14.2 Urinary System

14.2 Urinary System

Multiple Choice

Glomerular filtration rate is relatively constant due to

• renal autoregulation

• sympathetic regulation

• neurological regulation

• isonomic regulation

​Transport tubules for urine

​

​Ureters

​

Multiple Choice

What organ is B pointing to?

• Kidney
• Urethra
• Ureter
• Bladder

Smooth muscle ​for the temporary storage of urine

​

• ​detrusor muscle

• internal urethral sphincter​

• Trigone (openings)

  • R&L ureters

  • urethra

    ​

​Bladder

​

Multiple Choice

The ____ is a sac-like muscular organ that stores urine until it is ready to be released from the body

• Stomach
• Bladder
• Urethra
• Gallbladder

​Micturition- urination

​

​parasympathetic

1. excite the detrusor muscle

2. relax the internal sphincter​

​Sympathetic

1. relaxes detrusor

​Somatic

1. relaxes external sphincter (voluntary)​

​

​Bladder Innervation

​

​Canal that allows excretion of urine (micturition)

​

female

• shorter

• only urinary

• smaller diameter

Male

• longer

• both reproductive and urinary

• larger diameter​

​

​

​Urethra

​

Multiple Choice

A short tube where urine is released from the body is the _______.

• Ureter
• Kidney
• Bladder
• Urethra

Urinalysis

• ​Color

  • urochrome (breakdown of hemoglobin)

    • hydration state

• Odor

  • Time + bacteria= ammonia ​

• Specific Gravity

  • density ratio to distilled water

• pH

  • 6.0 metabolic acidic waste

• Chemical composition

  • urea (most abundant)​

​

Urine Compisition

​

Multiple Choice

A urine sample that is turbid is said to be

• Cloudy
• Clear
• Odorous
• Dark
• Dilute

​The glomerular filtration rate is a primary indicator of kidney function.

​

​

​GFR

​

Urine Collection

• Voided sample: collected as the person is urinating. It should be collected midstream, and the container must be sterile.

• Bladder expression - The bladder is palpated, and urine is manually expressed with pressure.

• Catheterization is when the nurse places a plastic tube, known as a catheter, into the urethra.

• Cystocentesis - A sterile needle is passed through the abdominal wall into a full bladder, and urine is withdrawn directly into the sterile syringe. 

Gross Examination

• Color - Normal is shades of yellow

• Clarity and consistency - Clear, cloudy, flocculent (containing particles)

• Odor - Ammonia, Sweet, fruity

• Presence of foam - When shaken, it produces a small amount of white foam.

pH Test

​metabolic or respiratory Acid-Base homeostasis or renal tubular disorders (no set norm value)

common causes: ​

Low pH

• protein diets

• cranberry juice

​High pH

• vegetarian diets​

Multiple Choice

normal urine pH is

• neutral

• acidic

• basic

• limitless

Protein Test

​A protein test is an indication of renal dysfunction​

​

Proteinuria - Albumin (liver protein) and uromodulin are found in urine.

​

Increased glomerular pressure or damage can lead to proteinuria

​

Urine has a foamy appearance

​

​

proteinuria

​Albumin Creatine Ratio Test

​

Creatine is an amino acid produced by normal muscle metabolism.

​

The UACR and GFR (glomerular filtration rate) help to identify

• kidney dysfunction.

​

​

​

​

​

​

​

​

​

​

Multiple Choice

a patient's urine sample and their chart indicates they have edema in their feet, which urinalysis test would most commonly be positive?

• nitrite

• hematuria

• proteinuria

• pH

Glucose Test

 glucose is abnormally eliminated in the urine due to improper functioning of the renal tubules

​

Glycosuria- high glucose concentration in the urine​

​

Indication of​:

• ​elevated plasma glucose

• renal absorption ​impairment

​

Multiple Choice

Glycosuria is

• protein in the urine

• glucose in the urine

• blood in the urine

• ketones in the urine

ketone Test

Ketone bodies are a byproduct of glycogen breakdown, muscle, and fat being utilized for metabolic energy

Used to monitor type 1 diabetes ​

​

Ketonuria - ​increased glycogen breakdown as a result of insulin deficiency

​

Indication of:

• electrolyte imbalance

• ketoacidosis

• ​dehydration

• diabetic coma​

Blood Test

​Test for the presence of blood or blood cell fragments in the urine

​

Hematuria- the presence of ​intact or fragments of RBCs in the urine

• Microscopic

• Macroscopic​

​

Indication of:

• ​Kidney infection

• Kid​ney stones

• Urinary System ​Cancers

​

Multiple Choice

hematuria

• blood in the urine

• ketones in the urine

• glucose in the urine

• protein in the urine

Urobilinogen and Bilirubin Test

​Urobilinogen is formed from the natural breakdown of Bilirubin

​

Bilirubin is formed from the natural breakdown of hemoglobin

​

Urine should not contain Bilirubin and only trace amounts of Urobilinogen

​

​Indication of:

• Bile duct obstruction

• Liver damage​

​

​

​

Multiple Select

check all that apply, urinalysis test that can detect liver dysfunction

• urobilinogen

• bilirubin

• nitrite

• blood

• pH

Nitrite and Leukocyte Test

Leukocyte test identifies if the body's immune response ​is activated due to infection or inflammation

Leukocyturia- WBCs in urine​

​

Nitrite test identifies the presence of nitrate reductase produced by certain bacteria

​

Indication of:

• Infections

• Inflammation

Specific Gravity Test

measures urine solute concentrations

​

Specific gravity is measured in comparison to the SG of distilled water 1.00

​

​Normal 1.005 -1.030

Though can vary

Usually, it is just a marker test to ​collaborate results from other tests

​

​High- dehydration, proteins, glucose...

Low- ​Electrolyte or hormone imbalances

​

Multiple Choice

a urine sample that has high concentration due to dehydration would have

• high specific gravity

• low specific gravity

• high pH

• low pH

Poll

kidney or bean

• kidney

• bean