65 terms

Renal and Urotic systems Lecture 4

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Nephron Unit
functional units of kidneys
filtrate the blood and form urine
Bowmans capsule
Ureters
transport urine to bladder
bladder andurethra
250-300 ml
normal output per hour
40-80 ml is what is filtered and excreted
what is not filtered out of glomerous
plasma protiens and large colloids
Obstruction of the outflow of urine
retrograde and decrease in GFR
retrograde
backflow
Renal diseases and complications
kidney stones, narrowing stricture, inflammation and infection, tomors, prostate problems
GFR
glomerual filtration rate
RBF
renal blood flow
maintainance of RBF
Systemic balancing act - kidneys intristic mech., Bp is maintained
Proximal tubule
reobsorbs sodium and conserves bicarbinate
Loop of Henle
Concentrates or dilutes urine, helps with H2O balance
Distal Tubule
controled by aldosterone, ADH, * big part in reobsorbing sodium in bloodstream and excerttes calcuim
ADH
controls the final concentration of urine
Urine should not contain
large molecules
protien
blood cells
glucose
Diuretics
reduce fluid volume, promote excetion of fluid as urine, interfere with renal NA+ reobsorbtion, alter the way the body has electolyes
Used to treat hypertyention and edema
Renal Hormones
Vitamin D, Erythropoietin, Atrial Natriuretic Peptide (ANP)
Vitamin D
Activation from kidneys and liver- important for caluim and phosphate balalnce
Erythropoietin
it matures RBC's
Atrial Natriuretic Peptide (ANP)
secreted by RA (right atruim) of Heart , activated by increased Bp in resonse by excess fluid volume
Renal Clearance
determines by how much of a substance can be cleared from the blood by the kidneys per given unit of time
Glomelular Filtration unit
measures unit output, best estimate of functioning renal tissue
indication of decreased GFR
BP increase, weight gain, swelling, adema
Blood Urea Nitrogen (BUN)
end product of metabolism- toxic
BUN levels
increase as GFR drops
rises in dehydration, acute and chronic renal failure, altered protien intake and protien catabolism
increase in BUN
shows hydration status, dehydrated
Creatinine
end product creatine metabolism in muscle- best for renal function
Creatine clearance
amount of time it takes to get rid of urine at a unit of tim, anything less than 50 is renal disease
Aging and Renal function
Urine gets darker
les toerant to deydration or water load
delayed reobsorbtion of glucose
delayed response to acid based changes
increased likelyhood of drug toxicity
UTO
Urinary tract Obstruction
Urinary Tract Obstruction
implodes floew proximal to blockage
dialates the Urinary system
increases risk of infection
compromises renal function
consequences of Obstruction
Hydroureter
Hydrononephrosis
Ureterohydronephonephrosis
Hydroureter
dialation of the uretor
Hydrononephrosis
enlargement of the renal pelvis or calcuses, results from blockage, results from ureter, problem with the kidney
Ureterohydronephonephrosis
H2O being held and inflammation of the bladder
Kidney stones
Renal Calculi
types of renal calculi
calcium oxalate
magnesium ammonium
cystine
uric acid
Predisposing factors of kidney stones
Urinary stasis, altered Urinary Ph, erroe in cystine metabolism, diet high in calcium, family history, high temperature, dehydration
clinical mannifestations of kidney stones
renal colic- flank radiating
urinary urgency
frequent urgency
freq. voiding
hematuia- ripping the lining
tratment of kidney stones
fluids and alangesics
dietary modification
lithotripsy
UTI
infammation of the urinary tract epithelium, Infection w/ pathogen, uncommon in elderly
Clinical manifestations of UTI
dysuria
frequency and urgency
flank or back pain
cloudy urine
hematuria
nocturia
most common retrograde
e-coli
Pyelonephritus
acending infection bladder to kidney, infection can cause edema, inflammation, Purulent urine. severe infect cause abcesses necrosis
Acute Pyelonephritus
fever chlls
flank or groin pain
frequency dysuria painful urination) and pyuria (urine cont pus)
costovertebral tenderness
hematuria
Chronic Pyelonephritis
persistant or recurrent infection of the kidney- chronic inflammation, destruction of tubules, atrophy or dialation of tubules, impairment ability to concentrate urine
other causes= drug toxicity (accetominophen) Ischemia(not enough O2, Radiation, Immune complex (lupus)
mannifestations of Chronic Pyelonephritis
hypertention
urinary frequency
flank pain
treatment of Pyelonephritis
2-3 weeks of anti microbials
fluids avoid irritants
hospitalization
Acute renal failure
classified as 3 different types :pre renal Intra renal Post renal can be reversible if treated early
Pre-renal ARF
Occurs in body Impairs kidney
Intra-renal ARF
Occurs within the renal tissue
Post-renal ARF
Occurs down stream of the kidney in the urinary tract
Overflow incontinence
frequent dribbling of full bladder
Urge Incontinence
uncontrolled contraction or over activity of detrusor muscle
Stress Incontinence
Leakage with coughing sneezing laughing lifting
Functional Incontinence
loss of urine related to mobility or environmental factors, cognitive problems
earliest stage of renal Chronic renal failure
renal impairment
renal insufficiency
GFR progressively decreases, mild anemia, BP up weakness and fatigue, decrease amount of urine, high BUM and Serum Creatine
End stage renal disease
dry flaky skin Hematological anemia, having problems balancing phosphates, GI metallic taste in mouth
Glomerulonephritis
inflammation of glomeruli, diabetes and hypertention can cause damage and scar tissue
Glomerular disease
could lead to renal failure protien-uria Increased GFR
Enuresis
involuntary urination that occurs after age when continence should be present
Micturation
the process of emptying the bladder
Urinary Retention
urine is produced normally but not appropriately excreted from the bladder
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