AAPC Fundamentals of Medicine (Ch. 10)

Urinary and Male Reproductive

Urinary System

Produces urine for excretion of metabolic waste, and fluid balance, Plays an important role in blood pressure control within the body

Urinary System Size

Four basic parts for females and five basic parts for males

Urinary System Parts

Two kidneys, Two ureters, One bladder, One urethra, Prostate gland (males only)

calic/o

Calix

cali/o

Calix

cyst/o

Filled sac or pouch, cyst, bladder, urinary bladder

dips/o

Thirst

glomerul/o

Glomerulus

hydr/o

Water, fluid

ket/o

Ketone bodies

lith/o

Calculus, stone

nephr/o

Kidney

pyel/o

Renal pelvis

ren/o

Kidney

trig/o

Trigone region, kidney

ur/o

Urine, urinary tract

ureter/o

Ureter

urethr/o

Urethra

urin/o

Urine

vesic/o

Urinary bladder

-lysis

Separation, loosening, dissolving, destruction

-uria

Urination or urinary

Kidneys

Bean-shaped organs, approximately the size of a fist

Kidneys

Located near the middle of the back, bilateral to the spine

Kidneys

Filter urea (waste) and excess fluid from blood

Nephron

Consists of glomerulus (ball of capillaries) and a renal tubule

Urea

Produced when foods are broken down, Carried in bloodstream to kidneys, Combined with water, and other waste substances forms urine after passing through nephron, Works with lungs, skin, and intestine to keep chemicals and water balanced

Ureters

Muscular tube carrying urine from the kidneys to bladder, Originate in renal pelvis and end in bladder, Receives urine through major calyces

Ureters

Approx. 12” long and 3-4 mm in diameter

Ureters

Muscles in wall constantly tight and relax (peristalsis) to force urine down

Ureters

Urine allowed to stand still or reflux can cause a kidney infection

Ureterovesical junction

Anatomical area where ureters join the bladder

Ureterovesical junction

Has 3 major components

Ureterovesical junction

Lower ureter

Ureterovesical junction

Trigone muscle

Ureterovesical junction

Adjacent bladder wall

Urinary bladder

Hollow, muscular, expandable organ collecting urine

Urinary bladder

Held in place by ligaments attached to other organs and by pelvic bones

Urinary bladder

Stores urine until nerves from bladder signal brain that bladder is full

Urinary bladder

Brain signals bladder to tighten and sphincter muscles to relax

Urinary bladder

Urine exits through urethra

Urethra

Tube connecting urinary bladder to outside of body

Urethra

In males, is the conduit for fluid waste and semen

Urethra

Shaped like an S to follow the line of the penis

Prostatic urethra

Portion of urethra passing along neck of urinary bladder, and through prostate gland

Prostatic urethra

Designed to accept drainage from tiny ducts within prostate

Prostatic urethra

Equipped with two ejaculatory tubes

Prostatic urethra

Due to this portion, males who have prostate issues tend to exhibit urinary dysfunction

Urethra

In females, straight

Urethra

In females, approx. 4 cm long

Urethra

In females, leads out of body via urethral orifice

Urethra

In females, has no reproductive function

Urethra

Bladder muscles will tighten and squeeze urine into urethra

Bladder neck

Proximal opening of urethra

Bladder neck

In men, adjacent from prostate gland

Bladder neck

If it does not open and close properly may become obstructed

Bladder neck

In men, caused by enlarged prostate

Bladder neck

In women, caused by pelvic prolapse

Chronic kidney disease (CKD)

Progressive disorder in which kidneys are damaged and not functioning properly

Chronic kidney disease (CKD)

Causes excess fluid and toxin build-up

Chronic kidney disease (CKD)

Urine production decreases

Chronic kidney disease (CKD)

Hypertension begins to rise, meaning less filtering happens

Chronic kidney disease (CKD)

5 stages: CKD I - CKD V

Chronic kidney disease (CKD)

CKD III has two substages

Chronic kidney disease (CKD)

Stages determined by glomerular filtration rate (GFR)

Chronic kidney disease (CKD)

How much blood is being filtered by glomeruli, lower number signifies more severe disease development

Chronic kidney disease (CKD)

Irreversible

Chronic kidney disease (CKD)

When kidneys stop functioning pt is in end-stage renal disease (ESRD)

Chronic kidney disease (CKD)

Requires the start of dialysis

Chronic kidney disease (CKD)

Treatment includes diet, medication, control of disease processes (DM, HTN), dialysis when required

Dialysis

Two types: hemodialysis, peritoneal dialysis

Hemodialysis

Involves accessing pt’s bloodstream through special surgical tunnel and passing blood into external machine to filter waste, toxins and excess fluid

Hemodialysis

Typically done 3-4 times a week for a minimum of 4 hours

Peritoneal dialysis

Filling abdomen with fluid called dialysate

Peritoneal dialysis

Over 8 to 24 hours period, dialysate pulls toxins and waste from blood via osmosis before being drained from abdomen

Acute renal failure and acute kidney injury

ARF and AKI

Acute renal failure and acute kidney injury

Caused by injury, severe illness, heart attack and anaphylactic reactions

Acute renal failure and acute kidney injury

Reversible

Acute renal failure and acute kidney injury

Some meds can initially cause AKI that resolves after med adjustment

Urinary incontinence

Inability to control urine leakage from bladder

Urinary incontinence

Has numerous causes, which vary depending on gender

Urinary incontinence

5 different types: stress, urge, mixed, overflow, functional

Urinary incontinence

Can be diagnosed symptomatically or by urodynamic testing

Urodynamic testing

Completed by urologist or gynecologist

Urodynamic testing

Completed with a mix of tests

Hydronephrosis

Dilation of kidney and renal pelvis due to an obstruction causing excess fluid and urine accumulation

Hydronephrosis

Causes of obstruction include urinary reflux, stones or cancers

Polyuria

Excessive production and passage of urine, often occurring with polydipsia

Polyuria

Often a symptom of other conditions like DM

Hematocele

Blood-filled sac found within the body area

-centesis

To puncture

-clasis

Surgical break or fracture

-desis

fixation, binding

-ectomy

Surgical removal

-graphy

Imaging

-lysis

To free up

-orraphy

Surgical suture

-opexy

Surgical fixation of an organ

-otomy

Incision, to cut open

-scopy

Observation, related to endoscope