Chapter 10- Urinary System and Urology notes

Urology

The medical specialty that studies the anatomy and \n physiology of the urinary system

Urinary System

removes waste products of cellular metabolism from the blood by producing, transporting, storing, and excreting urine

Anatomy of the Urinary System

Kidney

Ureter

Renal Pelvis

Bladder

Glomerulonephritis

Infection and inflammation of the glomeruli of the kidney; occurs as a complication of acute viral or streptococcal infection, when \n antigen–antibody complexes clog the pores of capillaries in the glomeruli

Hydronephrosis

Condition in which urine distends the renal pelvis and calices or ureter; occurs when a blood clot, infection, or kidney stone blocks \n the flow of urine

Nephrolithiasis

kidney stones

Nephropathy

general term for any disease of the kidney

Nephroptosis

Abnormally low position of a kidney

Polycystic Kidney Disease

Hereditary disease characterized by cysts in the kidney; growth of these cysts eventually destroys the nephrons and causes kidney failure

Pyelonephritis

Infection and inflammation of the renal pelvis of the kidney; caused by bacteria that travel upward from the bladder

renal cell cancer

A cancerous tumor (carcinoma) that begins in the epithelial cells (epi’s) in the tubules of the nephron

Renal failure

Disease in which urine production decreases and may even stop; can occur due to acute or chronic disease processes. \n • Acute kidney injury (AKI) occurs suddenly, usually due to trauma, blood loss, or overwhelming infection. \n • Chronic kidney disease (CKD) occurs gradually, with renal insufficiency progressing to renal failure

Uremia

Condition in which there is excessive buildup of urea in the blood due to renal failure.

Urinary Tract Infection

Bacterial infection somewhere in the urinary tract; usually involves E. coli that have traveled from the rectum into the urethra

Bladder Cancer

Presence of a cancerous tumor (carcinoma) in the epithelial cells (epi’s) of the bladder.

Cystitis

infection or inflammation of the bladder

Cystocele

Hernia in which the bladder bulges through a weakness in the muscular wall of the vagina or rectum, causing retention of urine inside the hernia

Incontinence

inability to voluntarily keep urine in the bladder caused by injury, surgery, dementia, or young children

Neurogenic bladder

Condition in which nerves to the bladder are not working properly; this causes urinary retention because the bladder does not contract

Overactive bladder

Condition in which the bladder has too many involuntary contractions, resulting in urgency and frequency; also known as urge incontinence

Urinary retention

inability to empty the bladder

Vesicovaginal fistula

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Abnormal passageway connecting the bladder to the vagina; urine flows through this passageway and continually leaks out of the \n body through the vagina. This occurs commonly when a young woman’s body is too immature (small) to have a birth

Urethritis

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Infection or inflammation of the urethra

Albuminuria (proteinuria)

presence of albumin the urine

Anuria

Complete absence of urine production by the kidneys

Bacteriuria

Presence of bacteria in the urine; indicative of infection somewhere in the urinary tract

Dysuria

Difficult or painful urination

Enuresis

Involuntary release of urine in an otherwise normal person who should have bladder control. \n • Term is not applicable to young children. \n • Nocturnal enuresis or bedwetting is involuntary urination during sleep

Frequency

Urinating often, usually in small amounts.

Glycosuria

Presence of glucose in the urine; associated with uncontrolled diabetes mellitus

Hematuria

Blood in the urine; may be gross/frank or microscopic

Hesitancy

Inability to initiate a normal stream of urine, with dribbling and a decrease in the width of the urinary stream

Ketonuria

Presence of ketones in the urine; occurs when the body metabolizes fat rather than glucose. Common with uncontrolled diabetes mellitus

Nocturia

Increased frequency and urgency of urination at night

Oliguria

Decreased or scanty production of urine due to kidney failure or dehydration

Polyuria

Excessive urine production; common symptom of diabetes mellitus and diabetes insipidus

Pyuria

Presence of white blood cells (WBCs) or pus in the urine; indicative of urinary tract infection (UTI)

Urgency

Strong urge to urinate with a sense of pressure in the bladder; caused by obstruction or inflammation

Blood urea nitrogen (BUN)

Blood test that measures the amount of urea in the blood; elevated levels mean the kidneys aren’t working properly. \n • Liver produces ammonia (has nitrogen) \n • Nitrogen combines with other elements to form urea

Creatinine

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Blood test that measures the amount of creatinine in the blood; elevated levels mean the kidneys aren’t working properly. \n • Creatinine is a waste product from muscle metabolization

Culture and sensitivity

Test in which a urine sample is swabbed onto a culture medium so that any bacteria present in the sample can be identified; the \n bacteria are then tested to determine their sensitivity to various antibiotics

drug screening

Urine test performed to evaluate whether an individual is using illegal, addictive, or performance-enhancing drugs

Leukocyte esterase

Quick urine dipstick test that detects the enzyme esterase, which is associated with the white blood cells that are present with a urinary tract infection (UTI)

Urinalysis

Urine test that describes the general characteristics of a patient’s urine and detects substances in it. \n • Includes consideration of color, odor, pH, sediment content, and specific gravity. \n • Screens for glucose, ketones, red blood cells (RBCs), white blood cells (WBCs), and various proteins

Albumin

protein in the urine that is an abnormal finding that indicates damage to the glomerulus

color

Normal urine is light yellow to amber in color. \n • Pink or reddish urine indicates bleeding in the urinary tract. \n • Turbid urine indicates presence of a UTI.

glucose

Glucose in the urine is an abnormal finding that indicates uncontrolled diabetes mellitus

Ketones

Lipids in the urine that are an abnormal finding that suggests uncontrolled diabetes mellitus or malnutrition

Odor

Normal urine has a faint odor; fruity-smelling urine suggests diabetes mellitus

pH

normal urine is slightly alkaline, with a pH just over 7

Red blood cells

Presence of RBCs indicates bleeding in the urinary tract

sediment

Several types of sediment may be present in urine: \n • Crystals (calcium oxalate, uric acid, etc.) can form kidney stones. \n • Epithelial cells (epi’s) are a normal finding because they are continually shed in the urinary tract

Specific gravity

Measurement of the concentration of urine as compared to that of water.

White blood cells

Presence of WBCs indicates a urinary tract infection (UTI); if the specimen is milky or cloudy, the result is reported as too numerous to \n count (TNTC)

Intravenous pyelography (IVP)

Radiologic procedure that uses x-rays and contrast dye to visualize the urinary system. \n • Dye is injected intravenously, then flows through the blood into the kidneys. \n • From the kidneys, the dye outlines the structures of the renal pelvis, ureters, bladder, and urethra

Kidneys, ureters, bladder (KUB) x-ray

X-ray of the kidneys, ureters, and bladder that shows only those structures and does not use contrast dye.

Renal angiography

Procedure that uses x-rays and radiopaque contrast dye to produce images of the renal artery

Ultrasonography

Use of high-frequency sound waves to produce an image of the urinary system

Voiding cystourethrography

Procedure in which contrast dye is inserted into the bladder through a catheter; the dye outlines the bladder and urethra, and an x-ray image is taken while the patient is urinating

Catheterization

Insertion of a flexible tube called a catheter through the urethra and into the bladder to drain urine. \n • A Foley catheter (image A) is an indwelling tube held in place by a balloon in the bladder. \n • A condom catheter (image B) fits over the penis and collects urine as it leaves the urinary meatus. \n • Creek for “to send or let down”

Dialysis

Procedure to remove waste products from the blood of a patient who is in renal failure. \n • In hemodialysis, a fistula is surgically created to accommodate two needles; one needle removes the blood and sends it to the dialysis machine for purification, and the other needle returns the blood to the body. \n • In peritoneal dialysis, a permanent catheter is inserted through the abdominal wall; dialysate fluid is put into the abdominal cavity via the catheter and left for several hours, then removed along with waste products from the blood

Hemodialysis

Needles inserted into the fistula in the patient’s arm take blood from the patient to the dialysis machine. In the machine, waste products move from an area of higher concentration (in the blood) to an area of lower concentration (in the dialysate fluid). The cleansed blood is pumped back through the fistula to the patient.

Intake and output

Procedure that documents a patient’s total amount of fluid intake (oral, nasogastric tube, intravenous line, etc.) and total amount of fluid output (urine, wound drainage, etc.) over the course of a day

Urine specimen

Process of collecting a patient’s urine for testing in the office or medical laboratory. \n • A clean-caught specimen is obtained after cleansing the urethral meatus to remove as many bacteria as possible. \n • Improperly obtained specimens may be contaminated with bacteria or menstrual blood

Antibiotics

Treat urinary tract infections (UTIs) caused by bacteria.

Antispasmodics

Relax smooth muscle in the walls of the urinary tract; used to treat cystitis or overactive bladder

Diuretics

Block sodium reabsorption in the kidney, which decreases blood volume and increases urine

Overactive bladder drugs

Decrease contractions of smooth muscle in the bladder.

Potassium supplements

Replace potassium that is lost when taking diuretic drugs

Urinary analgesics

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Relieve pain in the mucosa of the urinary tract.

Bladder neck suspension

Procedure to correct stress urinary incontinence (SUI); involves insertion of a supportive sling of muscle tissue or synthetic mesh around the bladder neck and urethra

Cystectomy

Surgical removal of the bladder; used in the treatment of bladder cancer

Cystoscopy

Use of an instrument called a cystoscope to examine the inside of the bladder \n • The cystoscope is inserted through the urethra. \n • A wide-angle lens and light allow a full view of the bladder

Kidney Transplant

Procedure to treat a patient in end-stage renal failure by transplanting a new kidney from a donor. \n • Recipients and donors are matched by blood and tissue type. \n • Donors may be living or deceased. \n • Recipients must take immunosuppressant drugs for the rest of their lives to prevent kidney rejection

Lithotripsy

Procedure that uses a laser or sound waves to break up a kidney stone. \n • Cystoscopic laser lithotripsy \n • Extracorporeal shock wave lithotripsy (ESWL) \n • Percutaneous ultrasonic lithotripsy

nephrectomy

Surgical removal of a diseased or cancerous kidney; also the procedure used to remove a healthy kidney from a living donor

Nephrolithotomy

Procedure in which an endoscope is inserted into the kidney through a slit in the skin, then used to remove a stone embedded in the renal pelvis or calices

Nephropexy

Surgical correction of an abnormally low kidney by suturing it into the correct position

Renal biopsy

Procedure in which a small piece of kidney is removed for microscopic analysis.

Stone basketing

Procedure in which a cystoscope is inserted into the bladder, then a small wire basket is passed through the scope to grab and remove kidney stones from the bladder

Urethroplasty

Plastic surgery procedure to reposition the urethral meatus in male patients who have hypospadias or epispadias

AKI

acute kidney injury

ARF

acute renal failure

BUN

blood urea nitrogen

C&S

culture and sensitivity

CAPD

continuous ambulatory peritoneal dialysis