Laxatives
Bulk Forming - Psyllium (Metamucil, Naturacil) |
Agents stretch intestinal wall to stimulate peristalsis. For chronic constipation
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Laxatives
Emollient or Wetting Docusate sodium (Colace) |
Stool softeners. For short-term therapy to relieve straingin on defecation (hemorrhoids, perianal surgery, pregnancy, recovery from MI)
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Laxatives and Cathartics
Stimulant Cathartics Bisacodyl (Dulcolax), caster oil, senna, phenolphthalein, cascara sagrada |
SE: Cramping
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Laxatives and Cathartics
Lubricants Mineral oil |
Coat fecal contents, allow easier passage of stool.
Prevents straining on defecation (hemorrhoids, perianal surgery) Decreases absorption of vitamins A, D, E, K |
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4 types of enemas
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Hypotonic - water pulled INTO the cell - swell - Tapwater
Isotonic - Equal - not pulling or pushing - Saline tap water (2 tsp salt) Hypertonic - water pull OUT of cell - Fleet Soap - Irritation, cramping - castile soap |
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List types of enemas and classify them
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Soapsuds-irritation
Oil retention-lubricate Carminative-Relief from gaseous distention Kayexalate-Exchange sodium for potassium Neomycin-Antibiotic |
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Barium Enema
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X-ray exam using opaque contrast medium to examin the lower GI tract
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Ultrasound
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Technique that uses high-frequency sound waves to echo off body organs, creating a picture
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Upper GI/Barium Swallow
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An x-ray exam using an opaque contrast medium (barium) to examine the structure and motility of upper GI tract including pharynx, esophagus and stomach
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Colonoscopy
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An endoscopic exam of entire colon with use of colonoscope inserted in rectum.
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Flexible sigmoidoscopy
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Exam of interior of sigmoid colon through use of flexible or rigid lighted tube.
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CT Scan
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An x-ray exam of body from many angles utilizing a scanner analyzed by a computer.
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MRI (magnetic resonance imaging)
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Noninvasive exam that uses magnet and radio waves to produce a picture of the inside of the body
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Enteroclysis
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Introduction of contrast material to jejunum, allowing entire small intesting to be studied
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Cystitis
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Inflammation of the urinary bladder characterized by pain, urgency, and frequency of urination.
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diuresis
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Increased formation and excretion of urine.
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erythropoietin
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Glycoprotein hormone synthesized mainly in the kidneys and released into the bloodstream in response to anoxia
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laxative
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Drug that acts to promote bowel evacuation
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meatus
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Opening through any part of the body (e.g., the urethral meatus).
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nephron
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Structural and functional unit of the kidney that contains a renal glomerulus and tubule.
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nephrostomy
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Surgical procedure in which an incision is made on the flank of the client so that a catheter can be inserted into the kidney pelvis for the purpose of drainage
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pyelonephritis
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Infection that spreads in the kidneys and causes flank pain, tenderness, low-grade fever, and chills.
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renal replacement therapies
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Treatments designed to carry out kidney function. Currently two methods of renal replacement exist: dialysis (peritoneal and hemodialysis) and organ transplantation.
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residual urine
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Volume of urine remaining in the bladder after a normal voiding; the bladder normally is almost completely empty after micturition.
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uremic syndrome
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Symptoms characterized by the presence of urinary constituents in the blood and altered regulatory functions causing marked fluid and electrolyte abnormalities, nausea, vomiting, headache, coma, or convulsions.
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urinary diversion
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Surgically created diversion of the ureter to the abdominal wall for the drainage of urine after removal of a diseased bladder.
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urosepsis
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Condition caused by bacteria in the urine that may lead to the spread of organisms into the bloodstream or kidneys.
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renin
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Proteolytic enzyme produced by and stored in the juxtaglomerular apparatus that surrounds each arteriole as it enters a glomerulus. The enzyme affects the blood pressure by catalyzing the change of angiotensinogen to angiotensin, a strong repressor.
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cations
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Positively charged electrolytes.
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stoma
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Artificially created opening between a body cavity and the body's surface (e.g., a colostomy) formed from a portion of the colon pulled through the abdominal wall.
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colostomy
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Surgical formation of an opening of the colon onto the surface of the abdomen through which fecal matter is emptied.
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Crohn's disease
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Disease involving inflammation of the small intestine.
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defecation
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Passage of feces from the digestive tract through the rectum.
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effluent
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A liquid, solid, or gaseous discharge from the ostomy. Usually composed of fecal material.
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endoscopy
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Visualization of the interior of body organs and cavities with an endoscope.
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enema
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Procedure involving introduction of a solution into the rectum for cleansing or therapeutic purposes.
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enterostomal therapist
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Nurse that is specially trained in the treatment of clients with ostomies.
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ileostomy
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Surgical formation of an opening of the ileum onto the surface of the abdomen through which fecal matter is emptied.
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impaction
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Presence of large or hard fecal mass in the rectum or colon.
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lactose intolerance
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Gastric disorder in which some foods, such as milk and milk products, are difficult or impossible to digest.
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masticate
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To chew or tear food with the teeth while it becomes mixed with saliva.
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Valsalva maneuver
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maneuver Any forced expiratory effort against a closed airway, as when an individual holds the breath and tightens the muscles in a concerted, strenuous effort to move a heavy object or to change positions in bed.
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bolus
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Round mass of chewed food ready to be swallowed.
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bowel training
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Program of exercises through which the client gains control of bowel reflexes by setting up a daily routine, attempting to defecate at the same time each day, and using measures that promote defecation
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cathartics
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Used to soften the stool and promote peristalsis.
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Clostridium difficile
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Infection that causes diarrhea and is acquired one of two ways, either by receiving antibiotics or procedures that normal bowel flora and cause on overgrowth of C. difficile or by contamination from health care worker's hands or direct contact with the environmental surfaces contaminated with C. difficile.
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flatulence
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Accumulation of gas in the bowel, causing the bowel wall to stretch and distend.
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laxatives
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Used to soften the stool and promote peristalsis; milder than a cathartic
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segmentation
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The small and large intestine are built of individually innervated and muscled sections called segments that work in concert to provide peristaltic movement.
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excoriation
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Injury to the skin's surface caused by abrasion.
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hemorrhoid
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Permanent dilation and engorgement of a vein within the lining of the rectum.
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polyps
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Small tumorlike growths that projects from a mucous membrane surface
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fiber
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Nutrient that contains cellulose, pectin, hemicellulose, and lignin; sources are mainly fruits and vegetables.
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chyme
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Viscous, semifluid contents of the stomach present during digestion of a meal that eventually pass into the intestines.
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peristalsis
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Coordinated, rhythmic, serial contractions of smooth muscle that force food through the digestive tract.
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paralytic ileus
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Usually temporary paralysis of intestinal wall that may occur after abdominal surgery or peritoneal injury and that causes cessation of peristalsis; leads to abdominal distention and symptoms of obstruction.
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An obstruction within a ureter, such as kidney stone, results in strong peristaltic waves that attempt to move the obstruction into the bladder. The strong peristaltic waves result in pain often referred to as _____________?
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Renal Colic
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trigone
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Smooth triangular area on the inner surface of the bladder..at the base of the bladder. An opening exists at each of the trigone's three angles. Two for the ureters and one for the urethra.
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In men, the urethra has three sections:
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The prostatic urethra
The membranous urethra the penile urethra |
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Brain structures that influence bladder function
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cerebral cortex, thalamus, hypothalamus and brain stem (inhibit urge to void or allow voiding)
Normal voiding - contraction of bladder and coordinated relaxation of the urethral sphincter and pelvic floor muscles |
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How does our body know when time to urinate?
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As volume increases, the bladder walls stretch, sending sensory impulses to the micturition center in the sacral spinal cord. Impulses from the micturition center respond to or ignore this urge, thus making urination under voluntary control.
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Renin
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functions as an enzyme to convert angiotensinogen to angiotensin. Angiotensin causes vasoconstriction and stimulates aldosterone release from the adrenal cortex. Aldosterone causes retention of water. Increasing arterial blood pressure and renal blood flow.
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