ch. 20 minors Flashcards
Stones caused by the precipitation of minerals, such as calcium and other substances from the urine or kidney filtrate are:
Calculi
a urethral or ureteral catheter that is left in place is an
indwelling catheter
backward flow of a body fluid is a
reflux
——- is an instrument or other device that puts pressure on tissue, usually to stop bleeding
Tamponade
Twisting of an organ or a structure on itself is
Torsion
Where is the retroperitoneal cavity located
posterior to the peritoneal cavity
The —– are the primary organs for filtration of the blood
Kidneys
The ——— is composed of a vast system of microscopic tubules that communicate directly with the capillaries to filter the blood
Glomerulus
—— ——– are formed by the precipitation of specific salts from filtrate that becomes supersaturated
kidney stones
—— —— are paired organs that lie on the medial side of the upper kidney
adrenal glands
the —— communicates with the lower bladder to enable excretion of urine from the body
urethra
—– is layered tissue sac that encases the testicles
scrotum
the —— —— surrounds the urethra and secretes an alkaline fluid that contributes to seminal fluid
prostate gland
——— patients are extremely careful of their AV access sites and need to take precautions to prevent injury at the site
Hemodialysis
a —– may be used to outline structures of the urinary system including any stones larger than 2mm
KUB
a ——- attaches to the head of a scope and accepts accessories
bridge
———— uses a rigid or flexible ureteroscope, which is inserted through the urethra and advanced into the renal pelvis and ureter
ureteroscopy
whenever electrosurgical instruments are used, the irrigation fluid must be
non-electrolytic
a —– incision is made in the skin and carried circumferentially
dorsal
a —— is a benign, fluid filled sac that developes in the anterior testis
Hydrocele
patients are monitored for post op —– and ——–
swelling and hemorrhage
a —— ——– is placed into the scrotal sac after orchiectomy
testicular prosthesis
the pt is prepped and draped for an abdominal laparoscopic procedure in what position?
Lithotomy
—– —– is performed for chronic and acute ESRD
Kidney Transplantation
for a transuretheral resection of the prostate gland the urethra is then dilated with —— —— —–
Van Buren Sounds
For a transurethral resection of the prostate gland, the rectoscope is inserted and resection begins at the —- and —– —— and continues in a systematic pattern
medial and lateral lobes
——- is the insertion of a suprapubic catheter into the bladder for drainage. From what 2 approaches is the catheter inserted?
cystostomy
-percutaneous or open approach
——- is the ligation of the veins of the testes to reduce venous backflow of blood into the internal spermatic veins to improve spermatogenesis
varicoelectomy
if the —– is the result of skin tightening the doctor may shorten the dorsal foreskin and remove any fibrous tissue that is causing the curvature
chordee
if associated with hypospadias, —– is corrected at time of hypospadias repair
chordee
- —— ———- (Marshall-Marchetti-Krantz procedure) is a suspension of the bladder neck and urethra to the cartilage of the pubic symphysis to treat urinary stress incontinence in the female
- What incision is made
Vesicourethral Suspension
Lower midline or Pfannenstiel
What catheter is inserted into the bladder following a ressection
30 cc three way foley
How long is the catheter in place for
12 to 24 hours
—– ——- away from the bladder is performed before or after radical cystectomy
urinary diversion
—— and —– —— (insertion of a tube into the renal pelvis for drainage) is indicated for selected pt with lodged in the renal pelvis or upper ureter. it is performed with fluroscopic guidance
PCNL and Percutaneous nephrostomy
the surgical removal of one kidney
simple nephrectomy
what position is the pt in for a simple nephrectomy
lateral with the flank over the table break or kidney lift and prepped for subcostal flank incision
how is an ochiectomy wound closed and dressed
inturrupted or subcuticular suture on fine cutting needle. Antibiotic ointment applied to incision. Gauze and scrotal fluffs for dressing
during a —– prostate is removed through rectoscope inserted through the urethra
TURP
—– is the reconstruction of ureter at the level of the renal pelvis
pyeloplasty
—— —– may be used during assesment of the bladder and retrograde pyelography
sterile water
—– total or partial removal of the bladder most often done to treat bladder cancer
cystectomy
—— of the testical is the rotation of the testicle around its proximal attachments
torsion
surgical removal of one or both testicles
ochiectomy
absorbtion of irrigation fluid may result in —-
vascular overload
The testicular artery and veins are cross clamped with —- or —- ——
kelly or mayo clamps
the spermatic cord is identified and vas defens are separated doubled clamped cut and ligated with —– —- —–
2.0 vicryl ties
The tissue and vessels are divided with esu and ligated with size 0 —— —— —– ——
absorbable synthetic suture ligatures
the ——- is delivered from the scrotum without rupturing it and the esu is used to make a small incision in the sac membrane
hydrocele
When perfomrming a simple nephrectomy, what and where is the incision made
flank incision along the twelfth rib extending along the border of the rectus muscle
——– is a very rare condition in which the urethral meatus is located on the top side of the penis. the defect is associated with extrophy of the bladder and other defects of the pelvis and gu system
epispadias
procedure in which stones are crushed
lithotripsy
——- ——– is designed to accept accessory instruments and the scope also has designated channels for suction irrigation and a telescope
rigid uteroscope
a small diameter semirigid ureteroscope is narrower than —— which allows for dialation of the tip under direct vision
7.5 fr
two non electrolytic solutions used during ressection
sorbitol or gycine
cell biopsy can be taken from the bladder with a —— ——
cytology brush
the ——— ——– has accommodations for continuous drainage, intraoperative fluoroscopy and xray
cystoscopy table
— is an xray of the kidneys ureters and bladder
KUB
—— may be used to outline structures of the urinary system including any stones over 2mm. however CT is now preffered for stone imaging
KUB
A —– —— is a radiologic procedure in which contrast media is injected through a cystoscope
Retrograde urogram
an —— is the component of the rigid endoscope system for cystoscopy which is blunt ended and minimizes mucosal trauma during insertion
obturator
4 examples of operative approaches
Flank, Gibson, inguinal and scrotal
——– is more commonly known as undescended testicals
cryptorchidism
The —– incisional approach is used for access to the lower ureter and may be used for donor kidney implantation
Gibson
the ——- ——- surgical approach the latissimus dorsi internal and external oblique muscles be transected for access to the operative site
subcostal flank
—— —— are more commonly known as prostate
suprarenal glands
—— —- encloses the kidneys and suprarenal glands
Gerotas fascia
The adrenal medulla secrete ———
catecholamines
between the ages 3 and 8 a pt might likely be diagnosed with —— ——-
wilms tumor
what positon is a pt in for a radical nephrectomy
supine
the —– —— is ligated and transected first in a radical or laparoscopic nephrectomy following isolation of the vessels and ureter
renal artery
the —- kidney is larger and slightly higher than the —–
Left – Right
the —– of the kidney is located medial midsection
hilum
—— is the basic structure composed of renal corpuscles and tubules and numbers over a million
nephron
simple nephrectomy is routinely performed in what position
lateral
cooling with — — or — —– is a measure taken to reduce the metabolic needs and prevents tubular necrosis of a kidney removed for transplant
collins solution or ice slush
a ——- used for chopping the kidney and ureter into small pieces for suctioning in a laparoscopic simple nephrectomy
morcellator
only 2 treatments for end stage kidney failure
dialysis and kidney transplant
What does the anesthesia provider give just before the surgeon clamps the renal vessels of the donor kidney?
Heparin and Mannitol in the iv 75. Protamine is given iv after the donor kidney is removed to prevent heparinization
What quadrant will a donor kidney be transplanted
Right lower
what will the st need to have ready for anastomosis of the renal vessels into the receipient
Potts scissors and 11 blade
what suture is used to anastomose vessels in transplants
fine, nonabsorbable double armed suture
cystoscopy and ureteroscopy procesures are performed in what position
lower lithotomy
a —- —- or — —- is used to ensure patency of the ureters or allow for dranage of urine from the kidneys
double-J or pigtail stent
—- —— —— is used through the uteroscope to capture an intact calulus or fragments if fractured by laser
basket stone forceps
a ——— is performed to remove a calculus lodged in the area of the hilum
pilolithotomy
—— ——- is how the pt is positioned for a proximal pyelolithotomy
lateral position
the bladder is attached to the —– in males
prostate
what muscle is responsible for emptying the bladder and closure of the bladder orifice
detrusor muscle
the vesical arteries that supply the bladder arise from the —– —- —–
internal iliac artery
—– —— or —– —– would be containdicated during cystoscopy for fulguration of bladder tumor
saline irrigation or distention fluid
a —- —- —- is applied to the head of the penis to keep the anesthetic jelly that is inserted into the male urethra prior to a cystoscopy from leaking out
flexible penile clamp
what unique feature of the cystocopy suite OR table
mesh drain attachement
an —– ——- —- exam might prompt the additional investigation of an prostate biopsy
elevated serum PSA
a ——- could be done on either a male or female patient
TURBT
Glass or plastic evacuator used to remove tissue and debris during a TURP
Ellik
3 contrast medias used in cystoscopy
omnipaque renografin and isovue
a resectoscope instrument is used in a —— or —— and includes the sheath , obturator, working element and esu loops
Turp Turbt
—— is a distention fluid which is nonelectrolytic and will lyse malignant tumor cells because of cellular uptake
water
——– excision of the urinary bladder
cystectomy
—- ——– is the more common name for ureteroileocutaneous diversion
ileal conduit
—– —— is the name of a continent urinary reservoir that may be performed following a cystectomy
Koch Pouch
the edge of the ilium that is brought out through the abdominal wall are everted and affixed to the skin for a ——– ——–
Stoma
( —— ) is a traditional type of suprapubic vesicourethral suspendsion
MMK
——- —— and —— ——- are performed to mainly
treat moderate to severe stress incontinence
vesicourethral suspension and pubovaginal slings
One of the main objectives of procedures for female stress incontinence is to restore the —— —— ——–
posterier urethrovesical angle
3 types of pubovaginal or suburethral slings
- Polypropylene mesh tape
- autograft fascia lata
- allograft fascia lata
what 3 sections of the male urethra divided into
prostatic, membranous and spongy
—- ——- ——- is the common diagnosis of a pt undergoing a TURP
Benign prostatic hypertrophy
4 types of resectoscopes
baumrucker, Iglesias, Stern-McCarthy and Nesbit
an —— —— ——- is used to resect the prostate gland tissue through a resectoscope
ESU Loop Electrode
What catheter is placed following a TURP
3 way 22 FR. Foley with 30 ML balloon
———– is a relf retaining retractor is used for open suprapubic prostatectomy
Judd-Mason
3 types of suprapubic catheters
Bonanno, Malecot and Pezzer
The specialized tissue within the seminiferous tubules produce ——
Sperm
—— is the term for an abnormal accumulation of serous fluid around the testis contained within the tunica vaginalis
Hydrocele
when is an orchiectomy performed
Testicular cancer, Trauma, or necrosis secondary to torsion
——- is the medical term for the free fold of skin that covers the glans penis
Prepuce
Term for the inability to retract the foreskin of the penis
phimosis
diabetes, vascular disorder, nerve damage and trauma are all possible causes of
Impotence
what is the most serious complication of penile implant surgery
SSI
a —– is used to dilate the corpora for placement of penile prosthesis
hegar
a ——– is performed for penile carcinoma resistant to chemotherapy or radiation
Penectomy
a suprapubic prostatectomy, insertion of penile implant and kidney transplant are all examples of:
Open Procedures
a TURP, Cystoscopy ad ureteral placement are all examples of
transuretheral procedures
Percutaneous nephrolithotomy is an example of
percutaneous procedure
a congenital condition in which the urethral opening is located on the ventral surface of the penis is ———-
hypospadias
a congenital downward bowing of the penis caused by fibrous bands is
Chordee
Inflammation of the glands penis due to poor hygiene
Balantitis
the ——- is the coiled segment of the spermatic ducts that stores sperm and is attached to the superior surface of the testis
epididymis
The —— —- that covers most of the testis, epidymis and lower spermatic cord is the
tunica vaginalis
——— are radioactive seed implants used to treat aggressive prostate cancers in situ; stronger effect so lower doses can be used
Palladium
——– ——– is the minimally invasive surgical approach for removal of the prostate with fewest post op complications and quickest recovery time
Robotic surgery
——— is the condition of abnormal increase in number or cells in tissues or organs
Hyperplasia
