Urinary System Chapter 10 PDF

**CHAPTER 10** **URINARY SYSTEM** This chapter reviews the concepts on the anatomy and physiology and medical terminology in reference to the urinary system. It helps the learners interpret abbreviations and terminologies to be able to communicate well with other health care workers in taking care...

**CHAPTER 10** **URINARY SYSTEM** This chapter reviews the concepts on the anatomy and physiology and medical terminology in reference to the urinary system. It helps the learners interpret abbreviations and terminologies to be able to communicate well with other health care workers in taking care individual clients with urinary problems/disorders. **Duration:** [ **1.5** hours] [hours] +-----------------------------------------------------------------------+ | **MAJOR TOPICS** | +=======================================================================+ | 1. 2. 3. 4. | +-----------------------------------------------------------------------+ **Activities:** 1. **Labeling Exercise** 2. **Word Building** 3. **Crossword Puzzle** **Before you proceed...** **Intended Learning Outcomes:** - Discuss the general function of the urinary system - Describe the different terms related to the structure and function of the urinary system - Give the terminologies needed for physical examination of the urinary system - Recognize tests that help diagnose urinary system disorders - Identify and define clinical symptoms and disorders of the urinary system and their treatments. **Key Terms:** **Let's Begin!** The urinary tract is the body's drainage system for removing urine, which is made up of extra fluid. For normal urination to occur, all body parts in the urinary tract need to work together, and in the correct order. Part of the urinary tract: **1. Kidneys (2)** - 2 bean-shaped organs, each about the size of a fist. The kidney filters about 120-150 quarts of blood to remove wastes and balance fluids **2. Ureters (2)** - Thin tube of muscle that connects kidneys to the bladder and carry urine to the urinary bladder. **3. Bladder** - A hollow, muscular balloon-shaped organ that expands as it fills with urine. The bladder acts like a reservoir which can hold 1.5-2 cups of urine **4. Urethra** - A tube located at the bottom of the bladder that allows urine to exit the body during urination **Note:** All parts of the urinary tract---the kidneys, ureters, bladder, and urethra---must work together to urinate normally. urinary tract  **KEY TERM** I. **[Normal Structure and Function]** **Terms** **Definition** ---------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Antidiuretic hormone (ADH) A hormone release by a pituitary gland that causes water reabsorption in the kidneys, thus concentrating the urine. Angiotensin A substance that increases blood pressure, activated in the body by a renin, an enzyme produced by the kidneys Calyx A cup-like cavity in the pelvis of the kidneys; also calix (plural:Calices) (roots: cali, calic) Diuresis Excretion of urine; usually meaning increased urinary excretion Diuretic A substance the increases the excretion of urine; pertaining to diuresis Erythropoietin (EPO) A hormone produce by the kidneys that stimulates red blood cell production in the bone marrow Glomerular capsule A cup-shaped structure at the beginning of the nephron that surrounds the glomerulus and received material filtered out of the blood; Bowman capsule Glomerular filtrate The fluid and dissolve materials that filter out of the blood and enter the nephron through the glomerular capsule Glomerulus The cluster of capillaries within the glomerular capsule (plural: glomeruli) (roo:glomerul/o) Kidney An organ of excretion (root: re/o, nephr/o); the two kidneys filter the blood and form urine, which contain metabolic waste products and other substances as needed to regulate the water, electrolyte, and pH balance of the body fluids Micturition The voiding of urine, urination Nephron A microscopic functional unit of the kidney; working with blood vessels, the nephron filters the blood and blood balances the composition of urine. Renal cortex The kidney's outer portion; contains portions of the nephrons Renal medulla The kidney's inner portion, contains portions of the nephrons and ducts that transport urine toward the renal pelvis. Renal pelvis The expanded upper end of the ureter that receives urine from the kidney; Greek root pyel/o means basin Renal pyramid A triangular structure in the renal medulla; composed of the nephrons' loops and collecting ducts Renin An enzyme produced by the kidneys that activates angiotensin in the blood Trigone A triangular at the base of the bladder formed by the openings of the 2 ureters and the urethra Tubular reabsorption The return of substances from the glomerular filtrate to the blood through the peri-tubular capillaries Urea The main nitrogenous (nitrogen-containing) waste product in the urine Ureter The tube that carries urine from the kidney to the bladder (root: ureter/o) Urethra The tube that carries urine from the bladder to the outside of the body (root: urethr/o) Urinary bladder The organ that stores and eliminates urine excreted by the kidneys (root: cyst/o, vesic/o) Urination The voiding of urine; urination Urine The fluid excreted by the kidneys. It consists of water, electrolytes, urea, other metabolic wastes, and pigments. A variety of other substances may appear in the urine in cases of disease. (root: ur/o) I. **[Roots Pertaining to the Urinary System]** **Root** **Meaning** **Example** **Definition of example** ----------------- ---------------------- ----------------- ------------------------------------------------------------------------ Ren/o kidney Suprarenal above the kidney Nephr/o Kidney Nephrosis Any noninflammatory disease condition of the kidney Glomerul/o Glomerulus Juxtaglomerular Near the glomerulus Pyel/o Renal pelvis Pyelectasis dilatation of the renal pelvis Cali/o, calic/o Calyx Caliceal Pertaining to a renal calyx (note addition of e);also spelled calyceal Root Meaning Example Definition of example ur/o Urine, urinary tract Urosepsis Generalized infection that originates in the urinary tract Urin/o Urine Nocturia Urination during the night Ureter/o Ureter Ureterostenosis Narrowing of the ureter Cyst/o Urinary bladder Cystocele Hernia of the urinary bladder Vesic/o Urinary bladder Intravesical Within the urinary bladder Urethr/o Urethra Urethrotome Instrument for incising the urethra II. **[Clinical Aspect of the Urinary Bladder]** +-----------------------------------+-----------------------------------+ | **Terms** | **Definition** | +===================================+===================================+ | Acidosis | Excessive acidity of the body | | | fluids | +-----------------------------------+-----------------------------------+ | Bacteriuria | Presence of bacteria in the urine | +-----------------------------------+-----------------------------------+ | Cast | A solid mold of a renal tube | | | found in the urine | +-----------------------------------+-----------------------------------+ | Cystitis | Inflammation of the urinary | | | bladder, usually as a result of | | | infection | +-----------------------------------+-----------------------------------+ | Dysuria | Painful or difficult urination | +-----------------------------------+-----------------------------------+ | Glomerulonephritis | Inflammation of the kidney | | | primarily involving the | | | glomeruli. | | | | | | The acute form usually occurs | | | after an infection elsewhere in | | | the body;the chronic form varies | | | in cause and usually | | | | | | Leads to renal failure | +-----------------------------------+-----------------------------------+ | Hematuria | Presence of blood in the urine | +-----------------------------------+-----------------------------------+ | Hydronephrosis | Collection of urine in the renal | | | pelvis caused by | | | obstruction;results in distention | | | and renal atrophy | +-----------------------------------+-----------------------------------+ | Hypokalemia | Deficiency of potassium in the | | | blood | +-----------------------------------+-----------------------------------+ | Hyponatremia | Deficiency of sodium in the blood | +-----------------------------------+-----------------------------------+ | Hypoproteinemia | Decreased amount of protein in | | | the blood;maybe caused by kidney | | | damage resulting in protein loss | +-----------------------------------+-----------------------------------+ | Hyperkalemia | Excess amount of potassium in the | | | blood | +-----------------------------------+-----------------------------------+ | Hypernatremia | Excess amount of sodium in the | | | blood | +-----------------------------------+-----------------------------------+ | Nephrotic syndrome | Condition that results from | | | glomerular damage leading to loss | | | of protein in the urine | | | (proteinuria). There is low | | | plasma protein (hypoproteinemia), | | | edema and increased blood lipids | | | as the liver releases | | | lipoproteins. Also called | | | Nephrosis | +-----------------------------------+-----------------------------------+ | Oliguria | Elimination of small amounts of | | | urine | +-----------------------------------+-----------------------------------+ | Proteinuria | Presence of protein, mainly | | | albumin, in the urine | +-----------------------------------+-----------------------------------+ | Pyelonephritis | Inflammation of the renal pelvis | | | and kidney, usually by infection | +-----------------------------------+-----------------------------------+ | Pyuria | Presence of pus in the urine | +-----------------------------------+-----------------------------------+ | Renal colic | Radiating pain in the region of | | | the kidney associated with the | | | passage of a stone | +-----------------------------------+-----------------------------------+ | Uremia | Presence of toxic levels of urea | | | and other nitrogenous substances | | | in the blood as a result of renal | | | insufficiency | +-----------------------------------+-----------------------------------+ | Urethritis | Inflammation of the urethra, | | | usually due to infection | +-----------------------------------+-----------------------------------+ | Urinary stasis | Stoppage of urine flow; urinary | | | stagnation | +-----------------------------------+-----------------------------------+ III. **[Diagnosis and Treatment ]** **Terms** **Definition** ------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Catheterization Introduction of tube into a passage, such as through the urethra into the bladder for withdrawal of urine Cystoscope An instrument for examining the interior of the urinary bladder. Also used for removing foreign objects, for surgery and for other forms of treatment Dialysis Separation of substances by passage through a semi-permeable membrane. Dialysis is used to rid the body of unwanted substances when the kidneys are impaired or missing. The two forms of dialysis are hemodialysis and peritoneal dialysis. Hemodialysis Removal of unwanted substances from the blood by passage through s semipermeable membrane Intravenous Pyelography (IVP) Intravenous urography Intravenous urography (IVU) Radiographic visualization of the urinary tract after intravenous administration of a contrast medium that is excreted in the urine;also called excretory urography or intravenous pyelography, although the latter is less accurate because the procedure shows more than just the renal pelvis Lithotripsy Crushing of a stone Peritoneal dialysis Removal of unwanted substances from the body by introduction of a dialyzing fluid into the peritoneal cavity followed by removal of the fluid Retrograde pyelography Pyelography in which the contrast medium is injected into the kidneys from below, by way of the ureters Specific gravity The weight of a substance compared with the weight of an equal volume of water. the specific gravity of normal urine ranges from 1.015 to 1.025. This value may increase or decrease in disease. Urinalysis Laboratory study of the urine. Physical and chemical properties and microscopic appearance are included Indwelling Foley Catheter A urinary tract catheter with a balloon at one end that prevents the catheter from leaving the bladder Lithotrite Instrument for crushing a bladder stone Anion gap A measure of electrolyte imbalance --------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Blood Urea Nitrogen (BUN) Nitrogen in the blood in the form of urea.An increase in BUN indicates an increase in nitrogenous waste products in the blood and renal failure. Clean-catch specimen A urine sample obtained after thorough cleansing of the urethral opening and collection in midstream to minimize the chance of contamination. Cystometrography A study of bladder function in which the bladder is filled with fluid or air and the pressure exerted by the bladder muscle at varying degrees of filling is measured. The tracing recorded is cystometrogram Protein electrophoresis Laboratory study of urinary proteins; used to diagnose multiple myeloma,Systemic Lupus Erythematosus, and lymphoid tumor Urinometer Device for measuring the specific gravity of urine **Terms** **Definition** ----------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Cystectomy Surgical removal of all part of the urinary bladder Ileal conduit Diversion of urine by connection of the ureters to an isolated segment of the ileum. One end of the segment is sealed, and the other drains through an opening in the abdominal wall. A procedure used when the bladder is removed or nonfunctional. Also called ileal bladder. Lithotomy Incision of an organ to remove a stone Renal transplantation Surgical implantation of a donor kidney into a patient IV. **[Surgery]** V. **[Normal Structure and Function : Supplementary terms: ]** Terms Definition ---------------------------------- ---------------------------------------------------------------------------------------------------------- Aldosterone A hormone secreted by the adrenal gland that regulates electrolyte excretion by the kidneys Clearance The volume of plasma that the kidneys can clear of a substance per unit of time;renal plasma clearance Creatinine A nitrogenous byproduct of muscle metabolism. An increase in blood creatinine is a sign of renal failure Detrusor muscle The muscle in the bladder wall Glomerular filtration rate (GFR) The amount of filtrate formed per minute by both kidneys Maximum transport capacity ( TM) The maximum rate at which a given substance can be transported across the renal tubule;tubular maximum Renal corpuscle The glomerular capsule and the glomerulus considered as a unit;the filtration device of the kidney VI. **[Symptoms and Conditions]** **Terms** **Definition** --------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Anuresis Lack of urination Anuria Lack of urine formation Azotemia Presence of increased nitrogenous waste, especially urea in the blood Azoturia Presence of increased nitrogenous compounds,especially urea in the urine Cystocele Herniation of the bladder into the vagina;vesicocele Dehydration Excessive loss of body fluids Diabetes insipidus A condition caused by inadequate production of antidiuretic hormone, resulting in excessive excretion of dilute urine and extreme thirst Enuresis Involuntary urination,usually at night; bed wetting Epispadias A congenital condition in which the urethra opens on the dorsal surface of the penis as a groove or cleft; anaspadias Glycosuria Presence of glucose in the urine, as in cases of diabetes mellitus Horseshoe kidney A congenital union of the lower pole of the kidneys, resulting in a horseshoe-shaped organ Hydroureter Distention of the ureter with urine due to obstruction Hypospadias A congenital condition in which the urethra opens on the undersurface of the penis or into the vagina Hypovolemia A decrease in blood volume Neurogenic bladder Any bladder dysfunction that results from a central nervous system lesion Nocturia Excessive urination at night Polycystic kidney disease A hereditary condition in which the kidneys are enlarged and contain many cysts Polydipsia Excessive thirst Polyuria Elimination of large amounts of urine;as in diabetes mellitus Retention of urine Accumulation of urine in the bladder because of an inability to urinate Staghorn calculus A kidney stone that fills the renal pelvis and calices to give a "staghorn" appearance Ureterocele A cyst-like dilation of the ureter near its opening into the bladder. Usually results from a congenital narrowing of the ureteral opening. Urinary frequency A need to urinate often without an increase in average output Urinary incontinence Inability to retain urine; may originate with a neurologic disorder,trauma to the spinal cord,weakness of the pelvic muscles, urinary retention, or impaired bladder function.In urgency incontinence,an urge causes sudden urination before one has enough time to reach a bathroom. In stress incontinence,urine leaks during a forceful activity such as coughing,sneezing or exercise. Urinary urgency Sudden need to urinate Water intoxication Excessive intake or retention of water with decrease in sodium concentration.May result from excess drinking ,excess ADH,or replacement of a large amount of body fluid with pure water. Causes an imbalance in the cellular environment,with edema and other disturbances. Wilms tumor A malignant kidney tumor that usually appears in children before the age of 5 years