Module 7 PDF - Urinary System

Prefix anhyperextra- Meaning Absent High level outside Combining form ur/o, urin/o ureter/o, vesic/o cyst/o urethr/o nat/o kal/o ren/o, nephr/o erythr/o cortic/o nephr/o glomerul/o pyel/o cali/o, calic/o trigon/o meat/o albumin/o glyc/o Meaning Irine ureters urinary bladder urethra sodium potassi...

Prefix anhyperextra- Meaning Absent High level outside Combining form ur/o, urin/o ureter/o, vesic/o cyst/o urethr/o nat/o kal/o ren/o, nephr/o erythr/o cortic/o nephr/o glomerul/o pyel/o cali/o, calic/o trigon/o meat/o albumin/o glyc/o Meaning Irine ureters urinary bladder urethra sodium potassium kidney Red cortex nephrons glomerulus renal pelvis calyx trigone meatus albumin Glucose )‫(التنسون ياحلوين يعني عبدالرحمن‬ ketone bodies Pus bilirubin Pelvis night stones calcium nitrogen Thirst Embryonicthe body ket/o, keton/o py/o bilirubin/o pyel/o noct/o lith/o calc/i azot/o dips/o blast/o corpor/o Suffix -poietin -uria -iasis -ptosis -tripsy -tomy Meaning substance that forms urine condition condition dropping or displacing crushing process of cutting into Urinary System The primary components of the urinary system are the kidney, ureter, urinary bladder, and urethra. These components work together in filtration—a process for removing waste products such as urea, potassium, uric acid, and creatinine from the blood. Many of these products are nitrogenous, meaning they are high in nitrogen. Eventually, these wastes exit the body as urine. The process of urination or voiding or micturition Urea is a nitrogenous waste formed in the liver and carried in the bloodstream to the kidneys. The urea then passes out of the bloodstream as the kidneys produce urine, which is also composed of water, salts, and acids. The urine then travels down the ureters into the urinary bladder and out of the body through the urethra. Structures of the Kidney The kidney secretes the enzyme renin and the hormone erythropoietin (EPO). The kidneys also release calciferal. Terms Definition Electrolytes such as sodium and potassium are chemical elements that, when dissolved in water, transmit electrical charges needed for proper muscle and nerve functioning. renin raises blood pressure to keep blood moving through the kidney. erythropoietin stimulates the production of red blood cells in the bone marrow. (EPO) calciferal an active form of vitamin D necessary for the absorption of calcium from the intestine. The cortex, or outer cradles approximately 1 million nephrons. These nephrons are considered the region parenchyma, the functional part of the kidney where urine is actually formed. The medulla, or holds most of the collecting tubules. Waste products enter the kidney from the inner region bloodstream through the renal artery, which enters the kidney through an outer concave, hollow notch called the hilum. Blood vessels and nerves enter and leave the kidney through this hilum. Filtration and Absorption Terms Definition Renal Artery, When blood flows into the kidney through the renal artery, it passes through Arterioles, and the smaller and smaller arteries in the cortex of the kidney. These small arteries, Role of Renin called arterioles, are so small that blood slows as it flows through them. If this slowed rate of flow drops low enough, then the kidneys secrete the hormone renin into the blood to stimulate contraction of the arterioles so that blood pressure is increased and the flow in the kidneys becomes normal again. Filtration From the renal artery and the arterioles, the blood enters the microscopic nephrons. The nephron is the functional part of the kidney, doing the bulk of its work, and processing blood plasma and urine formation. Each nephron includes a glomerulus and a renal tubule. Glomerular Capsule Because the walls of each glomerulus are so thin, water, salts, sugar, urea, and and Glomerulus other wastes can pass through from the bloodstream. The waste materials collect in a small cup at the mouth of a nephron, called a glomerular (or Bowman) capsule, which is wrapped around the glomerulus to catch them. The glomerulus and its capsule, together, make up the renal corpuscle, which is the beginning of the nephron unit. Larger substances such as proteins and Reabsorption Terms Renal Pelvis Ureter, Bladder, and Urethra The female urethra The male urethra Function of urethra blood cells cannot filter through the walls of the glomerulus and, consequently, remain in the bloodstream to be used. Being trapped in the glomerular capsule is not the last chance for these materials, however. Some useful substances such as water, salt, and sugar have one more chance to be returned to the bloodstream, and this second chance happens during the process of reabsorption. As these wastes exit the glomerular capsule by a proximal renal tubule, most of the water, all of the sugar, and almost all of the salts are returned to the bloodstream through tiny capillaries around each tubule. The other wastes remain in the proximal tubule where they are carried through the loop of Henle. The loop of Henle reabsorbs salts from this tubular fluid before the fluid moves through the distal convoluted tubule where water and salts are reabsorbed. The fluid is then carried out of the nephron via the collecting tubule. Urine Flow and Related Structures Definition From the nephron units, the urine flows into the larger collecting tubules in the renal pelvis, which is the central collecting region in the kidney. This small basin in the central part of the kidney is made up of more cup-shaped regions called calices or calyces. Each calyx helps collect the urine and aids its passage through the renal pelvis, which narrows into the ureter. The ureter is the urine's route out of the kidney and down to the urinary bladder. Both ureters enter through a triangular area in the bladder called the trigone, where the urine is then transferred into the urethra to exit the body. Here is how this process works: The urinary bladder is a collapsible, flexible bag. As urine accumulates in it, the bladder expands and puts pressure on the base of the urethra, which creates the urge to urinate. The bladder releases urine into the urethra through a series of small muscles shaped similar to rings. These sphincters control urine flow. is approximately 1.5 inches long, with a small meatus, that is, the opening to the outside of the body, between the clitoris and the opening of the vagina. is approximately 8 inches long, and the urinary meatus is at the tip of the penis. Notice that part of the male urethra is embedded in the prostate gland. The main functional difference is that the female urethra carries only urine out of the body, whereas the male urethra serves as an exit passageway for both urine and semen, although never at the same time. Terms the urinalysis (UA) Color analysis pH test albuminuria glycosuria Terms Ketonuria Ketoacidosis or ketosis pyuria phenylketonuria (PKU) hyperbilirubinemia specific gravity (sp gr) Terms Upper UTIs lower UTIs Renal failure Terms interstitial nephritis interstitial cystitis (IC) Urinalysis and Pathologic Conditions Definition The urinary system is unique in the sense that a great number of common disorders can be detected through the same simple multipurpose test One of the first and easiest aspects to check is the color of the urine specimen. Although normal urine ranges fairly widely in color, other substances can also affect its hue. After color analysis, the next test Vicky's urine undergoes is a pH test, which is used to determine to what degree the urine is acidic or alkaline (basic). one of the earliest signs of renal involvement in diabetes mellitus is the presence of an abnormal amount of albumin, a major blood protein in urine, a condition called albuminuria. A special, sensitive urinalysis test can aid in detecting albumin. The presence of too much glucose, or sugar, in the urine and is an indication of diabetes mellitus. Urinalysis Results Definition elevated levels of ketone bodies, also known as acetones, in the urine excessive blood acidity attributable to dangerous levels of blood ketones presence of pus in the urine, which will usually appear turbid or cloudy elevated levels of phenylketones excess levels of hemoglobin pigment bilirubin in the blood, which leads to bilirubinuria, or excess bilirubin in the urine comparison of density between the urine and water Urinary Tract Infections (UTIs) Definition are in the kidneys and ureters affect the bladder and urethra. is what its name indicates. The kidneys fail to excrete urine because of impaired filtration function. A large number of conditions, including high blood pressure, infection, and diabetes can lead to renal failure, which may be acute or chronic. The severity of renal failure can vary. The final phase of the chronic version is end-stage renal disease or chronic kidney disease (CKD), which can be fatal if not treated. Inflammatory Disorders and Symptoms Definition inflammation occurs in the connective tissue that lies between the renal tubules, or the renal interstitium. this condition is a response to his recent administration of a penicillin medication for tonsillitis. The condition can also develop from the excessive use of aspirin and aspirin-type drugs. Signs and symptoms may include poor renal function, a fever and skin rash and eosinophils in the blood and urine. is a chronic inflammation of the bladder wall, and pyelonephritis. With acute pyelonephritis, a bacterial infection in the renal of the urinary tract causes collections of pus (abscesses) to form in the kidney . Pus may also be in the urethritis ureteritis urethral stricture diuresis nocturia anuria Terms nephrolithiasis hypercalciuria polycystic kidney disease (PKD) uremia Azotemia diabetes insipidus (DI) diabetes mellitus (DM) polyuria polydipsia Terms nephroptosis renal cell carcinoma or hypernephroma Wilms tumor or nephroblastoma Bladder Malignancy urine (pyuria). A renal abscess can be visualized on radiographic images similar to this computed tomographic (CT) scan (arrow points to an abscess). Inflammation of the urethra Inflammation of a ureter A blockage can be caused by long-term medication use or long-term use of an indwelling urinary catheter, which can produce scarring and thus cause a fibrotic narrowing of the urethra. The patient experiences diminished force, dysuria (painful urination), polyuria (urinary frequency), and hesitation. caffeine or alcohol intake could cause diuresis—increased urine formation and secretion. frequent, excessive urination at night. diminished or absent urination usually caused by either renal dysfunction or a urinary tract obstruction. Kidney Stones, Cysts, and Other Disorders Definition Is the condition of having kidney stones, or renal calculi. Kidney stones are thought to be formed by high levels of calcium in the urine. Chronic dehydration, gout, and urinary tract infections can also lead to kidney stones, and some dietary choices may also increase the risk. is a condition in which multiple, fluid-filled sacs, or cysts, form both inside and outside the kidney. This condition is progressive but usually asymptomatic (without symptoms) until middle age, when the patient may develop nephrolithiasis, hematuria (blood in the urine), urinary tract infection, hypertension, and renal failure. is a toxic state in which a large amount of nitrogenous wastes accumulate in the blood because they are not being excreted in the urine. is another term that refers to high levels of urea. This term is primarily used when the abnormal levels can be chemically measured but have not yet produced symptoms. antidiuretic hormone (ADH) is either not secreted or the kidneys are resistant to it. insulin is either not adequately secreted or tissues are resistant to its effects. excessive excretion of urine. excessive thirst. Tumors and Nephrotic Syndrome Definition a dropping or displacing of the kidney because of weak support. a cancerous tumor of the kidney is a cancer of the kidney that occurs in childhood. It most often occurs in one kidney, although it can affect both, and typically affects children younger than five years of age. Wilms tumor may be treated with surgery, radiation therapy, and chemotherapy. the bladder is a more common site for malignancy, particularly in men, smokers, and individuals over the age of 50 years. Chemicals used by some kinds of industrial workers can also contribute to the risk. Early symptoms Nephrotic syndrome Glomerulonephritis usually include blood in the urine, increased urinary frequency, and dysuria, which is difficult or painful urination. Cancer is discussed in greater detail in a later module. is kidney disease with proteinuria, hypoalbuminemia, and edema. is inflammation of the glomeruli within the kidney that results in leaky glomeruli. Terms blood urea nitrogen (BUN) test creatinine clearance test (CrCl) computed tomography (CT) scan retrograde pyelogram (RP) radioisotope scan voiding cystourethrogram (VCUG) intravenous pyelogram (IVP) KUB Imaging Series and MRI Renal angiography MRI Detection of Tumors diagnostic sonography Diagnostic Procedures Definition is used to determine how much urea and nitrogen have accumulated in the blood (uremia). Of particular interest is the fact that chronic kidney disease (the final phase of chronic renal failure [CRF]) is now classified according to the level of creatinine clearance. measures the rate at which creatinine concentration in a blood sample is excreted in the urine over a 24-hour period. Creatinine clearance is a measure of how efficiently the kidneys are working. Creatinine clearance is also useful in assessing the glomerular filtration rate (GFR). can present multiple transverse x-ray views with or without the use of a contrast material. This CT scan clearly identifies multiple cysts in the kidney. involves the administration of a contrast medium through a catheter into the ureters from the bladder before x-ray images of the renal pelvis and ureters are taken. is an image of the kidney enhanced by the injection of a radioactive substance into the bloodstream. Both procedures reveal the presence of a renal embolus, urinary stones, and other obstructions. can also reveal abnormalities of the bladder. In this procedure, the bladder is filled with a contrast material, and real-time x-ray imaging (fluoroscopy) is performed as the patient expels urine. Reflux of the contrast material into the ureters is abnormal. is a special x-ray examination of the kidneys, bladder, and ureters. An iodinebased contrast material is injected into the patient’s arm. A series of x-ray images is then taken at different intervals to determine how the kidneys remove the dye and how it collects in the urine. An IVP may be performed to evaluate bladder and kidney infections, blood in the urine, flank pain (possibly attributable to kidney stones), and tumors. Both the kidney, ureters, and bladder (KUB) examination—also called urography—and magnetic resonance imaging (MRI), can demonstrate the kidneys in relation to other organs in the abdominopelvic region. is a diagnostic procedure during which radiographic images of the blood vessels of the kidney are made. This examination is performed using a contrast material. Renal angiography helps diagnose obstruction or constriction of blood vessels leading to the kidney. These changes may also be visualized on CT and MRI urography. Small renal tumors are now found earlier than ever because of the increased use of the CT scan and MRI. In MRI (magnetic resonance imaging), a cylindershaped machine produces an image using a changing magnetic wave to capture the movement of protons within the body, producing images of the kidney and surrounding structures in three planes of the body. With MRI urography, images are made of the pelvic and retroperitoneal regions. This test is useful in visualizing tumor invasion of blood vessels, lymph nodes, and adjacent tissue. Polycystic kidney disease can also be diagnosed using diagnostic sonography, which is also called ultrasonography or diagnostic ultrasound. This imaging cystoscopy Flexible cystoscopy Rigid cystoscopy procedure uses sounds waves to record images of internal organs and tissues. The image produced is called a sonogram. is the direct visualization of the urethra and urinary bladder using a cystoscope. uses a thin fiberoptic cystoscope for diagnosis and checkups of the urinary bladder. passes a hollow metal tube through the urethra into the bladder and is used to take biopsy samples, remove polyps, or perform laser treatments. Terms Treatment for Pyelonephritis The treatment for urethral stricture or narrowing Treatment of Kidney Stones dialysis Hemodialysis (HD) peritoneal dialysis (PD) Continuous ambulatory peritoneal dialysis (CAPD) cystostomy renal transplant renal angiography With love 7B Therapeutic Interventions Definition can be treated with antibiotics. If this condition becomes chronic, then renal tissue necrosis and scar formation can result. is usually surgery (urethroplasty) and typically involves urethral dilation urethrotomy. the kidney stones, which are treated by lithotripsy, the process of crushing calculi or stones so that they can pass from the body through the urethra. In extracorporeal shock wave lithotripsy (ESWL), a shock wave is administered from outside (extra-) the body (corpor/o) to crush the stones. some patients will need surgery to remove the stone through an incision in the kidney, called a nephrolithotomy. Removing the stone through an incision in the renal pelvis is a pyelolithotomy. When the kidneys can no longer separate nitrogenous waste materials from the bloodstream, dialysis can save a patient's life. First method of dialysis. uses an artificial kidney machine that receives waste-filled blood from the patient's bloodstream, filters it through an artificial porous membrane called a dialyzer, and then returns the dialyzed blood to the patient's body. Through anastomosis of an artery and vein, the surgeon creates an arteriovenous fistula, often in the patient’s arm, for easier access during HD (refer to figure). Second method of dialysis. PD uses a peritoneal catheter to introduce fluid into the abdominal (peritoneal) cavity. Waste materials in the capillaries of the peritoneum pass out of the bloodstream and into the fluid. This fluid is then drained from the body through the catheter. PD may be continuously performed. is a type of dialysis that does not require a machine; therefore the patient is free to walk around (ambulate). CAPD works by using the patient's own peritoneal membrane as a filtering unit for waste products. Automated peritoneal dialysis can be used while the patient is sleeping. The catherization required for peritoneal dialysis should not be confused with urinary catheterization, which is used for short-term urine drainage. A related procedure, cystostomy, is the creation of an artificial opening into the urinary bladder for insertion of a catheter. receiving a kidney from a donor), particularly in cases in which dialysis is no longer effective. Sometimes in the course of renal angiography, arterial constriction may be identified as the cause of changes in renal blood flow. When these changes occur, blood flow to the kidney can be greatly improved by a procedure called renal angioplasty. In this procedure, a balloon catheter is inserted through an artery and into the narrowed artery in the kidney. Inflating the balloon not only widens the stenosis (narrowing), but it also redistributes lipid deposits within the artery. Both widening and redistribution improves blood flow to the kidney, improving renal hypertension and preserving renal function. Stents (metal tubes) can be inserted to keep the vessel open.