bio chapter 10

label

kidney ureter bladder urethra

nephron label

glomerulus loop of henle collecting duct

kidneys - bean-shaped organ. help maintain homeostasis (pH, _____ pressure, and rbc production). Removes waste from _____ and reabsorbs _____ and ions.

blood blood water

ureter - Muscular tube that passes urine from the ______ to the urinary _______

kidney bladder

urinary bladder - _______ urine and expel. Serves as a reservoir for _____

collect urine

urethra - Single tube through which urine _______ to the outside from the urinary _______

empties bladder

glomerulus - Filtering portion of the ______, permeable to plasma and some dissolved _______

kidney solutes

loop of Henle (renal loop) - U-shaped portion of renal tubule in _______. helps concentrate filtrate by reabsorbing much of the _____ and useful solutes while allowing acids and wastes like urea to continue on to form _____

nephron water urine

collecting duct - receives filtrate from the distal ______, allows water reabsorption under the influence of antidiuretic _______ (ADH), and carries the remaining waste as _____ toward the renal calyces and renal pelvis for excretion.

tubule hormone urine

urinary and laboratory blood tests

creatinine - _____ product. usually cleared by kidney. high blood levels indicate ____ of kidney function

uric acid - high levels in blood can lead to gout, kidney ______

blood urea nitrogen - can indicate _________ in glomerular filtration

urinalysis - RBC, WBC, __, glucose

dip stick - _______

waste loss stones decrease pH glucose

acute kidney injury - sudden ________ function.

3 types/causes:

shock - blood ____ disrupted

tubular necrosis - can result from ______, lupus, sickle cell disease, etc.

obstructed urine flow - kidney ______, tumors

results in decreased renal profusion (less _____ flowing through kidneys), hypoxic ______ (low oxygen), obstruction, tubular injury, microthrombi (mini blood clots), and hyperkalemia

impaired flow toxins stones blood injury

who is more susceptible to AKI (acute kidney injury)? elderly, ________, chronic kidney disease, dehydration or volume _________, chronic diseases (heart, lung, liver), female ______, cancer, anemia

diabetes depletion gender

what events can trigger AKI (acute kidney injury)? sepsis, critical illness, circulatory _____, burns, trauma, cardiac surgery, major noncardiac _______, nephrotoxic _____, radiocontrast agents

shock surgery drugs

Lower UTI

2 types - urethritis : urethral _________ (itching, burning). Cystitis - _______ infection (frequent urination, painful urination, pain in lower back).

Typically caused by ________.

Elderly will also have symptom of altered ______ status.

More common in _____ because their urethra is shorter and their genitals are moist

infection bladder bacteria mental women

Upper UTI (pyelonephritis) - inflammation of the ______ (kidney stones, can lead to renal failure)

signs and symptoms:

dysuria - painful _______ feeling

pyuria - ___ in urine

treatment with ___________

altered ______ status (elderly)

kidney burning pus antibiotics mental

glomerulonephritis - inflammation of glomerulus (leading cause of _____ failure, chronic kidney disease).

Symptoms: chills, _____, and weakness. Edema in ____ and ankles, hematuria (blood in urine), albuminuria (albumin in _____), casts (bacteria lining tubules comes out in urine, can make urine ______).

Increased number of mesangial cells (______-like cells that provide structure). Causes ________ which narrows capillary lumens

renal fever face urine cloudy muscle pressure

kidney stones (urinary calculi or uroliths) - symptoms: serious sharp ____ in the side and back, below the ribs. Pain that spreads to the lower stomach area and _____. Pain that comes in _____ and varies in how intense it feels. Pain or a _______ feeling while urinating. Upset stomach, vomiting, fever, chills, and _____ in urine

Causes: urine contains more _______ -forming substances than the fluid in the urine can ______. The urine may lack substances that _______ crystals from sticking together

Treatment: lithotripsy - use _____ waves to shatter kidney stones

pain groin waves burning blood crystal dilute prevent sound

renal failure - chronic disease. gradual loss of kidney ________ (diabetes, shock, toxins, tumors). Inability to clear ____ and creatinine from the blood - results in toxin buildup.

risk factors: ________, glomerulonephritis, other CKD

uremia - ________ stage of renal failure

function urea diabetes terminal

how renal failure can affect other systems:

accumulation of _____ products, urea, uric acid, and creatinine in blood causes:

urinary system: pyuria, _________, albuminuria, and casts

nervous system: drowsiness, dim vision, ______ cloudiness, convulsions, or coma

digestive system: ammonia taste in _____, nausea, vomiting, and diarrhea

respiratory system: deep sighing respiration, urine smell to ______

waste hematuria mental mouth breath

CHRONIC KIDNEY DISEASE - ____ threating (worse than AKI)

risk factors: chronic glomerulonephritis, _____tension, diabetic nephropathy - inflammation of glomerulus (high levels of albumin in _____), most common _____ of CKD and end-stage renal disease

symptoms: _____tension that gets harder to control. Swelling of ____, ankles, hands or eyes. Foamy _____, confusion or difficulty ________, shortness of breath, ____ of appetite, nausea and vomiting, itching, tiredness and ________

life hyper urine cause hyper feet urine thinking loss weakness

dialysis - treatment of _______ kidney disease

2 types:

hemodialysis - blood _______ from body and mechanically filtered

peritoneal dialysis - _____ introduced into the abdominal cavity, toxic materials drawn ___ and fluid collected

when dialysis does not work, a kidney __________ is in order. When they do a kidney transplant, they ____ take out the old kidney unless it has ______

chronic removed fluid out transplant dont cancer

renal cell carcinoma - kidney cancer, ____. Forms from epithelial _____ (will be polygonal), are rapidly dividing and making a tumor which _______ on the nephrons. The distal and proximal convoluted ______ and bowman’s capsule get _________.

rare cells presses tubule scrunched

wilms tumor - rare but the most common type of kidney cancer in ________. Symptoms: ___ sided abdominal mass, fever, fatigue, hematuria. Do not palpate abdomen because could _______ tumor. Treatment: surgery to ______ kidney or part of kidney. Chemo and radiotherapy afterwards. Very ____ survival rate

children one rupture remove high

bladder cancer - can be diagnosed using cystoscope (endoscopy of bladder) through _______.

Ileal conduit - after bladder is removed, ureters can empty outside of ____. Reroute ureters into ileum and make a _____ in the ileum

urethra body pouch

congenital disorders

polycystic kidney disease - _____ filled pockets of tissue. Autosomal dominant. Eventually dialysis and kidney __________

Medullary sponge kidney - no symptoms until adulthood, increased occurrence of kidney ______. Increase _____ intake to reduce kidney stones

urethra mis-location - didn’t form correctly or located in the _____ places. Hypospadias and epispadias - opening on _____ parts of penis / genitals

fluid transplant stones fluid wrong wrong

age related issues:

lose urethral sphincter _______

30-40% degeneration of ________ between 25-85

urinary retention due to loss of ______ tone

prostate enlargement in men resulting in _____ retention. Compresses urethra and prevents from getting all the urine ___. Urine flow won’t be as ______ or as big

kidney and bladder cancer occurrence increases with ___

control nephrons muscle urine out steady age

nephron - Functional ____ of the kidney

unit

urea - Nitrogen-containing waste products formed in the _____

liver

creatinine - Nitrogen-containing waste products of _______ metabolism

protein

aldosterone - Principle hormone from the adrenal cortex that causes ______ retention and potassium secretion by the kidneys

sodium

antidiuretic hormone (ADH) - Stimulates _____ absorption by the kidneys. Constricts blood vessels

water

glomerulus - Tuft of capillaries situated inside the glomerular _______ of a nephron

capsule

glomerular capsule - Structure surrounding the glomerular capillaries of the _______

nephron

collecting tubule - the part of the nephron that _______ the distal tubule and carries the filtrate toward the collecting ____, where it becomes _____ that eventually ______ into the renal calyces and renal pelvis

follows duct urine drains

proximal tubule - the _____ segment of the nephron tubule that receives filtrate from the glomerular _______ and is where much of the _____, glucose, and electrolytes in the filtrate are reabsorbed.

first capsule water

distal tubule - the segment of the nephron tubule after the renal ____ that leads to the collecting ____, where the filtrate’s composition is further altered and antidiuretic hormone (ADH) influences _____ reabsorption

loop duct water

renal pelvis - Juncture between the _______ and the ureters; final urine from all collecting ducts _______ here

kidneys empties

micturition - _________ reflex

urination

acidosis - Condition in which the production of acids ______ the body’s pH

lowers

albumin - a _______ that circulates in the blood

protein

albuminuria - Presence of the plasma protein albumin in _____

urine

anuria - rare complete ____ of urine production

stop

dysuria - painful _______ feeling when urinating

burning

pyuria - ___ in urine

pus

hematuria - _____ in urine

blood

hyperkalemia - high blood _________

potassium

inflammatory kidney disease - ___ due to infection.

causes:

lupus nephritis - occurs when patient has systemic _____ (blood in urine, hypertension)

IgA nephropathy - IgA in glomeruli (Berger’s disease, can take years to ____ symptoms)

glomerulonephritis

acute post-streptococcal glomerulonephritis - immune/strep complexes _______ and accumulate, happens 1-4 weeks after infection

not lupus show trapped

hypertensive kidney disease - atherosclerosis of kidney capillaries (decreased blood ____ to kidneys stimulates increase in _____ pressure). Can cause you to have chronic ____ blood pressure, which causes ______ on the arteries of the kidneys. Subsequently narrow, thicken, or ____ blood vessels, impedes blood ____ to kidneys and they can’t do their job of filtering. ____ and medication can help. Surgery is sometimes needed

flow blood high stress scar flow diet

proteinuria - too much _______ in urine

protein

end-stage renal disease - complete _______ of kidney function. Kidneys no longer ____ as they should to meet the body’s needs. Blood pressure and blood sugar will be out of _______. If diabetic or hypertensive, monitor total urine _______ levels. If at high risk for ESRD, reduce dietary _______. Do not smoke.

failure work control protein protein

nephrotic syndrome - due to glomerular ______. The glomeruli are inflamed.

Results:

too much _______ in urine; proteinuria

low levels of _______ in blood; hypoalbuminemia

edema; ________ in parts of body

hyperlipidemia; high levels of cholesterol and other ______ in blood

Can be caused by lupus and/or ________

damage protein albumin swelling lipids diabetes

hydronephrosis - chronic kidney disorder. Retain _____ in kidney tubules (obstruction)

urine

hydroureters - chronic kidney disorder. Distension of _______ due to obstruction

ureters

chronic glomerulonephritis - glomerular inflammation that can lead to _____ failure (lupus, autoimmunity)

renal

urinary incontinence - loss of bladder _______ (age related)

control