Term
|
Definition
| The breakdownof mm fibers that lead to the release of mm fiber (myoglobin) into the bloodstream |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the breakdown of mm fibers that leads to the release of mm fiber (myoglobin) into the bloodstream? |
|
Definition
|
|
Term
| What are increased levels of nitrogens waste products, especially urea nitrogen, in the blood indicative of impaired renal clearance? |
|
Definition
|
|
Term
| What is it called when blood is present in the urine? |
|
Definition
|
|
Term
| What is it called when protein is present in the urine? |
|
Definition
|
|
Term
| What is severe decrease or lack of urine output of less than 100ml/day? |
|
Definition
|
|
Term
| What is urine output less than 400ml/day? |
|
Definition
|
|
Term
| What are tiny tube-shaped particles made up of WBC, RBC, or kidney cells? They are held together by a protein released by the kidney. |
|
Definition
|
|
Term
| What is point or place at which something originates, accumulates, or develops, as the center around which calculi (stone) form? |
|
Definition
|
|
Term
| What is the prescence of a stone or calculus anywhere in the urinary tract? |
|
Definition
|
|
Term
| What is concretion of crystals of material (uric acid, calcium phosphate) that initially from in the calices or pelvis of the kidneys? |
|
Definition
|
|
Term
| What is distention of a ureter with urine , usually resulting from an obstruction process? |
|
Definition
|
|
Term
| What is it called when swelling of one kidney due to a backup of urine? |
|
Definition
|
|
Term
| What is it called when a healthcare provider taps on the area (with heal of closed fist over costovertebral angle) over the kidneys and it produces pain? |
|
Definition
|
|
Term
| What is it called when a patient abnormally needs to urinate in the middle of the night? |
|
Definition
|
|
Term
| What is a strong and immediate urge to void brought about by involuntary detrusor overactivity? |
|
Definition
|
|
Term
| What is the term used to describe how often a patient is urinating? |
|
Definition
|
|
Term
| What is known as pus in the urine? |
|
Definition
|
|
Term
| What is also known as painful urination? |
|
Definition
|
|
Term
| What is the condition where urinary calculi are formed or located anywhere in the urinary system? |
|
Definition
|
|
Term
| What is bladder dysfunction caused by a lesion at any level in the nervous system? |
|
Definition
|
|
Term
| What is the ability to retain a bodily discharge voluntarily? |
|
Definition
|
|
Term
| What is also known as urination? |
|
Definition
|
|
Term
| What is an infection of the kidney medulla or cortex? |
|
Definition
|
|
Term
| What is inflammation of the urothelium (lining of the bladder) resulting from infection, irritation, presence of a foreign body, or trauma? |
|
Definition
|
|
Term
| What are the clinical manifestations of Benign Prostatic Hyperplasia/Hypertrophy (BPH)? |
|
Definition
-weak urinary stream
-abdominal "pushing" to move urine
-urinary hesitancy
-incomplete bladder emptying
-urgency, frequency |
|
|
Term
| What is Benign Prostatic Hyperplasia/Hypertrophy (BPH)? |
|
Definition
| enlargement of the prostate (result of age, exogenous drugs testosterone) that puts pressure on the urethra |
|
|
Term
| What are the 2 major causes of chronic renal failure (CRF)? |
|
Definition
|
|
Term
| What determines end-stage renal disease (ESRD)? |
|
Definition
| when GFR is decreased by 90% with GFR <10ml/min |
|
|
Term
| What are the levels of GFR with chronic renal failure (CRF)? |
|
Definition
|
|
Term
| How does mental status change with post renal acute renal failure (ARF)? |
|
Definition
|
|
Term
| What are the clinical manifestations of post renal acute renal failure (ARF)? |
|
Definition
-oliguria/anuria
-back/flank pain
-change in mental status (hyponatremia) |
|
|
Term
| What is post renal acute renal failure (ARF)? |
|
Definition
"beyond the bladder" <5% of all ARF
Usually related to a urinary tract obstruction that affects the kidneys bilaterally |
|
|
Term
| What are the three stages of acute renal failure (ARF)? |
|
Definition
1. oliguria- volume overload, increase K+, metabolic acidosis
2.diuretic-retention of tubular patency
3. recovery |
|
|
Term
| What are the causes acute tubular necrosis (ATN)? |
|
Definition
-antibiotics
-chemicals
-heavy metal poisons
-rhabdomyelosis (mm injury)
-x-ray contrast media* |
|
|
Term
| What is the most frequent manifestation on intrarenal acute renal failure (ARF)? |
|
Definition
|
|
Term
| What is intrarenal acute renal failure (ARF) typically caused by? |
|
Definition
| exposure to toxins, drugs, or autoimmune |
|
|
Term
| What is acute tubular necrosis (ATN)? |
|
Definition
| decrease GFR to hypoxia/ischemia & tubular cell injury |
|
|
Term
| What is intrarenal acute renal failure (ARF)? |
|
Definition
| intrinsic to the kidney itself |
|
|
Term
| What are the clinical manifestations of pre-renal acute renal failure (ARF)? |
|
Definition
-decreased GFR
-increased BUN & creatinine
-hyperkalemia
-tachycardia
-decreased urine output
-lethargy (confusion) |
|
|
Term
| What role does chronic NSAID use have in the potential development of pre-renal ARF? |
|
Definition
| renal PG maintains vasodilation of the renal artery/afferent arteriole. NSAIDS till inhibit this & cause vasoconstriction & hypoperfusion |
|
|
Term
| What might cause pre-renal acute renal failure (ARF)? |
|
Definition
-decrease in renal perfusion
-no tubular damage but decreased GFR |
|
|
Term
| What is pre-renal acute renal failure (ARF)? |
|
Definition
| "before" the kidney (50% of all ARF) |
|
|
Term
| In acute renal failure (ARF) what are 2 major problems that can kill your patient quickly? |
|
Definition
-hyperkalemia (high K+)
-metabolic acidosis (high H+) |
|
|
Term
| What is chronic renal failure (CRF)? |
|
Definition
|
|
Term
| What is acute renal failure (ARF)? |
|
Definition
| rapid onset renal failure |
|
|
Term
| What are the clinical manifestations of polycystic kidney disease? |
|
Definition
-abdominal pain
-hematuria
-proteinuria
-oliguria
-anuria
-HTN (fluid retention) |
|
|
Term
| What causes extreme pain in polycystic kidney disease? |
|
Definition
| the cysts swell and press against the renal capsule |
|
|
Term
| Where do the cysts develop in polycystic kidney disease? |
|
Definition
| -develop throughout cortex & medulla |
|
|
Term
| What do the cysts do in polycystic kidney disease? |
|
Definition
| -destroys normal nephrons |
|
|
Term
| How is polycystic kidney disease received? |
|
Definition
-genetic
-defective gene on short arm of chromosome 16
-autosomal dominant pattern |
|
|
Term
| What type of casts are typical in pyelonephritis? |
|
Definition
|
|
Term
| Why do casts for in pyelonephritis? |
|
Definition
| inflammation of the kidney |
|
|
Term
| What type of casts form in glomerulonephritis? |
|
Definition
|
|
Term
| Why do casts form in glomerulonephritis? |
|
Definition
| leakage of RBC from glomerulus or severe tubular damage |
|
|
Term
| Where do casts form in glomerulonephritis? |
|
Definition
| only in DCT or collecting ducts |
|
|
Term
| What is the hallmark syndrome of nephrotic syndrome? |
|
Definition
|
|
Term
| What are the clinical manifestations of nephrotic syndrome? |
|
Definition
-hypovolemia
-edema formation* (lack of oncotic pressure)
-protein malnutrition
-HTN |
|
|
Term
| What is nephrotic syndrome? |
|
Definition
| loss of protein in the urine of >3-5gm/day |
|
|
Term
| What is chronic glomerulonephritis? |
|
Definition
| fibrotic tissue development in the glomerulus leading to permanent decrease in GFR |
|
|
Term
| Why does HTN happen with glomerulonephritis? |
|
Definition
-increases protein loss
-hypovolemia
-RAA kicks in
-Na+ & H₂O are retained |
|
|
Term
| Why is there increased serum lipids with glomerulonephritis? |
|
Definition
-decreased albumin
-liver overproduces to compensate |
|
|
Term
| Why does edema happen with glomerulonephritis? |
|
Definition
-protein loss
-less colloid osmotic pressure |
|
|
Term
| What are the clinical manifestations of glomerulonephritis? |
|
Definition
-typically 7-10 days after strep throat
-hematuria & proteinuria
-oliguria from lowered GFR (<400mL/24 hrs)
-RBC casts
-edema
-increased lipids
-HTN |
|
|
Term
| The glomerular "leakiness" in glomerulonephritis allows what to happen? |
|
Definition
| RBC, WBC & protein into the urine |
|
|
Term
| What is the mechanism of acute glomerulonephritis? |
|
Definition
-type III hypersensitivity
-Ab/Ag complex trapped in glomerulus
-inflammatory response
-glomerulus is compromised & damaged
-the damage allows RBC, WBC & protein into the urine |
|
|
Term
| Glomerulonephritis is always accompanied by ________GFR and ____________ creatinine |
|
Definition
|
|
Term
| What is glomerulonephritis? |
|
Definition
| inflammation of the glomerulus |
|
|
Term
| What is a staghorn calculus? |
|
Definition
-a stone formed in the renal pelvis shaped like a horn
-made from magnesium-ammonium-phosphate mix |
|
|
Term
| What characteristic of urine with favor supersaturation and stone formation in uric acid stone? |
|
Definition
|
|
Term
| What is the significance of a high purine diet with uric acid stones? |
|
Definition
| increase purine metabolism from high protein intake produces more uric acid (rich in meats, liver) |
|
|
Term
|
Definition
|
|
Term
| What characteristic of urine will favor calcium oxalate stone formation? |
|
Definition
|
|
Term
| What are the risk factors for hypercalciuria? |
|
Definition
-increased GI absorption of Ca++
-increased demineralization of Ca++ from bone
-defect in tubular secretion from kidneys
-high levels of uric acid |
|
|
Term
|
Definition
|
|
Term
Side 3
Where do stones form? |
|
Definition
| they can form anywhere but typically in the ureters |
|
|
Term
| What are the consequences of urinary tract obstruction? |
|
Definition
| there can be back pressure into the kidney, which can decrease GFR, leading to renal failure. |
|
|
Term
|
Definition
| complete obstruction of ureter; accumulation of urine, ureter distended |
|
|
Term
|
Definition
| enlarged, swollen kidney from backed up urine |
|
|
Term
| What is any interference with urine flow at any site along the urinary tract leading to accumulation of urine behind the obstruction? |
|
Definition
|
|
Term
| What is the HALLMARK symptoms of pyelonephritis? |
|
Definition
| CVA tenderness (costovertebral angle tenderness) |
|
|
Term
| What are the s/s of pyelonephritis? |
|
Definition
-patient looks sick
-chills
-fever
-back pain
-HA |
|
|
Term
|
Definition
| infection of the renal pelvis, calices, parenchyma |
|
|
Term
| What are the s/s of a UTI? |
|
Definition
-cystitis (inflammation of bladder lining)
-dysuria
-frequency
-fever
-low back pain
-cloudy and/or strong odor urine
-pyuria (WBC in urine) |
|
|
Term
| What risk factor for UTI's are nurses capable of reducing the number of UTIs related to? |
|
Definition
|
|
Term
| What are some risk factors for UTI's? |
|
Definition
-women: failure to void after sexual activity
-pregnancy
-men: rectal sex (no condom)
-BPH
-kidney stones
-diabetes
-catheter
-neurogenic bladder (voiding dysfunction |
|
|
Term
| Compare gender anatomical differences for risk of UTI's? |
|
Definition
| women have a shorter urethra then men therefore women are more at risk than men. |
|
|
Term
| What are the protective mechanisms associated with urine? |
|
Definition
-voiding flushes out pathogens
-pH (acidic)
-osmolarity
-high concentration of UREA |
|
|
Term
| What are the characteristics of urine? |
|
Definition
-sterile
-specific gravity 1.010-1.030 |
|
|
Term
| What is the PSNS control on the bladder? |
|
Definition
"void" (Ach)
-contracts detrusor mm
-relaxes internal sphincter |
|
|
Term
| What is the SNS control of the bladder? |
|
Definition
"hold it" (NE)
-relaxes detrusor mm
-contracts external sphincter |
|
|
Term
| What is the triangle shape located in bladder that has openings from ureters. usually referring to the bladder mm? |
|
Definition
|
|
Term
| What is the smooth mm of the bladder body? |
|
Definition
|
|
Term
| What is located at base of urethra. controlled voluntarily? |
|
Definition
|
|
Term
| What is located at base of bladder, top of urethra. controlled involuntary? |
|
Definition
|
|
Term
Discuss the process of voiding (micturition).
Most is under ANS and some is under Somatic |
|
Definition
1. bladder fills
2.fullness felt (trigone stretched)
3. afferent signal to the brain
4. contraction of detrusor (muscarinic)
5. relaxation of internal sphincter (muscarinic) |
|
|
Term
| What is the capillary tuft at beginning of every nephron. it is the site of fluid filtration from the blood to the nephron tubule. it is what prevents passing of WBC, RBC, platelets? |
|
Definition
|
|
Term
| What is the cup-like sac that surrounds the golmerulus. it drains the glomerular filtrate directly into the PCT? |
|
Definition
|
|
Term
| What are located in the DCT. they sample the filtrate for NaCl content and send signals to the glomerulus to adjust GFR? |
|
Definition
|
|
Term
| What is the endocrine gland that regulates the function of each nephron. the apparatus is made up of the macula densa cells, extraglomerular mesangial cells, and JG cells? |
|
Definition
| juxtaglomerular apparatus |
|
|
Term
| What is it called when proteins are negatively charged and attract ions which then attract H₂O? |
|
Definition
| capillary osmotic/oncotic pressure |
|
|
Term
| What opposes filtration by holding H₂O & ions in capillaries? |
|
Definition
|
|
Term
| What is the enzyme that is produced & released mainly by the liver. known as renin substrate. Angiotensin I is formed when renin acts on angiotensinogen? |
|
Definition
|
|
Term
| What is the enzyme that converts Angiotensin I to Angiotensin II? |
|
Definition
|
|
Term
| What is the RAAS pathway? |
|
Definition
1. JG cells sense decreased BP
2. JG cells secrete renin
3. renin causes angiotensinogen to be converted to Angiotensin I
4. Angiotensin I circulates the lung and ACE converts it to Angiotensin II
5. Angiotensin II circulates to adrenal cortex & stimulates secretion of aldosterone
6. aldosterone increases reabsorption of Na+
7. therefore, water is retained & blood volume increases |
|
|
Term
| What is the role of aldosterone in the RAAS pathway and where is it secreted from? |
|
Definition
-aldosterone increases reabsorption of Na+ (DCT)
-secreted from adrenal cortex |
|
|
Term
| On which part of the tubular system does aldosterone act on? |
|
Definition
-distal convoluted tubule Na+ is reabsorbed(DCT)
-collecting duct K+ is excreted |
|
|
Term
| What is the role of ADH in blood volume maintenance? |
|
Definition
-ADH is a vasopressin
-it is secreted from posterior pituitary in response to increased osmolality by the osmoreceptors in the hypothalamus |
|
|
Term
| On which part of the tubular system does ADH act on? |
|
Definition
| collecting duct where it stimulates water reabsorption |
|
|
Term
What is the significance of HPO₄?
(handbook pg. 619-620) |
|
Definition
| this is used for an important buffer system. the excretion of H+ will be bound to a filtered phosphate and excreted in the urine. this excretes acid and gain bicarbonate |
|
|
Term
| What is the significance of NH₄? |
|
Definition
| excess H+ is attached to NH₃ to make NH₄ and excrete it through the kidneys. |
|
|
Term
| How does the kidneys excrete metabolic wastes? |
|
Definition
| it can excrete H+ attached to a NH₃ if the body is to acidic |
|
|
Term
| In the arterial blood, what is the best indicator of how well the kidneys are excreting metabolic wastes? |
|
Definition
|
|
Term
| In arterial blood, what is the best indicator of how well the lungs are excreting metabolic wastes? |
|
Definition
|
|
Term
| Renin causes the conversion of what? |
|
Definition
| Angiotensinogen to Angiotensin I |
|
|
Term
| What is the role of the macula densa? |
|
Definition
-sense changes in osmolality (NaCl)
-stimulate renin release from JG cells |
|
|
Term
| What is the role of the JG cells? |
|
Definition
-they are baroreceptors
-they synthesize, store, and secrete renin
-smooth mm cells in walls of afferent arteriole |
|
|
Term
| What happens if the GFR is too high? |
|
Definition
| -all filtrate would be lost to urine (good & bad) |
|
|
Term
| What happens if the GFR is too low? |
|
Definition
-too much tubular filtrate is reabsorbed
-glucose & waste products would be out of balance |
|
|
Term
| How does each individual nephron regulate GFR? |
|
Definition
| the macula densa in the DCT sense changes in the NaCl delivery |
|
|
Term
| What does not get filtered in the glomerulus? |
|
Definition
| negatively charged particles (protein) or particles too large to pass (RBC, WBC, platelets) |
|
|
Term
| What gets filtered in the glomerulus? |
|
Definition
-water
-electrolytes (H+, K+)
-solutes (creatinine, urea, glucose)
-organic acids
-phosphates |
|
|
Term
| The driving force of filtration in the glomerulus is why? |
|
Definition
|
|
Term
| What vasoconstricts to keep GFR constant? |
|
Definition
|
|
Term
| How does systemic BP affect GFR? |
|
Definition
| if there is an increase in BP it will in turn increase GFR |
|
|
Term
|
Definition
| to generate enough pressure for urine formation |
|
|
Term
| ow much Na+ & H₂O absorption occurs at the collecting duct? |
|
Definition
|
|
Term
| How much Na+ & H₂O absorption occurs at the distal convoluted tubule (DCT)? |
|
Definition
|
|
Term
| How much Na+ & H₂O absorption occurs at the Ascending Loop of Henle? |
|
Definition
|
|
Term
| How much Na+ & H₂O absorption occurs at the proximal convoluted tubule (PCT)? |
|
Definition
|
|
Term
| What are efferent arterioles? |
|
Definition
| they transport blood out of the glomerulus |
|
|
Term
| What are afferent arterioles? |
|
Definition
| they transport blood into the glomerulus |
|
|
Term
| What are the functions of the nephron? |
|
Definition
-filter water soluble substances from blood
-reabsorption of filtered nutrients, water, and electrolytes.
-secretion/excretion of wastes or excess substances into filtrate |
|
|
Term
| What is the function of the kidneys? |
|
Definition
-maintains fluid & electrolyte balance
-disposal of water-soluble wastes
-EPO production
-vitamin D activation
-20% total glucose production |
|
|
Term
| End product of muscle metabolism excreted by the kidneys. Reflects GFR and used to test for ARF. |
|
Definition
|
|
Term
| For every doubling of serum creatinine, there is a _____ decr in GFR |
|
Definition
|
|
Term
| Increased creatinine means _____ renal function |
|
Definition
|
|
Term
| Serum creatinine is relatively constant, unless there is _____ |
|
Definition
|
|
Term
| When is creatinine clearance test unreliable? |
|
Definition
|
|
Term
| End product of protein metabolism used to test for ARF |
|
Definition
| Blood Urea Nitrogen (BUN) |
|
|
Term
|
Definition
|
|
Term
| BUN _____ with liver disease |
|
Definition
|
|
Term
| BUN _____ with incr protein intake |
|
Definition
|
|
Term
| BUN _____ with decr fluid intake/dehydration |
|
Definition
|
|
Term
| BUN _____ with decr fluid intake/dehydration |
|
Definition
|
|
Term
| Bacterial counts greater than _____ in urinalysis indicate UTI |
|
Definition
|
|
Term
|
Definition
| Kidney-Ureter-Bladder (KUB) |
|
|
Term
|
Definition
| 90% of stones are radiopaque and can be seen on x-ray |
|
|
Term
| Used to breakup stones so they can be passed |
|
Definition
|
|
Term
| Often elevated in presence of prostate cancers and other prostate disorders |
|
Definition
| PSA (Prostate Specific Antigen) |
|
|
