Genitourinary System

1. Genitourinary System Medical Terminology: Anatomy, Physiology, Pathology, Diagnostics, & Treatments

2. Key Terms: • Cortex /medulla • Erythropoietin (EPO) • Libido • Meatus / orifice • Micturition • Percutaneous • Nitrogenous wastes / urea

3. Urinary System: Anatomy • Kidneys • Paired retroperitoneal organs • Renal cortex & medulla, • Renal artery & vein go through hilum • Ureters • Renal pelvis (hollow collecting chamber) • Tubular ureter, enters bladder at ureteral orifice

4. Urinary System: Anatomy • Urinary bladder • Has rugae (allows bladder expansion) • Trigone = triangular area at base determined by the 3 orifices in bladder • Urethra • Goes through prostate and penis in males • Very short in females (predisposes to UTI) • Meatus at end

5. Urinary Microanatomy • Nephron = microscopic renal structures that filter & reabsorb fluid and other ionic and chemical substances in the blood. • Maintain and regulate the amount of water, electrolytes and other materials in the body • Nitrogenous wastes (includes urea, uric acid, creatinine) from protein metabolism are eliminated (not reabsorbed) here

6. Urinary Microanatomy • Nephron • Renal corpuscle • Bowman capsule (encases glomerulus) • Glomerulus (bundle of capillaries) • Afferent arteriole • Efferent arteriole, forms peritubular capillaries • Renal tubule • Proximal convoluted tubule, Loop of Henle, distal tubule, collecting tubule • Leads to renal pelvis for urinary excretion to occur

7. Functions of the Nephron • Filtration • In renal corpuscle • Blood filtrate forced through Bowman capsule • Reabsorption • Of water, electrolytes, amino acids from filtrate as it passes through tubules • Secretion • Capillaries around tubules secretion waste (amnonia, uric acid, etc) into tubules, these wastes remain in the urine and are excreted

8. Male Reproductive System • Testes • Production of sperm & testosterone • Scrotum • Seminiferous tubules • Inside the testes • Coiled tubules that produce the sperm • Epididymis • Tightly coiled tubular structure on the superior pole of each testis, sperm storage

9. Male Reproductive System • Vas deferens (seminal duct) • Narrow tube formed by epididymis • Goes through inguinal canal over posterior part of bladder to join the seminal vesicle • Seminal vesicle • Nutrients to support sperm mobility (60% ejaculate) • Has a duct also • Ejaculatory duct • Joining of the vas deferens and seminal vesicle duct • Passes through prostate gland

10. Male Reproductive System • Prostate gland • Lobed gland at bladder base • Alkaline secretions are protective of sperm in acidic enviroments (30% ejaculate) • Cowper (bulbourethral) glands • Inferior to prostate, connected to urethra • Make alkaline secretions also

11. Male Reproductive System • Penis • Erectile tissue that encloses urethra • Glans penis • Prepuce (foreskin) • Urethral meatus

12. Combining Forms • Cysto- or vesico- • Glomerulo- • Litho- • Meato- • Nephro- or reno- • Pyelo- (renal pelvis) • Uro- • Uretero- • Urethro-

13. Combining Forms • Andro- (male) • Balano- (glans penis) • Epididymo- • Orcho-, orchio-, orchido- or testo- • Prostato- • Spermato- or spermo- • Vaso- (vas deferens) • Varico- • Vesiculo- (seminal vesicle)

14. Prefixes • Albumino- • Azoto- (nitrogenous compounds) • Bacterio- • Crypto- • Gonado- • Kali- • Ketono- • Nocto- • Oligo- • Pyo-

15. Suffixes • -cide (killing) • -genesis (forming or producing) • -spadias (slit or fissue) • -uria (urine)

16. Pathology: Renal • Pyelonephritis • Kidney infection, complicated UTI • Bladder infection (uncomplicated UTI) • Bladder infection ascends through ureters to kidneys • S/S: fever, nausea, vomiting, dysuria, flank pain. • Urinalysis: pyuria, hematuria, bacteriuria

17. Pathology: Renal • Glomerulonephritis • Inflammation of glomeruli • When inflamed, the glomerular membrane is more permeable • Common etiologies: strep infection, diabetes, autoimmune diseases (SLE, scleroderma, etc.) • Urinary findings: proteinuria, hematuria, protein casts, RBC casts

18. Pathology: Renal • Nephrolithiasis • Urinary salts solidify into stones • May cause obstruction (hydroureter, hydronephrosis), colic (spasmic pain), urine reflux into renal pelvis and tubules • Treatment: conservative, lithotripsy, percutaneous or cystographic lithotomy)

19. Pathology: Renal • Acute Tubular Necrosis (ATN) • Etiologies are ischemic and exposure to nephrotoxins • S/S; oliguria, hypercalcemia • May be irreversible

20. Other Pathologies • Bladder Neck obstruction (BNO) • Etiologies: enlarged prostate, calculi, blood clots, tumors • Bladder distention, infections (cystitis), urinary retention and overflow, difficulty voiding • Cryptorchidism • Failure of testes to descend into scrotum prior to birth • Commonly accompanies inguinal hernia • Surgical treatment: orchiopexy & herniorrhaphy

21. Other Pathologies: • Benign Prostatic Hyperplasia (BPH) • Associated with aging • Nodular hyperplasia • Gland enlargement impinges on and narrows urethral lumen • S/S: difficulty voiding, hesitancy • Treatment: usually surgical (TURP or suprapubic prostatectomy)

22. Oncology • Carcinoma of prostate • Second most common CA in men • Over 50 YOA most commonly • Racial risk factors (least in Asians, most in blacks) • Diagnostics: PSA (prostate-specific antigen) and physical exam • May be testosterone-sensitive cancers

23. Related Terms • Anuria (making no urine) • Azotemia (retaining nitrogenous wastes) • Chronic renal failure • Dysuria (painful urination) • Enuresis (involuntary urine discharge) • Fistula (abnormal connection) • Frequency (abnormally frequent urination) • Hesitancy (difficulty starting urinary stream)

24. Related Terms • Nephrotic syndrome (proteinuria, hypoproteinemia, edema due to permeable glomerular membrane) • Nocturia (urination at night) • Oliguria (making little urine) • Urgency (feeling the urgent need to urinate) • Wilms tumor (pediatric malignancy of the kidney)

25. Related Terms: Male Reproductive System • Anorchidism (congenital absence of 1/both testes) • Aspermia (failure to make/ejaculate sperm) • Balanitis (skin inflammation of glans penis) • Epispadias (urethral opening on dorsum of penis) • Erectile dysfunction (inability to get/maintain an erection)

26. Related Terms • Hydrocele (serous fluid in saclike cavity, often in scrotum) • Hypospadias (urethral opening on underside of penis) • Phimosis (stenosis of foreskin opening so that it cannot be retracted over glans penis) • Sterility • Varicocele (distention of veins of spermatic cord, palpable in scrotum)

27. Diagnostics • Digital rectal examination • Cystoscopy • Nephroscopy • Urethroscopy • Urinalysis (UA) • Prostate specific antigen (PSA) • Blood urea nitrogen (BUN)

28. Diagnostics • Cystography • Cystourethrography (also voiding) • Cystometrography(volume & pressure) • IVP (IV pyelography) • CT • Ultrasound (renal, scrotal)

29. Therapeutic Procedures • Dialysis • Hemodialysis, peritoneal dialysis • Lithotripsy • Circumcision • Nephrolithotomy • Nephropexy • Orchidectomy

30. Therapeutic Procedures • Transurethral resection of the prostate (TURP) • Urethrotomy (for urethral stricture) • Vasectomy (excision of vas deferens)

31. Pharmacology • Antibiotics • Antidiuretics • Antispasmodics • Diuretics • Potassium supplements (along with diuretics) • androgens

32. Pharmacology • Anti-impotence agents • Phosphodiesterase inhibitors • spermicides