MT 7

Functions of the Urinary System

Maintaining homeostasis

Filtering blood

Converting waste products and excess fluids into \n urine

Structures of the Urinary System

Two kidneys (2) \n • Two ureters (2) \n • One bladder (1) \n • One urethra (1)

kidneys

Filter blood to remove waste products and excess \n water

maintenance of fluid level, controlling BP

renal medulla

contains urine-collecting tubules

renal pelvis

funnel-shaped

site of urine collection

bowl or cup or reservoir of kidney

nephron

Microscopic functional units of the kidney \n • Site of urine production using filtration, reabsorption, and \n secretion

glomerulus

clusters of capillaries) \n – The glomeruli are where the process of filtration \n occurs between our blood & our kidneys

ureters

Two narrow tubes transporting urine from each kidney to the bladder

Ureteral orifices allow draining of urine from ureters into the bladder

urethra

Tube extending from bladder to exterior of the body

urethral meatus (external opening of the urethra)

Nephrologist

Specializes in diagnosing/treating diseases/disorders of kidneys

Urologist

Specializes in diagnosing/treating diseases/disorders of urinary system of females and genitourinary system of males

Acute renal failure (ARF)

Sudden onset of uremia \n – Fatal

Chronic kidney disease (CKD)

Progressive loss of renal function \n – Can be life-threatening

End-stage renal disease (ESRD)

Fatal unless kidney function replaced by dialysis or kidney \n transplant

Nephrotic Syndrome

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Nephrosis \n – Group of conditions when excessive amounts of \n protein are lost through urine

edema

Excessive fluid accumulation in body tissues

Glomerulonephritis

erythrocytes and proteins to leak into urine

Hyperproteinuria

high concentrations of protein in urine

Hypoproteinemia

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low concentration of protein in the blood

Hydronephrosis

Dilation of one or both kidney(s) due to obstruction \n resulting in backing up of urine

Nephroptosis

aka floating kidney) \n – Prolapse (sagging) of kidney into pelvic area when a person \n stands

Renal colic

Acute pain in kidney area caused by blockage during passage of \n kidney stone

anuria

absence of urine formation

oliguria

scanty/small amt of urine is produced

diuresis

increased output of urine

polyuria

excessive urination

dysuria

difficult painful urination

enuresis

involuntary discharge or urine

Nocturnal enuresis

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Aka Bed-wetting

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nocturia

frequent urination during the night

Urinary hesitancy

Difficulty in starting urinary stream \n – Also called bashful bladder syndrome

urinary retention

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Inability to completely empty the bladder \n – Also called ischuria

overflow incontinence

Continuous leaking from bladder

stress incontinence

Inability to control voiding under physical stress

more common in women

overactive bladder

urge incontinence

bladder muscles contract involuntarily

cystography

downward flow of urine

contrast medium

Intravenous pyelography (IVP)

Looking for blockages or changes to the urinary tract \n – Requires contrast medium

retrograde urography

upward flow of urine

contrast medium

KUB (kidneys, ureters, bladder)

x-ray

doesn’t require contrast medium

dialysis

Removes waste products, and excess water from \n blood when kidneys do not function properly

Hemodialysis (most common)

waste products filtered directly from patient's blood \n & into a hemodialysis unit that contains a sterilized \n filtering solution; cleansed blood returned to body \n through a vein

Peritoneal dialysis

lining of peritoneal (abdominal) cavity acts as filter to remove waste from the blood

Cystectomy

Surgical removal of all or part of the urinary bladder

Ileal conduit aka urinary ileostomy

Use of small piece of intestine to convey (aka divert or transport) \n urine to ureters and then to abdominal stoma/opening

Cystorrhaphy

Surgical suturing of wound/defect in bladder

Lithotomy

Surgical incision for removal of nephrolith (stone) from bladder \n – This surgical procedure is rarely performed anymore; this \n term now refers to physical examination position for \n procedures involving pelvis and lower abdomen

Urethral catheterization

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Most common type of urinary catheterization \n – Insertion of catheter through urethra and into the bladder for the \n removal of urine

Indwelling catheter

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Most common type of urethral catheter \n – Catheter remains inside body for prolonged time

Foley catheter

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Most common type of indwelling catheter \n – Flexible tube with balloon filled with sterile water at the end to hold \n it in place

Intermittent catheter

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Inserted as needed several times per day to drain urine from \n bladder \n – As opposed to an indwelling catheter

Suprapubic catheterization

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into bladder through small incision in abdominal wall just above the pubic bone \n – As opposed to a urethral catheter

Ablation

Removal of a body part, or destruction of its function (using \n surgery, hormones, drugs, heat, chemicals)

Radical Prostatectomy

Surgical removal of the entire prostate gland

Transurethral prostatectomy (TURP)

remove excess tissue from enlarge prostate gland

kegel exercises

strengthen muscles of pelvic floor

bladder retraining

Behavioral therapy

urinate at a schedule time

Assists with reestablishing voluntary bladder control

Genitalia

Organs of reproduction and their associated structures

Perineum

external surface area between pubic bone & coccycx (tailbone)

External male genitalia

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Penis and scrotum, which contains two testicles

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Internal male genitalia

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Include remaining structures of male reproductive \n system

Scrotum

surrounds, protects, and supports testicles

testicles

glands that produce sperm

Epididymis: coiled tube at the upper part of each testicle; stores sperm

semen

Whitish fluid containing sperm

seminal vesicles, bulbourethral glands and prostate gland add secretions to form semen

Foreskin

prepuce

Bulbourethral Glands

Cowper’s Glands

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urologist

genitourinary system of males and urinary system of females \n • x1 for females (urinary system only) \n • x2 for males (urinary and reproductive system)

Cryptorchidism

undescended testicle) \n • Developmental defect

Castration

Surgical removal or destruction of both testicles

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Vasectomy

surgical removal of a small portion of \n vas deferens \n – Prevents sperm from entering the ejaculate

Vasovasostomy

aka reverse vasectomy

External female genitalia

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vulva

Two fallopian tubes

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Site of fertilization (egg cell meets sperm \n cell) \n • Infundibulum: funnel-shaped opening into fallopian \n tube near the ovary \n • Fimbriae: finger-like extensions that catch the \n mature ovum when it leaves the ovary

Menarche

Beginning of menstruation (menstrual function)

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menopause

normal termination of menstruation during middle age

perimenopause

transition phase b/t regular menstrual periods and no periods at all

conception

occurs in the fallopian tubes when sperm penetrates and fertilizes ovum

implantation

Embedding of zygote into uterine lining \n • No longer called a zygote \n • Embryo = From implantation to the 8th week of \n pregnancy \n • Fetus = From 9th week of pregnancy to the time \n of birth

fraternal twins

Fertilization of separate ova by separate sperm cells \n resulting in two separate embryos

identical twins

Fertilization of single ova by single sperm that divides to \n form two embryos

chorion

outer membrane that encloses embryo

amnion

innermost membrane that surrounds embryo in the uterus amniotic fluid protects fetus and allows for the floating movements

umbilical cord

Carries blood, oxygen, and nutrients from placenta \n to the developing baby \n • Transports waste

Braxton Hicks contractions

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Intermittent painless contractions occurring frequently as pregnancy \n progresses

quickening

first movement felt by mother

nulligravida

woman who has never been pregnant

nullipara

woman who has never given birth to a viable child

primigravida

wiman during her first pregnancy

primipara

woman who has given birth to a viable child the first time

multiparous

woman who has given birth two or more times

Labor and delivery (L & D)

childbirth or parturition

lochia

Postpartum vaginal discharge that continues 4–6 weeks \n after childbirth

Colostrum

“first milk” \n – Specialized form of breast milk that delivers essential \n nutrients/antibodies to the newborn \n – Produced during late pregnancy and first few days after \n giving birth

lactation

Process of forming and secreting milk from breasts \n – Milk develops few days after giving birth and replaces \n colostrum

vernix

Greasy substance that protects fetus in utero \n – May be present at birth

meconium

Greenish material collecting in the intestine of fetus \n forming the first stool of the newborn \n – Aka “first poop”

gynecologist

Specializes in diagnosing/treating diseases/disorders of \n female reproductive system

obstetrician

Specializes in medical care during pregnancy, childbirth, \n and immediate postpartum

midwife

RN that specializes in OB/GYN & assists in Labor & Delivery

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neonatologist

Specializes in diagnosing/treating disorders of newborn

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infertility specialist

Diagnoses/treats problems associated with the conception \n and maintaining pregnancy