Pathophysiology, Screening and Management of Conditions of the Renal, Urinary and Endocrine Systems

Vocabulary flashcards for understanding key concepts related to the renal, urinary, and endocrine systems in the context of health and physical therapy.

Nephron

The functional unit of the kidney, responsible for forming urine.

1 million

Number of nephrons per kidney

renin

Enzyme produced by the kidneys that plays a crucial role in regulating blood pressure by controlling blood volume and vasoconstriction

Vitamin D and Ca++

Nephrons help regulate the balance of what two substances?

yellow or clear

Color of normal urine

4.6-8.0

pH of normal urine

genetic

What type of disease is polycystic kidney disease?

1.) Colonization

Stage of UTI in which the pathogen colonizes the urethra and ascends towards the bladder

2.) Uroepithelium penetration

Stage of UTI in which the pathogen penetrates the bladder and bacteria replicates, potentially forming biofilms

3.) Ascension

Stage of UTI in which bacteria ascends towards the kidneys via the ureters

4.) Pyelonephritis

Stage of UTI marked by an inflammatory response caused by infection of the renal parenchyma

5.) Acute kidney injury

Stage of UTI in which bacteria continues to cascade up to the kidneys, causing tissue injury

50

Incidence of UTI in females is _____ time greater than in males from age 20-50.

catheters

The presence of indwelling _____ increases risk of UTI by 3-10% for each year.

urethritis

Lower UTI marked by inflammation of the urethra caused by organisms like Gonococcus, Chlamydia, and E. coli

cystitis

Lower UTI marked by inflammation of the bladder; commonly progressed from urethritis

Pyelonephritis

Inflammation of the kidney tissue due to infection.

pyelonephritis

Sudden onset of _____ is marked by fever, chills, and pain/tenderness over one or both kidneys.

pyuria

The presence of pus or other WBCs in the urine

blood urea nitrogen

What does BUN stand for?

Glomerulonephritis

Inflammation of the glomeruli in the kidneys, affecting renal function.

2-3 weeks post-infection

How long does acute glomerulonephritis last?

pre-renal

Type of renal failure affecting the blood supply to the kidneys; associated with rhabdomyolysis

renal (intrinsic)

Type of renal failure marked by direct damage to renal tissues; ex: renal necrosis

post-renal

Type of renal failure marked by obstruction to urine flow; congenital, tumors, “stone” formation

Rhabdomyolysis

A condition involving the breakdown of muscle tissue, leading to hyperkalemia, arrhythmia, and elevated blood levels of muscle proteins

rhabdomyloysis

Condition associated with sever exercise, high dose statins, and prolonged immobilization

3

CKD is defined by loss of function lasting more than _____ months.

5

Number of stages of CKD

glomerular filtration rate (GFR)

Important criteria for monitoring progression of CKD

Stage 3

Stage of CKD typically requiring at least two meds to regulate HTN

Stages 4 and 5

Stage of CKD considered ESRD → dialysis and transplant

hypocalcemia and hypomagnesemia

Complications of renal disease that cause hypotension, arrhythmia, confusion/irritability, and increased GI motility

right internal jugular vein

Blood vessel involved in central vein catheterization during hemodialysis

peritoneal dialysis

Type of dialysis that is administered in-home, nearly continuously

peritoneal dialysis

Type of dialysis in which dialyzing solution is instilled into the abdominal cavity, allowing waste exchange across the peritoneum

primary

Obstructive pathology characterized by acquired/congenital malformation, strictures, renal/ureteral calculi, polycystic kidney disease, and neoplasms

secondary

Obstructive pathology associated with pregnancy, prostate enlargement, pelvic inflammatory disease, and abnormal aortic aneurysm

sudden

Onset of obstruction marked by severe and spasmodic, radiating pain with associated nausea/vomiting; typically caused by calculi

gradual

Onset of obstruction that is slower, initially pain-free, typically caused by tumors

sensory

Type of neurogenic bladder where the body doesn’t know that the bladder is full, and thus cannot trigger voiding

diabetes mellitus

Sensory neurogenic bladder can be a complication of what disease?

motor paralytic

Type of neurogenic bladder that is often the result of post-surgical/traumatic damage to parasympathetic innervation to the detrusor muscle

motor paralytic

Type of neurogenic bladder characterized by inhibition to the internal urethral sphincter and incontinence

uninhibited

Type of neurogenic bladder in which CNS damage affects the corticoregulatory tracts, leading to disinhibition and incontinence

reflex

Type of neurogenic bladder commonly associated with SCI, MS, and spinal shock

dependence and urinary retention

ADRs of diazepam

dry mouth, nausea, and dizziness

ADRs of Ditropan (anti-spasmodic)

dizziness, dry mouth, constipation

ADRs of parasympathetic antagonists

orthostatic hypotension, nausea, insomnia

ADRs of alpha-adrenergic blockers

endocrine glands

Ductless glands that produce and release hormones that modulate cellular activity

endocrine system

System associated with hypo- and hyperfunction resulting from underlying pathology and primary vs secondary dysfunctions

hypothalamus

Neuroendocrine gland that allows for CNS input into the endocrine system

hypothalamus-pituitary axis

Junction between the nervous and endocrine systems

ADH

The release of _____ is stimulated by increased osmotic pressure and fluid volume depletion, pain, stress, and emesis.

alcohol and glucocorticoids

Two substances that can inhibit the release of ADH

oxytocin

The production and release of _____ is stimulated by breast feeding action causing movement of milk.

oxytocin

Hormone that causes contraction of uterine smooth muscle cells during pregnancy

LH and FSH

Hormones that control production of sex hormones

LH and FSH

Hormones that cause follicular development and ovulation in women

LH

Hormone that stimulates the production of testosterone in men

FSH

Hormone that stimulates spermatogenesis in men

gonadotropin-releasing hormone

Hormone that controls the synthesis and release of LH and FSH

estrogen and testosterone

Two hormones that suppress the release of LH and FSH

prolactin

Hormone that stimulates milk production during pregnancy

dopamine

Neurotransmitter that inhibits the release of prolactin

GH

Hormone also called somatotropin

GH

Hormone that regulates metabolism by stimulating glucose uptake by muscle and fat; AA uptake and protein synthesis

GH

Hormone that inhibits lipolysis

growth hormone-releasing hormone (GHRH)

Hormone released by the hypothalamus that stimulates GH production and release by the anterior pituitary gland

somatostatin

Hormone released by the hypothalamus that inhibits the release of GH

TSH

Hormone that regulates structure/function of the thyroid gland and stimulates synthesis/release of thyroid hormones

thyrotropin-releasing hormone

Hormone secreted by the hypothalamus that stimulates the release of TSH by the anterior pituitary gland

adrenocorticotropic hormone (ACTH)

Hormone that simulates the adrenal cortex to release cortisol

corticotropin-releasing hormone (CRH)

Hormone secreted by the hypothalamus that stimulates the release of ACTH

anterior pituitary

MSH, enkephalins, and endorphins are released by what gland?

tumor (adenoma)

Most common cause of pituitary gland lesions, marked by headache and visual field deficits

lesions

Generalized hypopituitarism and central diabetes insipidus are associated with pituitary gland _____.

generalized hypopituitarism

Condition of the pituitary gland with insidious onset; clinical features depend on affected hormones (GH,TSH, ACTH)

hypothyroidism

Condition caused by TSH deficiency associated with generalized hypopituitarism

polyuria, polydipsia, dehydration

Signs/symptoms of nephrogenic diabetes insipidus

thyroid and parathyroid

Endocrine glands located anterior and lateral to the trachea, below the cricoid cartilage

thyroxine (T4)

Hormone that makes up 93% of thyroid secretions

thyroxine (T4)

Thyroid hormone that is converted into T3 and serves as a reservoir for T3 in the body

triiodothyronine (T3)

Hormone that makes up 7% of thyroid secretions

triiodothyronine (T3)

Thyroid hormone controlled by TSH and influenced by TRH; affects all cells and body processes

Hashimoto’s disease

Autoimmune, inflammatory form of thyroiditis that causes lower-than-normal levels of thyroid hormones

Hashimoto’s thyroiditis

Condition marked by destruction of thyroid tissue resulting in goiter and hyperfunction due to TSH reactive hypersecretion

goiter

Thyroid gland enlargement due to lack of dietary iodine, inflammation, tumor, or hypersecretion of TSH

goiter

Thyroid gland condition that causes swelling of the neck, pressure in the throat, and hoarseness

Insufficient release of TSH or TRH

Secondary disease associated with hypothyroidism

hormone replacement

Treatment for hypothyroidism

hypermetabolism

Condition associated with hyperthyroidism marked by nervousness, hyperactivity, palpations, heat sensitivity, sweating, and fatigue

thyroid storm

Condition associated with hyperthyroidism marked by cardiovascular collapse, shock, weakness, confusion, nausea, vomiting, and diarrhea

Aldosterone

A mineralocorticoid hormone produced by the adrenal cortex that controls electrolyte and water balance.

hyperparathyroidism

Condition that results in increased PTH production and hypercalcemia

hypoparathyroidism

Condition that results in decreased PTH secretion and hypocalcemia

hypoparathyroidism

Muscle tetany (laryngeal) is a complication of _____.

Adrenal Glands

Glands situated on top of the kidneys that produce various hormones, including cortisol and adrenaline.

adrenal cortex

Adrenal gland that produces steroid hormones including mineralocorticoids, glucocorticoids, and androgens