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CHAPTER 20: GU
| Question | Answer |
|---|---|
| KUB stands for | kidneys, ureters, bladder |
| BUN stands for | blood urea nitrogen |
| The MIBG study is a specific exam to detect and locate a tumor called? | pheochromocytoma |
| Detection of microscopic hematuria or Bence-Jones protein | UA |
| Contrast medium is filtered through the nephron | IVU |
| Cystoscopy injection of contrast media | Retrograde urogram |
| Useful in post op malignancy monitoring | PSA |
| Which fluids can be used with electrosurgery during a cystoscopy? | Sorbitol and glycine |
| What solution is used for kidney transplant? | Collins solution |
| What is needed to help with renal cooling? | Sterile ice slushed, sheet of sterile plastic, cooled Collins solution or Lahey intestinal bag |
| When a kidney is taken for transplant, why is renal cooling used? | To preserve renal function |
| Oblique lower abdominal incision used for cryptorchidism, orchiopexy, or radical orchiectomy | Inguinal incision |
| Transverse incision through the dartos muscle, tunica vaginalis to enter for hydrocelectomy | Scrotal incision |
| Used to expose the retropubic space for an MK or open prostatectomy | Pfannenstiel or low transverse incision |
| Used to access lower ureter and implant a donor kidney | Gibson incision |
| Used for adrenalectomy or a small low-lying kidney; incision below 12th rib to tip of rib ; can be prone for bilateral access | Lumbar incision |
| Used for pediatric donor kidney, radical nephrectomy and radical cystectomy | Midline abdominal incision |
| Incision 11th and 12th ribs w/ placement of a rib spreader | Intercostal incision |
| Used to expose the entire kidney or a high-lying kidney, removes the 11th or 12th rib | Transcostal incision |
| Most common pediatric tumor that is detected usually between 3-8 years of age? | Wilm's tumor |
| Where is the kidney located in the ventral cavity? | Retroperitoneal space in the lower thoracic and upper lumbar area |
| Which kidney is located higher in the abdomen and larger? | Left kidney |
| What kind of incisions can be used for a nephrectomy? | Flank or lumbar incision |
| What is the most common cause of kidney cancer? | Adenocarcinoma of the renal cells or renal cell carcinoma |
| What is the name of fascia that encapsulates the kidney and the adrenal gland? | Gerota's fascia |
| What should be done when irrigation is used? | Body temperature irrigation and keep track amount used |
| What medications will be given to the donor patient after the kidney is removed and why? | Protamine sulfate to reverse heparinization; Lasix and mannitol with IV fluids to promote urinary output |
| When major organs are harvested from a cadaver donor, why are the kidneys harvested last? | To preserve circulation as long as possible |
| Where is a donor kidney attached for an adult recipient? | In the right pelvis |
| Where is the donor kidney attached for a pediatric patient? | Midretroperitoneum posterior to colon |
| What are the determining factors regarding which type of incision will be used? | Partial or radical |
| Dual incisions will be made during the procedure to remove the wilms tumor, why? | To rule out a second tumor |
| What structures will have to be dissected free to excise the tumor? | The colon and mesentery |
| If you are performing a partial nephrectomy, what is used to control renal blood flow? | Vessel loop, small bulldog and renal cooling |
| For a laproscopic nephrectomy, what additional procedure will be accomplished prior to the start of the nephrectomy? | An ureterroscopy for the placement of a ureteral catheter and renal balloon catheter along with a 16f foley |
| What additional procedure may be necessary after the nephrectomy incisions are closed either intentionally or accidentally? | Chest tube |
| What diseases commonly require a kidney transplant for the patient to survive? | Polycystic kidney disease, diabetic nephropathy, end stage renal disease |
| How is the donor kidney protected from injury when being handled during the procedure? | Placed in a stockinette that has been soaked in electrolyte saline scrub solution or lactated ringers ice saline |
| What should be done jus prior to final stitch placement for each anastomosis? | ST should remind surgeon to irrigate the vessels with heparin sodium using a 10mL syringe and catheter |
| What is a pyelolithotomy? | Excision of a calculus from the renal pelvis |
| What can you anticipate will be inserted at the end of the pyelolithotomy procedure? | A closed wound drainage system is placed with the tube laterally exteriorized |
| Why is cystoscopy an incomplete term today? | It is a limited term than means to view the bladder but does not begin to identify all of the procedures than can be performed endoscopically |
| will the ST be scrubbed in for cystoscopy? | no, the procedure is a clean procedure |
| What is the STs main role during the cystoscopy procedure | To set up the equipment prior to the procedure & ensure adequate fluids are available for suction & irrigation |
| what is the wound classification for cystoscopy procedures? Why? | Wound classification of II: clean contaminated due to contact with mucus membranes |
| What can you expect to insert at the end of any ureteroscopy procedure such as a stone removal? why? | A J-stent is placed to maintain patency and prevent suture formation due to the postop edema or trauma with resultant scar tissue formation that can occur due to the stone removal or procedure |
| what is an important clinical landmark of the bladder? | The trigone |
| The bladder muscle is the __________ and the vascular supply arises from the internal iliac artery to the superior and inferior __________ arteries | Detrustor, vesical |
| how is a retrograde ureterogram (formerly called a RPG) completed? | used to image the integrity of the urethra; essential for diagnosis of urethral injury or urethral stricture. |
| What irrigation fluid will be used for a TURBT? | Sterile water |
| Which catheters can be used for a suprapubic cystostomy? | Malecot or Pezzer |
| Name to two portions of the adrenal gland | Cortex and Medulla |
| Cortex function: | secretes steroid type hormones essential to the control of fluid and balance |
| Medulla function: | Secretes epinephrine and norepinephrine |
| Peristalsis conducts urine from the kidney to the bladder. Why does the ureter run obliquely through the bladder wall? | Allows bladder to prevent reflux through muscular contraction upon the ureter |
| What are the anatomic boundaries of the trigone of the bladder? | 2 uretic orifices and internal urethral orifice |
| Name the three cavernous structures of the penis | corpus cavernosum right dorsal corpus cavernosum left dorsal corpus spongiosum |
| Function of detrusor muscle | Emptying the bladder and closing the bladder orifice |
| What are the functional units of the kidney? | Nephrons |
| How many nephrons are located within each kidney? | 1 million |
| The normal urine output over a 24-hour period is __________ to __________ mL | 1200 to 1500 |
| A hormone produced & released by the kidney that stimulates the production of red blood cells by the bone marrow | Erythropoietin |
| hormone secreted by the kidney; raises BP by influencing vasoconstriction | Renin |
| Detection of microscopic hematuria or Bence-Jones protein | UA |
| Contrast medium is filtered through the nephron | IVU |
| Cystoscopy injection of contrast media | retrograde urogram |
| useful in postop malignancy monitoring | PSA |
| When we anastomosis renal vessels, what should we have available? | #11 blade and Potts scissors |
| What kind of suture are we going to use on the vessels in the anastomosis? | Fine, non absorbable, double armed |
| What position is a cystoscopy and uretroscopy? | Low lithotomy |
| Where does calculi originate from? | Kidneys |
| What device will be used to get the stone fragments out? | Basket stone forcep |
| What is responsible for emptying the bladder and closing the bladder orfice? | Detrusor muscle |
| When injecting the lidocaine jelly how do we keep it from coming out? | Flexible penile clamp |
| Elevated PSA serum prompts for what additional test | Prostate biopsy |
| What light is used for endoscopic equipment illumination ? | Fiber optic |
| What is the name of dilators or sounds? | Van Buren |
| What do we use to resect the prostate gland? | Loop electrode |
| If a patient has testicular cancer, torsion or trauma, what procedure will we perform? | Orchiectomy |
| A common diagnosis of a patient undergoing a TURPT | BPH (benign prostatic hypertrophy) |
| What is the term for the inability to retract the foreskin? | Phimosis |
| Which dilating instrument is used for penile prosthesis? | Hagar dialator |
| True or False: Many hospitals only allow you to wear sterile gloves to set up a cystoscopy | True |
| True or False: Surgical Techs are not required to be knowledgeable in endoscope | False |
| True or False: Every instrument placed in uretha should be lubricated | True |
| What are the two types of dialysis? | Hemodialysis and Peritoneal dialysis |
| The medial border of the kidneys that receives the renal blood vessels is called the | hilum |
| Which outer portion of the kidney contains the glomeruli? | Cortex |
| Which structures unite to form the renal pelvis? | Major calyces |
| Which artery provides the blood supply to the kidney? | Renal |
| Which important clinical landmark is marked by ureteral and urethral orfices? | Trigone |
| Which artery provides blood supply to the bladder | Vesical |
| Which disorder is marked by multiple fluid filled, benign cysts in the parenchyma of the kidney? | Polycystic kidney disease |
| Which congenital condition is marked by the absence of the anterior wall of the urethra? | Epispadias |
| Which blood test can indicate the possibility of prostate cancer? | PSA |
| Which diagnostic tool involves the use of intravenous dye and radiological films to view the urological system? | IVU |
| What surgical instrument is used to remove tissue fragments from within the bladder during a transurethral resection of the prostate (TURP) | Ellik evacuator |
| A white blood cell count over what usually indicates infection | 10,000 |
| For kidney harvesting from a live donor, the surgeon would prefer to harvest the __________kidney because the renal vein is longer | LEFTWhich of the following is NOT a symptom of Cushing's syndrome? |
| The open surgical procedure used to treat stress incontinence in females is the? | MMK (Marshall-Marchetti-Krantz) |
| A radical cystectomy with ileal conduit is performed on patients who have been diagnosed with malignancy of the bladder. The ureters will be diverted to the? | Ileum |
| For implantation of a donor kidney the surgeon would make an incision that gives access to the lower portion of the ureter. This would be the ______Incision. | Gibson |
| Which of the following is NOT a symptom of Cushing's syndrome? | Tachycardia |
| Pheochromocytoma is a tumor affecting the ___. | Adrenal medulla |
| Addison's disease affects the ___. | Adrenal glands |
| True or False: PBH is a malignant cancer | False |
| True or False: Lithotripsy is used to remove the prostate | False |
| True or False: The position for a MMK is supine | True |
| The two corpora cavernosa are positioned on what side? | Dorsal |
| True or False: Testicular cancer is usually found in those over 45 years old | False 20-40 |
| The adrenal glands have both a cortex and medulla | True |
| This is the last part of the kidney before it turns into the ureter. | Renal pelvis |
| The nerve supply to the suprarenal glands is from the: | Celiac plexus |
| Which of the following is an overproduction of cortisol by the cortex of the suprarenal glands? | Cushing's syndrome |
| This is the area where the nerves and blood supply enter the kidneys. | Hilum |
| Bladder tumors usually present with: | Hematuria |
| The cortex of the adrenal gland secretes | steroid-type hormones |
Created by:
Vpoehlein