11 Lecture Notes Genitourinary System: Urinary System Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding

Structure and Function 11 GENITOURINARY SYSTEM: URINARY SYSTEM Structure and Function Kidneys Formation of urine Ureters, bladder, urethra Storage and elimination of urine 2

Function of Kidneys Remove waste products from blood 11 GENITOURINARY SYSTEM: URINARY SYSTEM Function of Kidneys Remove waste products from blood Regulate body’s tissue fluid Maintain electrolyte balance in blood Maintain acid-base balance in blood 3

Structure and Function Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Structure and Function Exercise Q: Name four organs of the urinary system? A: Kidneys, ureters, bladder, and urethra Q: What is the name of the structure that stores urine until it is voided? A: Urinary bladder Q: What is the main function of the kidneys? A: Remove toxic products from blood by forming urine. 4

End-Stage Renal Disease (ESRD) 11 GENITOURINARY SYSTEM: URINARY SYSTEM End-Stage Renal Disease (ESRD) 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. 5

End-Stage Renal Disease (ESRD) 11 GENITOURINARY SYSTEM: URINARY SYSTEM End-Stage Renal Disease (ESRD) Signs and Symptoms (continued) Severity of signs and symptoms varies depending on extent of renal damage and remaining function. 6

End-Stage Renal Disease (ESRD) 11 GENITOURINARY SYSTEM: URINARY SYSTEM End-Stage Renal Disease (ESRD) Treatment Dietary restriction of protein, sodium, and potassium intake. Antiemetics for nausea. Control of hypertension

Clinically Related Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Clinically Related Exercise Q: Mr. J requires renal transplantation because his kidneys no longer filter toxic wastes from the blood? His disease is charted as ESRD, or __________________. A: end-stage renal disease Q: A patient awaiting prostate CA surgery is currently continent, but is worried that after surgery he may not be able to control his bladder, a condition known as _____________. A: incontinence Q: Joan S presents at the clinic because of painful urination. The nurse notes a history of cystitis and documents her painful urination as _________. A: dysuria Q: This 38-year-old female is admitted with pyonephrosis. A key finding of the inflammatory condition is the accumulation of __________ in the kidneys. A: pus 8

Renal Calculi Signs and Symptoms 11 GENITOURINARY SYSTEM: URINARY SYSTEM Renal Calculi Signs and Symptoms Concentration of mineral salts in renal pelvis, calices of the kidney, or in the urinary tract. Renal calculi patients may remain asymptomatic for long periods. 9

Renal Calculi Signs and Symptoms (continued) 11 GENITOURINARY SYSTEM: URINARY SYSTEM Renal Calculi Signs and Symptoms (continued) If stone or calculus fragment lodges in a ureter, there may be intense pain and urinary urgency. If calculi are in the renal pelvis and calices, pain is duller and more constant. Back pain and severe abdominal pain may occur. Other symptoms include nausea, vomiting, chills and fever, hematuria, and abdominal distention. 10

Renal Calculi Treatment 11 Remove stones and prevent new formations. GENITOURINARY SYSTEM: URINARY SYSTEM Renal Calculi Treatment Remove stones and prevent new formations. Enhance elimination of stones and increase fluid intake. Small stones pass spontaneously without treatment. Large stones may require surgical intervention. 11

Renal Calculi Treatment (continued) 11 GENITOURINARY SYSTEM: URINARY SYSTEM Renal Calculi Treatment (continued) Antibiotics may be prescribed if calculus build-up is due to bacterial infection. Strong analgesics are prescribed for relief of intense pain. Ultrasound is used to locate and monitor calculi as they are being destroyed. 12

Clinically Related Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Clinically Related Exercise Q: Mrs J develops kidney stones even though various treatments were undertaken. The patient must undergo a surgical procedure in which an incision is made to remove the stones. This procedure is called ______________________. A: lithotomy Q: A patient diagnosed with renal calculi presents to the office complaining of pain in the kidney area. The medical term for this symptom is ________________. A: nephralgia or nephrodynia Q: Upon diagnosis of ureterolithiasis, the doctor informs Mrs. S that she may experience pain and have difficulty urinating. The medical term for painful or difficult urination is_____________. A: dysuria Q: Mrs. H presents with complaints of pain, nausea, and hematuria. Based on her past history of nephrolithiasis, the physician orders an imaging technique that utilizes high-frequency sound waves to detect presence of calculi. This imaging procedure is called an _________________. A: ultrasound 13

Hydronephrosis Signs and Symptoms 11 GENITOURINARY SYSTEM: URINARY SYSTEM Hydronephrosis Signs and Symptoms Distention of renal pelvis and calices due to pressure from accumulating urine. Pressure impairs, and may eventually interrupt, kidney function. 14

Hydronephrosis Signs and Symptoms (continued) 11 GENITOURINARY SYSTEM: URINARY SYSTEM Hydronephrosis Signs and Symptoms (continued) If obstruction is above bladder opening, only one kidney may be affected and person may be asymptomatic for a prolonged period. If both kidneys are affected, symptoms may include intense pain, nausea, vomiting, oliguria or anuria, and hematuria. 15

Hydronephrosis Treatment 11 GENITOURINARY SYSTEM: URINARY SYSTEM Hydronephrosis Treatment Remove obstruction, prevent complications, and treat underlying disorders. Catheterization for immediate relief of urinary pressure. Analgesics may be prescribed. Antibiotics are required if infection occurs. Surgery if needed to dilate a ureteral stricture. 16

Clinically Related Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Clinically Related Exercise Q: Mary presents at the clinic concerned because she only urinated once in the past 24 hours. The medical term for this symptom is (anuria, dysuria, enuria). A: anuria Q: Mrs. M presents because her urine is red. The nurse documents this finding as _________________. A: hematuria Q: Joan T is diagnosed with nephrosis and has swelling in the ankles, feet, and around the eyes. The medical term for swelling is____________________. A: edema Q: Radiographic studies of a patient’s kidneys reveal enlargement of the right kidney. The radiologist documents this as __________________________. A: nephromegaly Q: Mr. J undergoes surgical repair of the renal pelvis. Before obtaining informed consent, the physician charts this surgical procedure as ________________. A: pyeloplasty 17

Medical Vocabulary azotemia calculus catheterization diuretic dysuria 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical Vocabulary azotemia calculus catheterization diuretic dysuria electrolytes enuresis Note: To customize or add other disorders to your presentation, numerous images are available from the image bank. 18

Medical Vocabulary (continued) hematuria hypospadias hypertension 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical Vocabulary (continued) hematuria hypospadias hypertension incontinence nephrectomy nephrolithotomy Note: To customize or add other disorders to your presentation, numerous images are available from the image bank. 19

Medical Vocabulary (continued) nephrolithiasis nephrologist 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical Vocabulary (continued) nephrolithiasis nephrologist nephromegaly nocturia polyuria proteinuria Note: To customize or add other disorders to your presentation, numerous images are available from the image bank. 20

Medical Vocabulary (continued) pyuria transurethral uremia 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical Vocabulary (continued) pyuria transurethral uremia ureterostenosis urethrocele urinalysis urologist Note: To customize or add other disorders to your presentation, numerous images are available from the image bank. 21

Diagnostic Procedures 11 GENITOURINARY SYSTEM: URINARY SYSTEM Diagnostic Procedures Blood urea nitrogen (BUN) Cystoscopy Pyelography Urinalysis Voiding cystourography (VCUG) 22

Word Building Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Word Building Exercise Q: Visual examination of the bladder: ________________. A: cystoscopy Q: Process of recording (radiography) the bladder and urethra: _________________. A: cystourethrography Q: Process of recording (radiography) the renal pelvis: ___________. A: pyelography Q: Surgical repair of the renal pelvis A: pyeloplasty 23

Medical and Surgical Procedures 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical and Surgical Procedures Catheterization Insertion of a catheter into the bladder to withdraw urine. 24

Medical and Surgical Procedures 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical and Surgical Procedures (continued) Hemodialysis Patient’s blood is diverted into a dialysis machine for filtering. 25

Medical and Surgical Procedures 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical and Surgical Procedures (continued) Peritoneal dialysis Dialysis in which patient’s own peritoneum is used as the dialyzing membrane. Contaminated fluid drains out and is replaced with fresh solution. 26

Medical and Surgical Procedures 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical and Surgical Procedures (continued) Extracorporeal shock wave lithotripsy (ESWL) Powerful sound- wave vibrations break up calculi in urinary track or gallbladder. 27

Medical and Surgical Procedures 11 GENITOURINARY SYSTEM: URINARY SYSTEM Medical and Surgical Procedures (continued) Renal transplantation Diseased kidneys replaced by transplanted kidney. 28

Clinically Related Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Clinically Related Exercise Q: Mrs. C is unable to urinate after surgery so a catheter is inserted through the urethra and into her bladder to remove urine. This therapeutic procedures is known as _______________. A: catheterization Q: Mr. G is diagnosed with nephrolithiasis. The medical assistant explains that the kidney stones need to be crushed into smaller pieces so they can be expelled in the urine. Crushing of stones is a surgical procedure called __________. A: lithotripsy

Clinically Related Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Clinically Related Exercise Q: Mr. M is diagnosed with multiple renal calculi. The doctor explains that the treatment of choice is to use powerful sound- wave vibrations to break up the kidney stones. The abbreviation for this procedure is ______. A: ESWL Q: Mrs. A has a history of bladder carcinoma and presents for an endoscopy of the urinary bladder. Any growths that are present will be removed and biopsied. This visual examination of the bladder is a medical procedure called _____________. A: cystoscopy

Pharmacology Antibiotics Antispasmodics Diuretics 11 GENITOURINARY SYSTEM: URINARY SYSTEM Pharmacology Antibiotics Antispasmodics Diuretics 31

Clinically Related Exercise 11 GENITOURINARY SYSTEM: URINARY SYSTEM Clinically Related Exercise Q: 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). A: diuretic Q. 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). A: antispasmodic Q: Mrs. T is diagnosed with a urinary tract infection. To treat the bacterial infection, the physician prescribes a/an (analgestic, antibiotic, antispasmodic). A: antibiotic Q: To relieve the patient’s nephralgia, the physician prescribes a/an (analgesic, antibiotic, antispasmodic). A: analgesic 32