Urinary System Vocabulary-part 2
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| URINALYSIS |
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| Urinalysis | an examination of urine to determine the presence of abnormal elements that may indicate various pathologic conditions
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| Color | Normal color is yellow or straw-colored.A colorless, pale urine indicates a large amt of water in the urine, smoky-red or brown color of urine indicates the presence of large amts of blood.
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| Appearance | Normally, urine should be clear. Cloudy or turbid urine indicates a
urinary tract infection with pus (pyuria) and bacteria(bacteriuria).
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| pH | Determination of pH reveals the chemical nature of urine. It indicates to what degree a solution is acid or alkaline (basic). Normal urine is slightly acidic pH of 6.5.
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| pH continued... | However, in some infections of the bladder, the urine pH may be
alkaline, owing to the actions of bacteria in the urine that break down urea and release ammonia (an alkaline substance).
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| Protein | Small amounts of protein are normally found in the urine but not in sufficient quantity to produce a positive result by ordinary methods of testing. When urinary tests for protein become positive, albumin is usually responsible.
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| Protein continued... | Albumin is the major protein in blood plasma. If it is detected in urine (albuminuria), it may indicate a leak in the glomerular membrane, which allows albumin to enter the renal tubule and pass into the urine.
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| Protein continued... | Through more sensitive testing, smaller abnormal amounts of albumin may be detected, revealing microalbuminuria, when ordinary tests are negative. Microalbuminuria is recognized as the earliest sign of renal involvement in diabetes mellitus
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| Glucose | Sugar is not normally found in the urine. In most cases, when it does appear (glycosuria), it indicates diabetes mellitus.
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| Glucose continued... | In diabetes mellitus, there is excess sugar in the bloodstream (hyperglycemia), which leads to the “spilling over” of sugar into the urine. The renal tubules cannot reabsorb all the sugar that filters out through the glomerular membrane.
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| Specific gravity | The specific gravity of urine reflects the amts of wastes,minerals, & solids in urine. It's a comparison of the density of urine w/ water. The urine of patients w/ diabetes mellitus has a higher-than-normal specific gravity cause the presence of sugar.
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| Ketone bodies | Ketones (or acetones, a type of ketone body) are formed when fatty acids are broken down in the liver. Ketones accumulate in blood and urine when the body breaks down fat, instead of sugar, for fuel.
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| Ketone bodies continued... | Ketonuria occurs in diabetes mellitus when cells deprived of sugar must use up their available fat for energy. In starvation,
when sugar is not available, ketonuria and ketosis (ketones in the blood) occur as fat is catabolized abnormally.
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| Ketone bodies continued... | Ketones in the blood are dangerous because they increase the acidity of the blood (ketoacidosis). If severe, this may lead to coma (unconsciousness) and death.
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| Sediment and casts | The presence of abnormal particles in urine is sign of pathologic condition. Particles may settle 2 bottom of urine sample as sediment , may include cells (epithelial, white, or red blood cells), bacteria,crystals,& casts
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| Phenylketonuria (PKU) | This is a rare condition in which a baby is born unable to
break down an amino acid, phenylalanine. Resulting high blood levels of phenylalanine (phenylketones are detected in urine) can lead to mental retardation.
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| Phenylketonuria (PKU) continued... | PKU test originally was performed on urine specimens, now it's doneby pricking newborn ’ s heel 2 obtain a small blood sample. If phenylalanine is detected, infant is fed diet excluding phenylalanine. Affected children remain on diet until adulthood.
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| Bilirubin | This pigment substance, which results from hemoglobin breakdown, may be present in the urine (bilirubinuria) of patients with liver disease. Urobilinogen, a breakdown product of bilirubin, also may be found in the urine.
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| PATHOLOGIC TERMINOLOGY: KIDNEY, BLADDER, AND ASSOCIATED CONDITIONS |
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| KIDNEY |
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| glomerulonephritis | Inflammation of the glomeruli within kidney.This condition can follow a streptococcal infection. It results in leaky glomeruli,
hematuria, red blood cell casts, albuminuria, and when severe renal failure, and uremia.
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| interstitial nephritis | Inflammation of connective tissue lies between the renal tubules.Connective,supportive tissue lying between renal tubules madeup of renal interstitial cells. Interstitial cells in organ are found +2 essential, main functional cells, makeup the parenchyma
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| interstitial nephritis continued... | The parenchyma inthe kidney consists ofthe glomeruli&the renal tubules.Acute interstitial nephritis, increasingly common disorder, may come after use ofNSAIDs (nonsteroidal anti-infl ammatory drugs.May marked by fever,skinrash,&eosinophils inblood &urine.
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| nephrolithiasis | Kidney stones (renal calculi).Kidney stones usually are composed of uric acid or calcium salts. Stones often lodge in the ureter or bladder, as well as in the renal pelvis, and may require removal by lithotripsy or surgery.
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| nephrotic syndrome (nephrosis) | Group of clinical signs and symptoms caused by excessive protein loss in urine.Nephrotic syndrome may follow glomerulonephritis or exposure to toxins or certain drugs, immune diseases, and other pathologic conditions, suchas diabetes mellitus and cancer.
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| nephrotic syndrome continued... (nephrosis) | Two important signs of nephrotic syndrome are edema (swelling caused by fluid in tissue spaces) and hypoalbuminemia. Both of these changes are caused by massive leakage of protein into urine.
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| polycystic kidney disease (PKD)- Multiple fluid-filled sacs (cysts) within and on the kidney. | 2 types of hereditary PKD. 1type usually is asymptomatic (w/o symptoms) until middle age & then is marked by hematuria, urinary tract infections, nephrolithiasis, &renal failure. Other type of PKD occurs in infants/ children &results in renal failure.
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| pyelonephritis | The parenchyma of an organ is its essential and distinctive tissue. Nephrons makeup the renal parenchyma. Treatment consists of antibiotics and surgical correction of any obstruction to urine flow.
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| pyelonephritis continued... | Bacterial infection in the urinary tract causes collections of pus to form in the kidney, often associated with bacteria spilling into the bloodstream. Urinalysis reveals pyuria.
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| renal cell carcinoma (hypernephroma) | Cancerous tumor of kidney in adulthood.This tumor (see accounts for 2% of all cancers in adults. Hematuria is the primary abnormal finding, and the tumor often metastasizes to bones and
lungs. Nephrectomy or partial nephrectomy is the primary treatment.
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| renal failure | Decrease in excretion of wastes results from impaired filtration function. A large # of conditions, including HB pressure, infection, & diabetes, lead 2 renal failure, which may be acute (ARF) or chronic (CRF), reversible or progressive, mild or severe.
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| renal failure continued... | A newer classifi cation of chronic kidney disease (CKD) stages its severity by the level of creatinine clearance and glomerular
filtration rate (GFR), ranging from normal (stage 1) to end-stage renal failure(stage 5).
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| renal hypertension | High BP resulting from kidney disease. Renal hypertension is a type of secondary hypertension (high BP caused by an abnormal condition such as glomerulonephritis). Most common type of high BP is essential hyper-tension, or primary hypertension
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| renal hypertension continued... | Hypertension there is no obvious underlying medical condition.Chronic essential hyper-tension can damage blood vessels potentially resulting in stroke, myocardial infarction (heart attack), heart failure, or renal failure.
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| Wilms tumor | Malignant tumor of the kidney occurring in childhood. T his tumor may be treated with surgery, radiation therapy, and chemotherapy.
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| URINARY BLADDER |
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| bladder cancer | Malignant tumor of urinary bladder. Bladder cancer occurs more often in men (often smokers) & people older than 50 years old, industrial workers exposed 2 dyes & leather-tanning agents. Signs & symptoms include gross or microscopic hematuria & dysuria.
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| bladder cancer continued... | Cystoscopy with biopsy is the most common diagnostic procedure. Staging of the tumor is based on the depth to which the tumor invades the bladder wall and presence of metastasis. Superfi cial tumors are removed by electrocauterization (burning).
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| bladder cancer continued... | Cystectomy, chemotherapy, and radiation therapy are treatments for disease that has spread deeply into the bladder wall, to regional lymph nodes, or to distant organs.
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| ASSOCIATED CONDITIONS |
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| diabetes insipidus (DI) | Antidiuretic hormone (ADH) is not secreted, or there is a resistance of the kidney to ADH. In DI, the kidney produces large amounts of dilute urine (polyuria). Lack of ADH prevents water from being reabsorbed into the blood through the renal tubules.
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| diabetes insipidus (DI) continued... | Insipidus means tasteless, reflecting very dilute &watery urine, not sweet as in diabetes mellitus. Term diabetes comes from the Greek diabainein, meaning 2 pass through.Bothtypes ofdiabetes (insipidus and mellitus) are marked by polyuria and polydipsia.
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| diabetes mellitus (DM) | Insulin is not secreted adequately or tissues are resistant 2 its effects.The signs & symptoms of diabetes mellitus are glycosuria, hyperglycemia,polyuria,&polydipsia. W/O insulin, sugar can"t leave the bloodstream & is not avail 2 body cells 4 energy.
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| diabetes mellitus (DM) continued... | Sugar remains in the blood (hyperglycemia) & spills over into the urine (glycosuria). Mellitus means sweet, reflecting the content of the urine. Term diabetes, when used alone, refers to diabetes mellitus.
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| LABORATORY TESTS |
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| blood urea nitrogen (BUN) | Measurement of urea levels in blood. Normally, the blood urea level is low because urea is excreted in the urine continuously. However, when the kidney is diseased or fails, urea accumulates in the blood (uremia), leading to unconsciousness and death.
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| creatinine clearance | Measurement of the rate at which creatinine is cleared from the blood by the kidney. T his is an important test to assess the functioning of the kidney.
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| creatinine clearance continued... | A blood sample is drawn and the creatinine concentration in blood is compared with the amount of creatinine excreted in the urine during a fixed time period.
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| creatinine clearance continued... | If thekidney is not functioning well in its job of clearingcreatinine from blood, the amt of creatinine in blood will be high relative 2amt in urine.Creatinine clearance is useful indicator of glomerular filtration rate (GFR),normally is 90/120 mL/minute.
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| CLINICAL PROCEDURES |
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| CT urography | X-ray obtained using computed tomography (CT) show multi cross-sectional &other views of the kidney.CT scanners show multi views of kidney, taken w/ or w/o contrast material. 2 main indications are 2 detect kidney stones & 2evaluate patients w/ hematuria
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| kidneys, ureters, and bladder (KUB) | X-ray examination (without contrast) of the kidneys, ureters, and bladder. A KUB study demonstrates the size and location of the kidneys in relation to other organs in the abdomino pelvic region.
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| renal angiography | X-ray examination (with contrast) of the blood vessels of the kidney. T his procedure helps diagnose obstruction or constriction of blood vessels leading to the kidney. The same changes can be seen on CT and MRI urography.
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| retrograde pyelogram (RP) | X-ray image of the renal pelvis and ureters after injection of contrast through a urinary catheter into the ureters from the bladder. T his technique is useful in locating urinary stones and obstructions.
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| voiding cystourethrogram (VCUG) | X-ray image (w/ contrast) of the urinary bladder & urethra obtained while patient is voiding.The bladder is filled w/ contrast material, followed by fluoroscopy (real-time x-ray imaging).Reflux of contrast into ureters is abnormal&may occur w/recurrentUTI's.
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| ultrasonography | Imaging of urinary tract structures using high-frequency sound waves. Kidney size, tumors, hydronephrosis, polycystic kidney disease, and ureteral and bladder obstruction can be diagnosed using ultrasound techniques.
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| radioisotope scan | Image ofkidney obtained after injecting radioactive subst (radioisotope) inthe bloodstream.Pics show size&shape ofkidney &its functioning (renogram).Studies canindicate narrowing of blood vessels,diagnose obstruction,& determine individ function ofkidney.
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| MRI urography | Changing magnetic field produces images of kidney & surrounding structures in 3 planes of the body. The patient lies within a cylindrical magnetic resonance machine, & images are made of pelvic &retroperitoneal regions using magnetic waves.
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| OTHER PROCEDURES |
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| cystoscopy | Direct visualization of the urethra and urinary bladder with an endoscope (cystoscope). The procedure can be performed in two ways. Flexible cystoscopy uses a thin fi beroptic cystoscope and is used for diagnosis and check-ups of the urinary bladder.
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| cystoscopy continued... | Rigid cystoscopy uses a hollow metal tube, passed through the urethra and into the bladder. It is used to take biopsy samples, remove polyps, or perform laser treatments.
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| dialysis | Process of separating nitrogenous waste materials from the blood. Dialysis is used to treat acute or chronic renal failure and some cases of drug use. There are two methods:
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| dialysis continued... | 1. Hemodialysis (HD) uses an artificial kidney machine that receives wastefilled blood from the patient’ s bloodstream, filters it through an artificial porous membrane (dialyzer), and returns the dialyzed blood to the patient’ s body.
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| dialysis continued... | An arteriovenous fi stula (communication between an artery and a vein) is created surgically to provide easy access for hemodialysis
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| dialysis continued... | 2. Peritoneal dialysis (PD) uses a catheter to introduce fluid into the peritoneal (abdominal) cavity. Waste materials, such as urea, in the capillaries of the peritoneum pass out of the bloodstream and into the fluid.
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| dialysis continued... | The fluid is then removed by catheter. When used 2 treat patients w/chronic kidney disease, PD may be performed continuously by patient w/o mechanical support (CAPD—continuous ambulatory PD; or w/ aid of mechanical apparatus used at night during sleep.
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| lithotripsy | Urinary tract stones are crushed. Extracorporeal method uses shock waves direct 2 stone from outside body (extra = outside, corpor/o = body).Patient receives light sedation or anesthetic. Stones pass from body in urine after procedure.
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| renal angioplasty | Dilation of narrowed areas in renal arteries. A balloon attached 2 catheter is inserted into artery&then inflated 2 enlarge vessel diameter. Stents may be inserted 2 keep vessel open.Procedure is used 2 treat renal hypertension & preserve renal function.
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| renal biopsy | Removal of kidney tissue for microscopic examination. Biopsy may be performed at the time of surgery (open) or through the skin (percutaneous, or closed)
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| renal biopsy continued... | When latter technique is used, patient lies in the prone position; after administration of local anesthesia to overlying skin & muscles of back, physician inserts biopsy needle down into kidney. Specimens are obtained for examination by a pathologist.
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| renal transplantation | Surgical transfer of a kidney from a donor to a recipient.Patients w/ renal failure may receive a kidney from a living donor, such as an identical twin (isograft) or other person (allograft), or from a patient at the time of death (cadaver transplant).
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| urinary catheterization | Passage of a flexible, tubular instrument through the urethra into the urinary bladder.Catheters are used primarily for short- or long-term drainage of urine. Foley catheter is an indwelling catheter held in place by a balloon inflated w/liquid.
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