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Medical Terminology for Health Professions Ann Ehrlich/Carol L.Schroeder 7th Edition The Urinary System Chapter 9 © 2013 Delmar, Cengage Learning. All Rights Reserved Overview of Structures, Combining Forms, and Functions of the Urinary System Major Structures Kidneys Related Combining Forms nephr/o,ren/o Renal Pelvis pyel/o Urine ur/o, urin/o Ureters ureter/o Urinary Bladder cyst/o Urethra urethr/o Prostate prostat/o Primary Functions Filter the blood to remove waste products, maintain electrolyte concentrations, and remove excess water to maintain the fluid volume within the body. Collects urine produced by the kidneys. Liquid waste products to be excreted. Transport urine from the kidneys to the bladder. Stores urine until it is excreted. Transports urine from the bladder through the urethral meatus, where it is excreted. A gland of the male reproductive system that surrounds the male urethra. Disorders of this gland can disrupt the flow of urine. © 2013 Delmar, Cengage Learning. All Rights Reserved Primary Structures of the Urinary System The urinary system, also referred to as the urinary tract, consists of two kidneys, two ureters, one bladder, and a urethra. The adrenal glands, which are part of the endocrine system, are located on the top of the kidneys. © 2013 Delmar, Cengage Learning. All Rights Reserved FUNCTIONS OF THE URINARY SYSTEM The urinary system performs many functions that are important in maintaining homeostasis. Homeostasis is the process through which the body maintains a constant internal environment (home/o means constant, and -stasis means control). These functions include: • Maintaining the proper balance of water, salts, and acids in the body by filtering the blood as it flows through the kidneys. • Constantly filtering the blood to remove urea, creatinine, uric acid, and other waste materials from the bloodstream.Urea (you-REE-ah) is the major waste product of protein metabolism. Creatinine is a waste product of muscle metabolism. • Converting these waste products and excess fluids into urine in the kidneys and excrete them from the body via the urinary bladder. © 2013 Delmar, Cengage Learning. All Rights Reserved Kidneys • Primary Functions – Filter the blood to remove waste products – Maintain electrolyte concentrations – Remove excess water to maintain the fluid volume within the body The kidneys constantly filter the blood to remove waste products and excess water. These are excreted as urine, which is 95% water and 5% urea and other body wastes. About 200 quarts of blood are processed every day, producing an average of 2 quarts of urine. The kidneys also help the body maintain the proper level of fluid, produce hormones that control blood pressure and make red blood cells, and activate vitamin D to maintain healthy bones. • The term renal (REE-nal) means pertaining to the kidneys (ren means kidney or kidneys, and -al means pertaining to). • The two bean-shaped kidneys are located in the retroperitoneal space, with one on each side of the vertebral column below the diaphragm and the lower edge of the rib cage. Retroperitoneal means behind the peritoneum, which is the membrane that lines the abdominal cavity. • The renal cortex (REE-nal KOR-tecks) is the outer region of the kidney. This layer of tissue contains more than one million microscopic units called nephrons. The term cortex means the outer portion of an organ. • The medulla (meh-DULL-ah) is the inner region of the kidney, and it contains most of the urine-collecting tubules. A tubule is a small tube. (continues) © 2013 Delmar, Cengage Learning. All Rights Reserved Kidneys (continues) © 2013 Delmar, Cengage Learning. All Rights Reserved Kidneys • Related Word Parts (Combining Forms) – nephr/o – ren/o © 2013 Delmar, Cengage Learning. All Rights Reserved Nephrons The nephrons (NEF-ronz) are the microscopic functional units of each kidney. It is here that urine is produced through the processes of filtration, reabsorption, and secretion. Reabsorption is the return to the blood of some of the substances that were removed during filtration. • Each nephron contains a glomerulus (gloh-MER-you-lus), which is a cluster of capillaries (plural, glomeruli), surrounded by a cup-shaped membrane called the Bowman's capsule, and a renal tubule. • Blood enters the kidney through the renal artery and flows into the nephrons. • After passing through the filtration system of the glomerulus, the filtered blood containing protein and blood cells leaves the kidney and returns to the bloodstream through the renal vein. • The remaining filtrate flows into the renal tubules, where elements, including some water, sugar, and salts, are returned to the bloodstream via a nearby capillary. • Remaining waste products are continuously converted into urine, which is transported to the renal pelvis and collected in preparation for entry into the ureters. • If waste products are not efficiently removed from the bloodstream, the body cannot maintain homeostasis, with a stable balance of salts and other substances. © 2013 Delmar, Cengage Learning. All Rights Reserved Renal Pelvis • • Primary Function – Collects urine produced by the kidney Related Word Parts (Combining Forms) – pyel/o – The renal pelvis is the funnel-shaped area inside each kidney that is surrounded by the renal cortex and medulla. This is where the newly formed urine from the nephrons collects before it flows into the ureters. © 2013 Delmar, Cengage Learning. All Rights Reserved Ureters • Primary Function – Transport urine from the kidneys to the bladder • Related Word Parts (Combining Forms) – ureter/o The ureters (you-REE-ters) are two narrow tubes, each about 10 to 12 inches long, which transport urine from the kidney to the bladder. Peristalsis, which is a series of wave-like contractions, moves urine down each ureter to the bladder. (Peristalsis is also part of the digestive process, as described in Chapter 8.) Urine drains from the ureters into the bladder through the ureteral orifices in the wall of the urinary bladder. Orifice means opening. © 2013 Delmar, Cengage Learning. All Rights Reserved Urinary Bladder • • • • Primary Function – Stores urine until it is excreted Related Word Parts (Combining Forms) – cyst/o – The urinary bladder is an oval, hollow muscular organ that is a reservoir for urine before it is excreted from the body The bladder is located in the anterior portion of the pelvic cavity behind the pubic symphysis. The average adult bladder stores more than one pint of urine. Like the stomach, the bladder is lined with rugae. These folds allow it to expand when full and contract when empty. © 2013 Delmar, Cengage Learning. All Rights Reserved Urinary Bladder (continues) © 2013 Delmar, Cengage Learning. All Rights Reserved Urethra • Primary Function – Transports urine from the bladder through the urethral meatus, where it is excreted from the body • Related Word Parts (Combining Forms) – urethr/o The urethra (you-REE-thrah) is the tube extending from the bladder to the exterior of the body. Caution: the spellings ofureter and urethra are very similar! You may find it helpful to remember that the ureter comes first, both anatomically and alphabetically. • There are two urinary sphincters, one located at either end of the urethra. These muscular rings control the flow of urine from the bladder into the urethra, and out of the urethra through the urethral meatus. A sphincter is a ring-like muscle that closes a passageway . • The urethral meatus (you-REE-thrahl mee-AY-tus), also known as the urinary meatus, is the external opening of the urethra. The term meatus means the external opening of a canal. • The female urethra is approximately 1.5 inches long, and the urethral meatus is located between the clitoris and the opening of the vagina (see Chapter 14). In the female, the urethra conveys only urine. • The male urethra is approximately 8 inches long, and the urethral meatus is located at the tip of the penis. This urethra transports both urine and semen. • The prostate gland (PROS-tayt), which is part of the male reproductive system, surrounds the urethra. Most disorders of the prostate affect the male's ability to urinate. For more information about the role of the prostate gland in reproduction, see Chapter 14. © 2013 Delmar, Cengage Learning. All Rights Reserved Urine • Primary Function – Liquid waste product produced by the kidney that is to be excreted • Related Word Parts (Combining Forms) – ur/o, urin/o Urination, also known as voiding or micturition, is the normal process of excreting urine. • As the bladder fills up with urine, pressure is placed on the base of the urethra, resulting in the urge to urinate or micturate. • Urination requires the coordinated contraction of the bladder muscles and relaxation of the sphincters. This action forces the urine through the urethra and out through the urethral meatus. © 2013 Delmar, Cengage Learning. All Rights Reserved Prostate • Primary Function – A gland of the male prostate system that surrounds the male urethra – Disorders of this gland can disrupt the flow of urine • Related Word Parts (Combining Forms) – prostat/o © 2013 Delmar, Cengage Learning. All Rights Reserved MEDICAL SPECIALTIES RELATED TO THE URINARY SYSTEM • A nephrologist (neh-FROL-oh-jist) is a physician who specializes in diagnosing and treating diseases and disorders of the kidneys (nephr means kidney, and ologist means specialist). • A urologist (you-ROL-oh-jist) is a physician who specializes in diagnosing and treating diseases and disorders of the urinary system of females and the genitourinary system of males (ur means urine, and ologist means specialist). © 2013 Delmar, Cengage Learning. All Rights Reserved DIAGNOSTIC PROCEDURES OF THE URINARY SYSTEM •Urinalysis (you-rih-NAL-ih-sis) is the examination of urine to determine the presence of abnormal elements (urinmeans urine, and -analysis means a study of the parts). These tests, which are used to diagnose diseases as well as to detect the presence of substances such as illegal drugs, are discussed further in Chapter 15. •A bladder ultrasound is the use of a handheld ultrasound transducer to look for stones or for elevation of the bladder by an enlarged prostate, and to measure the residual amount of urine remaining in the bladder after urination. A normal bladder holds between 300 and 400 mL of urine. When more than this amount is still present after urination, the bladder is described as being distended, or enlarged. © 2013 Delmar, Cengage Learning. All Rights Reserved DIAGNOSTIC PROCEDURES OF THE URINARY SYSTEM • Urinary catheterization (kath-eh-ter-eye-ZAY-shun) is the insertion of a tube into the bladder to procure a sterile specimen for diagnostic purposes. It is also used to drain urine from the bladder when the patient is unable to urinate for other reasons. Another use is to place medication into the bladder. (See the later section “Treatment Procedures for the Urinary Bladder.”) • Cystoscopy (sis-TOS-koh-pee) is the visual examination of the urinary bladder with the use of a specialized type of endoscope known as a cystoscope (cyst/o means bladder, and -scopy means visual examination) (Figure 9.11). Anendoscope is an instrument used for visual examination of internal structures. A specialized cystoscope is also used for treatment procedures such as the removal of tumors or the reduction of an enlarged prostate gland. © 2013 Delmar, Cengage Learning. All Rights Reserved DIAGNOSTIC PROCEDURES OF THE URINARY SYSTEM • • Voiding cystourethrography (sis-toh-you-ree-THROG-rah-fee) is a diagnostic procedure in which a fluoroscope is used to examine the flow of urine from the bladder and through the urethra (cyst/o means bladder,urethr/o means urethra, and -graphy means the process of producing a picture or record). This procedure is often performed after cystography. Computed tomography, also known as a CAT scan, is more commonly used as a primary tool for evaluation of the urinary system because it can be rapidly performed and provides additional imaging of the abdomen, which may reveal other potential sources for the patient's symptoms. Nephrotomography is the use of a CAT scan to examine the kidneys. © 2013 Delmar, Cengage Learning. All Rights Reserved Radiographic Examinations of the Urinary System •Cystography (sis-TOG-rah-fee) is a radiographic, or x-ray, examination of the bladder after a contrast medium is instilled via a urethral catheter (cyst/o means bladder, and -graphy means the process of creating a picture or record). The resulting film is a cystogram. •An intravenous pyelogram (in-trah-VEE-nus PYE-eh-loh-gram) (IVP), also known as excretory urography, is a radiographic study of the kidneys and ureters (pyel/o means renal pelvis, and -gram means a picture or record). A contrast medium is administered intravenously to clearly define these structures in the resulting image. This examination is used to diagnose changes in the urinary tract resulting from nephroliths, infections, enlarged prostate, tumors, and internal injuries after an abdominal trauma © 2013 Delmar, Cengage Learning. All Rights Reserved Radiographic Examinations of the Urinary System • • A KUB (Kidneys, Ureters, Bladder) is a radio-graphic study without the use of a contrast medium. This study, also referred to as a flat-plate of the abdomen, is used to detect bowel obstructions and nephroliths. Despite its name, a KUB x-ray does not show the ureters. Retrograde urography is a radiograph of the urinary system taken after a contrast medium has been placed in the urethra through a sterile catheter and caused to flow upward through the urinary tract (ur/o means urine, and graphy means the process of creating a picture or record). Retrograde means moving backward. © 2013 Delmar, Cengage Learning. All Rights Reserved Diagnostic Procedures of the Prostate Gland • • A digital rectal examination is performed on men by using a lubricated, gloved finger placed in the rectum to palpate the prostate gland to detect prostate enlargement and to look for indications of prostate cancer or tumors of the rectum. In this context, the term digital means using a finger. Palpate means the use of touch to examine a body part. The prostate-specific antigen (PSA) blood test is used to screen for prostate cancer. This test measures the amount of prostate-specific antigen that is present in a blood specimen. The prostate-specific antigen is a protein produced by the cells of the prostate gland to help liquefy semen. The higher a man's PSA level, the more likely cancer is present. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Medications • Diuretics (dye-you-RET-icks) are medications administered to increase urine secretion, primarily to rid the body of excess water and salt. Some foods and drinks, such as coffee, tea, and alcoholic beverages, also have a diuretic effect. • Other drugs used to treat urinary tract problems include antibiotics for urinary tract infections and antispasmodics to block the signals that cause urinary incontinence. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Dialysis Dialysis (dye-AL-ih-sis) is a procedure to remove waste products, such as urea, creatinine, as well as excess water from the blood of a patient whose kidneys no longer function (dia- means complete or through, and -lysis means separation). The two types of dialysis in common use are hemodialysis and peritoneal dialysis. Patients can sometimes choose the type of long-term dialysis they prefer. Hemodialysis Hemodialysis (hee-moh-dye-AL-ih-sis) is the process by which waste products are filtered directly from the patient's blood (hem/o means blood, dia means complete or through, and -lysis means separation). Treatment is performed on an external hemodialysis unit commonly referred to as an artificial kidney (Figure 9.13). Hemodialysis is the most common type of dialysis. • A shunt implanted in the patient's arm is connected to the hemodialysis unit, and arterial blood flows through the filters of the unit. A shunt is an artificial passage that allows the blood to flow between the body and the hemodialysis unit. • The filters contain dialysate, which is a sterilized solution made up of water and electrolytes. This solution cleanses the blood by removing waste products and excess fluids. • Electrolytes are the salts that conduct electricity and are found in the body fluid, tissue, and blood. • The cleansed blood is returned to the body through a vein. • These treatments each take several hours and must be repeated about three times a week. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Dialysis In peritoneal dialysis (pehr-ih-toh-NEE-al dye-AL-ih-sis) the lining of the peritoneal cavity acts as the filter to remove waste from the blood. The dialysate, which is a sterile solution containing glucose, flows into the peritoneal cavity around the intestine through a catheter implanted in the abdominal wall. This fluid is left in for a period of time to absorb waste products and then drained out through the tube. The process is normally repeated several times during the day and can be done using an automated system. This type of dialysis has some advantages: for example, it can be done at home by the patient. However, it is considered less effective than hemodialysis (Figure 9.14). © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Dialysis • Continuous ambulatory peritoneal dialysis provides ongoing dialysis as the patient goes about his or her daily activities. In this procedure, a dialysate solution is instilled from a plastic container worn under the patient's clothing. About every 4 hours, the used solution is drained back into this bag and the bag is discarded. A new bag is then attached, the solution is instilled, and the process continues. • Continuous cycling peritoneal dialysis uses a machine to cycle the dialysate fluid during the night while the patient sleeps. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM The Kidneys • Nephrolysis (neh-FROL-ih-sis) is the surgical freeing of a kidney from adhesions (nephr/o means kidney, and-lysis means setting free). An adhesion is a band of fibers that holds structures together abnormally. •Note: The suffix -lysis means setting free; however, it also means destruction. Therefore, the term nephrolysis can also describe a pathologic condition in which there is destruction of renal cells. •A nephropexy (NEF-roh-peck-see), also known as nephrorrhaphy, is the surgical fixation of nephroptosis, or a floating kidney (nephr/o means kidney, and -pexy means surgical fixation). •A nephrostomy (neh-FROS-toh-mee) is the placement of a catheter to maintain an opening from the pelvis of one or both kidneys to the exterior of the body (nephr means kidney, and ostomy means creating an opening). In a kidney affected by hydronephrosis, this allows urine from the kidney to be drained directly through the lower back. Nephrostomy tubes are also used to gain access to the kidneys for diagnostic procedures. • Pyeloplasty (PYE-eh-loh-plas-tee) is the surgical repair of the ureter and renal pelvis (pyel/o means the renal pelvis, and -plasty means surgical repair). Hydronephrosis can cause damage to the ureter and renal pelvis. •A pyelotomy (pye-eh-LOT-oh-mee) is a surgical incision into the renal pelvis (pyel means the renal pelvis, and-otomy means surgical incision). This procedure is performed to correct obstructions such as a stone lodged in the junction between the renal pelvis and the ureter. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM •Renal transplantation, commonly known as a kidney transplant, is the grafting of a donor kidney, from either a living or nonliving donor, into the body to replace the recipient's failed kidneys. Kidney donors need to be genetically similar to the recipient, although a tissue match increases the success rate. A single transplanted kidney is capable of adequately performing all kidney functions and frees the patient from the need for dialysis (Figure 9.15). © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Treatment of Nephroliths Most small nephroliths (kidney stones) pass out of the urinary tract naturally over a period of two days to three weeks. This process can be quite painful and is sometimes accompanied by vomiting due to the pain. Larger stones may require surgical intervention. • Extracorporeal shockwave lithotripsy (ecks-trah-kor-POUR-eeal LITH-oh-trip-see) (ESWL) is the most common kidney stone treatment (lith/o means stone, and -tripsy means to crush). High-energy ultrasonic waves traveling through water or gel are used to break up the stone into fragments, which are then excreted in the urine. Extracorporeal means situated or occurring outside the body (Figure 9.16). Lithotripsy is also used to break up calculi in the ureter, bladder, or urethra. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Treatment of Nephroliths Most small nephroliths (kidney stones) pass out of the urinary tract naturally over a period of two days to three weeks. This process can be quite painful and is sometimes accompanied by vomiting due to the pain. Larger stones may require surgical intervention. • A percutaneous nephrolithotomy (per-kyou-TAY-nee-us nef-roh-lihTHOT-oh-mee) is the surgical removal of a nephrolith through a small incision in the back (nephr/o means kidney, lith means stone, and -otomy means surgical incision). A small tube is temporarily inserted through the incision into the kidney. First urine is removed; then the stone is crushed and the pieces are removed. This procedure is used if ESWL has not been successful, if an infection is present, or if the stone is particularly large. Percutaneous means performed through the skin. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM The Ureters •A ureterectomy (you-reh-ter-ECK-toh-mee) is the surgical removal of a ureter (ureter means ureter, and -ectomy means surgical removal). •Ureteroplasty (you-REET-er-oh-plas-tee) is the surgical repair of a ureter (ureter/o means ureter, and -plastymeans surgical repair). • Ureterorrhaphy (you-reet-eh-ROAR-ah-fee) is the surgical suturing of a ureter (ureter/o means ureter, and-rrhaphy means surgical suturing). •Ureteroscopy (you-reet-eh-ROS-koh-pee) is a treatment for a nephrolith lodged in the ureter (ureter/o means ureter, and -scopy means visual examination). A specialized instrument called a ureteroscope is inserted through the urethra and bladder into the ureter. If possible, the nephrolith is removed intact through the scope. If the stone is too large, a laser is used to break it up and the pieces are then removed. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM The Urinary Bladder •A cystectomy (sis-TECK-toh-mee) is the surgical removal of all or part of the urinary bladder. This procedure is usually performed to treat bladder cancer (cyst means bladder, and ectomy means surgical removal). •A neobladder (NEE-oh-blad-er) is a replacement for the missing bladder created by using about 20 inches of the small intestine. It allows patients to avoid having an abdominal stoma. •An ileal conduit (ill-ee-al KON-doo-it), or ileostomy, is the use of a small piece of intestine to convey urine to the ureters and to a stoma in the abdomen (ile means ileum or small intestine, and al means pertaining to). • Cystopexy (sis-toh-peck-see) is the surgical fixation of the bladder to the abdominal wall (cyst/o means bladder, and -pexy means surgical fixation). •Cystorrhaphy (sis-TOR-ah-fee) is the surgical suturing of a wound or defect in the bladder (cyst/o means bladder, and -rrhaphy means surgical suturing). •A lithotomy (lih-THOT-oh-mee) is a surgical incision for the removal of a nephrolith from the bladder (lith means stone, and -otomy means surgical incision). Although this surgery is no longer common, its name is still used to describe a physical examination position for procedures involving the pelvis and lower abdomen (see Chapter 15). © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM URINARY CATHETERIZATION Urinary catheterization, also known as cathing, is performed to withdraw urine for diagnostic purposes, to allow urine to drain freely, or to place a fluid such as a chemotherapy solution into the bladder (Figure 9.16). Note that the termcatheterization may also refer to inserting a tube into the heart (see Chapter 5). • An indwelling catheter remains inside the body for a prolonged time based on need (Figure 9.17A). Indwellingmeans residing within. This can be either a urethral or a suprapubic catheter. •Urethral catheterization is performed by inserting a plastic tube called a catheter though the urethra and into the bladder. • © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM URINARY CATHETERIZATION Suprapubic catheterization (soo-prah-PYOU-bick kath-eh-ter-eye-ZAY-shun) is the placement of a catheter into the bladder through a small incision made through the abdominal wall just above the pubic bone (Figure 9.17B). •A Foley catheter is the most common type of indwelling catheter. This device is made of a flexible tube with a balloon filled with sterile water at the end to hold it in place in the bladder. It is commonly used on postsurgical patients. •An intermittent catheter, also known as a short-term catheter, is inserted as needed several times a day to drain urine from the bladder. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM The Urethra •A meatotomy (mee-ah-TOT-oh-mee) is a surgical incision made in the urethral meatus to enlarge the opening (meat means meatus, and -otomy means surgical incision). • Urethropexy (you-REE-throh-peck-see) is the surgical fixation of the urethra to nearby tissue (urethr/omeans urethra, and -pexy means surgical fixation). This procedure is usually performed to correct urinary stress incontinence. •A urethrotomy (you-reh-THROT-oh-mee) is a surgical incision into the urethra for relief of a stricture (urethr means urethra, and -otomy means surgical incision). A stricture is an abnormal narrowing of a bodily passage. © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Prostate Treatment Ablation (ab-LAY-shun) is the term used to describe some types of treatment of prostate cancer. This treatment involves the removal of a body part or the destruction of its function through the use of surgery, hormones, drugs, heat, chemicals, electrocautery, or other methods. Electrocautery is the use of high-frequency electrical current to destroy tissue. •A prostatectomy (pros-tah-TECK-toh-mee) is the surgical removal of part or all of the prostate gland (prostatmeans prostate, and -ectomy means surgical removal). This procedure is performed to treat prostate cancer or to reduce an enlarged prostate gland; however, this treatment can lead to erectile difficulties. •A radical prostatectomy is the surgical removal of the entire prostate gland in cases where it is extremely enlarged or when cancer is suspected. •A transurethral prostatectomy, also known as a TURP, is the removal of excess tissue from an enlarged prostate gland with the use of a resecto-scope. A resectoscope is a specialized endoscopic instrument that resembles a cystoscope (Figure 9.18). • © 2013 Delmar, Cengage Learning. All Rights Reserved TREATMENT PROCEDURES OF THE URINARY SYSTEM Prostate Treatment Retrograde ejaculation is when an orgasm results in semen flowing backward into the bladder instead of out through the penis. This is a common side effect of the transurethral prostatectomy. Retrograde means moving backward. • Radiation therapy and hormone therapy are additional treatments used to control prostate cancer. Watchful waiting is often the prescribed course of action in older patients because this disease normally progresses slowly. URINARY INCONTINENCE TREATMENT • Kegel exercises, which were named for Dr. Arnold Kegel, are a series of pelvic muscle exercises used to strengthen the muscles of the pelvic floor. They are used to control urinary stress incontinence in both sexes, in men to treat prostate pain and swelling, and in women to condition the muscles so that they will recover quickly after childbirth. • Bladder retraining is behavioral therapy in which the patient learns to urinate on a schedule, with increasingly longer time intervals as the bladder increases its capacity. The goal is to reestablish voluntary bladder control and to break the cycle of frequency and urgency that results from urge incontinence. • © 2013 Delmar, Cengage Learning. All Rights Reserved ABBREVIATIONS RELATED TO THE URINARY SYSTEM Acute renal failure = ARF ARF = acute renal failure Benign prostatic hyperplasia (BPH), = BPH BPH = benign prostatic hyperplasia catheterization = cath cath = catheterization Chronic kidney disease = CKD CKD = chronic kidney disease Cystoscopy = cysto cysto = cystoscopy digital rectal examination = DRE DRE = digital rectal examination End-stage renal disease = ESRD ESRD = end-stage renal disease intravenous pyelogram = IVP IVP = intravenous pyelogram Polycystic kidney disease = PKD PKD = polycystic kidney disease transurethral resection of the prostate= TURP TURP = transurethral resection of the prostate urinary tract infection = UTI UTI = urinary tract infection © 2013 Delmar, Cengage Learning. All Rights Reserved Key Word Parts and Definitions • • • • • • • • -cele – hernia, tumor, swelling cyst/o – urinary bladder, cyst, sac of fluid dia– through, between, apart, complete -ectasis – stretching, dilation, enlargement glomerul/o – glomerulus lith/o – stone, calculus -lysis – breakdown, separation, setting free, destruction, loosening nephr/o – kidney • • • • • • • pexy – surgical fixation pyel/o – renal pelvis, bowl of kidney -tripsy – to crush ur/o – urine, urinary tract ureter/o – ureter urethr/o – urethra -uria – urination, urine © 2013 Delmar, Cengage Learning. All Rights Reserved (continues) Questions © 2013 Delmar, Cengage Learning. All Rights Reserved Question The medulla is the inner region of the kidney. It is also the name of a section of what other body part? a. intestines b. brainstem c. heart © 2013 Delmar, Cengage Learning. All Rights Reserved Answer b. brainstem © 2013 Delmar, Cengage Learning. All Rights Reserved Question The tube extending from the bladder to the outside of the body is the: a. ureter b. urethra c. ureta © 2013 Delmar, Cengage Learning. All Rights Reserved Answer b. urethra (Think of it as being further from the kidneys than the ureter.) © 2013 Delmar, Cengage Learning. All Rights Reserved Question Nocturnal enuresis is also known as bedwetting. True or False? © 2013 Delmar, Cengage Learning. All Rights Reserved Answer True © 2013 Delmar, Cengage Learning. All Rights Reserved Question Hemodialysis is the process by which cancer cells are filtered directly from the patient’s blood. True or False? © 2013 Delmar, Cengage Learning. All Rights Reserved Answer False: Hemodialysis is the process by which waste products are filtered from the patient’s blood. © 2013 Delmar, Cengage Learning. All Rights Reserved Answers to Learning Exercises © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Matching Word Parts 1 9.1. cyst/o 9.2. glomerul/o 9.3. -cele 9.4. nephr/o 9.5. lith/o Matching Word Parts 2 9.6. ur/o 9.7. pyel/o 9.8. -lysis 9.9. -pexy 9.10. -tripsy © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Matching Word Parts 3 9.11. dia9.12. -ectasis 9.13. ureter/o 9.14. urethr/o 9.15. -uria Definitions 9.16. ureters 9.17. cystolith 9.18. diuresis 9.19. renal pelvis 9.20. urethra 9.21. nephrons 9.22. urethra 9.23. urologist 9.24. epispadias 9.25. ablation © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Matching Structures 9.26. urethral meatus 9.27. glomerulus 9.28. renal cortex 9.29. urethra 9.30. ureters Which Word? 9.31. pyelotomy 9.32. ureterorrhagia 9.33. polyuria 9.34. cystitis 9.35. urea © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Spelling Counts 9.36. Wilms 9.37. incontinence 9.38. catheterization 9.39. Kegel 9.40. vesicovaginal Abbreviation Identification 9.41. benign prostatic hyperplasia 9.42. end-stage renal disease 9.43. extracorporeal shockwave lithotripsy 9.44. intravenous pyelogram 9.45. overactive bladder © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Term Selection 9.46. anuria 9.47. cystorrhaphy 9.48. nephrolysis 9.49. oliguria 9.50. hemodialysis Sentence Completion 9.51. nephritis 9.52. ureterolith 9.53. suprapubic catheterization 9.54. cystopexy 9.55. transurethral prostatectomy © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Word Surgery 9.56. hyper-, protein, -uria 9.57. hydr/o, nephr, -osis 9.58. cyst/o, urethr/o, -graphy 9.59. nephr/o, lith, -otomy 9.60. ureter/o, -rrhaphy True/False 9.61. True 9.62. False 9.63. False 9.64. True 9.65. True © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Clinical Conditions 9.66. nocturia 9.67. polycystic 9.68. interstitial cystitis 9.69. urethrostenosis 9.70. epispadias 9.71. peritoneal dialysis 9.72. ureteroplasty 9.73. prostate-specific antigen 9.74. glomerulonephritis 9.75. nephroptosis Which Is the Correct Medical Term? 9.76. uremia 9.77. nocturnal enuresis 9.78. ureterectasis 9.79. hypoproteinemia 9.80. nephrologist © 2013 Delmar, Cengage Learning. All Rights Reserved Chapter 9 Answers Challenge Word Building 9.81. cystostomy 9.82. nephrotomy 9.83. nephrosclerosis 9.84. cystoptosis 9.85. urethrocele 9.86. ureterolysis 9.87. nephromalacia 9.88. pyelonephritis 9.89. urethrostomy 9.90. cystoplasty Labeling Exercises 9.91. adrenal 9.92. kidney 9.93. vena cava 9.94. urethra 9.95. cortex 9.96. medulla 9.97. aorta 9.98. ureters 9.99. bladder 9.100. meatus © 2013 Delmar, Cengage Learning. All Rights Reserved