Urinary System Pathologies

1
Urinary System Pathologies

• To pee or not to pee

2
Organs of the urinary system

• 2 kidneys
• 2 ureters
• 1 urinary bladder
• 1 urethra

3
Responsibilities

• Producing
• Storing
• Excreting urine
• Cleansing waste product left from metabolism from
  the blood
• Regulation water, salts and acids to insure
  homeostasis of acid-base balance
• Part of regulating BP, ADH/vasopressin

4
Normal Function of the System

• The Nephron working unit responsible for
  filtration, reabsorption and secretion of urine.
  
• Each Kidney is made up of 1 million nephrons.

5
Other functions of the kidneys

• Secretes the hormone renin that raises BP
• Produces erythropoietin that stimulates
  production of rbcs.
• Plays a role in activation of Vitamin D

6
Trauma, Toxins, and Scarring

• Can all result in damage to renal function that
  may allow urea (nitrogenous waste of metabolism)
  or extracellular fluid and electrolytes to
  accumulate in the blood.

7
Other disorders

• Obstructions tumors, structural defects that may
  be acquired or congenital.
• Immunologic disorders
• Circulatory problems
• Cystic disease
• Metabolic disorders
• All can cause the system to be compromised

8
Common abnormal symptoms

• Loss of appetite
• Fever
• Nausea
• HA/body aches
• Flank pain
• Low back pain
• Hematuria
• Edema
• pruritus

• Decrease in urine output
• Increase in BP

9

• Usually symptoms reflect an accumulation of waste
  products in the blood causing electrolyte
  imbalances in the body.
• Often the first diagnostic test to be done is the
  urinalysis physical, chemical and microscopic
  examination of the urine
• What is meant by physical, chemical and micro
  exam of urine describe.

10
Urinalysis

• Demonstrates the filtration, absorption and
  elimination of metabolic waste and precise fluid
  and electrolyte balance
• Other tests may include C S, radiologic tests
  and view structural problems and cystoscopy or
  even biopsy of lesions.
• SEE PAGE 504 OF TEXT ROUTINE URINALYSIS

11

• See page 505 renal diagnostic tests

12
Urine Terminology

• Incontinence loss of voluntary control or the
  bladder
• Retention inability to empty the bladder, may be
  accompanied by overflow incontinence.
• Micturation (urination or voiding) reflex is
  stimulated by increased pressure within the
  urinary bladder as it distends (fills) the reflex
  is sent to
• Parasympathetic nerves and they send impulse to
  the sphincters of the bladder and the pelvic
  diaphragm (muscles) to relax and the bladder
  muscles contract emptying the bladder

13
Causes of Incontinence

• Increased intra-abdominal pressure
  laughing/coughing
• Multiple pregnancyies with vaginal delivery
• Age
• Spinal cord injuries
• Or brain damage in control areas

14
Common blood tests

• BUN blood, urea, nitrogen and serum creatinine
  indicate failure to excrete nitrous waste from
  protein metabolism. GFR
• Metabolic acidosis (decreased serum pH and
  decreased serum bicarbonate indicated decrease
  GFR, and failure of the tubules to control
  acid-base balance

15
Common blood tests cont.

• Anemia low hbg level indicated decreased
  erythropoietin secretion and/or bone marrow
  depression, due to accumulation of wastes.
• Electrolytes depend on related fluid balance
  specific to retention of fluid if GFR is
  decreased may result in a dilution effect, and
  lab values are not a true reflection of renal
  status. However may still require monitoring and
  treatment.

16
Common blood tests cont.

• Antibody level antistreptolysis O (ASO) or
  antitreptokinase (ASK) titers are used for
  diagnosis of post-streptococcal
  glomerulonephritis.
• Renin levels indicate possible cause of
  hypertension.
• C S used to ID causative organism of infection
  if present and best antibiotic

17
Common blood tests cont.

• 24-hour urines like creatinine or insulin
  clearance or radioisotope studies are used to
  access GFR.
• Radiologic tests IVP, angiography, ultrasound,
  Ct, MRI, radionuclide imagine all may be used to
  visualize structures and any abnormalities of the
  Urinary system
• Cystoscopy visualized the Lower UT and may be
  used in performing a biopsy or removing kidney
  stones.

18

• What is the normal pH of blood and urine?
• Urine
• 6.0 is this acid or base
• Acidic
• Blood
• 7.35 -7.45 is this acid or base
• Slightly basic

19
See text bos 11-1 pg 511

• Nephrotoxic agents

20
MORE TERMINOLOGY

• Ren/o
• Olig/o
• Nephr/o
• Pyel/o
• Hydr/o
• Calculi
• Lith/o
• Cyst/o

• Nocturia
• Polyuria
• Azotemia
• KUB
• IVP
• Cystourethrography
• Voiding (VCUG)