Final Exam Study Guide

• blood's path through renal system

  descending aorta -> renal arteries -> kidneys -> renal vein -> vena cava
• bruh

  A) cortex

  B) medulla

  C) renal column

  D) renal pyramid

  E) ureter

  F) minor calyx

  G) major calyx

  H) renal sinus (space)

  I) renal pelvis

  J) renal vein

  K) renal artery

  
• renal artery - branches off descending aorta

  • blood is filtered once it branches into capillaries
  • filtered blood enters renal venules --> renal vein --> vena cava
• renal arteries diverge at renals sinus, while renal veins converge at renal sinsu
• filtrate goes from renal pyramid --> column --> minor calyx --> major calyx -> renal pelvis --> ureter
• BRUH

  A) Juxtamedullary nephron

  B) cortical nephron

  C) Cortex

  D) Medulla

  E) Collecting Duct

  
• bruh

  A) renal artery

  B) renal vein

  C) inferior vena cava

  D) aorta

  
• bruh

  A) afferent arteriole

  B) glomerulus

  C) efferent arteriole

  D) peritubular capillaries

  E) vasa recta

  F) Ascending loop of Henle

  G) Descending loop of henle

  H) Proximal tubule

  I) distal tubule

  J) Bowman's capsule

  
• the afferent arteriole approaches the glomerulus
• efferent arteriole: exits the glomerulus
• filtrate -> Bowman's capsule -> proximal convoluted tubule (PCT) -> loop of Henle -> distal convoluted tubule -> collecting duct -> minor calyx
• blood -> afferent arteriole -> glomerulus -> efferent arteriole -> peritubular capillaries -> vasa recta -> renal venules -> renal veins
• bruh

  A) Juxtaglomerular cells

  B) Macula densa

  C) Juxtaglomerular apparatus

  D) pedicel (foot process)

  E) podocyte

  
• Changes in unpreserved urine

  • increased
  • pH - due to bacteria with urease breaking down urea to ammonia
  • nitrite - if bacteria can reduce nitrate
  • bacteria
  • turbidity - due to bacterial growth/precipitation of amorphous sediment
• Decreased changes in unpreserved urine

  • glucose - bacteria utilizes glucose for metabolism
  • ketones - if present as they are volatile; evaporate at RT
  • bilirubin - due to breakdown by light
  • urobilinogen - due to oxidation of bilirubin
• other changes in unpreserved urine

  • disintegration of RBC's and casts result in increase in pH
  • changes in color - due to oxidation or reduction of metabolites
• decreased in unpreserved urine - glucose, ketones, bilirubin, urobilinogen
• increased in unpreserved urine - pH, nitrite, bacteria, turbidity
• specimen collection

  • midstream - clean catch - clean urethra, start flow, stop flow, then catch urine
  • catheterization
  • suprapubic aspiration - needle stuck into bladder; should be sterile
• types of urine specimens

  • random - any concentration, most common
• types of urine specimens

  • 1st morning void - preferred, most concentrated (at night, kidneys conserve water), most likely to detect abnormalities
• types of urine specimens

  • 2nd morning specimen - used for glucose monitoring
• timed postprandial - after eating; 2 hour most common; also used for glucose testing and diabetes monitoring
• types of urine specimens

  • glucose tolerance testing - collected after fasting, collected 30 min after glucola, 1 hour after glucola, 2 hours after glucola, and 3 hours after glucola
• types of urine specimens

  • 24 hour urine - patient voids upon awakening; write down time of first void; collect rest of urine during the day in jug; next morning, urinate at time written yesterday into jug; ensures exactly 24 hours of urine is collected
• what kind of jug (preservative) is used for a 24 hour urine depends on what the doctor is looking for
• 3 glass collection - used to rule out prostate infections

  • patient has 3 containers labeled in ascending order; patient voids into each container according to numbers
• important terms

  • polyuria - excessive urination; generally, >2500 mL; associated with diabetes mellitus and diabetes insipidus
  • may be artificially induced by
  • diuretics - drugs that cause kidney to excrete more water
  • alcohol
  • increased fluid intake
• important terms

  • oliguria - reduced urination; between 100-500 mL per day; caused by vomiting, diarrhea, perspiration, burns, severe nephritis
• important terms

  • anuria - cessation of urination; <100 mL per day; caused by severe kidney damage; reduced blood flow to kidney
• cystitis - inflammation of bladder
• nephritis - inflammation of the kidney
• pyelonephritis - inflammation of kidney due to bacteria
• glomerulonephritis - inflammation of kidney not due to bacterial infection; blood, casts, protein in urine
• nephrosis - kidney degeneration
• nephrotic syndrome - increased permeability of glomerular membrane
• macroscopic analysis

  • color
  • yellow - most common color of urine, due to presence of urochrome pigments at normal excretory volume
• macroscopic analysis

  • straw (pale yellow) - drinking more water; excreting more water; diluting urochrome
• macroscopic analysis

  • dark yellow - decreased water excretion; caused by dehydration or water retention; could mean there is small amounts of bilirubin in urine
• macroscopic analysis

  • orange - usually from UTI analgesic
  • pyridium - urinary tract analgesic; thick pigment; makes urine viscous and orange