1. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley CHAPTER Medical Language Second Edition Urology 11

2. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Learning Objectives 1.Identify the structures of the urinary system. 2.Describe the process of urine production and excretion. 3.Describe common urinary diseases and conditions, laboratory and diagnostic procedures, medical and surgical procedures, and drug categories. 4.Give the medical meaning of word parts related to the urinary system. 5.Build urinary words from word parts and divide and define urinary words. 6.Spell and pronounce urinary words. 7.Analyze the medical content and meaning of a urology report. 8.Dive deeper into urology by reviewing the activities at the end of this chapter and online at Medical Terminology Interactive.

3. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy and Physiology The purpose of the urinary system is to produce, transport, store, and excrete urine.

4. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy of the Urinary System Kidneys –Reddish-brown in color –Shaped like kidney beans –Measure 4 inches long and 2 inches wide, weighs less than 1/2 pound –Hilum: area where renal artery enters and renal vein and ureter exit.

5. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-2 Right kidney

6. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-3 Cut section of a kidney Reprinted from McMinn’s Color Atlas of Human Anatomy, 2/E. McMinn, Hutchings, Human Anatomy, 19,46,66,71.78,127,137,237,238. Copyright 2002, with permission from Elsevier.

7. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy of the Urinary System Ureters –12-inch tube that connects the renal pelvis of the kidney to the bladder. –The ureteral orifices are the openings into the bladder. –Composed of smooth muscle

8. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy of the Urinary System Bladder –Located in the pelvic cavity and held in place by ligaments –Fundus: Rounded top of bladder –Inside of bladder is lined with mucosa –When bladder is empty, the mucosa collapses into folds, or rugae. –When bladder is full, smooth muscle in the bladder wall contracts to expel urine.

9. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-4 Bladder

10. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy of the Urinary System Urethra –A tube that carries urine from the bladder to the outside of the body. –External urethral sphincter is a muscular ring that can be consciously controlled to release or hold back urine.

11. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Anatomy of the Urinary System (cont’d) –In men, the urethra is 7 to 8 inches long. –The urethra is part of both the urinary and the male reproductive system, because it transports both urine and semen. In women, the urethra is much shorter, traveling only 1 to 2 inches from the bladder to the external surface of the body.

12. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-5 Male urinary system Figure 11-6 Female urinary system

13. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of the Formation of Urine The nephron, a microscopic structure, is the functional unit of the kidney and the site of urine production. The first part of the nephron is the glomerular capsule.

14. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of the Formation of Urine (cont’d) Within this ball-shaped structure, the arteriole divides and forms the glomerulus, a network of intertwining capillaries. Waste products in the blood include: –Urea –Creatinine –Uric acid –Drugs and products of drug metabolism

15. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley The blood that enters the nephron also contains: –Electrolytes –Glucose –Amino acids –Vitamins Physiology of the Formation of Urine (cont’d)

16. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley The job of the nephron is to remove the waste products from the blood but keep the nutritional substances. This process is known as filtration. Physiology of the Formation of Urine (cont’d)

17. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley The filtrate (waste products, water, and nutritional substances) flows into the proximal convoluted tubule of the nephron. Most of the water and nutritional substances move out of the tubule and return to the blood. This process is known as reabsorption. Physiology of the Formation of Urine (cont’d)

18. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley The proximal convoluted tubule becomes a U-shaped tubule known as the nephron loop. In the nephron loop, more water and electrolytes are reabsorbed. Physiology of the Formation of Urine (cont’d)

19. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of the Formation of Urine (cont’d) The nephron loop widens to become the distal convoluted tubule where more water and electrolytes, as well as amino acids and other nutritional substances, are reabsorbed. Urine is produced continuously by the nephrons in the kidneys.

20. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-8 Pathway of urine production and elimination Richard Hutchings/PhotoEdit Inc. COPY ME!

21. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley The process of eliminating urine from the body is described in several ways: –Urination –Micturition –Voiding –Passing water Physiology of the Formation of Urine (cont’d)

22. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Physiology of Other Functions of the Kidneys Besides producing and excreting urine, the kidneys also help the body to maintain a normal and constant internal environment. The kidneys respond if blood pressure decreases, if the pH of the blood decreases, or if the number of red blood cells decreases.

23. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions Kidneys and Ureters –Glomerulonephritis –Hydronephrosis –Nephrolithiasis

24. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-9 Kidney stone Custom Medical Stock Photo, Inc.

25. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-10 Nephrolithiasis Dr. E. Walker/Science Photo Library/Photo Researchers, Inc.

26. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Kidneys and Ureters (cont’d) –Nephropathy –Nephroptosis –Nephrotic syndrome –Polycystic kidney disease

27. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-11 Polycystic kidney disease Custom Medical Stock Photo, Inc.

28. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Kidneys and Ureters (cont’d) –Pyelonephritis –Renal cell cancer –Renal failure –Uremia

29. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-12 CT scan of the kidneys Simon Fraser/Freeman Hospital/Photo Researchers, Inc.

30. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Bladder –Bladder cancer –Cystitis

31. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-13 Acute cystitis Courtesy Chiang Mai University, The Faculty of Medicine, www.med.cmu.ac.th

32. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Bladder (cont’d) –Cystocele –Neurogenic bladder –Overactive bladder

33. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Bladder (cont’d) –Urinary retention –Vesicovaginal fistula

34. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Urethra –Epispadias –Urethritis

35. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Urine and Urination –Albuminuria –Anuria –Bacteriuria –Dysuria –Enuresis –Frequency

36. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Urine and Urination (cont’d) –Glycosuria –Hematuria –Hesitancy –Hypokalemia –Incontinence

37. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Urine and Urination (cont’d) –Ketonuria –Nocturia –Oliguria

38. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Diseases and Conditions (cont’d) Urine and Urination (cont’d) –Polyuria –Pyuria –Urgency –Urinary tract infection (UTI)

39. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-14 Cranberry juice.

40. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures Blood Tests –Blood urea nitrogen (BUN) –Creatinine

41. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Urine Tests –Culture and sensitivity (C&S) –Drug screening –Leukocyte esterase –24-hour creatinine clearance

42. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-15 Culture and sensitivity testing

43. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Urine Tests (cont’d) –Urinalysis (UA)  Color―Normal urine is light yellow to amber in color, depending on its concentration  Odor―Urine has a faint odor due to the waste products in it  pH―A test of how acidic or alkaline the urine is  Protein―Protein is not normally found in the urine; its presence indicates damage to the glomerulus

44. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Urine Tests (cont’d) –Urinalysis (UA) (cont’d)  Glucose―Glucose is not normally found in the urine; its presence indicates uncontrolled diabetes mellitus

45. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-16 Urine dipstick Faye Norman/Photo Researchers, Inc.

46. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Urine Tests (cont’d) –Urinalysis (UA) (cont’d)  Red blood cells (RBCs)  White blood cells (WBCs)  Ketones―not normally found in the urine; produced when the body cannot use or does not have enough glucose and instead metabolizes fat

47. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Urine Tests (cont’d) –Urinalysis (UA) (cont’d)  Specific gravity (SG)  Sediment  Other substances

48. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-17 Urinometer

49. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Radiology and Nuclear Medicine Procedures –Intravenous pyelography (IVP) –Kidneys, ureters, bladder (KUB) x-ray –Nephrotomography

50. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-18 Intravenous pyelogram CNRI/Photo Researchers, Inc.

51. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Radiology and Nuclear Medicine Procedures (cont’d) –Renal angiography –Renal scan –Ultrasonography

52. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-19 Sonogram Custom Medical Stock Photo, Inc.

53. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Laboratory and Diagnostic Procedures (cont’d) Other Laboratory Tests –Cystometry –Voiding cystourethrography (VCUG)

54. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical and Surgical Procedures Medical Procedures –Catheterization –Dialysis

55. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-20 Foley catheter

56. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-21 Hemodialysis

57. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical and Surgical Procedures (cont’d) Medical Procedures (cont’d) –Intake and output (I&O) –Urine specimen

58. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-22 Urine output Michal Heron/Pearson Education/PH College

59. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical and Surgical Procedures (cont’d) Surgical Procedures –Bladder neck suspension –Cystectomy –Cystoscopy

60. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-23 Cystoscopy

61. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical and Surgical Procedures (cont’d) Surgical Procedures (cont’d) –Kidney transplantation –Lithotripsy

62. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-24 Kidney transplantation Custom Medical Stock Photo, Inc.

63. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Figure 11-28 Lithotripsy Visuals Unlimited

64. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical and Surgical Procedures (cont’d) Surgical Procedures (cont’d) –Nephrectomy –Nephrolithotomy –Nephropexy –Renal biopsy

65. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Medical and Surgical Procedures (cont’d) Surgical Procedures (cont’d) –Stone basketing –Transurethral resection of a bladder tumor (TURBT) –Urethroplasty

66. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Drug Categories These categories of drugs are used to treat urinary Diseases and Conditions: –Antibiotic drugs –Antispasmodic drugs –Diuretic drugs –Drugs for overactive bladder –Potassium supplements –Urinary analgesic drugs

67. Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley Abbreviations