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The URINARY SYSTEM Also called excretory, genitourinary (GU) or urogenital system Main functions: Filters substances from the blood – Eliminates fluid body wastes – Urology :is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. ur/o: Relating to urine – Specialties and practitioners – – Urologist: A physician who deals with the study and treatment of – disorders of the urinary tract in women and the urogenital system in men Nephrology (kidney = nephro – Nephrologist : is a doctor who specializes in kidney health and kidney disease – Anatomy & Physiology Consists of • Two kidney – Two ureters – One bladder – One urethra – Ending of tract – external urinary meatus (Opening for passage of urine) • KIDNEYS: Located just above the waist • Retroperitoneal area (retro = behind) – On either side of spinal column – Bean-shaped – Outer cortex • Inner medulla Attached to the ureter that drains urine into the bladder Composed of millions of nephrons – Microscopic, basic units • OTHER ORGANS – – – URETERS Muscular tubes, contract to move urine – Transport urine from kidneys to bladder – Urethra • Conveys urine to the outside, via urinary meatus – Male – urine and semen – URINARY BLADDER – Cyst/o, cyst/i, vesic/o • Muscular, membranous sac • Serves as reservoir for urine • Holds approximately 300 - 400 mL – Expands and contracts – Two sphincters seal off bladder and hold urine Sensory nerve receptors signal when full – Urine excretion terms • Urination, voiding, micturition – • – URINE FORMATION Consists of 95% water, 5% solid substances • Void about 1000 - 1500 mL/day • 3 Processes: • Filtration:All diffusable materials pass from the blood into the nephron Reabsorption:Substances moved out of nephons into surrounding capillaries (blood) – – Secretion:Substances move from capillaries into the urine – • WELLNESS & ILLNESS: Urination problems: • Dysuria – pain or difficulty • Anuria – inability to produce urine • Hematuria – blood in urine • Nocturia – excessive urination at night • Oliguria – scant amount of urine produced • Polyuria - Increased production of urine • Pyuria – pus in urine • Glycosuria – presence of sugar in urine • 1- INFANTS & CHILDREN : • Horseshoe kidney • Congenital anomaly, kidneys attached • • Glomerulonephritis • Acute kidney infection • Poststreptococcal infection • Nephrotic syndrome (nephrosis);May occur after glomerulonephritis • Proteinuria( protein in the urine) • Albuminuria( albumin in the urine) • Can become chronic, leading to kidney failure • Urinary tract infections (UTI): More common in girls • Causes dysuria, fever, frequency, urgency, chills, pyuria • Pyelonephritis (pyel/o = urinary pelvis) • Inflammation of internal structures:May result from UTIs • Enuresis: Bedwetting • Wilm ‘s tumor:Malignancy of kidney :Usually found in infancy 2- ADOLESCENTS • Sytemic lupus erythematosus (SLE) • Commonly called lupus (wolf = lupus) • Autoimmune disorder,Most often seen in teenage girls • Often begins with nephritis, Hematuria,Proteinuria • • • it is an Inflammatory connective tissue disease in many body areas • Calculus or nephrolith:Stone(s) in the kidney • Nephrolithiasis: condition of having kidney stones • VERY painful • Renal colic – pain in abdomen • Flank pain – kidney area of back • Treatment: • Drink lots of water – wait for stone to pass • Shock wave lithotripsy: breaking up stones in kidney or ureter using • ultrasound 4- OLD AGE • Problems often due to weakened bladder muscles • Incontinence:Inability to hold urine • • Cystocele: Space or cavity = cele • Hernia of bladder that pushes it into the vagina • • Vesicoureteral reflux:: Flow of urine backward from bladder into ureter • TESTS • • General urine examination:Lab study of urine Valuable diagnostic tool • Can detect: • 1- Blood – renal disease, trauma • 2- Bacteria –infection • 3- Protein – sign of renal disease • 4- Glucose – diabetes • 5- Bilirubin –liver disease • PH = acidic • Blood tests: • Creatinine clearance level • Measures how blood is being filtered by kidney Blood urea nitrogen (BUN) • • • Measures level of urea • Indication of kidney function • Imaging tests • KUB (kidneys, ureters, bladder) :For simple screening • Renal scan:Uses a radioactive substance to view kidneys • Cystoscopy:Cystoscope inserted up through meatus to view urethra • and bladder . Intravenous pyelogram (IVP):Dye injected into vein • To view kidneys and surrounding structures • DIALYSIS: Accessing the blood to clear it of waste products through • artificial means Kidney unable to do this (kidney failure) • Two types • Hemodialysis:Machine used as an artificial kidney • Machine contains a membrane acting as a filter, and fluid bath • Usually 2 - 3 times/week • Peritoneal (PD) • Special fluid into peritoneal cavity • SURGICAL PROCEDURES • • Nephrectomy:Total removal of a kidney • Cystectomy:Removal of all/part of bladder • Nephrostomy:To create an opening from the kidney to the outside, so • urine can drain Stoma on abdominal wall • Continuous drainage of urine − bag • COMMON DRUGS • • Diuretics:Promote urination – • • Antibiotics:Treat UTIs • • Analgesics: Relieve urinary pain • • •