PowerPoint to accompany

Medical Language
for Modern
Health Care, 3e
Allan, Lockyer

Chapter 6:
Urinary System

© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any
manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
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Urinary System

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Lesson 6.1: Urinary System,

Kidneys, and Ureters

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Urinary System

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Word Analysis and Definition

• Identify and define the suffix of each term:
– nitrogenous -ous pertaining to
– renal -al pertaining to
– urinary -ary pertaining to
• Identify and define the root of each term:
– nephrectomy nephr/o- kidney
– renal ren- kidney

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Word Analysis and Definition

• Compare the following specialties:
– Nephrologist

– Medical specialist in diseases of the kidney.

– Urologist

– Medical specialist in disorders of the urinary system.

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Anatomy and Physiology of the Kidneys

Each kidney is a bean-shaped organ located on either side of the vertebral column
behind the peritoneum and lies against the deep muscles of the back. The left kidney is
behind the spleen, and the right kidney behind and below the liver. Waste-laden blood
enters the kidney at its hilum through the renal artery. Excess water, urea, and other
waste products are filtered from the blood by the kidney, collected in the ureter, and
carried off to the bladder through the renal pelvis at the hilum.
Each kidney has three regions:
An outer renal cortex —contains about 1 million nephrons, the basic filtration unit of
the kidney.
An inner renal medulla —containing the collecting ducts, which merge together to
form about
30 papillary ducts, that enter into a calyx.
A central renal pelvis —a funnel-shaped structure into which the calyces open, and
which forms the ureter.

•Location

•Structure

•Function
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Anatomy and Physiology of the

Kidneys
• Nephron

– Filtrate

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Anatomy and Physiology of the

Kidneys

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Word Analysis and Definition

• Change the following terms into the plural form
and define them:
– calyx calyces
Funnel-shaped structure
– cortex cortices
Outer portion of an organ
– glomerulus glomeruli
Plexus of capillaries; part of a nephron
– hilum hila
The part where the nerves and blood vessels enter and leave an organ

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Abbreviations
• Define the following abbreviations:
EMT-P emergency medical technician–paramedic
ESWL extracorporeal shock wave lithotripsy
IV intravenous
IVP intravenous pyelogram
KUB X-ray of abdomen to show kidneys, ureters, and bladder
TNM tumor, node, metastasis (tumor staging method)
VS vital signs

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Ureters

• Structure

• Function

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Keynote
“The muscle wall of the bladder acts as a
sphincter around the ureters to prevent
reflux of urine.”

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Renal Calculi
• Commonly known as kidney stones

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Word Analysis and Definition

• Identify the combining form and suffix of the following
terms and define them:

lithotripsy -tripsy to crush lith/o- stone

nephroscopy nephr/o- kidney -scopy to view, examine

ureteroscopy ureter/o- ureter -scopy to view, examine

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Disorders of the Kidneys

• Renal Cell Carcinoma is the most common form of kidney cancer and

occurs twice as often in men as in women.

• Wilms Tumor or nephroblastoma, is a malignant kidney tumor of

childhood.

• Benign Kidney Tumors such as renal adenoma, are usually asymptomatic

and are discovered incidentally.

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Disorders of the Kidneys (cont.)

• Hematuria or blood in the urine, can be caused by lesions anywhere in the

urinary system; trauma, infections, medications and congenital diseases.

• Acute Glomerulonephritis is an inflammation of the glomerulus.

• Chronic Glomerulonephritis can occur with no history of kidney disease and

present as kidney failure.

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Keynote

“Hematuria can be caused by a lesion

anywhere in the urinary system.”

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Disorders of the Kidneys (cont.)

• Nephrotic Syndrome involves large amounts of protein leaking out

into the urine so that the level of protein in the blood falls.

• Interstitial Nephritis is an inflammation of the spaces between the

renal tubules. Most often it is acute and temporary.

• Pyelonephritis is an infection of the renal pelvis. Most often it occurs

as part of a total urinary tract infection (UTI), commencing in the

urinary bladder.

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Word Analysis and Definition

• Analyze each term into elements and define the
term:
dialysis -lysis to separate dia- complete
An artificial method of filtration to remove
excess waste materials and water from the body
diuresis di- complete (from dia) -ur- urinary system
-esis abnormal condition
Excretion of large volumes of urine

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Disorders of the Kidneys (cont.)

• Primary Hypertension with its high blood pressure, can damage the
renal arterioles and glomeruli, causing them to thicken and narrow.

• Polycystic Kidney Disease is an inherited disease. Large, fluid-filled

cysts grow within the kidneys and press against the kidney tissue.

• Acute Renal Failure makes the kidneys suddenly stop filtering waste
products from the blood.

• Chronic Renal Failure is a gradual loss of renal function.

• End-Stage Renal Disease means the kidneys are functioning at less

than 10% of their normal capacity. At this point, life cannot be
sustained, and either dialysis or kidney transplant is needed.

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Disorders of the Kidneys (cont.)

• State the meaning of the following terms:
– anuria: absence of urine production

– azotemia: excess nitrogenous waste products in the blood

– hematuria: blood in the urine

– oliguria: scanty production of urine

– proteinuria: presence of protein in urine

– uremia: the complex of symptoms arising from renal failure

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Disorders of the Kidneys (cont.)

• Dialysis is an artificial method of removing waste materials and
excess fluid from the blood. It is not a cure but can prolong life.
There are several types of kidney dialysis:

• Hemodialysis filters the blood through an artificial kidney machine

( dialyzer ) .
• Peritoneal dialysis uses a dialysis solution that is infused into and
drained out of your abdominal cavity through a small, flexible,
implanted catheter.
• Continuous ambulatory peritoneal dialysis is performed by the
patient at home through an implanted abdominal catheter.
• Continuous cycling peritoneal dialysis uses a machine to
automatically infuse dialysis solution into and out of the abdominal
cavity during sleep.

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Abbreviations
• Define the following abbreviations:

ARF acute renal failure

CAPD continuous ambulatory peritoneal dialysis
CKD chronic kidney disease; also known
as chronic renal failure
CRF chronic renal failure; also known as chronic
kidney disease
ESRD end-stage renal disease
PKD polycystic kidney disease

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Lesson 6.2: Urinary Bladder

and Urethra

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Urinary Bladder and Urethra

The final passageway for the urine to escape to the outside is the urethra, a thin-walled tube that
takes urine from the floor of the bladder to the outside. At the base of the bladder, the
muscular wall is thickened to form the internal urethral sphincter. As the urethra passes
through the skeletal muscles of the pelvic floor, the external urethral sphincter provides
voluntary control of micturition. In the female the urethra is only about 1.5 inches long, and it
opens to the outside anterior to the vagina. In the male, the urethra is 7 to 8 inches in length
and passes through the penis. In both the male and the female, the opening of the urethra to
the outside is called the external urinary meatus.

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Word Analysis and Definition

• State the meaning of the following terms:
– diuresis excretion of large volumes of urine
– enuresis bed-wetting; urinary incontinence
– micturition act of passing urine
– urination the act of passing urine
– void to evacuate urine or feces

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Disorders of the Urinary Bladder and Urethra

• Urinary Tract Infection occurs when bacteria invade and multiply in the urinary
tract.
• Urinary Incontinence is loss of control of your bladder is called urinary
incontinence. The result is wet clothes. There are four types of urinary incontinence:
• Stress incontinence. Urine leaks because of sudden pressure on the lower stomach
muscles when you cough, laugh, sneeze, lift something heavy, or exercise.
Urge incontinence. The need to urinate comes on too fast for you to get to the
toilet.
Overflow incontinence. Small amounts of urine leak from a bladder that is
always full because you cannot empty it.
Functional incontinence. You cannot get to the toilet in time because of
arthritis or any other disease that makes moving quickly difficult.

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Keynote
“Ten million doctor visits each year are for
UTIs.”

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Disorders of the Urinary Bladder

and Urethra (cont.)
• Urinary Retention is the abnormal, involuntary holding of urine in the bladder.
• Bladder Cancer A primary symptom of bladder cancer is hematuria. Bladder cancer
is diagnosed by:

• Urinalysis to detect microscopic hematuria.

• NMP22 ® BladderChek ® , which detects elevated levels of a specific protein in the
urine even in the early stages of cancer.
• Imaging tests, such as IVP, CT scan, MRI scan, and ultrasound.
• Cystoscopy with biopsy, which is the definitive test.

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Abbreviations
• Define each of the following abbreviations:

– GI gastrointestinal
– E. coli Escherichia coli

– UTI urinary tract infection

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Word Analysis and Definition

• State the meaning of the following terms:
– dysuria difficulty or pain with urination

– frequency the number of times something happens

in a given time

– incontinence Inability to prevent discharge of urine or feces

– retention A holding in of what should normally be discharged

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Diagnostic Procedures
• Urinalysis
– Routine in the laboratory can include the following tests:

Visual observation examines color and clarity.

Odor of normal urine has a slight “nutty” scent. Infected urine has a foul odor.
pH measures how acidic or alkaline urine is. Specific gravity (SG) measures how
dilute or concentrated the urine is.
Protein is not detected normally in urine. Its presence (proteinuria) indicates
infection or urinary tract disease.
Glucose in the urine (glycosuria) is a spillover into the urine when the nephrons are
damaged or diseased or blood sugar is high in uncontrolled diabetes.
Ketones are present in the urine in diabetic ketoacidosis or in starvation.
Leukocyte esterase indicates the presence of white blood cells (WBCs) in the urine,
which in turn can indicate a UTI.
Urine culture from a clean-catch specimen is the definitive test for a UTI.
• Microscopic: Microscopic urinalysis is performed on the solids deposited by centrifuging a
specimen of urine. It can reveal Red blood cells (RBCs), WBCs, renal tubular epithelial cells
stuck together to form casts, WBCs stuck together to form bacteria.

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Abbreviations
• Define each of the following abbreviations:
– RBC Red Blood Cells

– SG Specific gravity (SG) measures how dilute or

concentrated the urine is.

– UA Routine urinalysis (UA) is done in the laboratory

and can include some tests.

– WBC White Blood Cells

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Diagnostic Procedures (cont.)

• Methods of Collecting Urine:
• random is taken with no precautions regarding contamination.
• first morning is used to determine the ability of the kidneys to concentrate urine
following overnight dehydration.
• clean-catch midstream is collected after the external urethral meatus is
cleaned.
• twenty-four hour is used to determine the amount of protein being excreted and
to estimate the kidneys’ filtration ability.
• suprapubic transabdominal needle aspiration of the bladder is used in
newborns and small infants to obtain a pure sample of urine.
• Catheterization can be used as a last resort to obtain a urine specimen. A soft
plastic or rubber tube (catheter) is inserted through the urethra into the bladder to
drain and collect urine .

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Diagnostic Procedures
• An X-ray of the Urinary Tract shows the kidneys, ureters, and bladder
• Intravenous Pyelogram. A contrast material containing iodine is injected
intravenously, and its progress through the urinary tract is then recorded on a series
of rapid x-ray images.
• Retrograde Pyelogram. Contrast material is injected through a urinary catheter
into the ureters to locate stones and other obstructions.
• Voiding Cystourethrogram. Contrast material is inserted into the bladder
through a catheter and x-rays are taken as the patient voids.

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Diagnostic Procedures
• Computed Tomography. X-ray images show cross-sectional views of the
kidneys and bladder.
• Magnetic Resonance Imaging. Magnetic fields are used to generate cross-
sectional images of the urinary tract.
• Ultrasound. High-frequency sound waves and a computer generate noninvasive
images of kidneys.

• Renal Angiogram X-rays with contrast material are used to assess blood flow to
the kidneys.
• Cystoscopy. A pencil-thin, flexible, tubelike optical instrument is inserted
through the urethra into the bladder to examine directly the lining of the bladder
and to take a biopsy if needed.

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Abbreviations
• Define each of the following abbreviations:
– CT computed tomography

– IVP intravenous pyelogram

– KUB x-ray of abdomen to show kidneys,

ureters, and bladder

– MRI magnetic resonance imaging

– VCUG voiding cystourethrogram

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Word Analysis and Definition

• State the meaning of each term. What do they have in
common?
– cast a cylindrical mold formed by materials in kidney tubules
– glycosuria presence of glucose in urine
– ketone chemical formed in uncontrolled diabetes or in starvation
– nitrite chemical formed in urine by Escherichia coli (E.Coli) and
other microorganisms

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Chapter 6 Summary
• Urinary System
– Kidneys

– Ureters

– Urinary Bladder

– Urethra

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