chapter 11 the urinary system
DESCRIPTION
Lesson 11.1 Learning Goals State the function of the urinary system, and analyze associated terms. Write the meanings of the word parts associated with the urinary system, and use them to build and analyze terms. Write the names of the structures of the urinary system, define the terms associated with these structures, and label the structures. Sequence the formation and excretion of urine. Write the names of the diagnostic tests and procedures for assessment of the urinary system when given their descriptions, or match them with their descriptions. Distinguish between normal and abnormal components of urine. Identify the major structures of the nephron and their functions. Lesson 11.1 focuses on learning the urinary system STRUCTURES as well as DIAGNOSTIC TESTS for this system. You will learn the structures of the urinary system and the internal structures of the kidney. You will also learn the names of the diagnostic tests for this system, as well as the types of substances in urine in health and disease.TRANSCRIPT
Chapter 11 The Urinary System
Welcome to Chapter 11! Urinary means pertaining to urine. The
urinary system plays an important role in maintaining homeostasis
by filtering the blood and maintaining the proper balance of water
and other substances, as well as performing other important
functions. Lesson 11.1 Learning Goals State the function of the
urinary system, and analyze associated terms. Write the meanings of
the word parts associated with the urinary system, and use them to
build and analyze terms. Write the names of the structures of the
urinary system, define the terms associated with these structures,
and label the structures. Sequence the formation and excretion of
urine. Write the names of the diagnostic tests and procedures for
assessment of the urinary system when given their descriptions, or
match them with their descriptions. Distinguish between normal and
abnormal components of urine. Identify the major structures of the
nephron and their functions. Lesson 11.1 focuses on learning the
urinary system STRUCTURES as well as DIAGNOSTIC TESTS for this
system. You will learn the structures of the urinary system and the
internal structures of the kidney. You will also learn the names of
the diagnostic tests for this system, as well as the types of
substances in urine in health and disease. Functions of the
Kidneys
Filter the blood by removing urea (the by-product of protein
metabolism) and other wastes Maintain proper balance of water,
salts, and other substances Eliminate wastes as urine Why is the
function of the kidneys as filters important? What happens when the
kidneys arent functioning well? Why is it possible to live without
1 kidney? An important mode of excretion is performed by the
kidneys, which are part of the urinary system. Additional Kidney
Functions
Produce renin (hormone that controls blood pressure) Produce
erythropoietin (hormone that stimulates red blood cell production)
Metabolize vitamin D to its active form What would happen if the
kidneys did not secrete renin? What would happen if the kidneys did
not secrete erythropoietin? (erythropoietin is a substance that
causes the production of red blood cells.) What would happen if the
kidneys did not convert vitamin D to its active form? The kidneys
also produce prostaglandins (fatty acid derivatives that affect
many organs, and degrade insulin). Label your Figure 11-1A as you
recognize these structures: kidney, ureters, bladder,
urethra.
Note the placement of the kidneys under the ribs. The bladder is
located just above what bone? (pubic bone) Trace the path of urine
from the kidney, an excretory route. Where does it go next?
(ureter, then bladder and urethra). Urine exits the urethra at the
urinary meatus. Remember the combining forms for kidney are ren(o)
and nephr(o). Suprarenal means above a kidney. Quick Quiz! What
term means between the kidneys? adrenal interrenal
infrarenal nephrotoxic The answer is B: interrenal. Adrenal refers
to the gland that sits near (atop) each of the kidneys. Infrarenal
is not an accepted medical term, but one can imagine it would mean
beneath the kidneys. Nephrotoxic refers to substances that are
harmful to the kidney. Terminology: Word Parts
ur(o) urine, urinary tract -uria urine or urination Major urinary
structures: cyst(o) bladder, cyst, fluid-filled sac nephr(o),
ren(o) kidney ureter(o) ureter urethr(o) urethra vesic(o) bladder
or blister What is the name for a medical specialist in the urinary
system? Combine poly- with -uria for a term that means excessive
urination. Micturition and voiding also mean urination. What are
the adjectives formed from those word parts? cystic, vesical,
nephric or renal, ureteral, urethral Combine cyst(o)/vesic/o,
nephr(o)/ ren(o), ureter(o), and urethr(o) with -itis to form:
cystitis, nephritis, ureteritis, urethritis Terminology
vesicoureteral, vesicovaginal, urethrovaginal
extracystic, abdominocystic, abdominovesical rectourethral,
urethrorectal genitourinary, urogenital Which term means pertaining
to the bladder and the ureter? vesicoureteral. Vesicovaginal means
pertaining to the urinary bladder and the vagina. Urethrovaginal
means pertaining to the urethra and the vagina. Which term means
outside a cyst or outside the bladder? extracystic. How about
pertaining to the bladder and the abdomen? (abdominocystic or
abdominovesical) Two terms mean pertaining to the rectum and the
urethra, but not all words can be reversed like this. Two terms
mean pertaining to the genitals (organs of reproduction) as well as
to the urinary structures. Kidney Cross Section What is the name of
the outer covering of the kidney? What structures traverse the
hilum of each kidney? renal artery and vein, renal pelvis opening
into the ureter. What happens within the renal pyramids? The
nephrons are the functional units of each kidney
The nephrons are the functional units of each kidney. What is the
path of urine formed in the renal pyramids? (collects into the
calyces, then the renal pelvis and down the ureter) Trace the path
of urine from where it enters the collecting system (glomerulus,
Bowman capsule, proximal convoluted tubule, descending limb, Loop
of Henle, ascending limb, distal convoluted tubule, collecting
duct, calyces, renal pelvis, ureter, bladder, urethra) Why are the
terms descending and ascending limbs used? Are those descriptions
accurate? What is the difference between the efferent and the
afferent arterioles? What is the path of blood through the
kidneys
What is the path of blood through the kidneys? (renal artery to
renal pyramids, separating into urine and venous blood, then out
the renal vein) What function do the peritubular capillaries
perform? (reabsorption of substances along the proximal and distal
tubules and loop of Henle) A hormone called antidiuretic hormone
(ADH) increases the reabosrption of water by the renal tubules,
thus decreasing the amount of urine produced. Terminology: Word
Parts
Internal structures of the kidneys: glomerul(o)glomerulus
pyel(o)renal pelvis Review: dist(o)distant proxim(o)near What terms
can be made from these word parts? Why are proxim(o) and dist(o)
important in the urinary system? Functions of the Nephron
Follow the arrows of urine formation. What are the 3 stages of
urine formation and where do they occur? (glomerular filtration,
tubular reabsorption, and tubular secretion) At which points can
substances be reabsorbed from the urine back into the bloodstream?
The glomerular filtration rate (GFR) is a calculated volume of
fluid filtered by the glomeruli. GFR forms the basis of a test of
kidney function. Formation and Excretion of Urine (cont.)
Trace the formation of urine from the glomerulus to the urethra.
Diagnostic Tests and Procedures
laboratory tests urinary catheterization urinary radiography
endoscopy How can the term urinalysis be analyzed? urin(o) + -lysis
What are the locations of the types of catheterization? What is the
purpose of urodynamic studies? (cystometrography, electromyography,
urethral pressure profile) Laboratory Tests urinalysis: physical,
chemical, and microscopic examination pH abnormal substances in
urine: ketones, sugar, protein, red blood cells, and white blood
cells specific gravity, urinometer, or chemical dipstick intake and
output (I&O) What is pH? (hydrogen ion concentration versus a
standard) What does the pH tell about a urine specimen? (The pH
test is used to determine the urine's degree of acidity or
alkalinity. Urine pH is normally acidic but may become alkaline in
the presence of a bladder infection. This is because the bacterial
breakdown of urea releases ammonia, which is very alkaline.) Why
measure substances in urine? What are the names of these 5 abnormal
substances in the urine? Urinalysis is abbreviated UA or U/A. What
is specific gravity? Why is specific gravity important? Discuss the
uses of intake and output (I&O). Simple urine tests include A,
a urinometer is used to determine the specific gravity, the degree
of concentration of a sample of urine; Glucose test strips provide
a means of screening for the presence of urine glucose. There is a
certain level called the renal threshold for reabsorption of
glucose; above that level it is excreted in the urine; B, testing
urine with a Multistix, a plastic strip with reagent areas for
various chemical constituents, allows qualitative testing. A
positive test result for an abnormal substance in the urine
generally requires further testing. Multistix can show the presence
of proteins such as albumin. A From Zakus S: Mosbys clinical skills
for medical assistants, 2001, Mosby. B From Bonewit-West K:
Clinical procedures for medical assistants, ed 6, Philadelphia,
2004, Saunders. What could each of these substances, when found in
urine, signify?
A, squamous epithelial cells line the insides of the tubules; their
presence in urine could be normal or indicate disease. Urinary
casts are gelatinous structures that take the shape of the renal
tubules. They are described by the element in the structure, such
as waxy, RBC, or WBC casts. B, waxy cast is made of protein, such
as in renal failure. C, RBC = bleeding D, WBC = infection E, Uric
acid crystalsdiscuss gout From Brunzel NA: Fundamentals of urine
& body fluid analysis, ed 2, St Louis, 2004, Saunders.
Terminology: Word Parts
urin(o) Urine Abnormal substances in urine: albumin(o) albumin
glyc(o), glycos(o) sugar hemat(o) blood ket(o), keton(o) ketone
bodies prote(o), protein(o) protein py(o) pus What terms describe
the presence of each of the abnormal substances in urine?
glycosuria, ketonuria, proteinuria, albuminuria, hematuria, pyuria
Excessive production of ketones, the end products of fat
metabolism, leads to their excretion, such as during fasting.
Ketoacidosis, however, means acidosis accompanied by an
accumulation of ketones in the body; it results from faulty
carbohydrate metabolism. Urea is a nitrogen compound that is
NORMALLY found in urine. Compare pyuria (presence of pus cells)
with pyorrhea: how do the definitions differ? Why might they be
related in a pathological condition? Practice the difference in the
pronunciations. Laboratory Tests (cont.)
urine specimen types: voided clean-catch catheterized urine
culture, antibiotic sensitivity test creatinine clearance test,
renal clearance test blood studies: serum creatinine blood urea
nitrogen Urinary specimens are collected according to the
laboratory or physicians instructions. A voided specimen is one in
which the patient voids into a container supplied by the lab or
office. A clean-catch specimen is based on the concept that tissues
adjacent to the urethral meatus must be cleansed before collection
to avoid contamination. A catheterized urine specimen is obtained
by placing a catheter into the bladder and withdrawing urine. This
method ensures an uncontaminated specimen. What is the purpose of a
urine culture and antibiotic sensitivity test? C&S means
culture and sensitivity. Creatinine is a normal product of
metabolism and is commonly found in blood, urine and muscle tissue.
Its measurement in blood and urine is an indicator of kidney
function. A creatinine clearance test measures the rate at which
creatinine is cleared from the blood by the kidney. Renal clearance
tests measure the efficiency with which the kidneys excrete
substances. Increased levels of serum creatinine can indicate renal
impairment; decreased level may be caused by muscle mass loss.
Blood urea nitrogen (BUN) is directly related to the metabolic
function of the liver and the excretory function of the kidney.
Urea forms in the liver as the end product of protein metabolism. A
critically elevated BUN indicates serious impairment in renal
function. Urinalysis Appearance Chemical color: usually pale
straw
odor: aromatic; similar to ammonia turbidity: should be clear
specific gravity: Chemical pH: 6 (possible range 4.6 8) glucose,
ketones, protein, bilirubin (urobilinogen), leukoesterase and
nitrites should all be none. Note that ingestion of some foods may
cause urine to have a foul smell. Microscopic examination of urine
is covered on the next slide. Urinalysis (cont.) Microscopic
crystals: none
RBCs: 0-2 per high-power field (HPF) WBCs: females 0-5/HPF; males
0-3/HPF bacteria: none or few/ HPF = less than 1000 colonies/mL
parasites: none casts: few to none Note that increased RBCs are
seen with indwelling or intermittent catheterization and/or with
menstruation. Indwelling Catheter What does indwelling mean? Why
are indwelling catheters used? A Foley catheter is held securely in
place by a balloon tip that is filled with a sterile liquid after
the catheter has been placed in the bladder. From Harkreader H,
Hogan MA, Thobaben M: Fundamentals of nursing, ed 3, St Louis,
2007, Saunders. Urinary Catheterization: Urethral
When would this type of catheterization be used? Urinary
Catheterization (cont.)
What are the names of each catheterization? (ureteral, suprapubic,
percutaneous nephrostomy) When would each type be used? Urinary
Catheterization (cont.)
What are the names of each catheterization? (ureteral, suprapubic,
percutaneous nephrostomy) When would each type be used? 26
Diagnostic Tests and Procedures (cont.)
urodynamic studies: cystometrography, electromyography urinary
radiography nephrosonography nephrotomography, nephrotomogram
intravenous urography, urogram intravenous pyelography, pyelogram
cystography, cystourethrography voiding cystourethrogram renal
angiography, renal arteriogram kidney scan, renography Urodynamic
studies measure aspects of voiding to evaluate problems with urine
flow. Cystometrography provides information about the effectiveness
of the bladder wall muscles. It may incorporate the use of a
urinary catheter with a cystometer attached to measure the bladder
capacity. Electromyography (EMG) can evaluate the strength of the
muscles used in voiding, the perineal muscles. The perineum
supports and surrounds the distal parts of the urogenital and
gastrointestinal tracts. Kegel exercises strengthen the pelvic
floor muscles. What does word analysis of the types of urography
tell you? (ask for urogram, pyelography, pyelogram, cystography,
cystourethrography) KUB is an abbreviation used for kidneys,
ureters, and bladder. A voiding cystourethrogram (VCUG) has
radiographs made before, during, and after urination. Renal
angiography (renal arteriography), a radiographic study to assess
the arterial blood supply to the kidneys, produces a renal
arteriogram. A kidney scan also provides information about renal
blood flow. Radioactive material is injected via an IV and absorbed
by kidney tissue. Special equipment measures, records, and produces
an image of the low-level radioactivity emitted. Renography means
the same as a kidney scan. Nephrotomography is helpful in assessing
various planes of the kidney tissue for tumors, cysts, or stones.
From Bontrager KL, Lampignano J: Textbook of radiographic
positioning and related anatomy, ed 6, St Louis, 2005, Mosby. When
would this test be important?
What is the name of the process that produces a urogram?
intravenous urography or intravenous pyelography (IVP). A urogram
is also called a pyelogram. When would this test be important? From
Lewis S, Heitkemper MM, Dirksen SR: Medical-surgical nursing,
assessment and management of clinical problems, ed 6, St Louis,
2004, Mosby. Note the arrow that shows a narrowing/stenosis of the
renal artery.
From Price S, Wilson L: Pathophysiology: clinical concepts of
disease processes, ed 6, St Louis, 2003, Mosby. Diagnostic Tests
and Procedures (cont.)
endoscopy cystoscopy cystoureteroscopy urethroscopy ureteroscopy
nephroscopy What are the names of the instruments used in the types
of urinary endoscopy? (cystoscope, nephroscope) Is urethroscopy
included in cystoscopy? Why? The combined term is
cystourethroscopy. Ureteroscopy is examination of a ureter.
Nephroscopy allows visualization of the kidney. A major use of this
procedure is to remove or crush renal calculi. What is the name of
the process that uses a cystoscope?
When would this process be important? (Examples: looking for
stones, bladder cancer) What might be seen during nephroscopy
(stones, cancer)
What could be accomplished by using a nephroscope? Quick Quiz!
Which of the following is normal to find in urine? blood
albumin urea glucose C: urea. Blood, albumin, and glucose are not
normally found in urine. Lesson 11.2 Learning Goals Match the terms
for urinary system pathologies with their meanings, or write the
names when given their descriptions. Describe the significance of
genitourinary infections and their association with some sexually
transmitted diseases. Match terms for surgical and therapeutic
interventions for interventions for urinary pathologies with
descriptions of the interventions, or write the names of the
interventions when given their descriptions. Select the correct
meanings of terms and write the meanings of abbreviations in a
health care report pertaining to the urinary system. Spell the
terms accurately. Pronounce the terms correctly. Write the meanings
of the abbreviations. Lesson 11.2 covers urinary system pathologies
and surgical and therapeutic interventions. What happens when the
kidneys fail? How can sexually transmitted diseases affect the
urinary system? Writing the meanings of word parts and choosing the
correct term when presented with its definition are good markers of
your progress in this chapter. Categorizing terms as anatomic,
diagnostic, pathologic, or therapeutic is also important. Of
course, spelling and pronouncing the terms correctly will help you
immeasurably in your chosen professions. Pathologies uropathy
renovascular disorders
disorders of urination: dysuria, polyuria, anuria (anuric),
oliguria, polyuria, nocturia, nycturia, urgency, frequency,
hesitancy, urinary reflux, incontinence, enuresis A uropathy is any
disease or abnormal condition of the urinary tract. Uropathies
include inflammatory, hereditary, obstructive and renovascular
disorders, plus some uropathies that result from metabolic
diseases. What does each disorder of urination mean? Analyze the
word parts if appropriate: dys- = dysfunction/pain; poly- =
excessive, an- = not; oligo- = scanty; noct- and nyct- = night.
What do these terms mean: urgency, frequency, hesitancy, reflux,
incontinence, enuresis (discuss each). Pathologies (cont.) kidney
disorders: uremia, renal failure (acute and chronic), nephromegaly,
nephrolysis, nephromalacia, polycystic kidney disease, nephrotic
syndrome diabetes mellitus, diabetic nephropathy, nephrotic
syndrome, diabetes insipidus renovascular diseases: renal artery
stenosis, renal hypertension, nephrosclerosis, renal vein
thrombosis Uremia is an accumulation of waste products in the
blood, including urea. Inability of the kidneys to excrete wastes,
concentrate urine, and function properly is renal failure. ARF
means acute renal failure; CRF stands for chronic renal failure.
What could cause nephromegaly? Define these terms and the word
parts they contain: nephrolysis, nephromalacia, polycystic kidney
disease, nephrotoxic, nephrotic syndrome. Diabetes mellitus is a
complex disorder of metabolism that is primarily a result of
insulin deficiency or insulin resistance. Diabetic nephropathy
results from diabetes mellitus. Chronic hyperglycemia an increased
blood pressure accelerates its progression. Nephrotic syndrome is
characterized by proteinuria and edema; it is a complication of
many diseases, such as diabetes mellitus. In contrast, diabetes
insipidus is not related to the bodys use of insulin. Its cause may
be hormonal or renal and it refers to several types of polyuria
(aka diuresis) in which urinary output exceeds 3000 mL/day. How
does reduced blood flow to the kidney from renal artery stenosis
cause hypertension? (leads to excessive secretion of renin, which
increases hypertension) Hypertension resulting form renal artery
stenosis or other kidney disorders is called renal hypertension.
Nephrosclerosis is hardening of the small arteries of the kiney and
results in decreased blood flow and eventual necrosis of kidney
cells. A blood clot in the renal vein is called renal vein
thrombosis. What is the disorder pictured. poly/cyst/ic kidney
disease
What is the disorder pictured? poly/cyst/ic kidney disease. What
are the meanings of cyst(o) = urinary bladder, cyst or fluid-filled
sac? Note the difference in sizes of the kidneys as well as the
cystic appearance of the diseased kidney. What is the functional
result of polycystic kidney disease? renal failure and uremia Is
polycystic kidney disease the most common cause of renal failure?
No, diabetic nephropathy and hypertension are the most common
causes of renal failure. Courtesy Department of Pathology, Duke
University Medical Center, Durham, North Carolina. Pathologies
(cont.) Uremia
an accumulation of waste products in the blood, including urea
caused by renal failure acute uremia can be characterized by
oliguria and high blood urea nitrogen chronic uremia can require
dialysis Why is the accumulation of urea measured by blood urea
nitrogen? Why is nitrogen important? Why is protein restricted in
the diets of people with kidney disease? Pathologies (cont.)
obstructive nephropathies: hydronephrosis, hydroureter,
urolithiasis, nephrolithiasis, ureterolithiasis, cystolithiasis
growths: polyps (bladder polyp), bladder cancer, Wilms tumor
structural alterations: uterine prolapse, ureterocele, urethrocele,
cystocele, urethrostenosis, ureterostenosis Define the obstructive
nephropathy terms and the word parts they contain. What are the
names for calculi of the kidney, ureter, and bladder? nephrolith,
ureterolith and cystolith Nephropathies can also be functional in
nature, such as a neurogenic bladder resulting from a lesion of the
nervous system. A polyp is any growth or mass protruding from a
mucous membrane; in the bladder it is called a bladder polyp. They
are usually removed if seen on cystoscopy even when cancer may not
be suspected. Bladder cancer is the most common malignancy of the
urinary tract. Wilms tumor is a malignant neoplasm of the kidney
that occurs in young children. Discuss structural alterations that
affect the urinary tract. What terms describe stones at their
various locations
What terms describe stones at their various locations?
(nephrolithiasis, ureterolithiasis, cystolithiasis,
urethrolithiasis) A ureteral or urethral stricture is a narrowing
of the inner space of the ureter or urethra. Benign Prostatic
Hyperplasia
Benign prostatic hyperplasia (BPH) is a nonmalignant,
noninflammatory enlargement of the prostate that may lead to
urethral obstruction. Urethrospasm may occur after TURP. Common in
men over 50 years of age, it may produce frequency, dysuria,
nocturia, and UTIs. Hydronephrosis v. Hydroureter
What does hydro- mean in hydronephrosis and hydroureter? What else
besides stones can cause blockages? (tumors) Renal Carcinoma Kidney
cancer, renal carcinoma, is a malignant neoplasm of the renal
parenchyma or the renal pelvis. From Kumar V, Abbas AK, Fauston N,
Mitchell RN: Robbins basic pathology, ed 8, Philadelphia, 2007,
Saunders. Cystocele What can weaken the wall of the vagina and lead
to a cystocele? (childbirth is the most common cause) Pathologies
(cont.) septicemia, glomerulopathy, ureteropathy
UTIs: cystitis, urethritis, pyelonephritis,
urethrocystitis/cystourethritis, cystitis, ureteritis,
ureteropyelonephritis, pyelitis, pyelonephritis, nephritis,
glomerulonephritis, interstitial nephritis sexually transmitted
diseases: gonorrhea, urethritis (See also Chapter 13) Septicemia is
a systemic infection in which pathogens are present in the
circulating blood, having spread from somewhere else in the body
such as the urinary tract; glomerulopathy is any disease of the
glomeruli; ureteropathy is any disease or disorder of the ureter.
UTIs: Define these terms and the word parts they contain. Why is
treatment of urethr/itis and cyst/itis important? These infections
have the potential to ascend the urinary tract and result in
ureteritis and pyelonephritis, eventually affecting kidney
function. Hematuria may be a sign of urinary tract infection.
Urethrorrhagia means urethral hemorrhage. Why are sexually
transmitted diseases (STDs) being discussed in the urinary chapter?
STDs formerly called venereal diseases (VD). Pathologies (cont.)
association of GU infections with STDs gonorrhea
can produce urethrorrhea in both genders may include urethritis,
dysuria, and pyuria Is gonorrhea the only STD that can produce
urethritis? No, Ureaplasma, Chlamydia, and Trichomonas can also be
transmitted sexually. Terminology: Word Parts
noct(i), nyct(o)night olig(o)few, scanty gon(o)genitals or
reproduction thromb(o)thrombus (internal blood clot) What terms can
be formed with these word parts? Hypospadias v. Epispadias
A, In hypospadias, the opening of the urinary meatus is below its
usual location. In epispadias, B, the opening is above its usual
location. From Zitelli BJ, Davis HW: Atlas of pediatric physical
diagnosis, ed 5, St Louis, 2007, Mosby. Surgical and Therapeutic
Interventions: Hemodialysis
What does analysis of the term dia/lysis reveal? (breaking down,
through) In renal insufficiency or renal failure, dialysis removes
the waste products and helps maintain the acid-base balance. How
does the therapy dialysis work? (Discuss the semi/permeable
membrane) A, On the left is the hemodialysis circuit. B, On the
right is a patient receiving hemodialysis at a dialysis center.
What is the difference between hemodialysis and peritoneal
dialysis? A, From Ignatavicius MS, Workman ML: Medical-surgical
nursing: critical thinking for collaborative care, ed 5, 2006,
Philadelphia, Saunders. B, From Lewis S, Heitkemper MM, Dirksen SR:
Medical-surgical nursing, assessment and management of clinical
problems, ed 6, St Louis, 2004, Mosby. Surgical and Therapeutic
Interventions (cont.)
lithotripsy, lithotomy: nephrolithotomy, pyelolithotomy,
ureterolithotomy, cystolithotomy, ESWL urinary diversion:
nephrostomy, ureterostomy, cystostomy, transureteroureterostomy,
ureterocystostomy, ureterocystoneostomy Lets define these terms and
the word parts that they contain. They may look like long terms,
but when broken into word parts, their meanings become clear very
quickly. ESWL stands for extracorporeal shock wave lithotripsy.
What does extracorporeal mean? Lithotripsy What is the advantage of
lithotripsy versus nephrolithectomy? What is the instrument called
that performs lithotripsy? lithotrite Nephrostomy, Ureterostomy,
Transureteroureterostomy
Why are nephrostomy and ureterostomy ever needed? A, catheter
dilation of a stenosed ureter. B, removal of a kidney stone.
From Athanasoulis CA et al: Interventional radiology, Philadelphia,
1982, Saunders. Surgical and Therapeutic Interventions
(cont.)
incision: suprapubic cystotomy, cystotomy, urethrotomy excision:
nephrectomy, laparoscopic nephrectomy, nephroureterectomy,
cystectomy, ureterectomy, renal transplant vascular therapy:
percutaneous transluminal renal angioplasty reparative procedures:
ureteroplasty, pyeloplasty, cystoplasty, nephropexy other
therapies: antibiotics, analgesics, antispasmodics, diuretics
Define these terms and the word parts that they contain. What
conditions would require each intervention? What is the purpose of
each of these therapies? Transurethral Resection
Transurethral means through the urethra. In transurethral resection
(TUR), small pieces of tissue from a nearby structure are removed
through the wall of the urethra. Transurethral resection of the
prostate (TURP), shown here, is a surgery of the prostate gland via
an instrument passed through the wall of the urethra. From Lewis S,
Heitkemper MM, Dirksen SR, OBrien PG, Bucher L: Medical-surgical
nursing, assessment and management of clinical problems, ed 7, St
Louis, 2007, Mosby. Quick Quiz! Which term means an abnormal
accumulation of waste products in the blood? uremia hematuria
septicemia thrombolytics A: Uremia is an abnormal accumulation of
waste products in the blood, including urea. Hematuria is blood in
the urine. Septicemia is pathogens in the blood from an infection
in another part of the body. Thrombolytics are medications used to
dissolve clots. Abbreviations ADH ARF BPH BUN C&S CRF EMG ESWL
GFR GU I&O
What medical terms do each of these abbreviations represent?
ADHantidiuretic hormone ARFacute renal failure BPHbenign prostatic
hypertrophy BUNblood urea nitrogen C&S culture and sensitivity
CRFchronic renal failure EMGelectromyography ESWLextracorporeal
shock wave lithotripsy GFRglomerular filtration rate
GUgenitourinary I&Ointake & output Abbreviations (cont.)
IVP KUB pH STD TUR TURP UA, U/A UTI VCUG VD
What medical terms do each of these abbreviations represent?
IVPintravenous pyelogram KUBkidneys, ureters, and bladder
pHpotential of hydrogen STD sexually transmitted disease
TURtransurethral resection TURPtransurethral resection of the
prostate UA, U/Aurinalysis UTIurinary tract infection VCUGvoiding
cystourethrogram VDvenereal disease