Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Chapter 6 Urinary System

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-2 Urinary System Function  removes waste material from the body, regulates fluid volume, and maintains electrolyte concentration in the body fluid.

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-3 The Urinary System

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-4 Male and Female Urinary System

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-5 Male Urinary Bladder

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-6 Three of Four Suffixes Beginning with -rrh Suffix Meaning Chapter -rrheaflow, discharge 4 -rrhagiarapid flow of blood 5 -rrhaphysuturing, repairing 6

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-7 Three Word Parts that Incorporate the Root “tom” Word Part Meaning Chapter -tome (S) instrument used 4 to cut -tomy (S) cut into or incision 5 tom/o (CV) cut, section 6

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-8 Urinary Tract Infection Cystitis

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-9 Clicker Question Which term means stones in the kidney? a) renal hypertension b) hydronephrosis c) renal calculi d) nephromegaly

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-10 Clicker Question  (renal pelvis) / cv / (stone) / cv / (incision) The correct term to label the diagram is? a)pyelolithostomy b)pyelolithotomy

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-11 Clicker Question Which of the following may be used to withdraw fluids: a) ESWL b) VCUG c) cath d) SC

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.6-12 Discharge Summary Bruno Oliver is a 32-year-old white male, appearing his stated age, who was admitted to the hospital after presenting himself to the emergency department on 09/20/xx in acute distress. He complained of intermittent pain in the right posterior lumbar area, radiating to the right flank. He has a family history of nephrolithiasis and has been treated for this condition two other times in the past ten years. This patient was admitted to the Urology Unit and was administered intravenous morphine sulfate for pain control. VITAL SIGNS: Low-grade temperature of Initial blood pressure was 146/92. The white blood count, hemoglobin, and hematocrit normal. The urinalysis showed microscopic hematuria. A KUB revealed calculi in the region of the right renal pelvis. A cystoscopy with a right retrograde urogram confirmed the presence of the three stones in the right kidney. Minimal ureteral obstruction was present. A percutaneous nephropyelolithotomy was completed with no complications. A ureteral stent was inserted as was an indwelling Foley catheter. Drainage from the right kidney was pale yellow in 48 hours. The Foley catheter was removed three days postoperatively. At discharge, the patient is voiding without difficulty. The stones were sent to the laboratory for analysis. The report indicated that they were calcium oxalate. The patient is to follow up with his urologist in a week to have his ureteral stent removed.

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Chapter 7 Male Reproductive System

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-14 Male Reproductive System Function  produce, sustain, and transport sperm, the male reproductive cell, and to secrete the hormone testosterone.

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-15 Male Reproductive Organs

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-16 Spermatozoon or sperm

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-17 Clicker Question Ochid/o, orchi/o, orch/o and test/o are all combining forms for testicle. a) T b) F

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-18 Benign Prostatic Hyperplasia

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-19 Varicocele

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-20 Clicker Question Which of the following means discharge from the prostate gland? a) phimosis b) hydrocele c) prostatorrhea d) prostatitis

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-21 Vasectomy 1. Incision is made into the covering of the vas. 2. Vas is exposed. 3. Segment of vas is excised. 4. Vas is replaced and skin is sutured.

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-22 Clicker Question Which of the following is the surgical removal of the forskin of the penis? a) vasectomy b) vesiculectomy c) circumcision d) hydrocelectomy

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-23 Clicker Question Which of the following is an STD? a) orgasm b) digital rectal exam c) coitus d) chlamydia

Copyright © 2009, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.7-24 Interact with Medical Records CHIEF COMPLAINT: Severe lower abdominal pain and the inability to void for the past 12 hours. PRESENT ILLNESS: Andrew Nguyen is a 75-year-old Asian-American man who came into the emergency department at 3:00 am stating that he was in great pain and could not urinate. He had not been seen by a physician for several years but claimed to be in good health except for “a little high blood pressure.” The patient reports urinary frequency, nocturia x2, hesitancy, intermittency, and diminished force and caliber of the urinary stream. He also has postvoid dribbling and the sensation of not having completely emptied the bladder. Earlier today, he had hematuria at the end of urination. MEDICATION ALLERGIES: None CURRENT MEDICATIONS: Benadryl 25 mg. at bedtime. PHYSICAL EXAM: Temperature 98.6ºF. Blood pressure 140/90. Pulse 98. Respirations 24. Palpation of the abdomen shows a suprapubic mass approximately three fingerbreadths below the umbilicus, dull to percussion and slightly tender. IMPRESSION: Urinary bladder distention caused by urinary outlet obstruction, probably from benign prostatic hyperplasia. PLAN: Indwelling Foley catheter for relief of urinary obstruction. Urology consult.