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Chapter 6: Urinary System

front 1 Nephron	back 1 functional unit of the kidney Each kidney contains more than a million nephrons. Functions: filter waste products from the blood, reabsorb water and nutrients (e.g., glucose and amino acids) from the tubular fluid, and secrete excess substances in the form of urine.
front 2 How much water do nephrons filter each day?	back 2 In an average person, the nephron filters about 190L of water out of glomerular blood each day
front 3 Formation of urine begins here	back 3 Glomerulus
front 4 Glomerulus	back 4 Tuft of capillaries with very thin walls and a large surface area

front 5 Erythropoietin	back 5 substance produced by the kidney stimulates the rate of production of red blood cells
front 6 Incontinence	back 6 involuntary emptying of the bladder at intervals caused by cerebral hemorrhage and spinal cord injury
front 7 Micturate	back 7 act of urinating
front 8 Unilateral renal agenesis	back 8 A rare congenital anomaly in which only one kidney forms

front 9 Unilateral renal agenesis image	back 9
front 10 hypoplastic kidney	back 10 Appears as a miniature replica of a normal kidney, with good function underdeveloped kidney
front 11 hypoplastic kidney image	back 11
front 12 Ectopic Kidney	back 12 Abnormal position, such as in the pelvis (pelvic kidney) or high near the diaphragm (intrathoracic kidney)

front 13 ectopic kidney image	back 13
front 14 Supernumerary kidney	back 14 A rare anomaly in which a small, rudimentary third kidney forms Functions normally, but are prone to infections that eventually may require their removal
front 15 Supernumerary kidney image	back 15
front 16 Horseshoe kidney	back 16 Kidneys fused at the lower poles The most common fusion anomaly

front 17 horseshoe image	back 17
front 18 Ureterocele	back 18 Ureterocele is a cystic dilatation of the distal ureter near its insertion into the bladder.
front 19 two types of ureterocele	back 19 Simple (adult) Ectopic
front 20 what age group is ureterocele normally found in? What is it commonly associated with?	back 20 Found almost exclusively in infants and children Commonly associated with ureteral duplication

front 21 ureterocele image	back 21
front 22 Glomerulonephritis	back 22 is a nonsuppurative inflammatory process involving the tufts of capillaries (glomeruli) that filter the blood within the kidney. Glomerulonephritis is an antigen-antibody reaction that most commonly occurs several weeks after an acute upper respiratory or middle ear infection with certain strains of hemolytic streptococci.
front 23 What is glomerulonephritis caused by?	back 23 More frequently, the inflammatory process is caused by a chronic autoimmune disorder.
front 24 What is glomerulonephritis cause?	back 24 Causes the glomeruli to be extremely permeable, allowing albumin and red blood cells to leak into the urine (resulting in proteinuria or hematuria). It causes oliguria - a smaller-than-normal amount of urine.

front 25 Glomerulonephritis image	back 25
front 26 What is pyelonephritis? What is it caused by? What does it affect?	back 26 Pyelonephritis is a suppurative inflammation of the kidney and renal pelvis with patchy distribution. It is caused by pyogenic (pus-forming) bacteria. It affects the interstitial tissue between the tubules. It often affects only one kidney. It is asymmetric if both kidneys are involved.
front 27 Where does pyelonephritis infection originate?	back 27 Infection usually originates in the bladder, ascends the ureter to involve the kidneys.
front 28 Who is pyelonephritis more common in?	back 28 Pyelonephritis is more common in women and children.

front 29 When does pyelonephritis develop? What is a contributing factor?	back 29 It develops in patients with obstruction of the urinary tract (enlarged prostate gland, kidney stone, congenital defect). It causes stagnation of urine - a breeding ground for infection. Instrumentation or catheterization of the ureter is also a contributing factor.
front 30 Symptoms of pyelonephritis are:	back 30 High fever Chills Sudden back pain that spreads over the abdomen Dysuria Pyuria Bacteria can be cultured from the urine or observed in the urinary sediment
front 31 pyelonephritis image	back 31
front 32 Oliguria	back 32 a smaller-than-normal amount of urine

front 33 Dysuria	back 33 painful urination
front 34 pyuria	back 34 pus in the urine
front 35 What is the most common nosocomial infection?	back 35 Cystitis
front 36 Cystitis	back 36 Cystitis is an inflammation of the urinary bladder.

front 37 Who is cystitis most common in? why?	back 37 It is most common in women. Due to a shorter urethra
front 38 what is a major cause of cystitis? other?	back 38 Major: Spread of bacteria present in fecal materia Other: Instrumentation or catheterization of the bladder Retrograde flow from urine bag • Bag must be kept below the patient to prevent retrograde flow. Sexual intercourse
front 39 cystitis symptoms	back 39 Urinary frequency, urgency, and burning sensation
front 40 cystitis image	back 40

front 41 Urinary calculi most commonly form in the kidney as ___________.	back 41 kidney stones
front 42 kidney stone symptoms	back 42 They are asymptomatic until they lodge in the ureter and cause partial obstruction. This results in extreme pain that radiates from the area of the kidney to the groin.
front 43 Cause of kidney stones varies.	back 43 Often reflect an underlying metabolic abnormality, such as hypercalcemia (resulting from hyperparathyroidism). Any cause of increased calcium excretion in the urine Urinary stasis and infection
front 44 Most accurate modality for kidney stones	back 44 CT

front 45 what can kidney stones cause?	back 45 Can cause hydronephrosis Blockage above the level of the bladder
front 46 Staghorn calculus	back 46 Renal calculus that completely fills the renal pelvis
front 47 Nephrocalcinosis	back 47 a condition in which calcium levels in the kidneys are increased
front 48 Hydronephrosis	back 48 distention of the pelvis and calyces of the kidneys

front 49 Hydronephrosis cause	back 49 blockage above the level of the bladder
front 50 the most common unifocal mass of the kidney.	back 50 renal cyst
front 51 Renal cyst	back 51 Fluid-filled, usually unilocular-Septa sometimes divide the cyst into chambers They vary in size. They may occur at single or multiple sites in one or both kidneys.
front 52 most common renal neoplasm	back 52 Renal cell carcinoma, also known as hypernephroma

front 53 what age group is renal cell carcinoma most common in?	back 53 It occurs predominantly in patients older than 40 years.
front 54 where does renal carcinoma originate in?	back 54 Renal carcinoma originates in the tubular epithelium of the renal cortex.
front 55 Classic symptom triad of renal cell carcinoma:	back 55 Hematuria Flank pain Palpable abdominal mass
front 56 the most common abdominal neoplasm of infancy and childhood.	back 56 Wilms’ Tumor (Nephroblastoma)

front 57 Where does Wilms' Tumor arise from?	back 57 It arises from embryonic renal tissue.
front 58 What does Wilms' Tumor appear as?	back 58 It may be bilateral. It tends to become very large and appear as a palpable mass.
front 59 who is renal vein thrombosis most common in?	back 59 Renal vein thrombosis occurs most frequently in children who are severely dehydrate.
front 60 modality of choice for renal vein thrombosis	back 60 ultrasound

front 61 what is the main reason for adults to get renal vein thrombosis?	back 61 In adults, is most often a complication of another renal disease
front 62 Malrotation	back 62 Rotation on the longitudinal or horizontal axis; asymptomatic
front 63 Crossed ectopia	back 63 An ectopic kidney lies on the same side as the normal kidney and is very commonly fused
front 64 Complete fusion and varied names	back 64 A rare anomaly that produces a single irregular mass has no resemblance to a renal structure Varied names - disk, cake, lump, and doughnut kidney

front 65 Duplication (duplex kidney)	back 65 A common anomaly that varies from a simple bifid pelvis to a completely double pelvis, ureter, and ureterovesical orifice.
front 66 what can complete duplication of the kidney be complicated by?	back 66 Complete duplication can be complicated by obstruction or by vesicoureteral reflux with infection.
front 67 Posterior Urethral Valves	back 67 Posterior urethral valves are thin transverse membranes in the urethra. Found almost exclusively in males Cause bladder outlet obstruction They may lead to severe hydronephrosis, hydroureter, and renal damage.
front 68 What is posterior urethral valves best demonstrated on?	back 68 This is best demonstrated on a voiding cystourethrogram.

front 69 What is renal tuberculosis? How is it spread?	back 69 Renal tuberculosis usually occurs as a secondary infection from lung involvement Hematogenous spread It can evolve from other sites.
front 70 When does renal tuberculosis manifest?	back 70 manifests 5 to 10 years after the primary infection.
front 71 What may renal tuberculosis lead to the development of?	back 71 It may lead to the development of small granulomas scattered in the cortical portion of the kidneys.
front 72 Papillary necrosis	back 72 is a destructive process involving a varying amount of the medullary papillae and the terminal portion of the renal pyramids.

front 73 Predisposing factors include of papillary necrosis:	back 73 Diabetes Pyelonephritis Urinary tract infection Urinary tract obstruction Sickle cell disease Phenacetin abuse
front 74 Polycystic kidney disease	back 74 an inherited disorder in which multiple cysts of varying size cause lobulated enlargement of the kidneys and progressive renal impairment.
front 75 One-third of patients with polycystic kidney disease also have? Does it interfere with hepatic function?	back 75 One-third of patients also have liver cysts. Do not interfere with hepatic function
front 76 Complications of polycystic kidney disease	back 76 About 10% have one or more saccular (berry) aneurysms of cerebral arteries May rupture and produce a fatal subarachnoid hemorrhage Many are hypertensive.

front 77 how is polycystic kidney disease diagnosed? why?	back 77 Most tend to be asymptomatic during the first three decades of life Early diagnosis is made either by chance or by specific search due to family history
front 78 where does carcinoma of the bladder most commonly originate?	back 78 most commonly originates in the epithelium.
front 79 what is carcinoma of the bladder referred to as? who is it most common in?	back 79 It is referred to as urothelial carcinoma Previously - transitional cell carcinoma It is most common in men over age 50. It is the fourth most common cancer in men.
front 80 predisposing factors of bladder cancer:	back 80 Industrial chemicals Cigarette smoking • Presumably due to carcinogenic metabolites being excreted in urine

front 81 what is acute renal failure? what does it result in?	back 81 Acute renal failure is a rapid deterioration in kidney function. It results in the accumulation of nitrogencontaining wastes in the blood. It causes a characteristic urinelike odor or “fishy” breath.
front 82 Two types of acute renal failure:	back 82 Prerenal Postrenal
front 83 Prerenal failure causes include:	back 83 Decreased blood flow to the kidneys (hemorrhage, dehydration, surgical shock) Cardiac failure Renal artery obstruction
front 84 Postrenal failure causes:	back 84 Urine outflow obstruction from both kidneys • Prostatic disease • Functional obstruction of the bladder neck

front 85 Other causes of acute renal failure:	back 85 Kidney diseases, such as glomerulonephritis, bilateral acute pyelonephritis, and malignant (severe) hypertension Nephrotoxic agents (antibiotics, radiographic contrast material, anesthetic agents, heavy metals, organic solvents) Intravascular hemolysis Large amounts of myoglobin (muscle protein) in the circulation from muscle trauma or ischemia
front 86 what makes chronic renal failure reflect?	back 86 may reflect prerenal, postrenal, or intrinsic kidney disease.
front 87 Causes of chronic renal failure include:	back 87 Bilateral renal artery stenosis Bilateral ureteral obstruction Intrinsic renal disorders, such as chronic glomerulonephritis, pyelonephritis, and familial cystic diseases
front 88 acid-base balance	back 88 stable concentration in body fluids

front 89 Bowman's capsule	back 89 cup-shaped end of renal tubule
front 90 collecting tubule	back 90 funnels urine into the papillary ducts in the renal pelvis
front 91 complete fusion	back 91 occurs in the kidneys and produces a single irregular mass that has no resemblance to a renal structure
front 92 electrolyte balance	back 92 equilibrium of electrolytes in the body

front 93 hydroureter	back 93 dilation of the ureter
front 94 hypernephroma	back 94 most common renal cell carcinoma
front 95 intrathoracic kidney	back 95 kidney located in the thoracic cavity
front 96 loop of henle	back 96 U-shaped portion of the renal tubule

front 97 nephrocalcinosis	back 97 calcium deposits within the substance of the kidney
front 98 pelvic kidney	back 98 kidney located in the pelvis
front 99 proximal convoluted tubule	back 99 second part of the Nephron, first part of renal tubule
front 100 supernumerary kidney	back 100 an extra kidney

front 101 trigone	back 101 triangular area of the posterior bladder, between the opening of the ureters and urethra
front 102 uremia	back 102 presence of excessive amounts of urea and nitrogen in the blood