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Chapter 13. Urinary System Diseases and Disorders. Anatomy and Physiology. Kidneys Remove waste products from bloodstream Ureters Tubules that run from kidney to bladder Transport urine. Anatomy and Physiology. Bladder Muscular organ that holds urine Urethra
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Chapter 13 Urinary System Diseases and Disorders
Anatomy and Physiology • Kidneys • Remove waste products from bloodstream • Ureters • Tubules that run from kidney to bladder • Transport urine
Anatomy and Physiology • Bladder • Muscular organ that holds urine • Urethra • Carries urine to outside of body
Anatomy and Physiology • Urine normally: • Clear, but slightly yellow to gold • Free from sediments • Distinct odor, but not foul-smelling • Specific gravity of 1.005 to 1.030 • pH of 6 • Changes in values indicate disease
Animation Click Here to Play Urine Formation Animation
Common Signs and Symptoms • Hematuria • Pyuria • Proteinuria • Dysuria
Common Signs and Symptoms • Nocturia • Oliguria • Anuria • Frequency/urgency
Diagnostic Tests • Urinalysis • Urine culture and sensitivity • Blood tests • Including blood urea nitrogen (BUN) and creatinine clearance • Intravenous pyelogram (IVP) • Kidney, ureter, and bladder (KUB)
Diagnostic Tests • Cystogram • Cystoscopy • Bladder and kidney biopsy • Catheterization
Urinary Tract Infections (UTIs) • Broad diagnosis covering infections of urinary tract • Including urethra, bladder, and kidneys • Most often caused by bacteria • Can be caused by virus and fungi • E. coli • Most common bacteria
UTIs • More common in females • Female urethra shorter and opening closer to rectum • Some females have improper toilet habits • Vaginal secretions may harbor bacteria while male prostatic secretions have antibacterial effect
UTIs • More common in females • Sexual intercourse may cause trauma to urethra and bladder leading to inflammation and infection • Pregnant females more susceptible due to pressure of uterus on urinary tract
UTIs • Diagnosis by urinalysis and culture of urine specimen • Treatment usually antibiotics
UTIs • Urethritis • Inflammation of urethra • More common in males • Commonly occurs with cystitis • Symptoms: • Swelling of urethra • Dysuria • Urethral discharge
UTIs • Cystitis • Inflammation of bladder • Also known as bladder infection • Honeymoon cystitis • Occurs in females as they become sexually active
UTIs • Cystitis • Treatment usually antibiotics • Antispasmodic medications may decrease bladder spasms • E.g., Pyridium • May cause urine to turn reddish-orange
UTIs • Pyelitis • Inflammation of kidney pelvis • Result of ascending infection from bladder • Rapid diagnosis and treatment imperative to prevent spread of infection
UTIs • Pyelonephritis • May be due to ascending or hematogenous infection • May affect one or both kidneys
UTIs • Pyelonephritis • Symptoms: • Sudden onset of fever and chills • Flank pain • Hematuria • Treated effectively with antibiotics
Diseases of the Kidney • Acute glomerulonephritis • Inflammation of glomerulus or filtering unit of kidney • Most common kidney disease • Occurs one to four weeks after strep infection
Diseases of the Kidney • Acute glomerulonephritis • Symptoms: • Flank pain • Fever • Loss of appetite • Malaise
Diseases of the Kidney • Acute glomerulonephritis • Symptoms: • Edema of eyes and ankles • Oliguria • Hematuria
Diseases of the Kidney • Acute glomerulonephritis • Treatment: • Antipyretic • Diuretic • Salt restriction • Protein restriction • Fluid restriction
Diseases of the Kidney • Chronic glomerulonephritis • Repeated bouts lead to chronic condition • Symptoms include those of acute glomerulonephritis and hypertension • Uremia may occur during late stages • Treatment: • Peritoneal • Hemodialysis
Diseases of the Kidney • Hydronephrosis • Urine in renal pelvis due to obstruction leading to dilation and distention of kidney pelvis • Diagnosis by pyelogram • Treatment: • Draining of kidney pelvis by surgery • Relief of obstruction
Diseases of the Kidney • Renal calculi • Also known as kidney stones • Form in kidney pelvis • Symptoms: • Hematuria • Renal or urinary colic • Extreme spasmodic flank pain
Diseases of the Kidney • Renal calculi • Diagnosis by IVP, KUB, and renal ultrasound • Treatment: • Pain medication • Increased fluid intake • Strain urine • Surgery
Diseases of the Kidney • Polycystic disease • Inherited disease causing enlargement of kidneys due to grape-like cysts • Slow, progressive disease • Symptoms: • Lumbar pain • Hematuria • Recurrent UTIs
Diseases of the Kidney • Polycystic disease • Treatment: • Management of hypertension and UTIs • Dialysis and kidney transplant • No cure
Diseases of the Kidney • Renal failure • Failure of kidneys to cleanse blood of waste products • BUN and creatinine measure kidney function • May be acute or chronic • Symptoms not significant until 75 percent of kidney function destroyed
Diseases of the Kidney • Renal failure • Treatment: • Management of cause of failure • Limitation of sodium and protein • Measure I & O (intake and output) • Antihypertensives • Diuretics • Antibiotics
Diseases of the Kidney • Renal failure • Long-term treatment: • Dialysis • Transplant
Diseases of the Kidney • Adenocarcinoma of the kidney • Risk factor: • Cigarette smoking • Frequently metastasizes to liver, brain, and bone before symptoms appear
Diseases of the Kidney • Adenocarcinoma of the kidney • Symptoms: • Painless hematuria • Flank pain • Fever • Diagnosis by KUB, IVP, CT scan, and biopsy
Diseases of the Kidney • Adenocarcinoma of the kidney • Treatment: • Nephrectomy • Chemotherapy • Radiation
Diseases of the Bladder • Urinary incontinence • Loss of urine flow control • Types: • Stress • Urge • Overflow
Diseases of the Bladder • Urinary incontinence • Treatment: • Empty bladder • Perform Kegel exercises to strengthen pelvic muscles • Have collagen injections near external sphincter to narrow urethra • Have Marshall-Marchetti-Krantz procedure
Diseases of the Bladder • Transitional cell carcinoma of the bladder • Most common neoplasm of urinary tract arising from lining of bladder • Diagnosis by cystoscopy and biopsy • Treatment depends on stage of tumor, transurethral resection (TUR), and cystectomy
Trauma • Straddle injuries • Neurogenic bladder
Rare Diseases • Goodpasture syndrome • Interstitial cystitis • Nonbacterial cystitis due to inflammation of inner lining of bladder
Effects of Aging • Urinary incontinence • Prostatic hypertrophy • Older males • Dribbling, frequency, pain or burning, and difficulty starting urine flow