what effect is trauma of an accident most likely to have on the urinary system course hero

by Christiana Howe 7 min read

What is the pathophysiology of acute kidney injury?

Jan 31, 2017 · What effect is the trauma of the accident most likely to have on Abby's urinary system? - The rate of glomerular filtration will decrease significantly. - In the case of trauma or shock, the rate of glomerular filtration will decrease significantly.

How robust is the proliferative response to renal tubular injury?

Abstract. Acute kidney injury (AKI) is the leading cause of nephrology consultation and is associated with high mortality rates. The primary causes of AKI include ischemia, hypoxia or nephrotoxicity. An underlying feature is a rapid decline in GFR usually associated with decreases in renal blood flow.

What is a urinary tract infection (UTI)?

Age and constipation. A decrease in urinary structure muscle tone is due to the lack of stretching due to indwelling catheters in the muscle as well as past trauma such as giving birth , muscle atrophy , and lack of hormones ( p 1270 ) . Age and constipation . 2.

How does renal tubular damage increase the risk of death?

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is. a. elevated total iron-binding capacity. b. elevated MCHC and MCV. c. elevated total and indirect bilirubin. d. positive direct or indirect Coombs test. A. In iron-deficiency anemia, the total iron-binding capacity is elevated.

What causes acute interstitial nephritis?

AKI from interstitial damage can result from acute interstitial nephritis due to an allergic reaction to a variety medications (commonly antibiotics such as penicillins, cephalosporins, sulfonamides) or an infection (bacterial illnesses such as leptospirosis, legionella, rarely pyelonephritis and viral illnesses such as Hanta virus), ( 381, 542 ).

What causes tubular necrosis?

Acute tubular necrosis (ATN) is the term used to designate AKI resulting from damage to the tubules. The two major causes of ATN are: 1 Ischemic – resulting from severe or protracted decrease in renal perfusion. 2 Nephrotoxic – resulting from a variety of exogenous compounds (e.g. aminoglycosides, amphotericin B, cis-platinum, radiocontrast media) and endogenous compounds (e.g. hemoglobin in hemolysis, myoglobin in rhabdomyolysis) that are toxic or potentially toxic to the kidney.

What is the leading cause of nephrology consultation?

Abstract. Acute kidney injury (AKI) is the leading cause of nephrology consultation and is associated with high mortality rates. The primary causes of AKI include ischemia, hypoxia or nephrotoxicity. An underlying feature is a rapid decline in GFR usually associated with decreases in renal blood flow.

How long does it take for renal blood flow to return to baseline?

Although total renal blood flow typically returns to baseline values between 1–4 weeks of recovery, our laboratory hypothesized that there is chronic impairment of medullary vascular function following AKI. This hypothesis was based on early pathological observations suggesting vasa recta capillaries from post AKI patients were separated from nearby cells of the loops of Henle, potentially compromising the efficiency of the processes driving the generation of the medullary concentration gradient. Using microfil to generate vascular casts, we demonstrated between a 30–50% reduction in the total number of microvessels, most pronounced in the inner stripe of the outer medulla, after recovery from AKI ( Figure 13) ( 32 ). It is important to note that such alterations in renal blood vessel density do not necessarily indicate a reduction in total RBF and GFR as these values were typically restored to normal levels when vessel density measurements were made ( 102, 250, 629 ). Recently published studies have shown reductions in peritubular capillary density in transplanted renal grafts; in these studies, the degree of capillary rarefaction is more pronounced in grafts experiencing delayed function ( 283, 510 ).

Which limb is most sensitive to ischemic damage?

In most animal models of AKI, the proximal tubule is considered the most sensitive cellular entity to ischemic, hypoxic or nephrotoxic damage ( 62, 68 ). However, the thick ascending limb of Henle is also highly metabolically active and is dramatically affected is certain models of AKI ( 61 ). In a rat model of ischemia reperfusion, early morphological alterations (such as tubular dilatation and loss of renal microvilli) are observed in all proximal tubule segments within hours of the initiation of reperfusion ( 489, 573 ). Proximal tubule cells within the S1 and S2 segment manifest a largely reversible injury; if cell death occurs, it localized primarily in the S3 segment ( 573 ).

What is the function of the kidney?

One of the most important functions of the kidney is the filtration and excretion of nitrogenous waste products from the blood. The measurements of elevated blood urea nitrogen (BUN) and creatinine serve as indicators of decreased renal function indicative of the decreased clearance of these waste products.

Is ATN a site of injury?

As mentioned above, the term ATN correctly identifies the site of injury, though relatively few renal epithelial cells undergo frank necrosis. More commonly, sublethal changes in renal tubular epithelial cells are present and thus the term acute tubular injury may be more appropriate. Importantly, even sublethal changes can have a major impact on the decrement in GFR that is the hallmark of AKI.

What are the most common pregnancy related traumas?

The most common pregnancy-related traumas are minor incidents, including motor vehicle crashes and mild blunt abdominal trauma. These situations require clinical judgment about the extent of maternal and fetal assessment.

What should be included in a trauma assessment?

Once the primary assessment has been completed, a secondary assessment should include obstetric and nonobstetric injuries and fetal well-being. A placental abruption may become apparent shortly after the injury.

What is the most common cause of death in pregnancy?

Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Nine out of 10 traumatic injuries during pregnancy are classified as minor, yet 60% to 70% of fetal losses after trauma are ...

How many pregnant women die in a car crash?

Overall, 2% of pregnant women are involved in a motor vehicle crash during their pregnancy, 7 and an estimated 368 pregnant women per year die as a result. 23 Motor vehicle crashes account for more than 50% of all trauma during pregnancy, with 82% of fetal deaths occurring during these crashes. 24

What are the physiologic changes of pregnancy?

3, 6 Physiologic changes include a 30% to 50% increase in blood volume and a 40% to 50% increase in respiratory rate. 7 Anatomic changes include elevated diaphragm, delayed gastric emptying, and progressive uterine growth.

What is the Kleihauer-Betke test?

The Kleihauer-Betke test should be performed after major trauma to determine the degree of fetomaternal hemorrhage, regardless of Rh status. To improve the effectiveness of cardiopulmonary resuscitation, clinicians should perform left lateral uterine displacement by tilting the whole maternal body 25 to 30 degrees.

How long should a pregnant woman be monitored for trauma?

Pregnant women at greater than 20 weeks' gestation who have experienced trauma should be monitored for a minimum of four hours by tocodynamometry. C. 8, 12. The Kleihauer-Betke test should be performed in all pregnant women who sustain major trauma.

What are the complications of a UTI?

Complications of a UTI may include: Recurrent infections, especially in women who experience two or more UTIs in a six-month period or four or more within a year. Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.

How to reduce the risk of urinary tract infection?

You can take these steps to reduce your risk of urinary tract infections: Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you'll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin. Drink cranberry juice.

Why does my bladder get infected?

Causes. Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail.

Which organs remove waste from the body?

Your urinary system — which includes your kidneys, ureters, bladder and urethra — removes waste from your body through urine. Your kidneys, located in the rear portion of your upper abdomen, produce urine by filtering waste and fluid from your blood.

What is the urinary system?

Male urinary system. Your urinary system — which includes your kidneys, ureters, bladder and urethra — removes waste from your body through urine. Your kidneys, located in the rear portion of your upper abdomen, produce urine by filtering waste and fluid from your blood. A urinary tract infection (UTI) is an infection in any part ...

What are the symptoms of a UTI?

Part of urinary tract affected. Signs and symptoms. Kidneys (acute pyelonephritis) Back pain or side (flank) pain. High fever.

What is the cause of UTI?

This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible.