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Senior Rotations > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

function of urinary system

A

filter blood

create and excrete urine

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2
Q

organs of male GU system

A

testes

vas/ductus deferens

seminal vesicles

ejaculatory ducts

penis

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3
Q

6 paired male reproductive organs

A

testes

epididymides

seminal vesicles

ejaculatory ducts

bulbourethral glands

vas deferens (seminal ducts)

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4
Q

describe the kidneys

A

remove waste/filter blood

BP

hematopoiesis

vitamin D

regulate fluid balance

pH

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5
Q

location of kidneys

A

retroperitoneal space

either side of T12-L3

right lower than left

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6
Q

blood supply to kidneys

A

renal artery

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7
Q

renal parenchyma

A

nephron-Gerota’s capsule

external cortex, inner medulla

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8
Q

perirenal fat pad and fascia renalis

A

fatty areolar tissue

position and protect kidneys

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9
Q

hilum of kidney

A

medial side

concave where renal artery and vein enter, ureter, and lymphatics

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10
Q

renal pedicle

A

lymphatics of the kidney

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11
Q

renal pelvis

A

funnel structure posterior to vascular pedicle

divides into calyces

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12
Q

adrenal gland

A

retroperitoneal on top of the kidneys

hormones

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13
Q

adrenal regions

A

medulla: epinephrine, norepinephrine
cortex: steroids, hormones, cortisol, aldosterone, androgens

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14
Q

ureters

A

penal pelvis to bladder

25-30cm 4-5mm diameter

retroperitoneal

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15
Q

ureteral action to propel urine

A

peristalsis

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16
Q

3 areas of calculi in ureters

A

UPJ: ureteropelvic junction

UVJ: ureterovesical junction

ureteral point crossing over external iliac vessels

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17
Q

urinary bladder

A

hollow muscular

anterior pelvic cavity

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18
Q

capacity of bladder

A

600-800mL

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19
Q

trigone of bladder

A

triangle forms base

orifices of ureters in the neck

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20
Q

blood supply of bladder

A

superior, middle, inferior vesical arteries

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21
Q

urethra

A

internal urethral orifice to outside

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22
Q

male urethra

A

20-25cm

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23
Q

female urethra

A

3-5cm

6-8mm in diameter

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24
Q

why are females prone to UTI

A

less distance to travel

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25
Q

verumontanum

A

elevation in prostatic urethra where seminal ducts enter

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26
Q

prostate gland

A

donut shaped at base of bladder neck

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27
Q

prostate and urethra

A

surrounds urethra

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28
Q

lobes in prostate

A

4-5

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29
Q

weight of healthy prostate

A

20-30g

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30
Q

true prostatic capsule

A

separates prostate and seminal vesicles from rectum

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31
Q

surgical capsule

A

outer ring of normal tissue surrounding hyperplastic inner tissue

TURP

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32
Q

blood supply to prostate

A

pudendal, hemorrhoidal, inferior vesical arteries (from internal iliac arteries)

prostatic venous plexus –> vesical plexus –> internal iliac veins

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33
Q

BPH

A

increased size of prostate

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34
Q

who is affected by BPH

A

men over 50

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35
Q

two most common methods of diagnosing BPH

A

rectal exam

prostate specific antigen blood test

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36
Q

BPH vs. prostate cancer

A

BPH: limited to prostate

cancer: malignant spread to skeletal system/lungs

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37
Q

penis

A

shaft: corpus spongiosum houses urethra

corpora cavernosa: 2 lateral

root with crura

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38
Q

vascular bodies for erection

A

corpus spongiosum urethrae

2 corpora cavernosa

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39
Q

prepuce (foreskin)

A

mucous membrane covering glans

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40
Q

scrotum

A

sac protecting testes

epididymides located within

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41
Q

tunica vaginalis

A

smoothing glistening membrane sac covering testes

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42
Q

testes

A

paired ovoid in scrotum

4-5cm long

3cm wide

2cm thick

testosterone, endocrine glands

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43
Q

epididymides

A

long convoluted duct –> vas deferens

final maturation and storage of sperm

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44
Q

vasa deferentia

A

paired continuations of epididymides –> ejaculatory ducts via peristalsis

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45
Q

spermatic cord

A

suspends testes in scrotum

vas deferens, vessels, cremaster muscle, nerves, lymphatics

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46
Q

ejaculatory ducts

A

paired tubes formed by union of seminal vesicles and vas deferens

sperm to urethra

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47
Q

seminal vesicles

A

paired at base/fundus of bladder and prostate

nourish sperm

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48
Q

bulbourethral glands

A

mucous secretions into urethra on either side of membranous and bulbar urethra

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49
Q

intravenous pyelogram/urogram

A

enhancement of KUB

contrast into a vein into kidney

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50
Q

retrograde pyelogram/urogram

A

contrast into ureters with a cystoscope

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51
Q

KUB

A

anterior to posterior x-ray for size, shape, position, stones

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52
Q

PSA blood test

A

prostate specific antigen

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53
Q

digital rectal exam

A

finger up rectum to check prostate size

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54
Q

topical anesthetic for cystoscopy

A

viscous lidocaine jelly

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55
Q

topical anesthetic for male

A

into urethra after prep and drape with urojet

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56
Q

topical anesthetic for female

A

cotton applicator into urethral meatus

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57
Q

why use sterile irrigation for cystoscopy

A

distend, visualize

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58
Q

irrigating fluid for simple surgical cysto

A

sterile water

distilled water

CHECK

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59
Q

irrigating fluid for TURP

A

3% sorbitol

1.5% glycine

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60
Q

special irrigating fluid in TURP

A

isotonic and nonelectrolytic to allow electrical transmission

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61
Q

4 components of a urologic endoscope

A

sheath

obturator

telescope

light source

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62
Q

3 types of urologic endoscopes

A

Brown-Buerger cystoscope

McCarthy Panendoscope

Wrappler Cystourethroscope

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63
Q

resectoscope

A

electrical current to excise tissue from bladder, urethra, prostate

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64
Q

4 types of resectoscope

A

Iglesias

Nesbit

Baumrucker

Stern-McCarthy

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65
Q

Bugbee electrode

A

in Brown-Buerger or Wrappler to fulgurate bladder tumors, control bleeding, ureteral meatotomy

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66
Q

evacuator

A

attach to endoscope to irrigate the bladder and aspirate stone fragments

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67
Q

2 types of evacuator

A

Ellik: double bowl glass w/ trap

Toomey: syringe with wide opening

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68
Q

suprapubic bladder drainage

A

drain bladder from incision in suprapubic region

uremia, nurogenic bladder, urinary retention

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69
Q

4 self-retaining catheters for suprapublic bladder drainage

A

Pezzer, Malecot, Foley, Bonanno

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70
Q

cystoscopy

A

endoscopic examination of the bladder

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71
Q

indications for cysto

A

hematuria

retention

UTI

cystitis

stones

72
Q

why is cysto class 2

A

outside world

disinfection vs. sterilization

73
Q

peri-urethral-transurethral collagen injection

A

intrinsic sphincter deficiency (F)

after prostatectomy (M)

helps hold pee

74
Q

transurethral ureteropyeloscopy

A

exam of ureters and renal pelvis

diagnose/remove stones

75
Q

urethral meatotomy

A

enlargement of urethral meatus to relieve stenosis

76
Q

urethral dilation and urethrotomy

A

dilation of urethra to open stricture

77
Q

phillips filiforms and followers, van buren sounds, McCarthy sounds, otis urethrotome

A

urethral dilation and internal urethrotomy for stricture

78
Q

urethroplasty

A

reconstruction of the urethra

stricture, fracture, narrow segments

79
Q

penectomy

A

partial or total removal of cancerous penis

80
Q

deep dosral and emissary vein ligation

A

ligation of deep dorsal vein of penis

vascular compromised impotence

81
Q

hydrocele

A

accumulation of fluid in scrotum

excision of tunica vaginalis

82
Q

varicocele

A

high ligation of gonadal veins to reduce backflow

83
Q

spermatocele

A

lobulated intrascrotal mass on head of epididymides

84
Q

vasectomy

A

remove a section of vas deferens for sterilization

85
Q

no scalpel vasectomy

A

fixation w/o entering scrotal sac

86
Q

what reverses vasectomy

A

vasovasostomy

87
Q

orchiectomy

A

removal of testicles

88
Q

unilateral orchiectomy

A

cancer

trauma

infection

89
Q

bilateral orchiectomy

A

metastatic carcinoma of prostate

90
Q

TURP

A

endoscopic resectoscope

leaves capsule intact removes hyperplastic inner tissue

91
Q

why TURP

92
Q

TURP for malignancy?

93
Q

why 30cc 3 way foley

A

stop bleeding

empty bladder

irrigation

94
Q

hematuria catheter

A

3 way foley for blood clots

reinforced for vigorous aspiration

95
Q

simple suprapubic prostatectomy

A

removal of prostate transvesically

96
Q

pros and cons of suprapubic prostatectomy

A

surgical correction of bladder at same time

hemorrhage

97
Q

suprapubic prostatectomy for malignancy?

A

no it would seed the bladder

98
Q

self retaining bladder retractor for suprapubic prostatectomy

A

omni tract

99
Q

simple retropubic prostatectomy

A

remova all hypertrophic prostate through anterior prostatic capsule by extravesical approach

100
Q

pros of simple retropubic prostatectomy

A

excellent exposure of prostate and bladder neck

controllable bleeding

101
Q

retropubic prostatectomy for malignancy?

102
Q

simple perineal prostatectomy

A

removal of prostatic adenoma through perineum

biopsy and radical excision to follow

103
Q

pros and cons of perineal prostatectomy

A

good anastomosis and bleeding control

preservation of bladder neck

can make fistulas and can’t biopsy iliac and obturator nodes

104
Q

perineal prostatectomy for malignancy?

105
Q

nerve sparing radical retropubic prostatectomy

A

removal of entire gland, capsule, and seminal vesicles

106
Q

pros of nerve sparing retropubic prostatectomy

A

spare neurovascular bundles to preserve potency

107
Q

2 self retaining abdominal retractors for retropubic prostatectomy

A

bookwalter

wishbone

108
Q

radical perineal prostatectomy

A

same as simple w/ lymph nodes through separate incision

109
Q

what accompanies radial perineal prostatectomy

A

laparoscopic or low abdominal lymph node dissection

110
Q

2 self retainers for perineal prostatectomy

A

thompson

omnitract wishbone 2150

111
Q

TURBT

A

removal of bladder tumor w/ resectoscope

sterile water to burst cancer cells

112
Q

suprapubic cystostomy

A

opening into bladder through a low abdominal incision for drain tubes

113
Q

suprapubic cystolithotomy

A

removal of bladder stones

114
Q

vesicourethral suspension

A

correction of stress incontinence caused by abnormal urethrovesical angle

115
Q

Marshall-Marchetti-Krantz procedure

A

bladder and urethra into pelvis by suturing vaginal tissue to back of symphysis pubis

116
Q

Burch procedure

A

nonabsorbable 0 suture into cooper ligament on each side of bladder neck

117
Q

transvaginal bladder neck suspension Pereyra

A

neck elevated from anterior rectus sheath passed blindly down retropubic space out vagina

118
Q

transvaginal bladder neck suspension Stamey

A

suture placed urethrovesical junction of ant. rectus fascia to vagina

119
Q

2 types of transvaginal suspensions

A

TVT sling, TVT sling w/ bone anchor

120
Q

TVT sling

A

tension free vaginal tape

hypermobility

intrinsic sphincter deficiency

stress incontinence

121
Q

graft for TVT sling

A

polypropylene mesh tape

122
Q

bladder augmentation enterocystoplasty

A

enlarge bladder with bowel

reflux incontinence

detrusor hyperactivity

chronic contracted bladder

neuropathic bladder

123
Q

radical cystectomy

A

remove bladder and pelvic nodes

malignancy or papillary tumors

124
Q

bladder substitution

A

creation of new bladder

after cystectomy for carcinoma

125
Q

5 bladder substitutions

A

right colocytoplasty

sigmoidocystopasty

orthotopic ileocolic neobladder

ileocecal bladder

ileoascending

126
Q

ileal conduit

A

urine flow diverted to an isolated bowel

incontinent division

127
Q

continent urinary division

A

control of urination

128
Q

4 continent divisions

A

Kock pouch

Indiana pouch

Camey ileocystoplasty

Meriz

129
Q

3 incisional approaches to the kidney

130
Q

percutaneous nephrolithotomy

A

break kidney stones with nephroscope

131
Q

litholapaxy

A

crushing stones in bladder

132
Q

Hendrickson-Bigelow lithotrite in litholapaxy

A

pass in urethra to bladder to crush stone

133
Q

extracorporeal shock wave lithotripsy

A

noninvasive externally applied acoustic pulse

134
Q

urolithiasis

A

kidney stones

135
Q

nephroureterectomy

A

remove kidney + ureter

tumors

hydroureteronephrosis

136
Q

heminephrectomy

A

remove portion of kidney

upper or lower pole condition

137
Q

nephrectomy

A

removal of a kidney

UPJ with hydronephrosis

138
Q

position for nephrectomy

139
Q

when do laparoscopic nephrectomy

A

benign disease

140
Q

2 laparoscopic approaches for nephrectomy

A

transabdominal

extraperitoneal

intraperitoneal

141
Q

radical nephrectomy

A

remove kidney, perirenal fat, adrenal gland, gerota’s capsule, periaortic nodes

142
Q

why do radical nephrectomy

A

parenchymal neoplasm

143
Q

radical vs regular nephrectomy

A

renal pedicle ligated before mobilizing kidney

gerota’s capsule removed en bloc w/ kidney

144
Q

adrenalectomy

A

removal of 1 or both adrenal glands

145
Q

4 indications for adrenalectomy

A

hypersecretion

neoplasm

carcinoma of prostate or breast

146
Q

3 positions for adrenalectomy

A

lateral

supine

prone

147
Q

kidney transplant

A

living-relative or cadaveric donor into iliac fossa

148
Q

why do renal transplant

A

restore function to maintain life in end-stage renal disease

149
Q

position for donor kidney

A

left lateral

150
Q

position for recipient kidney

151
Q

where is kidney placed

A

right renal/iliac fossa

152
Q

where are renal blood vessels anastomosed

A

renal vein to iliac vein

renal artery to internal iliac artery

153
Q

solutions to preserve kidney

A

cold saline

lactated ringers

154
Q

renal dialysis

A

extracorporeal removal of waste from blood

155
Q

peritoneal dialysis

A

peritoneum filters blood

156
Q

abdominal catheter for peritoneal dialysis

A

Tenckhoff

CAPD

157
Q

ureterostomy

A

opening into ureter for drainage to another point

158
Q

ureterectomy

A

remove a ureter

159
Q

ureterneocystostomy

A

division of distal ureter from blader to reimplant w/ submucosal tunnel

160
Q

ureterolithotomy

A

incision into ureter to remove a stone

161
Q

nephrostomy

A

opening into kidney for temp or permanent urine drainage

162
Q

nephrotomy

A

incision into kidney over collecting system with a calculus

163
Q

pyelolithotomy

A

removal of stone through renal pelvis

164
Q

pyelostomy

A

opening into renal pelvis to remove stones or for collecting

165
Q

circumcision

A

removing foreskin from glans

166
Q

3 common indications for circ

A

phimosis

balanoposthitis

papaphimosis

167
Q

orchiopexy/orchidopexy

A

move undescended testicles into scrotum

168
Q

why perform orchiopexy

A

cryptorchidism

169
Q

cryptorchidism

A

undescended testicles

170
Q

3 devices for circ

A

gomio clamp

hollister

plastibell

171
Q

retractile testes

A

testicle can move between scrotum and groin

172
Q

age for orchiopexy

173
Q

hypospadius

A

meatus on underside of penis or perineum

174
Q

epispadius

A

meatus of upper penis/dorsum

175
Q

chordee

A

downward curvature of penis

176
Q

hypospadius and epispadius repair

A

move meatus to the apex of the glans

177
Q

methods of hypo/epispadius repair

A

meatoplasty

glanuloplasty

orthoplasty-release chordee

urethroplasty

skin cover

scrotoplasty

Senior Rotations (8 decks)

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