Medical Terminology: Medical Terminology:

A Short CourseA Short Course

55thth edition editionDavi-Ellen ChabnerDavi-Ellen Chabner

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Urinary Urinary SystemSystem

Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.

3

Learning ObjectivesLearning Objectives

Name the organs of the urinary system Name the organs of the urinary system and describe their locations and functions.and describe their locations and functions.

Give the meaning of various pathological Give the meaning of various pathological conditions affecting the urinary system.conditions affecting the urinary system.

Recognize the uses and interpretation of Recognize the uses and interpretation of urinalysis as a diagnostic test.urinalysis as a diagnostic test.

Define combining forms, prefixes, and Define combining forms, prefixes, and suffixes of the urinary system’s suffixes of the urinary system’s terminology.terminology.

4

Learning Objectives Learning Objectives (cont’d.)(cont’d.)

List and explain some clinical List and explain some clinical procedures, laboratory tests, and procedures, laboratory tests, and abbreviations that pertain to the abbreviations that pertain to the urinary system. urinary system.

Apply your new knowledge to Apply your new knowledge to understanding medical terms in understanding medical terms in their proper contexts, such as their proper contexts, such as medical reports and records.medical reports and records.

5

IntroductionIntroduction

Nitrogenous wastesNitrogenous wastes urea urea creatinine creatinine uric aciduric acid

Kidneys Kidneys Filter nitrogenous wastes to form Filter nitrogenous wastes to form urineurine Maintain proper balance ofMaintain proper balance of

WaterWater EletrolytesEletrolytes Acids Acids

6

Introduction Introduction (cont’d.)(cont’d.)

Kidneys also secrete:Kidneys also secrete:

Hormones Hormones Renin:Renin: enzymatic hormone important enzymatic hormone important

in adjusting blood pressurein adjusting blood pressure

Erythropoietin:Erythropoietin: hormone that hormone that stimulates the red blood cell stimulates the red blood cell production in bone marrowproduction in bone marrow

7

Anatomy of the Major Anatomy of the Major OrgansOrgans

Organs of the Organs of the Urinary Urinary System in a System in a Male Male

8

Female Female

Urinary SystemUrinary System

Anatomy of the Major Anatomy of the Major Organs Organs (cont’d.)(cont’d.)

9

How Kidneys Produce How Kidneys Produce UrineUrine

Blood enters kidneys Blood enters kidneys through right and through right and left left renal arteriesrenal arteries

ArteriolesArterioles carry carry blood to blood to capillariescapillaries

GlomeruliGlomeruli filter filter bloodblood

10

How Kidneys Produce How Kidneys Produce Urine Urine (cont’d.)(cont’d.)

Glomerulus and Glomerulus and Bowman CapsuleBowman Capsule

Blood passes through Blood passes through glomeruliglomeruli

Bowman capsule Bowman capsule surrounds each surrounds each glomerulusglomerulus

Renal tubule is Renal tubule is attached to each attached to each Bowman capsuleBowman capsule

11

How Kidneys Produce How Kidneys Produce UrineUrine (cont’d.)(cont’d.)

Three steps in Three steps in the formation the formation of urineof urine

1.1. Glomerular Glomerular filtrationfiltration

2.2. Tubular Tubular reabsorptionreabsorption

3.3. Tubular secretionTubular secretion

12

How Kidneys Produce How Kidneys Produce UrineUrine (cont’d.)(cont’d.)

Glomerulus and Glomerulus and

a renal tubule a renal tubule combine to form a combine to form a unit called a unit called a nephronnephron..

13

How Kidneys Produce How Kidneys Produce Urine Urine (cont’d.)(cont’d.)

All collecting tubules All collecting tubules lead to thelead to the renal pelvis renal pelvis

Calyces or calices Calyces or calices are are small, cup-like regions small, cup-like regions of the renal pelvisof the renal pelvis

Illustration shows section of kidneyIllustration shows section of kidney

14

How Kidneys Produce How Kidneys Produce Urine Urine (cont’d.)(cont’d.)

Process of forming Process of forming and expelling and expelling urineurine

15

renal pelvisrenal pelvis

renal tubulerenal tubule

renal veinrenal vein

Central collection region in Central collection region in the kidneythe kidney

Microscopic tube in the Microscopic tube in the kidney in which urine is kidney in which urine is formed after filtration.formed after filtration.

Blood vessel that carries Blood vessel that carries blood away from the kidney blood away from the kidney and toward the heart.and toward the heart.

VocabularyVocabulary

16

ureaurea

ureterureter

urethraurethra

Major nitrogenous waste Major nitrogenous waste product excreted in urine.product excreted in urine.

Tube leading from each Tube leading from each kidney to the urinary kidney to the urinary bladder.bladder.

Tube leading from the Tube leading from the urinary bladder to the urinary bladder to the outside of the body.outside of the body.

VocabularyVocabulary

17

uric aciduric acid

urinary urinary bladderbladder

urinationurination

voiding voiding

A nitrogenous waste product A nitrogenous waste product excreted in the urine.excreted in the urine.

Hollow muscular sac that Hollow muscular sac that holds and stores urine.holds and stores urine.

Process of expelling urine.Process of expelling urine.

Emptying of urine from the Emptying of urine from the urinary bladder; urination or urinary bladder; urination or micturition.micturition.

VocabularyVocabulary

18

cyst/ocyst/o urinary bladderurinary bladder

vesci/ovesci/o urinary bladderurinary bladder

nephr/onephr/o kidneykidney

ren/oren/o kidneykidney

pyel/opyel/o renal pelvisrenal pelvis

ureter/oureter/o ureterureter

urethr/ourethr/o urethra urethra

TerminologyTerminologyCombining FormCombining Form MeaningMeaning

19

CystoscopyCystoscopy Visual examination of Visual examination of the the urinary bladderurinary bladder

IntravesicalIntravesical Pertaining to within the Pertaining to within the urinary bladderurinary bladder

NephritisNephritis Inflammation of the kidneysInflammation of the kidneys RenalRenal Pertaining to the kidneysPertaining to the kidneys PyelogramPyelogram Record of the renal pelvis Record of the renal pelvis

after after injection of contrastinjection of contrast UreterectomyUreterectomy Removal(Excision) of the Removal(Excision) of the

ureterureter UrethritisUrethritis Inflammation of the urethraInflammation of the urethra

TerminologyTerminology Meaning Meaning

20

Urinalysis – p. 126 Urinalysis – p. 126 A A urinalysisurinalysis (urine+ analysis) is a (urine+ analysis) is a separation of urine to determine its contents. separation of urine to determine its contents. The following chart shows typical urinalysis The following chart shows typical urinalysis findings:findings:

TestsTests NormalNormal AbnormalAbnormal

1.1. ColorColor light yellowlight yellow red (hematuria)red (hematuria)

2.2. AppearanceAppearance clearclear cloudy (infection)cloudy (infection)

3.3. pHpH slightly acidicslightly acidic alkaline (infections)alkaline (infections)

4.4. ProteinProtein very slightvery slight proteinuria reanal proteinuria reanal

diseasedisease

5.5. SugarSugar nonenone glycosuriaglycosuria

21

Pathologic ConditionsPathologic Conditions (cont’d.)(cont’d.)

KidneyKidney Albuminuria Albuminuria AnuriaAnuria DysuriaDysuria GlycosuriaGlycosuria HematuriaHematuria NephrolithiasisNephrolithiasis Renal FailureRenal Failure UremiaUremia

22

Other Pathologic Other Pathologic ConditionsConditions

PKD--The kidneys contain masses PKD--The kidneys contain masses of cysts. Typically polycystic of cysts. Typically polycystic kidneys weight 20 times more kidneys weight 20 times more than their usual weight.than their usual weight.

•Renal Renal HypertensionHypertension

•Wilms tumorWilms tumor

•Polycystic Polycystic kidneykidney disease disease (PKD)(PKD)

23

Pathologic Conditions- Pathologic Conditions- (cont’d.)(cont’d.)

KidneyKidney Renal cellRenal cell

carcinomacarcinoma

(hypernephroma) (hypernephroma)

Cancerous tumor Cancerous tumor

of the kidney of the kidney

in adulthood. in adulthood.

24

Other Pathologic Other Pathologic Conditions Conditions (cont’d.)(cont’d.)

Urinary bladderUrinary bladder Bladder cancerBladder cancer

Associated conditions Associated conditions Diabetes insipidusDiabetes insipidus Diabetes mellitusDiabetes mellitus

25

Laboratory Tests and Laboratory Tests and Clinical ProceduresClinical Procedures

Laboratory testsLaboratory tests Blood Urea Nitrogen (BUN)Blood Urea Nitrogen (BUN) CystoscopyCystoscopy Kidneys, ureters, bladder (KUB)Kidneys, ureters, bladder (KUB) Retrograde Pyelogram (RP)Retrograde Pyelogram (RP) UrographyUrography

26

Laboratory Tests – Laboratory Tests – (cont.)(cont.)

VoidingVoiding Cystourethrogram Cystourethrogram (VCUG)(VCUG) showing a normal female urethra. The showing a normal female urethra. The bladder is filled with contrast material, bladder is filled with contrast material, followed by x-ray imaging.- followed by x-ray imaging.- p.280p.280

27

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)CLINICAL PROCEDURES CLINICAL PROCEDURES

X-Ray StudiesX-Ray Studies

CT scanCT scan

kidneys, ureters, & bladder (KUB)kidneys, ureters, & bladder (KUB)

renal angiographyrenal angiography

retrograde pyelogram (RP)retrograde pyelogram (RP)

voiding cystourethrogram (VCUG)voiding cystourethrogram (VCUG)

28

CT-Computed TomographyCT-Computed Tomography

The scan with contrast shows a The scan with contrast shows a benign cyst on the kidney. benign cyst on the kidney.

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)

29

CLINICAL PROCEDURESCLINICAL PROCEDURES

Ultrasound ExaminationUltrasound Examination ultrasonography:ultrasonography: imaging imaging

urinary tract structures using urinary tract structures using high frequency sound waveshigh frequency sound waves

Radioactive StudiesRadioactive Studies radioisotope scan: radioisotope scan: image of image of

kidney after injecting a kidney after injecting a radioisotope (that concentrates in radioisotope (that concentrates in the kidney) into the bloodstreamthe kidney) into the bloodstream

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)

30

CLINICAL PROCEDURESCLINICAL PROCEDURES

Magnetic imagingMagnetic imaging magnetic resonance imaging magnetic resonance imaging

(MRI): (MRI): using magnetic field and using magnetic field and radio waves to produce images in all radio waves to produce images in all three planes of the bodythree planes of the body

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)

31

Other Clinical ProceduresOther Clinical Procedures Cystoscopy – p.7Cystoscopy – p.7 dialysis (hemodialysis and dialysis (hemodialysis and

peritoneal)- p.95,96peritoneal)- p.95,96 lithotripsy – p. 180 Case 4 Urologylithotripsy – p. 180 Case 4 Urology renal angioplastyrenal angioplasty renal biopsyrenal biopsy renal transplantationrenal transplantation urinary catheterizationurinary catheterization

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)

32

CytoscopyCytoscopy—direct visual examination of —direct visual examination of urinary bladder with an endoscope – urinary bladder with an endoscope – p. 7p. 7

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)

33

Hemodialysis (HD): Hemodialysis (HD): Waste materials (urea, Waste materials (urea, creatinine, and uric acid) are separated from creatinine, and uric acid) are separated from the blood my a machine. – the blood my a machine. – p. 95, 119, 280p. 95, 119, 280

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)

34

Continuous Continuous ambulatory ambulatory peritoneal peritoneal dialysis dialysis (CAPD) – p.96(CAPD) – p.96

Laboratory Tests and Laboratory Tests and Clinical Procedures Clinical Procedures

(cont’d.)(cont’d.)

35

ARFARF BUN BUN CAPDCAPD CKDCKD CRFCRF HDHD KUBKUB RPRP UAUA UTIUTI

What are these useful What are these useful abbreviations?abbreviations?

(p. 280)(p. 280)

36

REVIEW SHEETREVIEW SHEET cyst/ocyst/o ________________________

vesic/ovesic/o ________________________

nephr/onephr/o ________________________

ren/oren/o ________________________

pyel/opyel/o ________________________

ureter/oureter/o ________________________

urethrourethro ________________________

37

cyst/ocyst/o urinary bladderurinary bladder

vesic/ovesic/o urinary bladderurinary bladder

nephr/onephr/o kidneykidney

ren/oren/o kidneykidney

pyel/opyel/o renal pelvisrenal pelvis

ureter/oureter/o ureterureter

urethr/ourethr/o urethraurethra

REVIEW SHEETREVIEW SHEET