1. 14
The Urinary System

2. Multimedia Directory Slide 26 Kidney Animation
Slide 32 Urinary System Animation
Slide 49 Kidney Stones Video
Slide 72 Renal Failure Video
Slide 83 Performing a Peritoneal Dialysis Video
Slide 96 Urinalysis Video

3. Learning Objectives
After completing this chapter, you will be able to:
Define and spell the word parts used to create terms for the urinary system
Identify the major organs of the urinary system and describe their structure and function

4. Learning Objectives (cont.)
After completing this chapter, you will be able to:
Break down and define common medical terms used for symptoms, diseases, disorders, procedures, treatments, and devices associated with the urinary system
Build medical terms from the word parts associated with the urinary system

5. Learning Objectives (cont.)
After completing this chapter, you will be able to:
Pronounce and spell common medical terms associated with the urinary system

6. The Urinary System Functions
Removes unwanted waste materials
Recycles other materials
Kidneys—most important organs of urinary system
Filter gallons of fluids from the bloodstream every day

7. The Urinary System (cont.)
Kidneys
Remove:
metabolic wastes
toxins
excess ions
water
Return needed materials back to the blood
Help regulate blood pressure, pH, and red blood cell production

8. Prefixes dia- = through en- = within, upon, on, over endo- = within
epi- = upon, over, above, on top
hyper- = excessive, abnormally high, above
hypo- = under, below normal
poly- = many

9. Combining Forms albumin/o = albumin (a protein)
azot/o = urea, nitrogen
bacteri/o = bacteria
blast/o = germ, bud, developing cell
cyst/o = sac, bladder

10. Combining Forms (cont.)
glomerul/o = little ball, glomerulus
gluc/o = glucose, sugar, sweet
glyc/o, glycos/o = glycogen, glucose, sugar, sweet
hydr/o = water

11. Combining Forms (cont.)
ket/o, keton/o = ketone bodies
lith/o = stone
lys/o = break apart, dissolve
meat/o = opening, passage
nephr/o = kidney

12. Combining Forms (cont.)
noct/o = night
olig/o = few in number
py/o = pus
pyel/o = renal pelvis

13. Combining Forms (cont.)
ren/o = kidney
son/o = sound
spadias/o = rip, tear
sten/o = narrowness, constriction
tens/o = pressure

14. Combining Forms (cont.)
tom/o = to cut
ureter/o = ureter
urethr/o = urethra
ur/o, urin/a, urin/o = urine
vesic/o = sac, bladder

15. Suffixes -cele = hernia, swelling, protrusion -iasis = condition of
-ion = act or process
-lysis = to loosen, dissolve

16. Suffixes (cont.) -meter = measuring instrument
-pexy = surgical fixation, suspension
-ptosis = falling downward, drooping
-rrhaphy = suturing

17. Suffixes (cont.) -tripsy = surgical crushing
-trophy = nourishment, development
-uresis = urination
-uria = condition of urine, urination

18. Anatomy and Physiology
Urinary system includes
kidneys
ureters
urinary bladder
urethra

19. Figure 14.1: Organs of the urinary system

20. Figure 14.2: Position of urinary organs

21. Kidneys About the size of a clenched fist Divided into three regions
renal pelvis
renal medulla
renal cortex
Renal medulla and renal cortex are composed of tubes called nephrons

22. Figure 14.3 The kidney

23. Kidneys (cont.) Nephrons
Bowman’s capsule (BC)—hollow ball at one end of nephron
Glomerulus—a tightly coiled capillary
Renal corpuscle—Bowman’s capsule and the glomerulus together
Renal tubule—a long twisting portion at the other end of a nephron

24. Kidneys (cont.) Urine formation is a 3-stage process Blood filtration
Reabsorption
Secretion

25. Figure 14.4: The nephron

26. Click on the screenshot to view an animation on the kidney.
Kidney Animation
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27. Ureters
Spaghetti-sized, tubular organs that transport urine from the kidneys to the urinary bladder

28. Urinary Bladder Hollow, muscular organ that temporarily stores urine
Has elastic walls that shrink and expand

29. Urethra A muscular tube that transports urine out of the body
Internal urethral sphincter—keeps urine from entering the urethra while being stored in the bladder
External urethral sphincter—muscle that is under voluntary control

30. Urethra (cont.)
External urethral orifice or urinary meatus—opening to the exterior
Micturition or voiding—the release of urine to the exterior

31. Figure 14.5: Urinary bladder and urethra

32. Urinary System Animation
Click on the screenshot to view an animation on the urinary system.
The animation may take a moment before playing.
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33. Word Roots glomerul = little ball meat = opening nephr = kidney
ren = kidney
ureter = ureter
urethr = urethra
urin, ur = urine

34. Symptoms and Signs Albuminuria Anuresis Anuria
Presence of albumin (a protein normally in the blood) in the urine
Anuresis
Inability to pass urine
Anuria
Cessation of urine production or output
A daily rate of less than 100 ml per day

35. Symptoms and Signs (cont.)
Azotemia
Abnormally high urea and other nitrogenous compounds in the blood
Also called uremia
Bacteriuria
Presence of bacteria in the urine
Diuresis
Condition of urine passing through
Usually refers to excessive urine discharge

36. Symptoms and Signs (cont.)
Dysuria
Difficulty or pain in urination
Enuresis
Involuntary release of urine
Nocturnal enuresis is also known as bed-wetting
Glycosuria
Presence of glucose in the urine
Often a symptom of diabetes mellitus

37. Symptoms and Signs (cont.)
Hematuria
Presence of blood in the urine
Ketonuria
Presence of ketone bodies in the urine
A common sign of acidosis among patients suffering from diabetes mellitus
Nocturia
Urination at night

38. Figure 14.6: Hematuria and pyuria

39. Symptoms and Signs (cont.)
Oliguria
Decreased production of urine
Polyuria
Excessive urination
Proteinuria
Presence of protein in the urine
Pyuria
Presence of pus (white blood cells) in the urine

40. Diseases and Disorders
Cystitis
Inflammation of the urinary bladder
Cystocele
Protrusion of the urinary bladder
Cystolith
Stone in the urinary bladder

41. Diseases and Disorders (cont.)
Epispadias
Congenital defect; urinary meatus positioned on dorsal surface of penis
In the female, meatus opens dorsal to clitoris
Glomerulonephritis
Inflammation of the glomeruli within a kidney

42. Diseases and Disorders (cont.)
Hydronephrosis
Condition of water in a kidney
Usually caused by obstruction and backup of urine
Hypospadias
Congenital defect; urinary meatus opens on underside of the penis
In the female, the opening is within the vagina

43. Figure 14.7: Hydronephrosis

44. Diseases and Disorders (cont.)
Incontinence
Involuntary discharge of urine and/or feces
Stress incontinence
Involuntary discharge of urine due to a cough, sneeze, or strained movement

45. Diseases and Disorders (cont.)
Nephritis
Inflammation of a kidney
Nephroblastoma
Tumor that originates from a kidney that includes developing embryonic cells
Also called Wilms’ tumor

46. Figure 14.8: Nephroblastoma

47. Diseases and Disorders (cont.)
Nephrohypertrophy
Excessive development of a kidney, resulting in an abnormal growth in size
Nephrolithiasis
Presence of one or more stones in a kidney

48. Figure 14.9: Nephrolithiasis

49. Click on the screenshot to view a video on the topic of kidney stones.
Kidney Stones Video
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50. Diseases and Disorders (cont.)
Nephroma
Kidney tumor
Nephromegaly
Enlargement of a kidney
Nephroptosis
Condition of a drooped kidney position
Also called floating kidney

51. Diseases and Disorders (cont.)
Polycystic kidney
Incurable genetic kidney condition characterized by many fluid-filled cysts

52. Figure 14.10: Polycystic kidney Source: Simon Fraser/Royal Victoria Infirmary, Newcastle/Science Photo Library/Photo Researchers, Inc.

53. Diseases and Disorders (cont.)
Pyelitis
Inflammation of the renal pelvis
Pyelonephritis
Inflammation of the renal pelvis and nephrons
Renal calculi
Stones in the kidney
Renal hypertension
Elevated blood pressure caused by kidney disease

54. Diseases and Disorders (cont.)
Stricture
Abnormal narrowing, as in urethral stricture
Uremia
Excess of urea and other nitrogenous wastes in the blood
Ureteritis
Inflammation of a ureter

55. Diseases and Disorders (cont.)
Ureterocele
Protrusion of the distal end of a ureter into the urinary bladder
Ureterolithiasis
Presence of stone(s) in a ureter
Ureterostenosis
Condition of a narrowed ureter

56. Diseases and Disorders (cont.)
Urethrocystitis
Inflammation of the urethra and urinary bladder
Urinary retention
Abnormal accumulation of urine in the urinary bladder
Results from an inability to void

57. Diseases and Disorders (cont.)
Urinary suppression
Acute stoppage of urine formation by the kidneys
Urinary tract infection
Infection of urinary organs, usually the urethra and bladder
Symptoms often include fever, dysuria, and lumbar or abdominal pain
Abbreviated UTI

58. Figure 14.11: Urinary tract infection

59. Treatments, Procedures, and Devices
Blood urea nitrogen
Elevated urea concentration in a blood sample indicates kidney disease
Abbreviated BUN

60. Treatments, Procedures, and Devices (cont.)
Creatinine
Protein that is a normal component of urine
Elevated levels in a urine sample indicate kidney disease
Cystectomy
Excision of the urinary bladder

61. Treatments, Procedures, and Devices (cont.)
Cystography
X-ray technique of imaging the urinary bladder
Image: cystogram
Cystolithotomy
Incision into the urinary bladder to remove a stone

62. Treatments, Procedures, and Devices (cont.)
Cystoplasty
Surgical repair of the urinary bladder
Cystopyelography
X-ray technique of imaging the urinary bladder and renal pelvis after injection of contrast dye
Image: cystopyelogram

63. Treatments, Procedures, and Devices (cont.)
Cystorrhaphy
Suturing of the urinary bladder wall
Cystoscopy
Use of a cystoscope to visually examine the urinary bladder

64. Figure 14.12: Cystoscopy

65. Treatments, Procedures, and Devices (cont.)
Cystostomy
Surgical creation of an artificial opening into the urinary bladder to provide an alternate exit pathway for urine
Cystotomy
Incision into the urinary bladder
Also called vesicotomy

66. Figure 14.13: Cystostomy

67. Treatments, Procedures, and Devices (cont.)
Cystoureterography
X-ray technique of imaging the urinary bladder and ureters using a radiopaque contrast dye
Image: cystoureterogram

68. Treatments, Procedures, and Devices (cont.)
Cystourethrography
X-ray technique of imaging the urinary bladder and urethra using a radiopaque contrast dye
Image: cystourethrogram
Voiding cystourethrogram—the x-ray is taken after the bladder is emptied of urine

69. Treatments, Procedures, and Devices (cont.)
Fulguration
Surgical procedure that destroys living tissue with an electric spark
Removes tumors or polyps from the interior bladder wall

70. Treatments, Procedures, and Devices (cont.)
Hemodialysis
Procedure that removes nitrogenous wastes and excess ions from the blood
Dialysis replaces the normal function of the kidneys

71. Figure 14.14: Hemodialysis

72. Click on the screenshot to view a video on the topic of renal failure.
Renal Failure Video
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73. Treatments, Procedures, and Devices (cont.)
Kidney, ureter, and bladder x-ray
X-ray procedure that images the abdomen
Assesses position of urinary organs
Identifies calculi or other obstructions
Abbreviated KUB

74. Treatments, Procedures, and Devices (cont.)
Lithotripsy
Surgical technique that crushes stones
Lysis
Gradual reduction of symptoms of an acute disease or the destruction of red blood cells or bacteria

75. Figure 14.15: Lithotripsy

76. Figure 14.15 (continued): Lithotripsy Source: Visuals Unlimited

77. Treatments, Procedures, and Devices (cont.)
Meatoscopy
Use of a modified endoscope, or meatoscope, to visually examine the urinary meatus
Meatotomy
Incision made to enlarge the urinary meatus

78. Treatments, Procedures, and Devices (cont.)
Nephrectomy
Excision of a kidney
Nephrography
X-ray technique of imaging a kidney
Image: nephrogram

79. Treatments, Procedures, and Devices (cont.)
Nephrology
Study and treatment of kidney disease
Specialist: nephrologist
Nephrolysis
Freeing of the kidney from inflammatory adhesions

80. Treatments, Procedures, and Devices (cont.)
Nephropexy
Surgical fixation of an abnormally mobile kidney
Nephroscopy
Use of a nephroscope to visually examine the kidney

81. Treatments, Procedures, and Devices (cont.)
Nephrosonography
Ultrasound procedure in which a kidney is imaged with the use of sound waves
Nephrostomy
Surgical creation of a permanent artificial opening between the renal pelvis and the exterior of the body

82. Treatments, Procedures, and Devices (cont.)
Nephrotomography
X-ray technique of imaging the kidney using sectional x-ray exposures
Image: nephrotomogram
Peritoneal dialysis
Procedure in which toxic wastes are removed by artificial filtration to compensate for kidney failure

83. Peritoneal Dialysis Video
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84. Treatments, Procedures, and Devices (cont.)
Pyelolithotomy
Incision into the renal pelvis to remove a stone
Pyelogram
X-ray image of the renal pelvis
Retrograde pyelogram—a contrast medium is injected into the urethra
Intravenous pyelogram—iodine is injected into the bloodstream

85. Figure 14. 16: Retrograde pyelogram Source: Clinique Ste
Figure 14.16: Retrograde pyelogram Source: Clinique Ste. Catherine/ CNRI/Science Photo Library/Photo Researchers Inc.

86. Treatments, Procedures, and Devices (cont.)
Pyeloplasty
Surgical repair of the renal pelvis
Usually involves removing an obstruction
Pyelostomy
Surgical creation of a temporary artificial opening into the renal pelvis to provide an alternate exit route for urine

87. Treatments, Procedures, and Devices (cont.)
Renal transplant
A donor kidney, usually obtained from a close relative, is implanted to replace a nonfunctional kidney

88. Figure 14.17: Renal transplant

89. Figure 14.17 (continued): Renal transplant

90. Treatments, Procedures, and Devices (cont.)
Renography
Nuclear medicine test that uses a radioactive substance to highlight internal aspects of a kidney
Recording: renogram

91. Treatments, Procedures, and Devices (cont.)
Specific gravity
Relative concentration of water molecules in a liquid sample
Clinical lab test evaluates filtration and water reabsorption in the kidneys using a urinometer

92. Treatments, Procedures, and Devices (cont.)
Ureterectomy
Excision of a ureter
Ureterogram
X-ray image of the ureters
Ureterostomy
Surgical creation of an artificial opening through the ureter to provide an alternate exit route for urine

93. Treatments, Procedures, and Devices (cont.)
Ureterotomy
Incision into the wall of a ureter
Urethropexy
Surgical fixation of the urethra to correct stress incontinence
Urethroplasty
Surgical repair of the urethra

94. Treatments, Procedures, and Devices (cont.)
Urethroscopy
Use of a urethroscope to visually examine the urethra
Urethrostomy
Surgical creation of an artificial opening into the urethra to establish an alternate exit route for urine

95. Treatments, Procedures, and Devices (cont.)
Urethrotomy
Incision into the urethra
Urinalysis
Clinical lab tests performed on a urine specimen, often measuring specific gravity, creatinine, glucose, protein, and pH
Abbreviated UA

96. Click on the screenshot to view a video on the topic of urinalysis.
Urinalysis Video
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97. Treatments, Procedures, and Devices (cont.)
Urinary catheterization
Insertion of a catheter into the urinary bladder to drain urine

98. Figure 14.18: Urinary catheterization

99. Figure 14.18 (continued): Urinary catheterization

100. Treatments, Procedures, and Devices (cont.)
Urinary endoscopy
Use of an endoscope to view internal structures of the urinary system
Includes cystoscopy, meatoscopy, nephroscopy, and urethroscopy
Urinometer
Instrument that measures the water density of urine, a value known as specific gravity

101. Figure 14.19: Urinometer

102. Treatments, Procedures, and Devices (cont.)
Urology
Study and treatment of diseases of the urinary system
Specialist: urologist
Vesicourethral suspension
Surgery performed to stabilize the urinary bladder position as a treatment for stress incontinence

103. Pharmaceuticals
Antibiotics
Antispasmodics
Diuretics

104. Abbreviations BC
BUN
cath HD
IVP
KUB

105. Abbreviations (cont.) RP SG UA
UTI
VCUG

106. Classroom Response System
Pretest

107. What does nephrolithiasis mean?
condition of renal calculi
renal tumor
inflammation of the kidney
normal kidney

108. What does nephrolithiasis mean?
condition of renal calculi
renal tumor
inflammation of the kidney
normal kidney

109. The combining form for renal pelvis is:
nephr/o
pyel/o
cyst/o
ureter/o

110. The combining form for renal pelvis is:
nephr/o
pyel/o
cyst/o
ureter/o

111. Ureteritis is defined as:
excess urea present in the blood
urinary strictures
inflammation of a ureter
urinary retention

112. Ureteritis is defined as:
excess urea present in the blood
urinary strictures
inflammation of a ureter
urinary retention

113. UTI is the common abbreviation for which of the following?
under toe infection
upper tract infection
urinary tract irritation
urinary tract infection

114. UTI is the common abbreviation for which of the following?
under toe infection
upper tract infection
urinary tract irritation
urinary tract infection

115. The suffix -tripsy means:
surgical removal
loss of balance
surgical crushing
pushing

116. The suffix -tripsy means:
surgical removal
loss of balance
surgical crushing
pushing

117. What is nephrology?
The medical field that studies and treats disorders associated with the kidneys
The medical field that studies and treats disorders associated with the urinary tract
The medical field that studies and treats disorders associated with nerve disorders
The medical field that studies and treats disorders associated with pain

118. What is nephrology?
The medical field that studies and treats disorders associated with the kidneys
The medical field that studies and treats disorders associated with the urinary tract
The medical field that studies and treats disorders associated with nerve disorders
The medical field that studies and treats disorders associated with pain

119. What does the suffix -pexy mean?
together
fixation
same
around

120. What does the suffix -pexy mean?
together
fixation
same
around

121. What does the suffix -stomy mean?
result of an action
single
surgically closing an opening
surgical creation of an opening

122. What does the suffix -stomy mean?
result of an action
single
surgically closing an opening
surgical creation of an opening

123. What does the suffix -otomy mean?
incision
surgical creation of an opening
surgically closing an opening
apart

124. What does the suffix -otomy mean?
incision
surgical creation of an opening
surgically closing an opening
apart

125. The word cystorrhaphy means which of the following?
a diagnostic procedure using a modified endoscope to view the interior of the urinary bladder
a procedure in which an incision is made through the urinary bladder wall to remove a stone
suturing the urinary bladder wall
surgical creation of an opening in the kidney

126. The word cystorrhaphy means which of the following?
a diagnostic procedure using a modified endoscope to view the interior of the urinary bladder
a procedure in which an incision is made through the urinary bladder wall to remove a stone
suturing the urinary bladder wall
surgical creation of an opening in the kidney

127. Classroom Response System
Post-test

128. What is the function of the urinary system?
maintain proper oxidation of the body by removing unwanted waste materials
maintain the purity and health of the body’s fluids by removing unwanted waste materials
maintain proper circulation in the body by maintaining cardiac output
maintain proper utilization of the body’s ingested food

129. What is the function of the urinary system?
maintain proper oxidation of the body by removing unwanted waste materials
maintain the purity and health of the body’s fluids by removing unwanted waste materials
maintain proper circulation in the body by maintaining cardiac output
maintain proper utilization of the body’s ingested food

130. What does the combining form albumin/o mean?
pus
fat
urine
protein

131. What does the combining form albumin/o mean?
pus
fat
urine
protein

132. Choose the appropriate match:
blast/o : opening
gluc/o : sugar
pyel/o : ureter
ren/o : urine

133. Choose the appropriate match:
blast/o : opening
gluc/o : sugar
pyel/o : ureter
ren/o : urine

134. What does anuresis mean?
without urination
scanty urine
excessive urination
difficulty urinating

135. What does anuresis mean?
without urination
scanty urine
excessive urination
difficulty urinating

136. What is diuresis? lack of urine production painful urination
excessive discharge of urine
normal urine production

137. What is diuresis? lack of urine production painful urination
excessive discharge of urine
normal urine production

138. What does the prefix en- mean?
outside
middle
away
within

139. What does the prefix en- mean?
outside
middle
away
within

140. What does the prefix ana- mean?
down up
away
within

141. What does the prefix ana- mean?
down up
away
within

142. What is epispadias?
a congenital defect resulting in abnormal positioning of the urinary meatus
an overactive bladder
spasms of the epithelial layer
stones in the urinary bladder

143. What is epispadias?
a congenital defect resulting in abnormal positioning of the urinary meatus
an overactive bladder
spasms of the epithelial layer
stones in the urinary bladder

144. Glomerulonephropathy is which of the following?
a condition relating to stones in the glomeruli
any disease of the glomeruli
pain in the kidneys
involuntary discharge of urine

145. Glomerulonephropathy is which of the following?
a condition relating to stones in the glomeruli
any disease of the glomeruli
pain in the kidneys
involuntary discharge of urine

146. Incontinence is which of the following?
the inability to urinate
an excess of urea and other wastes in the urine
the involuntary discharge of urine
fecal matter

147. Incontinence is which of the following?
the inability to urinate
an excess of urea and other wastes in the urine
the involuntary discharge of urine
fecal matter