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Elderly female patient with urinary problem (Upstream (Old age, May be…
Elderly female patient with urinary problem
Background
Anatomy of urinary system
Kidney
Renal cortex
Where erythropotein is produced
Provides space for arterioles and venules
Renal medullla
Contains nephrons responsible for maintaining water and salt balance of blood
Major calyx
Urine flows through it
Papilla of pyramid
Transport urine from kidneys cortical section to the lumen of a calyx
Renal pelvis
A funnel for urine flowing to the ureter
Minor calyx
Collects urine from pyramid
Ureter
Carries urine from the kidney to the urinary bladder
Layers around kidneys
Renal fascia
Anchors kidney and adrenals to surrounding structures
Perirenal fat capsule
Fatty mass that surrounds kidneys
Cushions it from blows
Fibrous capsule
Transparent capsule
Prevents infection in surrounding regions from spreading to the kidney
Renal column
Allows cortex to be better anchored
Renal artery
Carries blood to the kidneys
Renal vein
Carries blood filtered by kidney
Urinary bladder
Stores urine
Urethra
Carries urine from bladder to outside
Nephron
Cortical nephron
Glomerulus further from the cortex medulla junction
Short nephron loop
Efferent arteriole supplies peritubular capillaries
Juxtamedullary nephron
Glomerulus closer to the cortex medulla juntion
Efferent arteriole supplies vasa recta
Long nephron loop
Consists of renal corpuscle and renal tubule
Conditions
Osteoporosis
Body constantly absorbs and replaces bone tissue
Diabetes mellitus
When body can not produce enough insulin to break down glucose
Hypertension
Force of the blood against the artery walls is too high
Filtration, reabsorption and secretion
Glomerular filtration
Takes place in the renal corpuscle
Produces a cell and protein free filtrate
Tubular reabsorption
Selectively moving substances from the filtrate back into the blood
Takes place in renal tubules and collecting ducts
Tubular secretion
Selectively moving substances from the blood into the filtrate
Takes place along the length of the tubule and collecting ducts
Downstream
Effects of blood pressure on kidneys
Can cause arteries around the kidneys to narrow
If vessels are damaged they may stop removing wastes and extra fluids
Effects of high blood pressure on the body
Damages arteries that can become blocked
Can lead to heart attack
Effects of DM II on kidneys
Too high blood sugar levels can damage the kidneys
Can cause waste and fluids to build up in your blood instead leaving the body
Diabetic neuropathy
Effects of DM II on body
damages blood vessels
Damages eyes, kidneys, nerves, and other body parts
Effects of osteoporosis on kidneys
Increased risk of fractures
Effects of osteoporosis on body
Makes bones weak and brittle
How do diseases affect each other
Having diabetes and osteoporosis can increase the risk of falls and fractures
Having hypertension and diabetes increases risk of heart attack or stroke.
Having hypertension and osteoporosis can accelerate osteoporosis
Cause of blood in urine
High blood pressure is a risk factor for kidney disease which can cause small amounts of blood in urine
Patient will die if nothing changes
Upstream
Old age
May be over weight
May have a low calcium intake
May have eating disorder
May lack certain hormones
She may smoke
Genetics