Chapter 9 presentation
- 1. Chapter 9 The Urinary System Sheila Reyes Bio 120
- 2. The Urinary System is consists of: Two kidneys Two tubes called ureters A sac called the urinary bladder And another tube called the urethra Fig. 1A. Front View of Urinary Tract
- 3. Functions of Urinary System: Maintains homeostasis of extracellular fluid by filtering out electrolytes and waste products. These organs control the amount of water and salts that are absorbed back into the blood and what is taken out as waste. This system also acts as a filtering mechanism for the blood.
- 4. Kidneys Filters the blood. Bean-shaped, fist sized organs lying on each side of the lumbar vertebrae. Located behind the peritoneal membrane. Fig. 1B. Diagram of a kidney
- 5. Ureters Are long, narrow tubes connecting the kidney to the bladder. Urine is removed along each ureter by peristalsis, the same type of muscle contraction that moves food through the digestive tract. Empty into the urinary bladder.
- 6. Urinary Bladder where urine is stored to be released from the body. It can hold between one half to two cups of urine before it needs to be emptied. Everyday about two to five cups of urine pass through the bladder. Fig. 1C. Urinary Bladder
- 7. Urethra Tube that carries urine out of the body from the urinary bladder. Urethral meatus is the external opening of the urethra. In females, the urethra is 1.6 inches long. In males, the urethra is 7.9 inches long.
- 8. Urine Culture a test to find and identify germs (usually bacteria) that may be causing a urinary tract infection (UTI). Urine in the bladder normally is sterile-it does not contain any bacteria or other organisms (such as fungi). But bacteria can enter the urethra and cause an infection. Fig 2A. Urine culture in a specimen cup
- 9. A urine culture may be done to: Find the cause of a urinary tract infection (UTI). Make decisions about the best treatment for a UTI. This is called sensitivity testing. Find out whether treatment for a UTI worked.
- 10. Results: Normal: No bacteria or other organisms (such as fungi) grow in the culture. The culture result is negative . Abnormal: Organisms (usually bacteria) grow in the culture. The culture result is positive . A count of 100,000 or more bacteria per ml of urine may be caused by an infection. A count ranging from 100 to 100,000 could be either caused by infection or by contamination of the sample (you may need a repeat urine culture). If the count is 100 or less, infection is unlikely; however, a count of 100 or less may also be seen if you are already taking antibiotics.
- 11. Urinary Tract Infection (UTI) A urinary tract infection (UTI) is an infection involving the kidneys, ureters, bladder, or urethra. These are the structures that urine passes through before being eliminated from the body. Simple infections occur in healthy urinary tracts and do not spread to other parts of the body. They usually go away readily with treatment. Complicated infections are caused by anatomic abnormalities, spread to other parts of the body, are worsened by underlying medical conditions, or are resistant to many antibiotics. They are more difficult to cure.
- 12. Causes of UTI: At least 90% of uncomplicated infections is a type of bacteria called Escherichia coli better know as E. coli . These bacteria normally live in the bowel (colon) and around the anus. Conditions that block (obstruct) the urinary tract, such as kidney stones. Incomplete bladder emptying (for example, spinal cord injury or bladder decompensation after menopause). Women who are sexually active: Sexual intercourse can introduce larger numbers of bacteria into the bladder. Infection is more likely in women who have frequent intercourse. Infection attributed to frequent intercourse is nicknamed "honeymoon cystitis." Urinating after intercourse seems to decrease the likelihood of developing a urinary tract infection. Young children: Young children have trouble wiping themselves and washing their hands well after a bowel movement. Poor hygiene has been linked to an increased frequency of urinary tract infections. Hospitalized patients or nursing home residents: Many of these individuals are catheterized for long periods and are thus vulnerable to infection of the urinary tract.
- 13. Symptoms: Dysuria: pain or burning during urination Frequency: more frequent urination (or waking up at night to urinate); often with only a small amount of urine Urgency: the sensation of not being able to hold urine Hesitancy: the sensation of not being able to urinate easily or completely (or feeling that you have to urinate but only a few drops of urine come out) Cloudy, bad-smelling, or bloody urine Lower abdominal pain Mild fever (less than 101 F), chills, and "just not feeling well" (malaise)
- 14. Treatment Drink plenty of water. Avoid coffee, alcohol, and spicy foods, all of which irritate the bladder. Quit smoking. Smoking irritates the bladder and is known to cause bladder cancer. Take a pain-relieving medication. Use a hot-water bottle to ease pain. Finish all antibiotic medication even if you are feeling better before the medication is gone. Follow your health-care provider's treatment recommendations. Fig 3A. Urine test for UTI
- 15. Chronic Renal Failure Can become irreversible renal failure. Waste products are not filtered resulting in uremia and death. is a worldwide public health problem and is now recognized as a common condition that is associated with an increased risk of cardiovascular disease and chronic renal failure Fig 4A. A patient undergoing hemodialysis
- 16. Stages of CRF According to K/DOQI guidelines: Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2) Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m2) Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m2) Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m2) Stage 5: Kidney failure (GFR <15 mL/min/1.73 m2 or dialysis)
- 17. Causes of CRF: Vascular disease - Renal artery stenosis, atheroemboli, hypertensive nephrosclerosis, renal vein thrombosis Primary glomerular disease - Membranous nephropathy, immunoglobulin A (IgA) nephropathy, focal and segmental glomerulosclerosis (FSGS) Secondary glomerular disease - Diabetes mellitus, systemic lupus erythematosus, rheumatoid arthritis, mixed connective tissue disease, scleroderma, Goodpasture syndrome, Wegener granulomatosis, mixed cryoglobulinemia, postinfectious glomerulonephritis, endocarditis, hepatitis B and C, syphilis, human immunodeficiency virus (HIV), parasitic infection Tubulointerstitial disease - Drugs (eg, sulfa, allopurinol), infection (viral, bacterial, parasitic), Sjögren syndrome, chronic hypokalemia, chronic hypercalcemia, sarcoidosis Urinary tract obstruction - Urolithiasis, benign prostatic hypertrophy, tumors, retroperitoneal fibrosis, urethral stricture, neurogenic bladder
- 18. Treatment: Controlling blood pressure is the key to delaying further kidney damage. Do not smoke. Eat meals that are low in fat and cholesterol Get regular exercise (talk to your doctor or nurse before starting). Take drugs to lower your cholesterol, if necessary. Keep your blood sugar under control. Special medicines called phosphate binders, to help prevent phosphorous levels from becoming too high Treatment for anemia, such as extra iron in the diet, iron pills, special shots of a medicine called erythropoietin, and blood transfusions Extra calcium and vitamin D (always talk to your doctor before takin
- 19. Cystoscopy the use of a scope (cystoscope) to examine the bladder. This is done either to look at the bladder for abnormalities or to help with surgery being performed on the inside of the urinary tract (transurethral surgery). Fig 5A. Use of Cytoscope to examine the bladder
- 20. Risks: Generally a safe procedure. Serious complications are rare. There is the risk of infection, bleeding, and complications from the anesthesia. Antibiotics are used before the surgery to reduce the incidence of urinary tract infection. Bleeding is generally controlled during the procedure with the use of cautery. Risk of perforation or a tear. Creates scar tissue. Men can sometimes experience pain and swelling in the testicles after an extensive procedure. This is called epididymitis. Urinary retention (inability to urinate) can occur after cystoscopy.
- 21. Recovery: Most people undergoing cystoscopy will be able to go home the same day as the procedure. Recovery depends on the type of anesthesia. If only local anesthetic is used, you can go home immediately. For other people, a recovery period of 1-4 hours is necessary. During this observation period, the anesthetic will wear off, and you will need to be able to urinate prior to leaving.
- 22. References: Webmd.com Emedinehealth.com Essentials of Medical Terminology 3 rd Ed. ( Juanita Davies)