Genitourinary Flashcards
Where are the kidneys located?
retroperitoneal space
what do the kidneys regulate?
blood volume and composition
vascularity/blood supply of the kidneys (2)
- highly vascularized
- receive blood from renal arteries
pedicle/hilum composition and relation (4)
- lymphatics
- nerves
- blood vessels
- entering the hilum*
what is the renal parenchyma and what is it made up of? (2)
- substance of kidney found within fibrous capsule
- further divided into renal cortex and renal medulla
perirenal fat pad functions (2)
- anchors kidney in place
- protects from trauma
nephrectomy: PT position
lateral with kidney rest elevated
nephrectomy: incision
flank incision
nephrectomy: pedicle clamp
- occludes renal pedicle during ligation*
- giant right angle
what is excised during radical nephrectomy? (4)
- adrenal gland
- kidney
- perirenal fat/fascia
- periaortic lymph nodes
what is the most common site for recipient of kidney transplant?
right iliac fossa
adrenal glands are located in the… (2)
- retroperitoneal space
- superior pole of each kidney
what is secreted by the adrenal glands? (3)
- sex hormones
- steroids
- epinephrine
ureters are located in the
retroperitoneal space
length of ureters
- 25-30cm*
- firbomuscular tubes
how do ureters propel urine?
undergo peristaltic waves to propel urine
calculi/symptoms (7)
- stones that form in kidney
- painful and frequent urination
- flank pain
- oliguria
- nausea and vomitting
- UTI
- hematuria
urolithiasis
PT forms calculi in urinary collecting system
strictures- 3 common areas where calculi form as result of narrowing
- uretero-pelvic junction
- uretero-vesical junction
- ureters cross over external iliac vessels
ureteroscopy: pathophysiology (2)
- tumors
- strictures
capacity of bladder
350-700ml
3 corners of the trigone (2)
- orifices of the ureters
- bladder neck
male/female urethra length
20-25cm
3-5cm
other name for incontinence
enuresis
Describe prep performed on cystoscopy PTs? (3)
- pubic area including perineum
- external genitalia
- extends to thighs
cystoscopy: position
-lithotomy
indications for cystoscopy (7)
- hematuria
- UTI
- fistulas
- urinary retention
- incontinence
- calculi
- bladder tumors
irrigation used for diagnostic cystoscopy (2)
- distilled water
- cell lysing effect
disinfection of cystoscopy instruments
glutaraldehyde (cider)
why is cystoscopy considered wound class 2
- controlled entry into aerodigestive urinary tract*
- high level disinfection sufficient instead of sterilization
radical cystectomy performed on PTs with
invasive malignant disease of the bladder
what is removed in radical cystectomy? (4)
- entire bladder
- lymph nodes nearby
- part of urethra
- organs containing cancer cells nearby
illeal conduit is..
-diversion technique in which segment of bowel is utilized to create neobladder that drains through stoma into collection device
what supplies blood to the bladder and what must be done to it in order to remove bladder?
- inferior vesical artery
- ligated and divided in order to remove bladder
what is the prostate gland? (2)
- periurethral gland found in males
- composed of 4-5 glandular regions
what do secretions from prostate gland do?
-viability and mobility of sperm
What are the indications for a transurethral prostatectomy?
- BPH – benign prostatic hypertrophy*
- enlargement of organ or tissue due to increase in size of cells
What is an ellick evacuator and what is it used for during TURP?
-a double bowled glass instrument used to aspirate resected tissue during TURP
What type of irrigation is used for TURP and why? (4)
- glycine*
- non-electrolytic irrigation for TURP*
- prevents burning of entire bladder
- no conduction
- isotonic
3 types of resectoscopes used for TURP (3)
- iglesias
- nesbit
- baumrucker
function of 3-way foley catheter in TURP procedure? (3)
- pressure hemostasis
- bladder irrigation
- urine elimination
Sound used and function for TURP procedure?
- van buren sound*
- used to dilate meatus and urethra
TURP procedure complications? (5)
- hemorrhage (most common)*
- SSI
- urethral stricture
- urethral injury
- TURP SYNDROME
suprapubic prostatectomy: definition/aka
- aka trans-vesicocapsular prostatectomy*
- care taken to avoid injury to ureters*
- enucleation of hyperplastic prostate adenoma
simple retropubic prostatectomy approach
extravesical approach
how is prostate dissected during suprapubic prostatectomy?
bluntly dissected by surgeons fingers
What is phimosis?
-foreskin cannot be contracted due to congenital narrowing of opening of foreskin
What is paraphimosis?
-foreskin cannot be reduced due to being trapped by glans penis
What is balanoposthitis (balanitis)?
-inflammation of the glans penis
What are the two devices used to facilitate circumcision? (2)
- gamco device
- plastibell
What is a chordee?
-painful downward curvature of the penis on erection
penectomy definition
surgical removal of the penis for medical or personal reasons
Name 3 types of indwelling catheters used for suprapubic bladder drainage?
- pezzar
- malecot
- foley
hydrocelectomy: pathophysiology
collected serous fluid in membrane surrounding the tunic vaginalis
orchiopexy
fixation in scrotum of undecided testis
What is cryptorchidism/ who does it affect? (2)
- undescended testicles
- premi babies
What is a testicular torsion and how is it repaired? (2)
- twisting of the spermatic cord
- can cause necrosis
