Med Term Chapter 11

retroperitoneal

Because the kidneys line outside of the peritoneum, their location is said to be

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

Diagnostic tests include

transurethral resection of bladder tumor (TURBT)

Early stages confined to the bladder lining respond to... malignant tissue is destroyed with an electric current or high-energy lasers with devices passed through the urethra

ureteroscopic stone removal

For larger stones, it may be necessary to break them into smaller pieces using an endoscope fitted with a laser beam before removing the fragments. no incision required

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) The new kidney is usually placed below the diseased one for attaching it to existing blood vessels. The diseased kidneys usually remain in place unless there is concern that they will cause infection, uncontrolled hypertension, or reflux to the kidneys.

RP

retrograde pyelogram, retrograde pyelography

olig/o

scanty

oliguria

scanty urine production

hilum (hilus) renal artery renal vein

Near the medial border is the _____, an opening through which the _____ enters and the ____ exits the kidney.

urgency

sensation of the need to void immediately commonly occurs in UTI

peristaltic wave

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

hematuria, frequency, dysuria, and abdominal or back pain

signs and symptoms of bladder cancer

high blood pressure (hypertension), edema, and impaired renal function

signs and symptoms of glomerulonephritis

pH

symbol for degree of acidity or alkalinity

pH

symbol that expresses the alkalinity or acidity of a solution 7 is neutral greater than 7 is alkaline less than 7 is acidic

nuclear scan

technique in which a radiopharmaceutical called a tracer is introduced into the body (inhaled, ingested, or injected) and a specialized camera (gamma) is used to produce images of organs and structures reverse of a conventional radiography Rather than being directed into the body, radiation comes from inside the body and is then detected by a specialized camera to produce an image

the proximal convoluted tubule, followed by the narrow loop of Henle, then the larger distal tubule, and finally the collecting tubule transports newly formed urine to the renal pelvis for excretion by the kidneys

the four sections of the renal tubule

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 may be used to provide access to kidney structure or kidney function or deliver medications

filtration, reabsorption, and secretion

three physiological functions the nephron performs as it produces urine

dia-

through, across

Nitrogenous products

toxic must be continually eliminated from the body or death can occur within a few days

TURBT

transurethral resection of bladder tumor

antibiotics

treat bacterial infections of the urinary tract by acting on the bacterial membrane or one of its metabolic processes type prescribed depend on the infecting organism and the type and extent of infection ciprofloxacin, Cipro, sulfamethoxazole/trimethoprim, Bactrim

antibiotic therapy, appropriate to the infecting organism

treatment for pyelonephritis

trigone

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

hemodialysis

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

peritoneal

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 fluid remains in the cavity for 1-2 hours and is then removed

US

ultrasound, ultrasoundography

ureter/o

ureter

urethr/o

urethra

UA

urinalysis

UTI

urinary tract infection

urinalysis (UA)

urine screening test that includes physical observation, chemical tests, and microscopic evaluation not only provides information on the urinary structures but may also be the first indicator of such system disorders as diabetes and liver and gallbladder disease

ur/o

urine, urinary tract

Radiation therapy teletherapy brachytherapy

uses high-energy beams directed at the malignancy from a machine outside of the body (_____) or through seeds planted within the tumor (____).

VUR

vesicoureteral reflux

VCUG

voiding cystourethrography

ureteral orifice

where urine enters the bladder

voiding cystourethrography (VCUG)

x-ray of the bladder and urethra performed before, during, and after voiding using a contrast medium to enhance imaging performed to determine the cause of repeated bladder infections or stress incontinence and to identify congenital or acquired structural abnormalities of the bladder and urethra

nitrogenous waste and excess electrolytes

The harmful products excreted by the urinary system include...

type, stage, and grade of the malignancy

Treatment depends on

bladder

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

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

What does the urinary system consist of?

hydroureter

When dilation affects the ureter, it is called

renal corpuscle glomerulus Bowman capsule

_____ is composed of a tuft of capillaries called the _____ and a modified, enlarged extension of the renal tubule known as _____ that encapsulates the glomerulus

-iasis

abnormal condition (produced by something specified)

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 causes are enlargement of the prostate, urethral strictures, and calculi that lodge in the ureter

fistula

abnormal passage from a hollow organ to the surface or from one organ to another most common type is vesicovaginal in which a passage forms between the bladder and vagina causes include previous pelvic surgery such as hysterectomy, difficult and prolonged labor, or reduced blood supply to area

anuria

absence of urine production or output may be obstructive, in which there is a blockage proximal to the bladder, or unobstructive, which is caused by severe damage to the nephrons of the kidneys

erythropoietin

acts on bone marrow to stimulate production of red blood cells when blood oxygen levels are low

ATN

acute tubular necrosis

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 two most common types are diabetes and hypertension

cyst/o vesic/o

bladder

BNO

bladder neck obstruction

bladder neck obstruction (BNO)

blockage at the base of the bladder that reduces or prevents urine from passing into the urethra can be caused by benign prostatic hyperplasia, bladder stones, bladder tumors, or tumors in the pelvic cavity

BUN

blood urea nitrogen

renal artery

carries blood that contains waste products to the nephrons for filtering

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

causes of urinary system disorders

Interstitial cystitis (IC) painful bladder syndrome

chronic inflammation of the bladder that is not caused by bacterial infection and is not responsive to conventional antibiotic therapy

C&S

culture and sensitivity

cysto

cystoscopy

antispasmodics

decrease spasms in the urethra and bladder by relaxing the smooth muscles lining their walls, thus allowing normal emptying of the bladder Bladder spasms can result from such conditions as urinary tract infections and catheterizations. oxybutynin, Ditropan

blood urea nitrogen (BUN)

determines the amount of nitrogen in blood that comes from urea, a waste product of protein metabolism Because the kidneys clear urea from the bloodstream, the test is used as an indicator of kidney function.

culture and sensitivity (C&S)

determines the causative organism of an infection and identifies how the organism responds to various antibiotics may be performed when bladder infections are chronic or unresponsive to treatment

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 may result in hydronephrosis if the obstruction is in the proximal portion of the ureter or hydroureter and hydronephrosis if the obstruction is in the distal portion of the ureter

EMG

electromyogram, electromyography

ESRD

end-stage renal disease

cystoscopy (cysto)

examination of the urinary bladder for evidence of pathology, obtaining biopsies of tumors or other growths, and removal of polyps using a specialized endoscope a catheter can be inserted into the hollow channel in the cystoscope to collect tissue samples or introduce contrast media during radiography

EU

excretory urography

urinary bladder

expandable hollow organ acts as a temporary reservoir for urine

EBT

external beam therapy

ESWL

extracorporeal shock-wave lithotripsy

secretion

final stage of urine formation Substances are actively secreted from the blood in the peritubular capillaries into the filtrate in the renal tubules. Waste products, such as ammonia, uric acid, and metabolic products of medications, are secreted into the filtrate to be eliminated in the urine. Urine leaves the collecting tubule and enters the renal pelvis. From here it passes to the bladder until urination takes place.

nephropexy

fixation of a floating or mobile kidney

filtrate

fluid that passes from the blood through the capillary walls of the glomeruli into Bowman capsule similar to plasma but with less protein forms urine

urethra

formed by the base of the trigone a tube that discharges urine from the bladder length is 1.5 inches in women and 7-8 inches in men

-genesis

forming, producing, origin

ultrasoundography (US) ultrasound sonography echo

high-frequency waves (ultrasound) are directed at soft tissue and reflected as echoes to produce an image on a monitor of an internal body structure noninvasive procedure that does not require a contrast medium used to diagnose renal calculi and tumors, ureteral and bladder obstructions, hydronephrosis, and other urinary tract disorders

intravenous pyelography (IVP) excretory urography (EU)

imagine of the urinary tract after IV injection of a contrast medium detect kidney stones, enlarged prostate, internal injuries after an accident or trauma, and tumors in the kidneys, ureters, and bladder

neurogenic bladder

impairment of bladder control due to brain or nerve conduction nerve damage due to trauma or disease are common causes

urethrotomy

incision of a urethral stricture corrects constrictions of the urethra that make voiding difficult

nephrotic syndrome

loss of large amounts of plasma protein, usually albumin, through urine due to an increase permeability of the glomerular membrane Hypoproteinemia, edema, and hyperlipidemia are commonly associated with it

electromyography

measures the contraction of muscles that control urination using electrodes placed in the rectum and urethra determines whether incontinence is due to weak muscles or other causes

dialysis

mechanical filtering process used to cleanse the blood of toxic substances, such as nitrogenous wastes, when kidneys fail to function properly Nitrogenous waste products are collected in a solution called dialysate, which is discarded at the end of the procedure.

blood plasma

nephrons are responsible for maintaining homeostasis by continually adjusting and regulating the contents of

noct/o

night

pyel/o

renal pelvis

potassium supplements

replace potassium due to depletion caused by diuretics Dietary sources of potassium are usually not sufficient to replace potassium loss caused by diuretics. potassium chloride K-Tab, Kaon Cl

renal

nuclear scan of the kidneys used to determine their size, shape, and position also used to determine the amount of blood the kidneys are able to filter over time, determine renal artery hypertension, and evaluate a kidney transplant to identify signs of rejection

dysuria

painful or difficult urination, commonly described as burning sensation while urinating symptom of numerous conditions but most commonly urinary tract infection (UTI)

PCNL

percutaneous nephrolithotomy

nephrologists

physicians who practice in this specialty

PKD

polycystic kidney disease

cystocele

prolapsing or downward displacement of the bladder due to weakening of the supporting tissues between a women's bladder and vagina commonly the result of vaginal childbirth, frequent straining with constipation, or lifting heavy objects

diuretics

promote and increase the excretion of urine grouped by their action and are used to treat edema, hypertension, heart failure, and various renal and hepatic disease furosemide, Lasix, spironolactone, Aldactone

py/o

pus

Wilms tumor

rapidly developing malignant neoplasm of the kidney that usually occurs in children diagnosis is established by an excretory urogram (EU) with tomography The tumor is well encapsulated in the early stages but may metastasize to other sites, such as lymph nodes and lungs, at later stages

kidneys

regulate the composition of extracellular fluids and secrete the hormone erythropoietin

cystectomy

removal of the bladder

urinary meatus

During urination, urine is expelled from the body through the urethral opening (_____).

a renal corpuscle and a renal tubule

Each nephron consists of

1 million nephrons

Microscopic examination of the kidney tissue reveals the presence of approximately...

filtrate

Once this happens, the fluid is no longer plasma but is called...

nephrons

Renal cortex and renal medulla contain portions of the microscopic filtering units of the kidney called...

ureter kidney

Renal pelvis forms where the _____ merges with the _____.

bacteriuria pyuria hematuria

Results of a urinalysis usually reveal bacteria in the urine (_____), pus in the urine (_____), and when lesions are present, blood in the urine (_____).

Endoscopic tests, radiological evaluations, and laboratory tests that evaluate renal function

Typically used to diagnose disorders of the urinary system

renal pelvis

Waste material, now in the form of urine, passes to a hollow chamber, the ____.

The kidneys carry out the major work of the urinary system, while the other structures are mainly passageways and storage areas.

What carry out the major work of the urinary system?

regulation of the extracellular fluids of the body (primarily plasma and tissue fluid) The kidneys accomplish this function through the formation of urine. Urine passes out of the kidneys via the ureters to the urinary bladder, where it is temporarily stored before it is excreted from the body through the urethra.

What is the primary function of the urinary system?

afferent arteriole efferent arteriole

a larger _____ carries blood to the glomerulus, and a smaller _____ carries blood from the glomerulus The difference in size of these vessels provides the needed pressure to force blood plasma into the Bowman capsule.

albumin/o

albumin, protein

retro-

backward, behind

bacteri/o

bacteria (singular bacterium)

reabsorption

begins as filtrate travels through the long, twisted pathway of the tubule Most of the water and some of the electrolytes and amino acids are returned to the peritubular capillaries and reenter the circulating blood.

left and right kidneys

each about the size of a fist located in the abdominal cavity slightly above the waistline concave medial border gives beanlike shape

bladder cancer

fourth most common cancer in men and eighth most common cancer in women malignancy usually arises from the lining of the bladder The two most common types in the US are transitional cell carcinoma and adenocarcinoma. commonly found early treatment is usually effective

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

general signs and symptoms of ANT include

glomerul/o

glomerulus

immunotherapy intravesical

Surgery may be combined with biological therapy, which stimulates the immune system to attack cancer cells, and chemotherapy, commonly delivered into the vein (intravenous) or directly into the bladder (_____).

polycystic kidney disease (PKD)

inherited disease in which sacs of fluid called cysts develop in the kidneys If cysts increase in number or size or if they become infected, kidney failure may result. Dialysis or kidney transplant may be necessary for renal failure.

stent placement

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

ureteral

insertion of a thin narrow tube into the ureter to prevent or treat obstruction of urine flow from the kidney indwelling stents require constant monitoring because they may lead to infections, blockages, or stone formations To avoid complications, they must be removed or changed periodically.

IC

interstitial cystitis

IVP

intravenous pyelogram, intravenous pyelography

diurnal enuresis

involuntary discharge of urine during the day

nocturnal enuresis

involuntary discharge of urine during the night

enuresis incontinence

involuntary discharge or urine

nephralgia

pain in the kidneys

dysuria

painful urination

kal/i

potassium (an electrolyte)

nitrogenous waste

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

electrolytes

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

peritoneum

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

ureter

slender tube about 10-12 inches long carry urine in peristaltic waves to the bladder

rugae

small folds of the bladder that expand as the bladder fills

lith/o

stone, calculus

calculi

stones

nitrogenous wastes, the end products of protein metabolism, excess electrolytes, and many other products that exceed the amount tolerated by the body

substances removed by the nephrons are...

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

symptoms of pyelonephritis

nephrology

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

urology

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

urologist

the physician who specializes in diagnosis and treatment of genitourinary disorders

acute tubular necrosis (ATN) ischemic ATN nephrotoxic ATN

the tubular portion of the nephron is injured by a decrease in blood supply (_____) or after the ingestion of toxic chemicals (_____) does not produce specific signs and symptoms diagnosis relies on a positive history of risk factors When tubular damage is not severe, the disorder is usually reversible.

micturition

urination

-uria

urine

renal vein

After waste products are removed, blood leaves the kidney by way of the...

percutaneous nephrolithotomy (PCNL)

For excessively large stones or patients who have contraindications to ESWL, an alternative treatment is... In this procedure, a surgeon makes a small incision in the skin, and forms an opening in the kidney. The surgeon inserts a nephroscope into the kidney to locate and remove the stone. If the stone is large, the surgeon uses an ultrasonic or electrohydraulic probe to break it into smaller fragments, which are then more easily removed. The surgeon may also insert a nephrostomy tube, which remains in place during the healing procedure. For stones that have descended into the ureters, it may be possible to remove them using a specialized ureteroscope fitted with a small basket. The surgeon passes the ureteroscope through the urethra and bladder and into the ureter and collects the stones in the basket.

when a routine urinalysis identifies abnormalities ex) forms of glomerulonephritis and chronic urinary tract infection

Frequently, asymptomatic urinary diseases are first diagnosed...

prostate gland and the penis

In men, the urethra passes through the...

extracorporeal shock-wave lithotripsy

In one method of treatment, calculi are pulverized using concentrated ultrasound waves, called shock waves, directed at the stones from a machine outside the body.

renal cortex renal medulla

In the frontal section, two distinct areas are visible: and outer area, the _____, and a middle area, the _____.

circulatory collapse, severe hypotension, hemorrhage, dehydration, or other disorders that affect blood supply

Ischemia may occur because of

nephrolithiasis urolithiasis ureterolithiasis colic refluxes

Stones (calculi) may from in any part of the urinary tract (_____), but most arise in the kidney Commonly form when dissolved urine salts begin to solidify If they increase in size, they obstruct urinary structures. When they lodge in the ureters, a condition called _____, they cause an intense throbbing pain known as _____. Because urine is hindered from passing into the bladder, it flows backward (_____) into the renal pelvis, causing it to dilate.

changes in urination pattern, output, or dysuria

Symptoms specific to urinary disorders include...

meat/o

opening, meatus

peritubular capillaries

The efferent arteriole passes behind the renal corpuscle to form the _____ a network of capillaries that surround the renal tubule

normal composition, volume, and pH of blood and tissue fluid

The process of urine formation helps maintain...

hypercalcemia

increased blood levels of calcium

glomerulonephritis permeable proteinuria

inflammation of the glomerular membrane in the nephrons, causing it to become leaky (_____). Red blood cells and protein, which normally remain in the blood, pass through the inflamed glomerulus and enter the tubule. Retention of water and salts follows, resulting in injury to the glomeruli. Urinalysis reveals blood in the urine, hematuria, and protein in the urine, _____. One of the most common causes of glomerular inflammation is a reaction to toxins gives off by pathogenic bacteria, especially streptococci that have recently infected another part of the body, usually the throat. Most recover with no lasting kidney damage

pyelonephritis kidney infection nephritis

inflammation of the kidney and renal pelvis most common form of kidney disease that may affect one or both kidneys infection may lead to destruction or scarring of renal tissue, impairing kidney function often a result of an ascending infection from the bladder more common in women than in men The onset of the disease is usually acute.

peristaltic waves

keep urine flowing to the bladder rather than regurgitating back into the kidney when bladder pressure is high during urination

keton/o

ketone bodies (acids and acetones)

nephr/o ren/o

kidney

Adenocarcinomas

less common type arise from mucus-secreting glands in the bladder

Transitional cells

line the bladder and the inside of the ureters and urethra These cells are able to expand when the bladder is full and contract when it is empty.

plasma

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

electrolyte

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

azot/o

nitrogenous compounds

filtration

occurs in the renal corpuscle plasma containing water, electrolytes, sugar, and other small molecules is forced from the blood within the glomerulus into Bowman capsule to form filtrate Filtrate resembles plasma except that the amount of protein in filtrate is less than that found in blood.