The Urinary System

1
Medical Terminology

• Chapter 11
• The Urinary System

2
Function

• Maintaining Homeostasis
• Constantly filtering blood to remove urea and
  other waste products
• Maintaining the proper balance of water, salts,
  and other substances by removing or reabsorbing
  them as needed
• Excreting the waste products via the urine

3
Anatomy Physiology

• Urinary System
• 2 kidneys
• 2 ureters
• 1 urethra
• 1 bladder

4
Anatomy Physiology

• Urine is formed in the kidneys
• Ureters carry the urine to the bladder
• Bladder is a temporary reservoir for the urine
• Urine is excreted through the urethra

5
Anatomy Physiology

• Function of the Kidneys

• Maintain the chemical composition of the blood by
  selective secretion of solutes
• Maintain blood pH, thus contributing to acid base
  balance
• Excretion of nitrogenous waste products of
  protein metabolism, mainly urea, uric acid, and
  creatinine
• Degrade insulin
• Metabolize Vitamin D to its active form
• Production of renin, erythropoietin, and
  prostaglandins
• Maintain plasma volume by varying the
  
  excretion of water

6
Anatomy Physiology

• Renal
• Pertaining to the kidney
• Ureteral
• Pertaining to the ureter
• Cyst(o)
• Bladder, cyst or fluid filled sac
• Urethral
• Pertaining to the urethra

7
Anatomy Physiology

• Kidney is encased in a fibrous capsule
• Fibrous capsule provides protection
• The notch or depression on the inner border where
  the renal artery, renal vein, lymphatics, and
  nerves enter or leave the kidney
• Hilum
• Pyel(o)
• Renal pelvis
• Funnel shaped structure located in the center of
  each kidney

8
Anatomy Physiology

• Nephr(o)
• Kidney
• Nephron
• Functional unit of kidney comprised of a
  glomerulus and tubules.
• Glomerulus is a cluster of blood vessels
  surrounded by Bowman's capsule

9
Anatomy Physiology

• Glomerulus
• Filter for the blood
• Bowmans capsule collects the substances that
  filter through the glomerular walls and passes
  them through a long twisting tube.
• The renal tubule is a long twisting tubule that
  consists of a proximal tubule, a loop of Henle,
  and a distal tubule that opens into a collecting
  duct.
• The function of the nephron is to filter blood
  and reabsorption of the substances that the body
  conserves.

10
Anatomy Physiology

• Waste products and some of remaining water in the
  tubules after reabsorption combine to become
  urine
• This urine passes through the collecting duct to
  the renal pelvis
• From renal pelvis urine passes through the
  ureters to the bladder
• Bladder collapsible muscular bag that serves as
  a reservoir for urine

11
Anatomy Physiology

• Healthy bladder can hold 500 ml ( 1 pint) or more
• Micturition, voiding, urination expelling urine
  form the bladder
• Glomerular filtration rate (GFR) calculates the
  volume of fluid filtered by the glomeruli

12
Diagnostic Tests Procedures

• Physical Assessment KUB
• Abdominal inspection
• Auscultation
• Palpation
• Percussion

13
Diagnostic Tests Procedures

• Laboratory tests Urinalysis
• Color
• Specific gravity
• Chemicals
• pH, urea, ammonia, creatinine, salts, sugar,
  albumin, ketones, blood

14
Diagnostic Tests Procedures

• Gylcosuria
• Sugar in the urine
• Hematuria
• Blood in the urine
• Proteinuria
• Protein in the urine
• Albuminuria
• Albumin in the urine
• Ketonuria
• Ketones in the urine

15
Diagnostic Tests Procedures

• Microscopic study
• Body cells
• Crystals
• Bacteria
• Pyuria
• Pus in the urine
• Pus necrotic white blood cells

16
Diagnostic Tests Procedures

• Urine culture
• Identify pathogenic bacteria present
• Urine sensitivity
• Antibiotic sensitivity test

17
Diagnostic Tests Procedures

• Voided specimen
• Clean catch specimen
• Catheterized specimen
• 24 hour urine collection
• Urine
• Calcium
• Creatinine

18
Diagnostic Tests Procedures

• Blood tests
• Serum creatinine test
• Blood urea nitrogen (BUN)

19
Diagnostic Tests Procedures

• Urinary Catheterization
• Catheter through urethra
• Temporary or permanent drainage of urine
• Urethral
• Ureteral
• Suprapubic
• Nephrostomy

20
Diagnostic Tests Procedures

• Urodynamic studies
• Cystometrography
• Measure bladder capacity in relation to changing
  urine pressure
• Electromyography
• Evaluate the strength of the muscles used in
  voiding

21
Diagnostic Tests Procedures

• Urinary Radiography
• KUB X-ray (kidneys, ureters, bladder)
• Intravenous pyelography (IVP)
• Cystography
• Urethrography
• Cystourethrography
• Voiding cystourethrogram

22
Diagnostic Tests Procedures

• Renal angiography
• Renal arteriogram
• Kidney scan (renography)
• Nephrosonography
• Nephrotomography

23
Diagnostic Tests Procedures

• Visual examination of the bladder
• Cystoscopy
• Urethroscopy
• Cystourethroscopy
• Nephroscopy

24
Pathologies

• Uropathy
• Any disease of the urinary tract
• Renovascular disorders
• Affecting Blood vessels of the kidneys
• Dysuria
• Difficult or painful urination
• Polyuria
• Excretion of an abnormally large amount of urine

25
Pathologies

• Anuria
• Absence of urination
• olig(o)
• Few
• Oliguria
• Diminished capacity to form urine

26
Pathologies

• Urination Patterns
• Urgency
• Frequency
• Hesitancy
• Urinary retention
• Incomplete emptying of the bladder
• Urinary reflex
• Abnormal backward or return flow of urine from
  the bladder into the ureters

27
Pathologies

• Continence
• Ability to control bladder or bowel function
• Urinary incontinence
• Inability to control urination
• Enuresis
• Inability to control urination (bedwetting)
• Nocturia
• Excessive urination at night

28
Pathologies

• Nephromegaly
• Enlarged kidney (unilateral, bilateral)
• Uremia
• Accumulation of toxic products in the blood

29
Pathologies

• Acute renal failure
• Oliguria
• Rapid accumulation of nitrogenous wastes in the
  blood
• Caused by
• Nephritis
• Interference with renal blood flow
• Conditions that disrupt urinary output
• Reversible when cause is identified and treated

30
Pathologies

• Chronic renal failure
• Condition in which the kidney gradually ceases to
  remove metabolic wastes and excessive water from
  the blood.
• Uremia is a major characteristic.
• May lead to the need for dialysis
• Kidney impairment is not reversible once the
  disease progress to the end stage.

31
Pathologies

• Nephrotoxic
• Substance that is toxic or destructive to the
  kidney cells
• Nephrolysis
• Destruction of the kidney or freeing the kidney
  from adhesions
• Nephromalacia
• Abnormal softening of the kidney

32
Pathologies

• Urethrorrhagia
• Urethral hemorrhage
• Urethrorrhea
• Discharge from the urethra

33
Pathologies

• Urinary Tract Infection
• Infection of one or more structures of the
  urinary system
• Urinary frequency
• Discomfort during urination
• Backache
• Fever
• Blood or pus in urine

34
Pathologies

• Septicemia
• Systemic infection in which pathogens are present
  in the circulating blood, having spread from an
  infection in another part of the body such as the
  urinary tract
• Urethritis
• Pyelonephritis

35
Pathologies

• Cystitis
• Inflammation of the bladder
• Ureteritis
• Inflammation of a ureter
• Ureteropathy
• Any disease of the ureter
• Ureteropyelonephritis
• Inflammation of ureter, renal pelvis and the
  kidney

36
Pathologies

• Pyelonephritis
• Inflammation of the kidney and renal pelvis
• Polycystic kidney disease
• Renal disorder in which the kidneys are enlarged
  and contain many cysts. Also called polycystic
  renal disease.

37
Pathologies

• Nephritis
• Inflammation and abnormal kidney function
• Glomerulonephritis
• Glomeruli within the kidneys are inflamed
• Nephrotic syndrome
• Abnormal condition of the kidney characterized by
  marked proteinuria and edema
• Diabetic nephropathy
• Disease of the kidneys resulting from diabetes
  mellitus

38
Pathologies

• Obstructive nephropathies
• Conditions that interfere with the flow of urine
• Prolapsed adjacent structures
• Tumors
• Stones
• Narrowing of ureters or urethra
• Dysfunctions of the bladder
• Hydronephrosis
• Hydroureter

39
Pathologies

• Uterine prolapse
• Loss of support that anchors the uterus, can
  result in pressure on the bladder
• Urethrocele
• Herniation of the urethra
• Cystocele
• Herniation of the bladder

40
Pathologies

• Benign prostatic hyperplasia
• Enlargement of the prostate
• Nonmalignant
• Noninflammatory
• Common in men over 50 years of age

41
Pathologies

• Urinary stones are named according to their
  location and can vary greatly in size
• Nephrolithiasis
• Kidney stone
• Ureterolithiasis
• Presence of stones in the ureter

42
Pathologies

• Ureteral or urethral stricture
• Narrowing of the lumen of the ureter or urethra
• Ureteral stenosis
• Urethral stenosis
• Ureteralvesical junction
• Pertains to ureter and bladder

43
Pathologies

• Renovascular disease
• Problems of the blood vessels of the kidney
• Nephrosclerosis
• Hardening of the small arteries of the kidney
• Stenosis of the renal artery
• Partial or complete blocking of one or both renal
  arteries
• Thrombosis of the renal vein
• Blood clot in the renal vein

44
Pathologies

• Genitourinary and Urogenital
• Pertains to the genitals as well as the urinary
  organs
• Many genitourinary infections are sexually
  transmitted diseases
• gon(o)
• Genitals or reproduction
• Gonorrhea
• Infection known for its discharge

45
Pathologies

• Gonococcus is the bacterium that causes,
• Gonorrhea
• Inflammation of the urethra
• Urethritis

46
Surgical Therapeutic Interventions

• Kidney Dialysis
• When kidneys fail, dialysis removes waste
  products from the body
• Hemodialysis
• Blood is filtered
• Peritoneal dialysis
• Solution is introduced and drained from the
  peritoneal cavity

47
Surgical Therapeutic Interventions

• Renal transplant
• Kidney is received from a suitable donor
• Nephrectomy
• Surgical excision of a kidney
• Immunosuppressive therapy

48
Surgical Therapeutic Interventions

• Renal carcinoma
• Cancer of the kidney
• Cystectomy
• Surgical excision of the bladder
• Urinary diversion
• Ureterostomy
• Nephrostomy
• Transureteroureterostomy

49
Surgical Therapeutic Interventions

• Lithotripsy
• Crushing of a stone
• Litholysis
• Dissolving a kidney stone
• Extracorporeal shock wave lithotripsy (ESWL)
• Ultrasonic energy form a source outside the body
  to break up a stone

50
Surgical Therapeutic Interventions

• Nephrolithotomy
• Removal of kidney stones by cutting through the
  body of the kidney
• Pyelolithotomy
• Removal of a stone from the renal pelvis
• Ureterolithotomy
• Removal of stone from the ureter
• Cystolithotomy
• Removal of stone form the bladder

51
Surgical Therapeutic Interventions

• Percutaneous transluminal renal angioplasty
• Treatment for renal artery stenosis
• Anticoagulant therapy
• Treatment for renal vein thrombosis
• Catheter dilation
• Treatment for stricture of the ureter or urethra

52
Surgical Therapeutic Interventions

• Ureterectomy
• Partial or complete surgical excision of the
  ureter
• Ureteroplasty
• Surgical repair of a ureter
• Cystoplasty
• Surgical repair of the bladder

53
Surgical Therapeutic Interventions

• Cystostomy
• Formation of a new opening in the bladder
• Cystotomy
• Incision of the bladder
• Urethrotomy
• Surgical incision of the urethra

54
Surgical Therapeutic Interventions

• TURP
• Transurethral resection of the prostate
• instrument passes through the urethra to get to
  the prostate gland where pieces of the prostate
  gland are removed through a special instrument

55
Surgical Therapeutic Interventions

• Nephroptosis gradual downward displacement of
  the kidney. Also called floating, hypermobile, or
  wandering kidney.
• Nephropexy
• Surgical fixation of the kidney

56
Surgical Therapeutic Interventions

• Urinary incontinence
• Inability to control urination
• Treatment varies by the many causes
• Urinary retention
• May require catheterization or medications

57
Surgical Therapeutic Interventions

• Treatment for Urinary Tract Infection
• Antibiotics
• Analgesics
• Increased intake of fluids
• Diuretics
• Cause polyuria or diuresis
• Urethrospasm
• Antispasmodic medication to prevent muscle spasms

58
Chapter 11 The Urinary System

• Class Exercises

59
What does it Mean?

• Bacteri(o)
• bacteria
• dipl(o)
• double
• glomerul(o)
• glomerulus
• gylcos(o)
• sugar
• gon(o)
• genital or reproduction

60
True or False Kidney Function

• Degrade insulin
• True
• Excrete waste products of metabolism
• True
• Help maintain the chemical composition of the
  blood
• True

61
True or False Kidney Function

• Maintain blood pH
• True
• Manufacture Vitamin K
• False
• Produce erythropoietin
• True
• Vary excretion of water
• True

62
What does it Mean?

• Nephr(o)
• kidney
• nos(o)
• disease
• pyel(o)
• renal pelvis
• ren(o)
• kidney
• -rrhagia
• hemorrhage

63
What does it Mean?

• -rrhaphy
• suture
• -rrhexis
• rupture
• staphyl(o)
• grape-like cluster
• strept(o)
• twisted
• ureter(o)
• ureter

64
What does it Mean?

• Urethr(o)
• urethra
• urin(o)
• urine
• glycosuria
• the presence of sugar in the urine
• cystostomy
• formation of an opening into the urinary bladder

65
What does it Mean?

• Ureterolithiasis
• presence of stones in the ureter
• cystorrhexis
• rupture of the bladder
• ketonuria
• excretion of ketones in the urine
• nosocomial
• pertaining to or originating in a hospital
• renal
• pertaining to the kidney

66
What does it Mean?

• Pyelitis
• inflammation of the renal pelvis
• lithotripsy
• crushing of calculus within urinary system or
  gall bladder followed by washing out
• cystoscopy
• visual examination of the bladder with an
  instrument that is inserted through the urethra

67
Spelling

• Ureteroskopy
• ureteroscopy
• urethrosel
• urethrocele
• urethrorhagia
• urethrorrhagia
• dialisis
• dialysis
• pyonefrosis
• pyonephrosis

68
Spelling

• Nefrostomy
• nephrostomy
• pieloplasty
• pyeloplasty
• nefron
• nephron

69
Matching

• 1. Inflammation of a ureter
• 2. Instrument used to visualize the bladder
• 3. Incision of the urinary bladder
• 4. Surgical repair of the renal pelvis
• 5. Suture of the lip

• A. Cheilorrhaphy
• B. Ureteritis
• C. Cystoscope
• D. Pyeloplasty
• E. Cystotomy

70
Matching

• 1. Enlargement of the kidney
• 2. Absence of urine
• 3. Hemorrhage from the urethera
• 4. Herniation of the bladder
• 5. Ultrasonic scanning of the kidney

• A. Anuria
• B. Urethrorrhagia
• C. Cystocele
• D. Nephrosonography
• E. Nephromegaly

71
Define the Term

• Cystoscopy
• examination of the interior of the bladder
• glomerulopathy
• any disease of the filtering part of the kidney
• cardionephric
• pertaining to the kidney and heart
• lithotripsy
• crushing of calculus within the urinary system

72
Define the Term

• Cystoscope
• instrument used to view the interior of the
  bladder
• polyp
• growth protruding from mucous membrane
• Intravenous Pyelogram (IVP)
• the record obtained when a contrast medium is
  injected into a vein and x-rays are taken to
  observe kidney function.

73
Define the Term

• Ureteropyelitis
• inflammation of a ureter and the renal pelvis
• streptococcal pharyngitis
• infection of the throat caused by streptococci
• urethrocele
• herniation of the urethra
• polyuria
• excessive urination

74
Define the Term

• Anuria
• absence of urine
• nephrorrhaphy
• suture of the kidney
• urography
• radiography of the urinary system
• albuminuria
• presence of albumin in the urine
• glycosuria
• excretion of sugar in the urine

75
Define the Term

• Cystorrhexis
• rupture of the bladder
• nephrosonography
• ultrasound of the kidney
• nephrolysis
• destruction of kidney tissue
• dysuria
• difficult urination
• cystitis
• inflammation of the bladder

76
Define the Term

• Pyuria
• pus in the urine
• cystostomy
• formation of a new opening into the bladder
• nephritis
• inflammation of the kidney
• nephrolith
• kidney stone

77
Define the Term

• Glomerulonephritis
• inflammation of kidney which involves the clump
  of capillaries that act as filters
• staphyloccoci
• cocci that grow in grape like clusters
• streptococci
• cocci that grow in twisted chains
• nephrocele
• herniation of the kidney

78
Define the Term

• Diuresis
• increased urination
• uremia
• accumulation of waste products in the blood
• nephrectomy
• removal of a kidney
• ureteritis
• inflammation of a ureter

79
Matching

• 1. A kidney stone
• 2. Surgical fixation of a floating kidney
• 3. Herniation of ureter
• 4. Surgical transplantation of a ureter to a
  different place in the bladder
• 5. Sugar in the urine
• 6. Formation of a new opening into the bladder

• A. Cystostomy
• B. Glycosuria
• C. Ureterocystostomy
• D. Uretorocele
• E. Renal calculus
• F. Nephropexy

80
What does it Mean?

• Hematuria
• blood in the urine
• ureterolith
• a stone in the ureter
• pyeloplasty
• surgical repair of the renal pelvis
• nosocomial
• originating in the hospital
• dysuria
• difficult urination

81
What does it Mean?

• Unilateral nephromegaly
• enlargement of one kidney
• urethrorrhagia
• hemorrhage from the urethra
• nephrorrhaphy
• suture of the kidney
• polycystic kidney disease
• the presence of many fluid filled sacs throughout
  the kidney

82
What does it Do?

• Urethra
• carries urine from the bladder
• ureters
• carries urine to the bladder
• bladder
• reservoir for urine
• kidneys
• filters blood and excretes waste on the form of
  urine

83
What does it Mean?

• Cystitis
• inflammation of the bladder
• nephrolysis
• destruction of kidney tissue
• nephropexy
• surgical fixation of a floating kidney
• anuria
• absence of urine
• incision of the bladder
• cystotomy

84
What does it Mean?

• Spherical bacteria
• cocci
• rod shaped bacteria
• bacilli
• resection of the bladder
• cystectomy
• excision of a renal calculus from the pelvis of
  the kidney
• pyelolithotomy

85
What does it Mean?

• Cystoplegia
• paralysis of the bladder
• toxemia
• presence of microorganisms or their toxins in the
  blood
• nephrolithiasis
• a condition marked by the presence of renal
  calculi

86
Case Study

• Last week, my neighbor Mrs. O. was complaining of
  back pain, blood in her urine, and painful
  urination. She went to see the physician who
  specializes in urinary problems. The physician
  ordered a urine test. It was found that she had
  albumin in her urine. The physician then ordered
  a ultrasonic scanning of the kidney. She was
  diagnosed with kidney stones and an enlarged left
  kidney.

87
Case Study

• The physician spoke with Mrs. O. and decided she
  needed to have the kidney stones surgically
  crushed. Mrs.. O. had to have a tube inserted
  into her bladder to drain urine. Mrs. O. is now
  home and happy to be with her family.

88
Case Study

• Dorsodynia
• hematuria
• dysuria
• Urologist
• urinalysis
• albuminuria

89
Case Study

• nephrosonography
• nephrolithiasis
• unilateral nephromegaly
• Lithotripsy
• catheter