Term
| where is most of the blood found? |
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Definition
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Term
| what problems do pts with end stage renal disease usually face? |
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Definition
| these pt cannot resorb or discharge water appropriately and have fluid overload and electrolyte imbalances (can become hypercalemic and come in with a cardiac dysrhythmia secondary to kidney failure) |
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Term
| changes in the electrolytes (K, Na, Ca, Cl) can affect what? |
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Definition
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Term
| can the kidney prevent the heart from being in an acidic environment? |
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Definition
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Term
| how can the kidney regulate BP? |
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Definition
| by regulating erythropoietin and angiotensive ions to maintain TPR, and thus BP |
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Term
| can renal function affect HR, SV, and BP? |
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Definition
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Term
| what are the mult. functions of the kidneys? |
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Definition
| regulation of water/electrolyte balance, body fluid osmolality/electrolyte concentrations, and acid/base balance. also, excretion of metabolic waste and foreign chemicals, regulation of arterial pressure, secretion of hormones, and gluconeogenesis |
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Term
| what is the optimal pH for the human body? |
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Definition
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Term
| what is the optimum Na+ level in the body? |
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Definition
|
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Term
| what is the optimum K+ level in the body? |
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Definition
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Term
| where are the kidneys found? |
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Definition
| in the retroperitoneal space |
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Term
| what can a pt's urine tell you about their kidneys? |
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Definition
| if they are dehydrated, if they are at volume overload, if they are working right?, if they have an infarction, if they have nitrates/leukocytes in the urine, if they are pregnant |
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Term
| what is the normal level of urine production? |
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Definition
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Term
| what is found in the medial hilum of the kidney? |
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Definition
| renal artery, vein, nerve supply and ureter |
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Term
| what is found in the outer cortex and inner medulla of the kidney? |
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Definition
| the renal pyramids, renal papilla, minor calices, and major calices |
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Term
| how much does a kidney usually weigh? |
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Definition
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Term
| what kind of pressure system is the aorta (where it feeds the kidneys)? why is this of use? |
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Definition
| high pressure, which allows the resistance associated with filtration to be overcome |
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Term
| why is the placement of the adrenal glands on top of the kidneys a beneficial location? |
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Definition
| b/c these can release hormones back into major circulation |
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Term
| what are things that can happen with a kidney stone? |
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Definition
| hydronephrosis, obstructive neuropathy |
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Term
| where are the kidneys located posteriorly? what does this mean for possible injuries here? |
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Definition
| in the costo-vertebral angle (CVA), and a fractured rib may cause damage here |
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Term
| can UTIs cause lower back pain? kidney stone? |
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Definition
| yes, the pain can travel up the ureters in either case |
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Term
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Definition
| a test for CVA tenderness, which if positive, can indicate a kidney infection |
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Term
| what is the relationship between the psoas muscle and the kidney? |
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Definition
| the kidney lies on the psoas muscle, and if pts are moving the psoas to go up the stairs or something and it irritates an already swollen kidney - this could be an indicator that it is time to check for infectious materials in the urine |
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Term
| why is the peri-renal fat good? |
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Definition
| it is good for shooting ultrasound beams for to get a visualization |
|
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Term
| how much of cardiac output is the kidneys? what is the effect of BP changes on them? |
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Definition
| 21% of CO @ 1200 mL/min (or 1.2 L/min). therefore, if BP goes down, this can cause the kidneys to fail |
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Term
| what is the function of the renal capsule? |
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Definition
| to maintain integrity of the whole - if the kidney starts to swell, it will hurt a lot |
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Term
| what do the afferent and efferent arterioles do? |
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Definition
| afferent: blood in to the kidney, efferent: blood out |
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Term
| does more blood go in or come out of the kidneys? |
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Definition
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Term
| what do the capillaries around the glomerulus and bowman's capsule look like? |
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Definition
| they are very leaky, designed to filter out the ultrafiltrate of plasma. |
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|
Term
| what should not be filtered out into bowman's capsule? |
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Definition
| protein, WBCs, RBCs, and platelets |
|
|
Term
| what do the mesangial cells do? |
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Definition
| these try to keep the protein from being filtered out as well as maintain the necessary water level |
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Term
| what are some major things the kidneys control that affect the heart? |
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Definition
| water concentration affects preload/afterload, electrolyte concentration affects action potentials, EKG, cardiac activity, and neuronal function, and monitoring affets TPR (increases/decreases blood to the kidney through afferent/efferent arteriolar diameter) |
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|
Term
| what is the function of the PCT brush border? |
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Definition
| this creates an even larger surface area |
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|
Term
| what are the 2 functions of renal blood flow? |
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Definition
| 1) to keep the kindeys alive (functional) 2) blood filtration for the whole body (neutralizing) |
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|
Term
| how much fluid do people usually drink per day? how much water does the body produce per day? |
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Definition
| ingested: ~2 L produced: ~200 mL. that is ~2.3 L that comes in, needs to be balanced by about that much going out |
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|
Term
| does the kidney sense cardiac issues and attempt to compensate? |
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Definition
|
|
Term
| how much fluid is found intracellularly? |
|
Definition
| 28 L (2x what you find extracellularly - problematic w/O2 exchange) |
|
|
Term
| how much fluid is found interstitially? |
|
Definition
|
|
Term
| how much fluid is in the plasma? |
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Definition
|
|
Term
| why is it important to be aware of fluid levels in different compartments? |
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Definition
| certain medications go into certain compartments and stay there, some won’t get to certain ones fast enough |
|
|
Term
| do the kidneys maintain balance in the extracellular compartments? what does this help perpetuate? |
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Definition
| yes, Cl, bicarb, etc - this maintenance by the kidneys helps the action potential cycle continue |
|
|
Term
| what are 2 good tests for metabolites in the blood that will give you an idea of kidney function? |
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Definition
|
|
Term
| what happens if you put a cell in an isotonic, hypertonic, and hypotonic solution? |
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Definition
isotonic: cell stays the same
hypertonic: cell shrinks
hypotonic: cell swells |
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|
Term
| what is a rough way to estimate the osmolarity? |
|
Definition
| multiply the Na+ concentration by 2 |
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|
Term
| what are osmoles? what important function do they perform? |
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Definition
| osmoles are various particles in the blood such as metabolites that need to be in the appropriate concentration in the blood so that the osmotic pressure gradient is in the right direction, which allows fluids and electrolytes to move across membranes in the kidney |
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|
Term
| how can you add fluid to the body in a way that maintains integrity of the vasculature? |
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Definition
|
|
Term
| what is hypernatraemia? what can cause it? |
|
Definition
| a too-high level of Na+, which can happen if the kidneys are not correctly regulating the electrolytes - neuronal and cardiac function can be affected |
|
|
Term
| what can dehydration lead to? |
|
Definition
| low BP and poor CO (secondary to low SV) |
|
|
Term
| what can too high volumes of blood lead to? |
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Definition
|
|
Term
| what can happen in the extremities especially when force of contraction, SV and CO fall? |
|
Definition
| edema, or increased fluid in the compartments |
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|
Term
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Definition
| volume is continually added to a certain compartment and the resulting pressure causes the vasculature to start to stretch. flow remains constant, but velocity starts to drop, leading to high BP, increases afterload and the heart can then infarct and die |
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