Chapter 11
The Urinary System
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1
Lesson 11.1

Learning Goals
1. State the function of the urinary system, and analyze associated
2.
3.
4.
5.
6.
7.
terms.
Write the meanings of the word parts associated with the urinary
system, and use them to build and analyze terms.
Write the names of the structures of the urinary system, define the
terms associated with these structures, and label the structures.
Sequence the formation and excretion of urine.
Write the names of the diagnostic tests and procedures for
assessment of the urinary system when given their descriptions, or
match them with their descriptions.
Distinguish between normal and abnormal components of urine.
Identify the major structures of the nephron and their functions.
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Functions of the Kidneys
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
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Filter the blood by removing urea (the byproduct of protein metabolism) and other
wastes
Maintain proper balance of water, salts, and
other substances
Eliminate wastes as urine
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Additional Kidney Functions
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
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Produce renin (hormone that controls blood
pressure)
Produce erythropoietin (hormone that
stimulates red blood cell production)
Metabolize vitamin D to its active form
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5
Quick Quiz!

What term means between the kidneys?
A.
B.
C.
D.
adrenal
interrenal
infrarenal
nephrotoxic
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Terminology: Word Parts
ur(o)
urine, urinary tract
-uria
urine or urination
Major urinary structures:
cyst(o)
bladder, cyst, fluid-filled sac
nephr(o), ren(o) kidney
ureter(o)
ureter
urethr(o)
urethra
vesic(o)
bladder or blister
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Terminology




vesicoureteral, vesicovaginal, urethrovaginal
extracystic, abdominocystic, abdominovesical
rectourethral, urethrorectal
genitourinary, urogenital
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Kidney Cross Section
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Terminology: Word Parts
Internal structures of the kidneys:
glomerul(o)
pyel(o)
Review:
dist(o)
proxim(o)
glomerulus
renal pelvis
distant
near
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12
Functions of the Nephron
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Formation and Excretion of Urine
(cont.)
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Diagnostic Tests and Procedures
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laboratory tests
urinary catheterization
urinary radiography
endoscopy
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Laboratory Tests
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urinalysis: physical, chemical, and
microscopic examination
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


pH
abnormal substances in urine: ketones, sugar,
protein, red blood cells, and white blood cells
specific gravity, urinometer, or chemical dipstick
intake and output (I&O)
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A From Zakus S: Mosby’s clinical skills for medical assistants, 2001, Mosby.
B From Bonewit-West K: Clinical procedures for medical assistants, ed 6, Philadelphia, 2004, Saunders.
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From Brunzel NA: Fundamentals of urine & body fluid analysis, ed 2, St Louis, 2004, Saunders.
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Terminology: Word Parts
urin(o)
Urine
Abnormal substances in urine:
albumin(o)
albumin
glyc(o), glycos(o)
sugar
hemat(o)
blood
ket(o), keton(o)
ketone bodies
prote(o), protein(o)
protein
py(o)
pus
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Laboratory Tests (cont.)
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urine specimen types:
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voided
clean-catch
catheterized
urine culture, antibiotic sensitivity test
creatinine clearance test, renal clearance test
blood studies:


serum creatinine
blood urea nitrogen
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Urinalysis
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Appearance
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color: usually pale straw
odor: aromatic; similar to ammonia
turbidity: should be clear
specific gravity: 1.005-1.030
Chemical


pH: 6 (possible range 4.6 – 8)
glucose, ketones, protein, bilirubin (urobilinogen),
leukoesterase and nitrites should all be none.
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Urinalysis (cont.)

Microscopic
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crystals: none
 RBCs: 0-2 per high-power field (HPF)
 WBCs: females 0-5/HPF; males 0-3/HPF
 bacteria: none or few/ HPF = less than 1000
colonies/mL
 parasites: none
 casts: few to none
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Indwelling Catheter
From Harkreader H, Hogan MA, Thobaben M: Fundamentals of nursing, ed 3, St Louis, 2007, Saunders.
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Urinary Catheterization: Urethral
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Urinary Catheterization (cont.)
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Urinary Catheterization (cont.)
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Diagnostic Tests and Procedures
(cont.)


urodynamic studies: cystometrography,
electromyography
urinary radiography








nephrosonography
nephrotomography, nephrotomogram
intravenous urography, urogram
intravenous pyelography, pyelogram
cystography, cystourethrography
voiding cystourethrogram
renal angiography, renal arteriogram
kidney scan, renography
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From Bontrager KL, Lampignano J: Textbook of radiographic positioning and related anatomy, ed 6, St Louis, 2005, Mosby.
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From Lewis S, Heitkemper MM, Dirksen SR: Medical-surgical nursing, assessment and management of clinical problems, ed 6, St Louis, 2004, Mosby.
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From Price S, Wilson L: Pathophysiology: clinical concepts of disease processes, ed 6, St Louis, 2003, Mosby.
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Diagnostic Tests and Procedures
(cont.)

endoscopy


cystoscopy
cystoureteroscopy
urethroscopy
ureteroscopy

nephroscopy


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Quick Quiz!

Which of the following is normal to find in
urine?
A.
B.
C.
D.
blood
albumin
urea
glucose
Copyright © 2012, 2009, 2005, 2001, 1997, 1993, 1988, 1983 by Saunders, an imprint of Elsevier Inc.
34
Lesson 11.2

Learning Goals
1.
2.
3.
4.
5.
6.
7.
Match the terms for urinary system pathologies with their
meanings, or write the names when given their descriptions.
Describe the significance of genitourinary infections and their
association with some sexually transmitted diseases.
Match terms for surgical and therapeutic interventions for
interventions for urinary pathologies with descriptions of the
interventions, or write the names of the interventions when given
their descriptions.
Select the correct meanings of terms and write the meanings of
abbreviations in a health care report pertaining to the urinary
system.
Spell the terms accurately.
Pronounce the terms correctly.
Write the meanings of the abbreviations.
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Pathologies
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

uropathy
renovascular disorders
disorders of urination: dysuria, polyuria,
anuria (anuric), oliguria, polyuria, nocturia,
nycturia, urgency, frequency, hesitancy,
urinary reflux, incontinence, enuresis
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Pathologies (cont.)
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

kidney disorders: uremia, renal failure (acute
and chronic), nephromegaly, nephrolysis,
nephromalacia, polycystic kidney disease,
nephrotic syndrome
diabetes mellitus, diabetic nephropathy,
nephrotic syndrome, diabetes insipidus
renovascular diseases: renal artery stenosis,
renal hypertension, nephrosclerosis, renal
vein thrombosis
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Courtesy Department of Pathology, Duke University Medical Center, Durham, North Carolina.
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Pathologies (cont.)
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Uremia




an accumulation of waste products in the blood,
including urea
caused by renal failure
acute uremia can be characterized by oliguria and
high blood urea nitrogen
chronic uremia can require dialysis
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Pathologies (cont.)
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

obstructive nephropathies: hydronephrosis,
hydroureter, urolithiasis, nephrolithiasis,
ureterolithiasis, cystolithiasis
growths: polyps (bladder polyp), bladder
cancer, Wilms tumor
structural alterations: uterine prolapse,
ureterocele, urethrocele, cystocele,
urethrostenosis, ureterostenosis
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Benign Prostatic Hyperplasia
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Hydronephrosis v. Hydroureter
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Renal Carcinoma
From Kumar V, Abbas AK, Fauston N, Mitchell RN: Robbins’ basic pathology, ed 8, Philadelphia, 2007, Saunders.
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Cystocele
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Pathologies (cont.)



septicemia, glomerulopathy, ureteropathy
UTIs: cystitis, urethritis, pyelonephritis,
urethrocystitis/cystourethritis, cystitis,
ureteritis, ureteropyelonephritis, pyelitis,
pyelonephritis, nephritis, glomerulonephritis,
interstitial nephritis
sexually transmitted diseases: gonorrhea,
urethritis (See also Chapter 13)
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Pathologies (cont.)
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
association of GU infections with STDs
gonorrhea


can produce urethrorrhea in both genders
may include urethritis, dysuria, and pyuria
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Terminology: Word Parts
noct(i), nyct(o)
olig(o)
gon(o)
thromb(o)
night
few, scanty
genitals or reproduction
thrombus (internal blood clot)
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Hypospadias v. Epispadias
From Zitelli BJ, Davis HW: Atlas of pediatric physical diagnosis, ed 5, St Louis, 2007, Mosby.
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Surgical and Therapeutic
Interventions: Hemodialysis
A, From Ignatavicius MS, Workman ML: Medical-surgical nursing: critical thinking for collaborative care, ed 5, 2006, Philadelphia, Saunders. B, From Lewis
S, Heitkemper MM, Dirksen SR: Medical-surgical nursing, assessment and management of clinical problems, ed 6, St Louis, 2004, Mosby.
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Surgical and Therapeutic
Interventions (cont.)


lithotripsy, lithotomy: nephrolithotomy,
pyelolithotomy, ureterolithotomy,
cystolithotomy, ESWL
urinary diversion: nephrostomy,
ureterostomy, cystostomy,
transureteroureterostomy, ureterocystostomy,
ureterocystoneostomy
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Lithotripsy
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Nephrostomy, Ureterostomy,
Transureteroureterostomy
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From Athanasoulis CA et al: Interventional radiology, Philadelphia, 1982, Saunders.
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Surgical and Therapeutic
Interventions (cont.)





incision: suprapubic cystotomy, cystotomy,
urethrotomy
excision: nephrectomy, laparoscopic nephrectomy,
nephroureterectomy, cystectomy, ureterectomy, renal
transplant
vascular therapy: percutaneous transluminal renal
angioplasty
reparative procedures: ureteroplasty, pyeloplasty,
cystoplasty, nephropexy
other therapies: antibiotics, analgesics,
antispasmodics, diuretics
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Transurethral Resection
From Lewis S, Heitkemper MM, Dirksen SR, O’Brien PG, Bucher L: Medical-surgical nursing, assessment and management of clinical problems, ed 7, St Louis,
2007, Mosby.
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Quick Quiz!

Which term means an abnormal
accumulation of waste products in the blood?
A.
B.
C.
D.
uremia
hematuria
septicemia
thrombolytics
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57
Abbreviations
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







ADH
ARF
BPH
BUN
C&S
CRF
EMG
ESWL
GFR
GU
I&O
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Abbreviations (cont.)










IVP
KUB
pH
STD
TUR
TURP
UA, U/A
UTI
VCUG
VD
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