introduction urinary system.ppt

Introduction to the Urinary System

VOCN42BApr, 2012

Urinary Tract

• Upper, lower tract• Location and span• Blood supply

Question

Is the following statement true or false?

The urethra are the hollow tubes that extend from the kidneys to the bladder.

Answer

False.

The ureters are the hollow tubes that extend from the kidneys to the bladder, which drain urine. In males, they measure approximately 24 cm, in females, approximately 4 cm.

Urinary Tract

• Internal renal structure

• The urethrovesical unit

• Process of urine formation

Renal Structures: Parenchyma

• Cortex (Outer Layer) Structures– Nephrons: Microscopic; Approximately 1 million• Smallest functioning renal structure

– Glomerulus; Afferent arteriole; Efferent arteriole; Bowman’s capsule; Distal and proximal convoluted tubules; Loop of Henle; Collecting tubule

• Medulla (Inner Layer) Structures– Calyces (pyramids); Renal pelvis; Ureter

Renal Nephron

<Insert Figure 57-3>

Question


The nephron is the smallest functioning renal structure.

Answer

True.

The nephron is the smallest functioning renal structure. While being microscopic in size, there are approximately 1 million nephrons per kidney.

Urethrovesical Unit

• Pelvic Floor Muscles: Form sling, which supports bladder, urethra, rectum, various reproductive organs

• Urinary Bladder: Hollow, muscular organ; Shape, size dependent on client age, amount of urine contained (usu. 300 – 500 ml)

• Urethra: Hollow tube; Begins at bladder neck, ends at external meatus– Length: Male ≈ 24 cm; Female ≈ 4 cm

Urine

• Formation: Three steps– Glomerular filtration; Tubular reabsorption; Tubular

secretion• Elimination: Renal pelvis through ureter into bladder– Peristaltic action– Nerve reflex triggered ≈ 150ml urine– Bladder muscle contracts; Sphincter muscles relax

Assessment• History• Physical Examination • Diagnostic Tests– Radiography• KUB; X-ray

– Ultrasonography– CT; MRI– Angiography– Cytoscopy

Cytoscopy

• Visualization of the bladder’s internal structures

Pyelograms

• Intravenous Pyelogram (IVP): Radiologic study to evaluate structure, function of KUB– Using radiographs

• Retrograde Pyelogram: Visualization of complete ureter, renal pelvis needed– Performed during cystoscopy– Carries risk of sepsis, severe UTI

• Nursing Management

Question


Performing an IVP carries the risk of sepsis or introducing microbes which could cause an urinary tract infection.

Answer

False.

Performing an IVP involves introducing IV contrast and producing radiographs. A retrograde pyelogram is performed during an cystoscopy and carries the risk of sepsis or introducing microbes which could cause an urinary tract infection.

Biopsy

• Purpose– Diagnose cancer; Assesses prostatic enlargement– Monitor progression of renal disease – Evaluates treatment of renal transplant rejection • Risk of postprocedure bleeding


Diagnostic Tests

• Cystogram: Evaluates bladder structure abnormalities, filling

• Voiding Cystourethrogram: Rapid series of x-rays while voiding– Contraindicated in UTI

• Urodynamic Studies: Evaluate bladder, renal function; Assess cause of reduced urinary flow, urinary retention or incontinence– Uroflowmetry; Cystometrogram


Laboratory Tests

• Urinalysis: Study of urine components, characteristics; Monitors efficacy of treatment of known urinary, renal conditions – Urine culture and sensitivity (C & S)– 24-hour urine collection; Urine protein– Urine specific gravity; Urine osmolality– Blood urea nitrogen (BUN); Creatinine clearance• Measure of renal function
