1. Chapter 7 Urinary System

2. Introduction Nitrogenous wastes urea creatinine uric acid
Nitrogenous wastes
urea
creatinine
uric acid
BUN: Blood Urine Nitrogen
BUN levels tend to increase when the kidneys or liver are damaged. Having too much urea nitrogen in the blood or having high BUN levels can be a sign of kidney or liver problems.

3. Uremia
Increased levels of urea in the blood, as noted by an increase in BUN, also called Azotemia

4. Introduction
filter nitrogenous waste to form urine, about 200 quarts of blood are filtered every day to form 2 quarts of urine
maintain proper balance of water, electrolytes (sodium, potassium) and acids
release hormones (renin: enzyme hormone important in adjusting blood pressure; erythropoietin (epo): hormone that stimulates red blood cell production in the bone marrow; calciferol: active form of vitamin D necessary for the absorption of calcium from the intestine)
degrade and eliminate hormone from the bloodstream

5. erythropoietin (epogen)

6. Review
___________________: enzymatic hormone important in adjusting blood pressure ___________________: hormone that stimulates the red blood cell production in bone marrow

7. Kidneys also adjust amount of water and electrolytes for proper muscle and nerve function.
Other functions
–Produce urine
–Secrete an active form of Vitamin D so intestines can absorb calcium

9. Basic Anatomy of the Kidney
The kidneys are covered by a thin, fibrous membrane called the renal capsule. However, the outermost functional region of the kidney is the renal cortex.
Ureters – Muscular tubes that transport urine from each kidney to the bladder.
Urinary Bladder – A sac that collects and holds urine that comes from the ureters.
Urethra – a narrow passageway where urine passes from the bladder to the outside of the body, called urination.

10. Basic Anatomy of the Kidney
Renal Pelvis – basin-like area that collects urine from the nephrons, it narrows into the upper end of the ureter
Calyx – extension of the renal pelvis; they channel urine from the pyramids to the renal pelvis
Cortex – the outer region of the kidney; extensions of the cortical tissue, contains about one million blood filtering nephrons
Nephron – these are the filtration units in the kidneys

12. Basic Anatomy of the Kidney
Medulla – inner region of the kidney contains 8-12 renal pyramids. The pyramids empty into the calyx.
Ureter – collects filtrate and urine from renal pelvis and takes it to the bladder for urination
Renal Artery – branches off of the aorta bringing waste-filled blood into the kidney for filtering in the nephrons; the renal artery is further subdivided into several branches inside the kidney. Each minute, the kidneys receive 20% of the blood pumped by the heart. Some arteries nourish the kidney cells themselves.
Renal Vein – removes the filtered blood from the kidneys to the inferior vena cava

13. Renal Artery
Branches into smaller and smaller arteries, eventually leading to microscopic filtering units called nephrons.

15. Nephron
Microscopic functional unit of the kidney Forms urine in renal corpuscles and tubules by process of filtration, reabsorption, and secretion

16. Anatomy of the Major Organs
Organs of the Urinary System in a Male

17. Anatomy of the Major Organs
Organs of the Urinary System in a Female

18. How Kidneys Produce Urine – p. 220
• Blood enters kidneys through right and left renal arteries
• Arterioles carry blood to capillaries
• Glomeruli filter blood

19. Three steps in the formation of urine
1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion

20. 1.Name four organs of the urinary system.
Kidneys, ureters, bladder, and urethra
2. What is the name of the structure that stores urine until it is voided?
Urinary bladder
3. What is the main function of the kidneys?
Remove toxic products from blood by forming urine

21. Combining Forms – p. 280
Cyst/o Meaning urinary bladder (ex: Cystocele, Cystoscopy)
Vesic/o Meaning "bladder or blister“ (ex: vesicourethral)
Glomerul/o
Meat/o Meaning meatus

24. Combining Forms Nephr/o (meaning kidney, ex: nephrologist)
Ren/o (meaning kidney)
Pyel/o meaning  renal pelvis (ex: pyeloplasty)
Ur/o menaing urine
Urino/o meaning urine

25. Urinoma
A urinoma is a mass formed by encapsulated extravasated urine.

26. Combining Forms
Ureter/o ureter
Urethr/o urethra

27. Building Terms Cyst/o/scopy Cyst/o/cele Nephr/oma Ur/emia
• Ureter/o/stenosis

28. Suffixes
-emia
-iasis (indicating a diseased condition: psoriasis, cholelithiasis)
-lysis (ex: dialysis)
-pathy (ex: uropathy)
-pexy (fixation, usually surgical; ex: urethropexy,  surgical procedure where support is provided to the urethra)

30. Suffixes
- ptosis ("falling, dropping, or prolapse of an organ“, ex: Nephroptosis)
-tripsy ("to crush, break, or pulverize“ ex:  lithotripsy)
-uris

33. Building Terms
Azot/emia
Lith/iasis
Dia/lysis

35. Kidney Stone

36. Building Terms Nephr/o/pathy Nephr/o/ptosis Lith/o/tripsy Poly/uria
An/uria
Hemat/uria
Noct/uria

37. BPH: Benign Prostate Hypertophy

38. Pathology of the renal system
ESRD:
End State Renal Disease Signs and Symptoms
Irreversible stage with gradual, progressive deterioration of kidney function.
Kidneys lose ability to excrete nitrogenous end products of metabolism.
Progressive weakness, anorexia, diarrhea, pruritus, and polyuria.

39. Pathology of the renal system
ESRD:
•Usually result of chronic renal failure (CRF), the gradual, progressive deterioration of kidney function to the point that the kidneys cannot sustain their necessary day-to-day activity.
Treatment • Dietary restriction of protein, sodium, and potassium intake
• Antiemetics for nausea
• Control of hypertension
Dialysis?

41. Renal Calculi Signs and Symptoms
Concentration of mineral salts in the renal pelvis, in the calices of the kidney, or in the urinary tract.
Renal calculi patients may remain asymptomatic for long periods

42. Cystitis
Bacterial infection often cause acute or chronic cystitis. In acute cystitis the bladder contains blood as a result of mucosal hemorrhage

43. Hydronephrosis

44. Polycystic Kidney Disease (PKD)
The kidneys contain masses of cysts. Typically polycystic kidneys weigh 20 times more than their usual weight

45. Urinalysis (UA)
Used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes. A urinalysis involves checking the appearance, concentration and content of urine
Tests include:
Protein
Glucose
Specific Gravity (amount of wastes, minerals, ans solids)
Alcohol/drugs
Infection

46. Urinalysis (UA)
Ketone Bodies: Occur when the body breaks down fats instead of sugar for fuel
Ketones make the blood acidic and lead to Ketoacidosis which can lead to coma and death
DKA

47. Urinalysis (UA)
Sediment: Presence of abnormal particles, blood cells, bacteria…
Phenylketonuria (PKU): can accumulate in the urine of infants who lack an enzyme called phenylalnine hydroxylase and leads to retardation

48. Pathologic Terminology
Glomerulonephritis
Interstitial nephritis
Nephrolithiasis
Nephrotic syndrome
Polycystic kidneys (PKD)

49. Hypernephroma Renal cell carinoma
Cancerous tumor of the kidney in adulthood

50. Pathologic terms Pyelonephritis Renal cell carcinoma Renal failure
Renal hypertension
Wilms Tumor: Malignant tumor of the kidney occurring childhood usually before the age of 5 (usually unilateral)

51. Urinary Bladder
Bladder Cancer

52. Associated Conditions:
Diabetes Insipidus: Lack of ADH prevents H2O from being reabsorbed
Diabetes Mellitus (DM): Inadequate secretion of use of insulin. Sugar can not leave the bloodstream and be available to cells for energy
Type I and II

53. Quick Quiz A term that means frequent (voluntary) urination at night:
A. Anuria
B. Nocturia
C. Diuresis
D. Hematuria

54. Diagnostic Procedures
BUN: Normally low, accumulates in the blood when kidney is disease. Can lead to death
Creatinine Clearance test: The creatinine clearance test helps provide information about how well the kidneys are working. The test compares the creatinine level in urine with the creatinine level in blood.
When BUN and Creatinine levels are both elevated it may represent acute renal failure

55. X-Ray Studies CT scan Kidneys, Ureters and Bladder (KUB)
Renal Angiography
Retrograde pyelogram (RP), KUB after contrast
Voiding cystourethrogram (VCUG):  technique for visualizing a person's urethra and urinary bladder while the person urinates (voids).

56. CT Scan

57. Voiding cystourethrogram (VCUG)

58. Clinical Procedures
Ultrasonography: Imaging urinary tract structures using high frequency sound waves
Radioisotope Scan: Image of kidney after injecting radioisotope (that concentrates in the kidney) into the bloodstream
Magnetic resonance imaging (MRI): Using magnetic field and radio waves to produce images in all three planes of the body

60. Other Clinical Procedures
Cystoscopy: Visual exam with an endoscope
Dialysis: Separating wastes from blood
Lithotripsy: Removal of stones
Exracorpeal shock wave lithrotripsy (ESWL): Powerful sound wave vibrations break up calculi in urinary tract of gallbladder

61. Clinical Procedures
Renal angioplasty: Dilation of narrow arteries
Renal Biopsy
Renal transplantation
Urinary catheterization (foley cath, condom cath…)

63. Cystoscopy
direct visual examination of urinary bladder with an endoscope.

64. Continuous ambulatory peritoneal dialysis (CAPD)

65. Abbreviations pg 305
ADH
ARF
CRF
BUN UA
UTI
VCUG

66. Which combining form means pus?
A. Pyel/o
B. Lith/o
C. Ogli/o
D. Py/o

67. A term that means no urine production
A. Anuria
B. Nocturia
C. Diuresis
D. Hematuria

68. Pharmacology
Treat bacterial infection of urinary tract. Act on the bacterial membrane or one of its metabolic processes. Type of antibiotic prescribed depends on the infecting organism and the type and extent of infection.

69. Pharmacology
Antispasmodics: –Suppress spasms in ureter, bladder, and urethra by relaxing smooth muscles lining their walls. Allow normal emptying of the bladder
Diuretics: –Promote and increase excretion of urine. (Lasix)

70. A chest x-ray reveals an accumulation of fluid in the lungs
A chest x-ray reveals an accumulation of fluid in the lungs. The doctor prescribes a drug to stimulate production and flow of urine. The drug is a/an (antispasmodic, antidiuretic, diuretic).
Mr. Q was catheterized for surgery and now experiences spasms in the urethra and bladder. To decrease the spasms and allow normal emptying of the bladder, the doctor prescribes a/an (antispasmodic, antidiuretic, diuretic).

71. Mrs. T is diagnosed with a urinary tract infection
Mrs. T is diagnosed with a urinary tract infection. To treat the bacterial infection, the physician prescribes an (analgesic, antibiotic, antispasmodic).
To relieve the patient’s nephralgia, the physician prescribes an (analgesic, antibiotic, antispasmodic).

72. Review
urinary-system-flash-cards/