1. List and define 5 indicators for urinalysis.
2. Explain the difference between Diabetes Mellitus and Diabetes Insipidus.
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3. Divide. Label and give meaning of three medical terms pertaining to the urinary system
4. In the urinary system case study for this week’s module, the two patients had many signs and symptoms and were diagnosed by the same physician..
- a. What were the symptoms experienced by each patient?
- b. What signs were evident from the lab tests?
- c. What was the diagnosis for each patient?
- d. What was done to reach the final diagnosis?
Chapter 7
Urinary System
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Learning Objectives
Name the organs of the urinary system and describe their locations and functions.
Give the meaning of various pathological conditions affecting the urinary system.
Recognize the uses and interpretation of urinalysis as a diagnostic test.
Define combining forms, prefixes, and suffixes of the urinary system’s terminology.
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Learning Objectives (cont’d.)
List and explain some clinical procedures, laboratory tests, and abbreviations that pertain to the urinary system.
Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records.
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Chapter 7
Lesson 7.1
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Introduction
Nitrogenous wastes
urea
creatinine
uric acid
Kidneys
Filter nitrogenous wastes to form urine
Maintain proper balance of
Water
Eletrolytes
Acids
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Why is nitrogenous waste excreted from the body in a soluble rather than gaseous form?
By what medium does urea travel to the kidneys?
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Introduction (cont’d.)
Kidneys also secrete
Hormones
Renin: enzymatic hormone important in adjusting blood pressure
Erythropoietin: hormone that stimulates the red blood cell production in bone marrow
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Kidneys also adjust amount of water and electrolytes for proper muscle and nerve function.
Are there other important functions performed by the kidneys?
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Anatomy of the Major Organs
Organs of the Urinary System in a Male
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Have students name the organs of the urinary system labeled 1-4 in the figure.
What is the size and weight of a normal kidney?
What function is performed by the ureters?
What function is performed by the urinary bladder?
What function is performed by the urethra?
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Anatomy of the Major Organs
Organs of the Urinary System in a Male
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Have students name the organs of the urinary system labeled 1-4 in the figure.
What is the size and weight of a normal kidney?
What function is performed by the ureters?
What function is performed by the urinary bladder?
What function is performed by the urethra?
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Anatomy of the Major Organs (cont’d.)
Female
Urinary System
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How does the female urinary system differ from the male urinary system?
What is the trigone and what function does it perform?
What is micturition?
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Female
Urinary System
Anatomy of the Major Organs (cont’d.)
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How does the female urinary system differ from the male urinary system?
What is the trigone and what function does it perform?
What is micturition?
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QUICK QUIZ:
1. What is micturition?
Nitrogenous waste
Urination; voiding
Outer section of the kidney
Triangular area in the bladder
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Correct answer is B, urination; voiding
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How Kidneys Produce Urine
Blood enters kidneys through right and left renal arteries
Arterioles carry blood to capillaries
Glomeruli filter blood
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The renal artery branches into smaller arteries, arterioles, and glomeruli located throughout the cortex of the kidneys.
What is a glomerulus?
There are approximately one million glomeruli in the cortex of each kidney.
How does the kidney regulate blood pressure?
Why is maintenance of proper blood pressure important to the kidneys’ function?
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How Kidneys Produce Urine
Blood enters kidneys through right and left renal arteries
Arterioles carry blood to capillaries
Glomeruli filter blood
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The renal artery branches into smaller arteries, arterioles, and glomeruli located throughout the cortex of the kidneys.
What is a glomerulus?
There are approximately one million glomeruli in the cortex of each kidney.
How does the kidney regulate blood pressure?
Why is maintenance of proper blood pressure important to the kidneys’ function?
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How Kidneys Produce Urine (cont’d.)
Glomerulus and Bowman Capsule
Blood passes through glomeruli
Bowman capsule surrounds each glomerulus
Renal tubule is attached to each Bowman capsule
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What functions do the glomerulus, Bowman capsule, and renal tubule perform in the production of urine?
Why don’t proteins and blood cells usually appear in the urine?
What is the process of reabsorption?
What is secretion?
What substances make up urine? (Note: These substances become toxic if allowed to accumulate.)
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How Kidneys Produce Urine (cont’d.)
Glomerulus and Bowman Capsule
Blood passes through glomeruli
Bowman capsule surrounds each glomerulus
Renal tubule is attached to each Bowman capsule
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What functions do the glomerulus, Bowman capsule, and renal tubule perform in the production of urine?
Why don’t proteins and blood cells usually appear in the urine?
What is the process of reabsorption?
What is secretion?
What substances make up urine? (Note: These substances become toxic if allowed to accumulate.)
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How Kidneys Produce Urine (cont’d.)
Three steps in the formation of urine
Glomerular filtration
Tubular reabsorption
Tubular secretion
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What functions are performed in each of the three steps in the formation of urine?
The combination of a glomerulus and a renal tubule is called a nephron. (There are more than 1 million nephrons in a kidney.)
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How Kidneys Produce Urine (cont’d.)
Three steps in the formation of urine
Glomerular filtration
Tubular reabsorption
Tubular secretion
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What functions are performed in each of the three steps in the formation of urine?
The combination of a glomerulus and a renal tubule is called a nephron. (There are more than 1 million nephrons in a kidney.)
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How Kidneys Produce Urine (cont’d.)
Glomerulus and
a renal tubule combine to form a unit called a nephron.
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How Kidneys Produce Urine (cont’d.)
Glomerulus and
a renal tubule combine to form a unit called a nephron.
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QUICK QUIZ:
Approximately how many nephrons are in a kidney?
100,000,000
10,000,000
1,000,000
100,000
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Correct answer is C, 1 million
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How Kidneys Produce Urine (cont’d.)
All collecting tubules lead to the
renal pelvis
Calyces or calices
are small, cup-like regions of the renal pelvis
Illustration shows section of kidney
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Notice how secretion and reabsorption are functions of the same organs.
Cup-like regions in the renal pelvis are called calyces or calices.
Where do all connecting tubules lead?
The renal pelvis narrows to form the ureter.
To which organ does the ureter lead?
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How Kidneys Produce Urine (cont’d.)
All collecting tubules lead to the renal pelvis
Calyces or calices are small, cup-like regions of the renal pelvis
Illustration shows section of kidney
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Notice how secretion and reabsorption are functions of the same organs.
Cup-like regions in the renal pelvis are called calyces or calices.
Where do all connecting tubules lead?
The renal pelvis narrows to form the ureter.
To which organ does the ureter lead?
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How Kidneys Produce Urine (cont’d.)
Process of forming and expelling urine
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How is urine flow from the bladder to the urethra controlled?
What triggers the need to urinate?
Urine finally exits the body through the urinary meatus.
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How Kidneys Produce Urine (cont’d.)
Process of forming and expelling urine
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How is urine flow from the bladder to the urethra controlled?
What triggers the need to urinate?
Urine finally exits the body through the urinary meatus.
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Vocabulary
arteriole
Bowman capsule
calyx or calix
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Refer to p. 216 for definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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arteriole
Bowman capsule
calyx or calix
Small artery.
Enclosing structure surrounding each glomerulus
Cup-like collecting region of the renal pelvis
Vocabulary
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Refer to p. 216 for more detailed definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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catheter
cortex
creatinine
Vocabulary
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Refer to p. 216 for definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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catheter
cortex
creatinine
Tube for injecting or removing fluids
Outer region
Waste product of muscle metabolism
Vocabulary
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Refer to p. 216 for more detailed definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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electrolyte
erythropoietin (EPO)
Vocabulary
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Refer to p. 216 and 217 for definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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electrolyte
erythropoietin (EPO)
A chemical element that carries an electrical charge when dissolved in water.
A hormone secreted by the kidney to stimulate production of red blood cells by bone marrow.
Vocabulary
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Refer to p. 216 and 217 for more detailed definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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filtration
glomerulus
hilum
Vocabulary
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Refer to p. 217 for definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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filtration
glomerulus
hilum
Passive process whereby some substances pass through a filter or other material.
Tiny ball of capillaries in the cortex of kidney.
Depression in the part of an organ where blood vessels and nerves enter and leave.
Vocabulary
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Refer to p. 217 for more detailed definitions.
How do each of these terms play a role in the urinary system?
Which organs are involved in filtering urine?
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kidney
meatus
medulla
Vocabulary
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Refer to pp. 217 for definitions.
What path does waste take through the urinary system?
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kidney
meatus
medulla
One of two bean-shaped organs behind the abdominal cavity.
Opening or canal
Inner region
Vocabulary
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Refer to pp. 217 for definitions.
What path does waste take through the urinary system?
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micturition
nephron
nitrogenous waste
Vocabulary
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Refer to pp. 218 for definitions.
What path does waste take through the urinary system?
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micturition
nephron
nitrogenous waste
Urination.
The functional unit of the kidney where filtration, reabsorption, and secretion take place.
Substance containing nitrogen and excreted in urine.
Vocabulary
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Refer to pp. 218 for more detailed definitions.
What path does waste take through the urinary system?
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potassium (K+)
reabsorption
renal artery
Vocabulary
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Refer to pp. 218 for definitions.
What path does waste take through the urinary system?
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potassium (K+)
reabsorption
renal artery
An electrolyte important to body processes.
Renal tubules return materials necessary to the body back into the bloodstream.
Blood vessel that carries blood to the kidney.
Vocabulary
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Refer to pp. 218 for more detailed definitions.
What path does waste take through the urinary system?
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renal pelvis
renal tubule
renal vein
Vocabulary
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Refer to pp. 220-221 for definitions.
What path does waste take through the urinary system?
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renal pelvis
renal tubule
renal vein
Central collection region in the kidney
Microscopic tube in the kidney in which urine is formed after filtration.
Blood vessel that carries blood away from the kidney and toward the heart.
Vocabulary
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Refer to pp. 218 for more detailed definitions.
What path does waste take through the urinary system?
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renin
sodium (Na+)
trigone
Vocabulary
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*
Refer to p. 221 for definitions.
What is another term for urination?
What is renin and where is it formed?
Where is the trigone located?
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renin
sodium (Na+)
trigone
An enzymatic hormone synthesized, stored, and secreted by the kidney.
An electrolyte regulated in the blood and urine by the kidneys.
Triangular area in the urinary bladder in which ureters enter and the urethra exits.
Vocabulary
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*
Refer to p. 221 for definitions.
What is another term for urination?
What is renin and where is it formed?
Where is the trigone located?
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urea
ureter
urethra
Vocabulary
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*
Refer to p. 221 for definitions.
What is another term for urination?
What is renin and where is it formed?
Where is the trigone located?
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urea
ureter
urethra
Major nitrogenous waste product excreted in urine.
Tube leading from each kidney to the urinary bladder.
Tube leading from the urinary bladder to the outside of the body.
Vocabulary
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uric acid
urinary bladder
urination
voiding
Vocabulary
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*
Refer to p. 221 for definitions.
What is another term for urination?
What is renin and where is it formed?
Where is the trigone located?
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uric acid
urinary bladder
urination
voiding
A nitrogenous waste product excreted in the urine.
Hollow muscular sac that holds and stores urine.
Process of expelling urine.
Emptying of urine from the urinary bladder; urination or micturition.
Vocabulary
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STRUCTURES
cali/o , calic/o _________
cyst/o _________
glomerul/o _________
meat/o _________
Combining Form Meaning
Terminology: Structures,
Substances and Urinary Symptoms
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Refer to pp. 219 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
cali/o , calic/o calyx (calix)
cyst/o urinary bladder
glomerul/o glomerulus
meat/o meatus
Terminology: Structures,
Substances and Urinary Symptoms
Combining Form Meaning
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*
Refer to pp. 219 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
cyst/o cystitis ________________
Combining Form Terminology Meaning
Terminology: Structures,
Substances and Urinary Symptoms
Bacterial infections often cause acute or chronic cystitis. In acute cystitis, the bladder contains blood as a result of mucosal hemorrhage (see figure, Acute cystitis).
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Refer to pp. 220-226 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
cyst/o cystitis inflammation of the urinary bladder
Combining Form Terminology Meaning
Bacterial infections often cause acute or chronic cystitis. In acute cystitis, the bladder contains blood as a result of mucosal hemorrhage (see figure, Acute cystitis).
Terminology: Structures,
Substances and Urinary Symptoms
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*
Refer to pp. 220-226 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
nephr/o ___________
pyel/o ___________
ren/o ____________
trigon/o ____________
Terminology: Structures,
Substances and Urinary Symptoms
Combining Form Meaning
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*
Refer to pp. 220-221 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
nephr/o kidney
pyel/o renal pelvis
ren/o kidney
trigon/o trigone
Terminology: Structures,
Substances and Urinary Symptoms
Combining Form Meaning
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*
Refer to pp. 220-221 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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Terminology: Structures,
Substances and Urinary Symptoms
STRUCTURES
nephr/o hydronephrosis _________________
Combining Form Terminology Meaning
Obstruction of urine flow may be caused by renal calculi (stone) as shown in figure. Notice the buildup of excess fluid in the kidney.
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Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
nephr/o hydronephrosis Condition of excess fluid (water) in the kidney.
Combining Form Terminology Meaning
Obstruction of urine flow may be caused by renal calculi (stone) as shown in figure. Notice the buildup of excess fluid in the kidney.
Terminology: Structures,
Substances and Urinary Symptoms
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*
Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
ureter/o __________
urethr/o __________
vesic/o __________
Terminology: Structures,
Substances and Urinary Symptoms
Combining Form Meaning
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*
Refer to pp. 221 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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STRUCTURES
ureter/o ureter
urethr/o urethra
vesic/o urinary bladder
Terminology: Structures,
Substances and Urinary Symptoms
Combining Form Meaning
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*
Refer to pp. 221 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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SUBSTANCES and SYMPTOMS
albumin/o ________
azot/o ________
bacteri/o ________
dips/o ________
Terminology: Structures,
Substances and Urinary Symptoms
Combining Form Meaning
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*
Refer to pp. 221-222 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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SUBSTANCES and SYMPTOMS
albumin/o albumin
azot/o nitrogen
bacteri/o bacteria
dips/o thirst
Terminology: Structures,
Substances and Urinary Symptoms
Combining Form Meaning
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*
Refer to pp. 221-222 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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SUBSTANCES and SYMPTOMS
ket/o, keton/o __________
lith/o __________
noct/o __________
olig/o __________
-poietin __________
Combining Form
Or Suffix Meaning
Terminology: Structures,
Substances and Urinary Symptoms
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*
Refer to pp. 222 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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SUBSTANCES and SYMPTOMS
ket/o, keton/o ketone bodies
lith/o stone
noct/o night
olig/o scanty
-poietin substance that forms
Combining Form
Or Suffix Meaning
Terminology: Structures,
Substances and Urinary Symptoms
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*
Refer to pp. 222 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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SUBSTANCES and SYMPTOMS
py/o __________
-tripsy __________
ur/o __________
urin/o __________
-uria __________
Combining Form
Or Suffix Meaning
Terminology: Structures,
Substances and Urinary Symptoms
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*
Refer to pp. 222-223 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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SUBSTANCES and SYMPTOMS
py/o pus
-tripsy to crush
ur/o urea
urin/o urine
-uria urination; urine condition
Combining Form
Or Suffix Meaning
Terminology: Structures,
Substances and Urinary Symptoms
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*
Refer to pp. 222-223 for definitions.
Using the given combining forms, can you form and define other terms not listed in the slide?
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Urinalysis
Tests included in a Urinalysis
Color
Appearance
pH
Protein
Glucose
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*
Colorless urine = large amount of water in urine. Smoky-red or brown indicates presence of blood in urine.
Normal pH is 6.5 (slightly acidic).
Protein test looks for albumin, which indicates a leak in the glomerular membrane.
Glucose presence signals possibility of diabetes.
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Urinalysis (cont’d.)
Tests included in a Urinalysis
Specific gravity
Ketone bodies
Sediment
Phenylketonuria
Bilirubin
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*
Specific gravity reflects amounts of wastes and minerals.
Ketone bodies appear when the body breaks down fat.
Sediment are abnormal particles.
Phenylketonuria indicates a lack of enzyme, especially in infants. PKU test measures this.
Bilirubin results from a hemoglobin breakdown.
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QUICK QUIZ:
In a urinalysis, what does the test specific gravity reflect?
A. The chemical nature of urine
B. Presence of albumin
C. Blood in the urine
D. Amount of wastes, minerals and solids in the urine
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*
Correct Answer is D, specific gravity compares the density of urine with that of water.
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Chapter 7
Lesson 7.2
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*
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Pathologic Conditions
Kidney
glomerulonephritis
interstitial nephritis
nephrolithiasis
nephrotic syndrome
polycystic kidneys (PKD)
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*
See pp. 225-226.
Glomerulonephritis is the inflammation of the kidney due to infection and can lead to hypertension and renal failure if untreated.
What is interstitial nephritis?
What procedure might a physician recommend for a patient with nephrolithiasis?
Nephrotic syndrome is a collection of symptoms caused by excessive protein in the urine.
Polycystic kidneys are a hereditary condition of progressive growth of cysts.
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Pathologic Conditions
Kidney
polycystic
kidney
disease (PKD)
PKD–The kidneys contain masses of cysts. Typically polycystic kidneys weight 20 times more than their usual weight.
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*
See pp. 225-226.
Glomerulonephritis is the inflammation of the kidney due to infection and can lead to hypertension and renal failure if untreated.
What is interstitial nephritis?
What procedure might a physician recommend for a patient with nephrolithiasis?
Nephrotic syndrome is a collection of symptoms caused by excessive protein in the urine.
Polycystic kidneys are a hereditary condition of progressive growth of cysts.
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Pathologic Conditions (cont’d.)
Kidney
pyelonephritis
renal cell carcinoma
renal failure
renal hypertension
Wilms tumor
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*
See p. 229.
Pyelonephritis is the inflammation of the renal pelvis and renal medulla and is the most common type of kidney infection.
Renal cell carcinoma is adult cancer of the kidney—2% of all adult cancers.
What occurs during renal failure?
How does renal hypertension differ from essential hypertension?
Wilms tumor is a malignant tumor of the kidney occurring in childhood and is an example of an eponym.
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Pathologic Conditions
Kidney
Renal cell
carcinoma
(hypernephroma)
Cancerous tumor
of the kidney
in adulthood.
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*
See pp. 226 for more detail.
Glomerulonephritis is the inflammation of the kidney due to infection and can lead to hypertension and renal failure if untreated.
What is interstitial nephritis?
What procedure might a physician recommend for a patient with nephrolithiasis?
Nephrotic syndrome is a collection of symptoms caused by excessive protein in the urine.
Polycystic kidneys are a hereditary condition of progressive growth of cysts.
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Pathologic Conditions (cont’d.)
Urinary bladder
Bladder cancer
Associated conditions
Diabetes insipidus
Diabetes mellitus
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*
Bladder cancer is the most common form of malignancy in the urinary system.
What risk factors are associated with bladder cancer?
Diabetes insipidus: inadequate secretion or resistance of the kidney to antidiuretic hormone
Diabetes mellitus: inadequate secretion or improper utilization of insulin
How does each of these conditions affect the kidneys?
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QUICK QUIZ:
A term that means frequent (voluntary) urination at night is:
Anuria
Nocturia
Diuresis
Hematuria
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*
Correct answer is nocturia.
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Laboratory Tests and Clinical Procedures
Laboratory tests
blood urea nitrogen (BUN)
creatinine clearance test
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*
Which procedure tests for uremia?
Which test measures the rate at which creatinine is cleared from the blood?
What is azotemia?
What role do the kidneys play in BUN levels?
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Laboratory Tests and Clinical Procedures (cont’d.)
CLINICAL PROCEDURES
X-Ray Studies
CT scan
kidneys, ureters, & bladder (KUB)
renal angiography
retrograde pyelogram (RP)
voiding cystourethrogram (VCUG)
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*
How do these x-rays differ?
Which tests require contrast material?
Why is it important to measure the size of the kidneys (KUB)?
Which tests require urinary catheterization?
Why would someone have RP instead of IVP?
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CT-Computed Tomography
The scan with contrast shows a benign cyst on the kidney.
Laboratory Tests and Clinical Procedures (cont’d.)
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*
See page 228 for more detailed description.
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VOIDING CYSTOURETHROGRAM
(VCUG)showing a normal female urethra. The bladder is filled with contrast material, followed by x-ray imaging.
Laboratory Tests and Clinical Procedures (cont’d.)
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*
See page 228-229 for more detailed description.
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CLINICAL PROCEDURES
Ultrasound Examination
ultrasonography: imaging urinary tract structures using high frequency sound waves
Radioactive Studies
radioisotope scan: image of kidney after injecting a radioisotope (that concentrates in the kidney) into the bloodstream
Laboratory Tests and Clinical Procedures (cont’d.)
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*
What is hydronephrosis?
What might cause the kidney to be enlarged?
What can be diagnosed in the urinary system using sound waves?
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CLINICAL PROCEDURES
Magnetic imaging
magnetic resonance imaging (MRI): using magnetic field and radio waves to produce images in all three planes of the body
Laboratory Tests and Clinical Procedures (cont’d.)
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*
How is an MRI of the kidney performed?
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Other Clinical Procedures
cystoscopy
dialysis
lithotripsy
renal angioplasty
renal biopsy
renal transplantation
urinary catheterization
Laboratory Tests and Clinical Procedures (cont’d.)
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*
Cystoscopy allows for visual examination through a hollow metal tube.
What is the difference between hemodialysis and peritoneal dialysis?
What procedure might be required to remove kidney stones?
Describe the process of catheterization.
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Hemodialysis (HD)
Laboratory Tests and Clinical Procedures (cont’d.)
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*
How is a cytoscopy performed?
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Continuous ambulatory peritoneal dialysis (CAPD)
Laboratory Tests and Clinical Procedures (cont’d.)
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*
CAPD can be performed continuously by the patient without artificial support.
What other peritoneal dialysis procedures may be performed?
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Abbreviations
ADH _______________
ARF _______________
BILI _______________
BUN _______________
CAPD _______________
Cath _______________
CCPD _______________
CKD _______________
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*
Which abbreviations stand for disorders, which are measurements, and which are procedures?
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ADH antidiuretic hormone
ARF acute renal failure
BILI bilirubin
BUN blood urea nitrogen
CAPD continuous ambulatory peritoneal dialysis
Cath catheter; catheterization
CCPD continuous cycling peritoneal dialysis
CKD chronic kidney disease
Abbreviations (cont’d.)
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*
Which abbreviations stand for disorders, which are measurements, and which are procedures?
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CL- _____________________
CRF _____________________
C & S _____________________
cysto _____________________
ESRD _____________________
HCO3- _____________________
HD _____________________
IC _____________________
Abbreviations (cont’d.)
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*
Which items are pathologies, and which are treatments?
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CL- chloride, a kidney excretion
CRF chronic renal failure
C&S culture and sensitivity testing
cysto cystoscopic examination
ESRD end-stage renal disease
HCO3- bicarbonate, an electrolyte conserved by the kidney
HD hemodialysis
IC interstitial cystitis, chronic inflammation of the bladder wall
Abbreviations (cont’d.)
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*
Which items are pathologies, and which are treatments?
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K+ __________________
KUB __________________
Na+ __________________
PD __________________
pH __________________
PKU __________________
sp gr __________________
UA __________________
UTI __________________
VCUG __________________
Abbreviations (cont’d.)
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*
Ask students to identify the category of metabolite, treatment, condition, or test.
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K+ potassium, an electrolyte
KUB kidney ureter and bladder
Na+ sodium, an electrolyte
PD peritoneal dialysis
pH symbol for degree of acidity or alkalinity
PKU phenylketonuria
sp gr specific gravity
UA urinalysis
UTI urinary tract infection
VCUG voiding cystourethrogram
Abbreviations (cont’d.)
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*
Ask students to identify the category of metabolite, treatment, condition, or test.
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QUICK QUIZ:
The abbreviation RP is associated with which of the following?
A. Fluid is injected into the peritoneal
cavity and then drained out
B. Contrast is injected into the urinary
bladder and ureters and x-rays are
taken of the urinary tract.
C. Nitrogenous wastes removed from
patient’s blood
D. An electrolyte secreted by renal tubules
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*
CORRECT Answer is B abbreviation is for retrograde pyelogram
Incorrect answer A. is CAPD, continous ambulatory periotoneal dialysis
Incorrect Answer C is HD, hemodialysis
Incorrect Answer D is K+ potassium
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REVIEW SHEET
albumino/o ____________
angi/o ____________
azot/o ____________
bacteri/o ____________
cali/o, calic/o ____________
cyst/o ____________
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*
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albumino/o albumin (protein)
angi/o vessel (blood)
azot/o urea; nitrogen
bacteri/o bacteria
cali/o, calic/o calyx (calix)
cyst/o urinary bladder
REVIEW SHEET
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*
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dips/o ____________
glomerul/o ____________
glycos/o ____________
hydr/o ____________
isch/o ____________
ket/o; keton/o ____________
REVIEW SHEET
combining forms
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*
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dips/o thirst
glomerul/o glomerulus
glycos/o sugar
hydr/o water
isch/o to hold back; back
ket/o; keton/o ketones; acetones
REVIEW SHEET
combining forms
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*
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lith/o ____________
meat/o ____________
necr/o ____________
nephr/o ____________
noct/o ____________
ogli/o ____________
REVIEW SHEET
combining forms
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*
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lith/o stone
meat/o meatus
necr/o death
nephr/o kidney
noct/o night
ogli/o scanty
REVIEW SHEET
combining forms
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*
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py/o __________
pyel/o __________
ren/o __________
trigon/o __________
ur/o __________
REVIEW SHEET
combining forms
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*
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py/o pus
pyel/o renal pelvis
ren/o kidney
trigon/o trigone
ur/o urine; urinary tract
REVIEW SHEET
combining forms
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*
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ureter/o ____________
urethro ____________
urin/o ____________
vesic/o ____________
REVIEW SHEET
combining forms
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*
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ureter/o ureter
urethr/o urethra
urin/o urine
vesic/o urinary bladder
REVIEW SHEET
combining forms
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*
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-ectasis ______________
-ectomy ______________
-emia ______________
-esis ______________
-gram ______________
-lithiasis ______________
REVIEW SHEET
SUFFIXES
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*
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-ectasis stretching; dilation
-ectomy removal; excision
-emia blood condition
-esis condition
-gram record
-lithiasis condition of stones
REVIEW SHEET
SUFFIXES
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*
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-lithotomy ____________________
-lysis ______________
-megaly ______________
-ole ______________
-osis ______________
-pathy ______________
REVIEW SHEET
SUFFIXES
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*
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-lithotomy incision for removal of a stone
-lysis breakdown
-megaly enlargement
-ole little; small
-osis condition
-pathy disease
REVIEW SHEET
SUFFIXES
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*
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-plasty _________________
-poietin _______________
-ptosis _______________
-rrhea _______________
-sclerosis _______________
-stomy ___________________
REVIEW SHEET
SUFFIXES
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*
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-plasty surgical repair
-poietin substance that forms
-ptosis droop; sag
-rrhea flow; discharge
-sclerosis hardening
-stomy new opening (to form a mouth)
REVIEW SHEET
SUFFIXES
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*
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-tomy _____________
-tripsy ___________
-uria ___________
REVIEW SHEET
SUFFIXES
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*
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-tomy process of cutting
-tripsy to crush
-uria urination
REVIEW SHEET
SUFFIXES
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*
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a-, an- _____________
anti- _____________
dia- _____________
dys- _____________
REVIEW SHEET
PREFIXES
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*
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a-, an- not; without
anti- again
dia- complete
dys- bad; painful
REVIEW SHEET
PREFIXES
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*
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en- __________
peri- __________
poly- __________
retro- __________
REVIEW SHEET
PREFIXES
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*
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en- in; within
peri- surrounding
poly- many, much
retro- behind; back
REVIEW SHEET
PREFIXES
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*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
The combining form dips/o means:
Stone
Scanty
Thirst
Water
QUICK QUIZ:
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*
C Thirst is the correct answer
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Which combining form means pus?
pyel/o
lith/o
ogli/o
py/o
QUICK QUIZ:
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*
D, py/o is the correct answer
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8. The combining form isch/o means:
Scanty
To hold back; back
Night
Trigon
QUICK QUIZ:
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*
B To hold back or back is the correct answer
Urinary System Case Study
To help us understand how the urinary system functions, let’s meet two patients—Vicky James and Owen Seagraves. Each is visiting general practitioner, Dr. Pandit, to express some concerns about symptoms that seem, in some ways, to be very similar, and yet, in other ways, seem to indicate different disorders altogether.
Vicky is a third-grade teacher and an avid hiker. Owen is an athletic director at a small college. These two patients have never met, although in the small tourist town in which they both live, they happen to share the same physician—Dr. Pandit.
Dr. Pandit’s nurse calls Vicky into an examination room first. Vicky says she has not been feeling well lately. She primarily complains of blood in the urine but is also concerned about swollen ankles and back pain. The nurse takes her blood pressure and asks Vicky for a urine sample.
Unlike Vicky, Owen says at first that he has “no urinary symptoms” that he can identify, but that, instead, he has been having what he refers to as “gas pains that are getting worse and worse—I mean, excruciating.” He says that these pains also give him nausea. In addition, he has the same leg swelling Vicky reports but also complains of a rash.
Only when asked about elimination does Owen think to mention a “slight decrease” in urine output but an increase in the number of times he has to get up in the middle of the night.
The similarity of some of Vicky and Owen’s symptoms intrigues the nurse who takes their histories. After the remainder of her intake interview with her patients, the nurse muses that they both have flank pain and leg swelling and both mention that they are exhausted. However, one has weight loss and blood in the urine, whereas the other has less urine overall.
During pre-examination interviews, the nurse discovered that both Vicky and Owen have high blood pressure today.
The nurse also records that Vicky has a fever. She is curious to see how the Dr. Pandit will approach each patient’s symptoms.
Owen is having minimal difficulties with urination, but he does have troublesome side pains. Dr. Pandit suspects—among other things—that a blockage could be in Owen’s urinary system, perhaps a stone. In fact, evidence of a stone in the ureters often begins as side pain that eventually shifts to the lower back.
After color analysis, the next test Vicky’s urine undergoes is a pH test, which is used to determine to what degree the urine is acidic or
alkaline
(basic). The abbreviation pH stands for potential hydrogen. Urine pH may become alkaline with a bladder infection because the bacterial breakdown of urea releases ammonia, which is very alkaline.
In addition, one of the earliest signs of renal involvement in diabetes mellitus is the presence of an abnormal amount of
albumin
, a major blood protein in urine, a condition called
albuminuria
(albumin/o = albumin; -uria = urine condition). A special, sensitive urinalysis test can aid in detecting albumin. The presence of too much
glucose
(glyc/o), or sugar, in the urine is called
glycosuria
and is an indication of
diabetes mellitus
.
A urinary tract infection (UTI) is usually classified as either an upper UTI or a lower UTI. Upper UTIs are in the kidneys and ureters, and lower UTIs affect the bladder and urethra. In Owen’s case, not only is an infection present, but Dr. Pandit is also beginning to suspect Owen’s bigger problem is acute
renal failure
—possibly caused by an obstruction.
Renal failure is what its name indicates. The kidneys (ren/o) fail to excrete urine because of impaired filtration function. A large number of conditions, including high blood pressure, infection, and diabetes can lead to renal failure, which may be
acute
or
chronic
. The severity of renal failure can vary. The final phase of the chronic version is end-stage renal disease or
chronic kidney disease (CKD)
, which can be fatal if not treated.
Owen’s particular inflammation occurs in the connective tissue that lies between the renal tubules, or the renal interstitium; this condition is called interstitial
nephritis
. In Owen’s case, this condition is a response to his recent administration of a penicillin medication for tonsillitis. The condition can also develop from the excessive use of aspirin and aspirin-type drugs. Signs and symptoms may include poor renal function, a fever and skin rash similar to the one shown in the illustration, and eosinophils in the blood and urine.
Dr. Pandit takes his patient off the offending drug to clear up the nephritis.
remember that Dr. Pandit suspects—among other possibilities—that Owen may have a urinary blockage. A blockage can be caused by long-term medication use or long-term use of an indwelling urinary catheter, which can produce scarring and thus cause a fibrotic narrowing of the urethra, called
urethral stricture
. The patient experiences diminished force,
dysuria
(painful urination),
polyuria
(urinary frequency), and hesitation.
Owen’s next test is scheduled, but before the day arrives, the pain in his side returns and is worse than ever. The pain is also now occurring in his back. Owen calls Dr. Pandit’s office to tell him that the pain is so bad he is sweating profusely and vomiting. Dr. Pandit tells Owen to get to the emergency department right away.
From these symptoms, Dr. Pandit quickly moves to confirm his earlier suspicion and takes action. Owen, indeed, has
nephrolithiasis
—that is, the condition (-iasis) of having kidney (nephr/o) stones (lith/o), or renal calculi.
Let’s return to our patient, Vicky.
Blood in the urine, along with symptoms such as pain in her back, swelling, high blood pressure, and fatigue, all suggest some sort of
nephropathy
, that is, a kidney disorder. Yet Vicky does not have a urinary tract infection, nor does she show evidence of having a kidney stone.
At one point, Dr. Pandit thought that the pain and a feeling of a lump in Vicky’s side might mean a
nephroptosis
—that is, a dropping or displacing (-ptosis) of the kidney (nephr/o) because of weak support. Her other symptoms, however, do not support that diagnosis.
Blood in the urine, pain, and/or a lump in the back (or side), along with leg and ankle edema, can all signal a number of disorders, of course; however, one of the more serious is
renal cell carcinoma
, or a cancerous tumor of the kidney (also called hypernephroma). In Vicky’s case, diagnostic sonography revealed renal cell carcinoma.
Being physically fit helps Owen make a quick recovery from the lithotripsy procedure. However, treatment is still far from over. Now that the primary cause—
nephrolithiasis
—has been treated, Owen, “happy and stone free,” can now be treated for secondary
acute renal failure
, a complication of his kidney stones. This treatment consists of the administration of the hormone
erythropoietin
to stimulate the production of red (erythr/o) blood cells (-poietin = substance that forms).
Now that his kidney stones have been treated, Owen’s treatment can focus on preventing the buildup of toxins by restricting his fluid intake, along with other dietary modifications. Owen is also given
antibiotics
and
diuretics
. The next focus is on bringing a potentially dangerous
hyperkalemia
(increased blood potassium) under control (Kal/i = potassium). Owen is intravenously (IV) administered calcium, glucose insulin, and oral potassium exchange resin. Finally, his blood pressure is brought back under control.
Soon Owen is back at work. Along with his regular exercise routine, he watches his sodium intake and has regained all of his former energy.
Six months later, life is looking much better for both Vicky and Owen. Both appear to be in good health after potentially life-threatening disorders. Vicky, of course, will continue to receive blood tests to check for kidney function at 3- or 4-month intervals for several years. Chest x-ray images, CT scans of the abdomen and chest, and other imaging tests will help monitor for any recurrence of the cancer.
When they both left Dr. Pandit’s office after follow-up visits, the nurse remarks, “Those two amaze me. Just think, not so many decades ago, recovery would have been a lot more difficult for both of them.”
Dr. Pandit nods, “And maybe out of reach.”
