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urinary system

consists of two kidneys, two ureters, the urinary bladder, and the urethra

primary function of the urinary system

regulation of the extracellular fluids of the body (primarily plasma and tissue fluid)

urine

passes out of the kidneys via the ureters to the urinary bladder and then excreted out of the body through the urethra

electrolyte

mineral salt (sodium, potassium, or calcium) that carries an electrical charge when in solution

filtrate

fluid that passes from the blood through the capillary walls of the glomeruli into Bowman capsule

nitrogenous waste

product of protein metabolism that include urea, uric acid, creatine, creatinine, and ammonia

peristaltic wave

sequence of rhythmic contraction of smooth muscles of a hollow organ to force material forward and prevent backflow

peritoneum

serous membrane that lines the abdominopelvic cavity and covers most of the organs within the cavity

pH

symbol that expresses the alkalinity or acidity of a solution

pH of 7

neutral solution

plasma

liquid portion of blood that is filtered by the nephrons to remove dissolved wastes

nitrogenous wastes and excess electrolytes

the harmful products excreted by the urinary system

nitrogenous products

are toxic; must be eliminated from the body or death can occur

proper balance of electrolytes

vital for proper functioning of the muscles, heart, and nerves

erythropoietin

a hormone secreted by the kidney that acts on bone marrow to stimulate production of red blood cells when blood oxygen levels are low

macroscopic structures

two kidneys, two ureters, a bladder, and a urethra

kidney

left and right; each about the size of a fist; beanlike in shape; located in the abdominal cavity slightly above the waistline

retroperitoneal

the kidneys lie outside of the peritoneum

renal cortex

the outer area on a kidney seen in the frontal section

renal medulla

the middle area on a kidney seen in the frontal section

nephrons

microscopic filtering units of the kidney in the renal cortex and renal medulla

hilum (hilus)

an opening through which the renal artery enters and the renal vein exits the kidney

renal artery

carries blood that contains waste products to the nephrons for filtering

renal vein

after waste products are removed, blood leaves the kidney in this

process of urine formation

helps maintain the normal composition, volume, and pH of blood and tissue fluid

renal pelvis

a hollow chamber where waste material, urine, passes through; where the ureter merges with the kidney

ureter

a slender tube about 10” or 12” long that carries urine in peristaltic waves to the bladder

ureteral orifice

the place where urine enters the bladder

urinary bladder

an expandable hollow organ; acts as a temporary reservoir for urine

rugae

small folds in the bladder that expand as the bladder fills

trigone

a triangular area at the base of the bladder is delineated by the openings of the ureters and the urethra

urethra

a tube that discharges urine from the bladder; formed by the base of the trigone

urethra length

1.5” in women and about 7” to 8” in men (passes through the prostate gland and the penis)

urination

micturition; urine is expelled from the body through the urinary meatus

urinary meatus

the urethral opening

nephrons

one million in the kidney that adjust and regulate the contents of blood plasma

parts of a nephron

a renal corpuscle and a renal tubule

renal corpuscle

in a nephron; composed of a glomerulus and the Bowman capsule

glomerulus

a tuft of capillaries in the renal corpuscle

Bowman capsule

an enlarged extension of the renal tubule that encapsulates the glomerulus

afferent arteriole

carries blood to the glomerulus

efferent arteriole

carries blood from the glomerulus

peritubular capillaries

a network of capillaries that surround the renal tubule; formed from the efferent arteriole passing behind the renal corpuscle

renal tubule

in a nephron; composed of the proximal convoluted tubule, the loop of Henle, the distal tubule, and the collecting tubule

transports newly formed urine to the renal pelvis for excretion by the kidneys

nephron’s physiological functions

filtration, reabsorption, and secretion

filtration

occurs in the renal corpuscle, where the plasma is forced from the blood to form filtrate

reabsorption

most of the water and some of the amino acids and electrolytes are returned to the peritubular capillaries and reenter the circulating blood

secretion

the final stage of urine formation where the urine leaves the body with the waste products

albumin/o

albumin, protein

azot/o

nitrogenous compounds

bacteri/o

bacteria

cyst/o or vesic/o

bladder

glomerul/o

glomerulus

kal/i

potassium (an electrolyte)

keton/o

ketone bodies (acids and acetones)

lith/o

stone, calculus

meat/o

opening, meatus

nephr/o or ren/o

kidney

noct/o

night

olig/o

scanty (decreased production)

py/o

pus

pyel/o

renal pelvis

ur/o

urine, urinary tract

ureter/o

ureter

urethr/o

urethra

-genesis

forming, producing, origin

-iasis

abnormal condition by something specific

-uria

urine

dia-

through, across

retro-

backward, behind

causes of urinary system disorders

include congenital anomalies, infectious diseases, trauma, or conditions that secondarily involve the urinary structures

asymptomatic urinary diseases

are first diagnosed when a routine urinalysis identifies abnormalities

urinary disorder symptoms

include changes in urination pattern, output, or dysuria

urology

the branch of medicine concerned with urinary disorders and diseases of the male reproductive system

urologist

the physician who specializes in diagnosis and treatment of genitourinary disorders

nephrology

the branch of medicine concerned specifically with diseases of the kidney, electrolyte imbalance, renal transplantation, and dialysis therapy

nephrologists

physicians who practice in the specialty of nephrology

pyelonephritis

an inflammation of the kidney and renal pelvis; may affect one or both kidneys; treated through antibiotic therapy; also called kidney infection or nephritis

pyelonephritis symptoms

may include dysuria, nephralgia, fatigue, urinary urgency and frequency, chills, fever, nausea, and vomiting

dysuria

painful urination

nephralgia

pain in the kidneys

pyelonephritis urinalysis

usually reveals bacteriuria, pyuria, and hematuria

bacteriuria

bacteria in the urine

pyuria

pus in the urine

hematuria

blood in the urine

glomerulonephritis

an inflammation of the glomerular membrane in the nephrons, causing it to become leaky

inflamed glomerulus

allows red blood cells and protein, which usually remain in the blood, to pass through and enter the tubule

glomerulonephritis urinalysis

reveals hematuria and proteinuria

proteinuria

protein in the urine

glomerulonephritis symptoms

hypertension, edema, and impaired renal function

common cause of glomerular inflammation

a reaction to the toxins given off by pathogenic bacteria, especially streptococci

calculi

stones; commonly form when dissolved urine salts begin to solidify

urolithiasis

stones that form in any part of the urinary tract

nephrolithiasis

stones that form in the kidney

ureterolithiasis

stones that lodge the ureter; cause colic

colic

an intense throbbing pain

extracorporeal shock-wave lithotripsy

calculi are pulverized using shock waves directed at the stones from a machine outside the body

shock waves

concentrated ultrasound waves

percutaneous nephrolithotomy

a surgeon makes a small incision in the skin, and forms an opening in the kidney to take out the stones

ureteroscopic stone removal

no incision required to remove calculi in the ureter; use of a ureterscope through the urethra and bladder to locate and remove stone

acute tubular necrosis

ATN; the tubular portion of the nephron is injured; two types

ischemic ATN

decrease in blood supply to nephron tubules

nephrotoxic ATN

ingestion of toxic chemicals that affect nephron tubules

ATN signs and symptoms

includes oliguria, fluid retention, mental apathy, nausea, vomiting, and hypercalcemia

oliguria

scanty urine production

hypercalcemia

increased blood levels of calcium

bladder cancer

arises from the lining of the bladder; usually found early and treatment is usually effective

transitional cell carcinoma

malignancy of the cells that line the bladder and inside of the ureters and urethra

adenocarcinoma

arise from mucus-secreting glands in the bladder

bladder cancer signs and symptoms

hematuria, frequency, dysuria, and abdominal or back pain

bladder cancer diagnostic tests

include cystoscopy with biopsy of suspicious lesions as well as urine cytology, in which a urine sample is checked for malignant cells

TURBT

a process in which malignant tissue is destroyed with an electric current or high-energy lasers with devices passed through the urethra; transurethral resection of bladder tumor

cystectomy

removal of the bladder

immunotherapy

stimulates the immune system to attack cancer cells

chemotherapy

commonly delivered into the vein (intravenous) or directly into the bladder (intravesical)

radiation therapy

uses teletherapy and brachytherapy

teletherapy

high-energy beams directed at the malignancy from a machine outside of the body

brachytherapy

“seeds” planted within the tumor

anuria

absence of urine production or output

bladder neck obstruction (BNO)

blockage at the base of the bladder that reduces or prevents urine form passing into the urethra

cystocele

Prolapsing or downward displacement of the bladder due to weakening of the supporting tissues between a woman's bladder and vagina

dysuria

painful or difficult urination, commonly described as a "burning sensation" while urinating

end-stage renal disease (ESRD)

any type of kidney disease in which there is little or no remaining kidney function, requiring the patient to undergo dialysis or kidney transplant for survival

enuresis

involuntary discharge of urine; also called incontinence

fistula

abnormal passage from a hollow organ to the surface of from one organ to another

hydronephrosis

abnormal dilation of the renal pelvis and the calyces of one or both kidneys due to pressure from accumulated urine that cannot flow past an obstruction in the urinary tract

interstitial cystitis (IC)

chronic inflammation of the bladder wall that is not caused by bacterial infection and is not responsive to conventional antibiotic therapy; also called painful bladder syndrome

nephrotic syndrome

loss of large amounts of plasma protein, usually albumin, through urine due to an increased permeability of the glomerular membrane

neurogenic bladder

impairment of bladder control due to brain or nerve conduction

polycystic kidney disease (PKD)

inherited disease in which sacs of fluid called cysts develop in the kidneys

urgency

sensation of the need to void immediately

vesicoureteral reflux (VUR)

disorder caused by the failure of urine to pass through the ureters to the bladder, usually due to impairment of the valve between the ureter and bladder or obstruction in the ureter

Wilms tumor

rapidly developing malignant neoplasm of the kidney that usually occurs in children

dialysis

mechanical filtering process used to cleanse the blood of toxic substances, such as nitrogenous wastes, when kidneys fail to function properly

hemodialysis

type of dialysis in which an artificial kidney machine receives waste-filled blood, filters the blood, and returns the dialyzed (clean) blood to the patient's bloodstream

peritoneal dialysis

type of dialysis in which toxic substances are removed from the body by using the peritoneal membrane as the filter by perfusing (flushing) the peritoneal cavity with a warm, sterile chemical solution

kidney transplant

replacement of a diseased kidney with one that is supplied by a compatible donor (usually a family member or a cadaver who has donated the kidney prior to death)

nephropexy

fixation of a floating or mobile kidney

nephrostomy

the passage of a tube through the skin and into the renal pelvis to drain urine to a collecting receptacle outside the body when the ureters are unable to do so

stent placement

placement of a mesh tube inserted into a natural passage of conduit in the body to prevent or counteract a disease-induced, localized flow constriction

ureteral stent placement

insertion of a thin narrow tube into the ureter to prevent or treat obstruction of urine flow from the kidney

urethrotomy

incision of a urethral stricture

electromyography (EMG)

measures the contraction of muscles that control urination using electrodes placed in the rectum and urethra

cystoscopy

Examination of the urinary bladder for evidence of pathology, obtaining biopsies of tumors or other growths, and removal of polyps using a specialized endoscope

blood urea nitrogen (BUN)

determines the amount of nitrogen in blood that comes from urea, a waste product of protein metabolism

culture and sensitivity (C&S)

determines the causative organism of an infection and identifies how the organism responds to various antibiotics

urinalysis (UA)

urine screening test that includes physical observation, chemical tests, and microscopic evaluation

ultrasonography

high-frequency sound waves (ultrasound) are directed at soft tissue and reflected as "echoes" to produce an image on a monitor of an internal body structure; also called ultrasound, sonography, and echo

bladder US

US produces images of the bladder to measure pre- and postvoid residual urine, thus determining bladder volume and, potentially, identifying incomplete bladder emptying

intravenous pyelography (IVP)

imaging of the urinary tract after IV injection of a contrast medium; also called excretory urography (EU)

nuclear scan

technique in which a radioactive material (radiopharmaceutical) called a tracer is introduced into the body (inhaled, ingested, or injected) and a specialized camera (gamma camera) is used to produce images of organs and structures

renal nuclear scan

nuclear scan of the kidneys used to determine their size, shape, and position

voiding cystourethrography (VCUG)

x-ray of the bladder and urethra performed before, during, and after voiding using a contrast medium to enhance imaging

antibiotics

treat bacterial infections of the urinary tract by acting on the bacterial membrane or one of its metabolic processes

antispasmodics

decrease spasms in the urethra and bladder by relaxing the smooth muscles lining their walls, thus allowing normal emptying of the bladder

diuretics

promote and increase the excretion of urine

potassium supplements

replace potassium due to depletion caused by diuretics

ATN

acute tubular necrosis

BNO

bladder neck obstruction

BUN

blood urea nitrogen

C&S

culture and sensitivity

cysto

cystoscopy

EBT

external beam therapy

EMG

electromyogram, electromyography

ESRD

end-stage renal disease

ESWL

extracorporeal shock-wave lithotripsy

EU

excretory urography

IC

interstitial cystitis

IVP

intravenous pyelogram, intravenous pyelography

pH

symbol for degree of acidity or alkalinity

PCNL

percutaneous nephrolithotomy

PKD

polycystic kidney disease

RP

retrograde pyelogram, retrograde pyelography

TURBT

transurethral resection of bladder tumor

UA

urinalysis

US

ultrasound; ultrasonography

UTI

urinary tract infection

VCUG

voiding cystourethrography

VUR

vesicoureteral reflux

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