GU test Flashcards
microscopic unit of the kidney
nephron
main artery leading into the kidney
renal
the renal artery is a direct branch off what major vesel?
aorta
3 of the layers that enclose the kidney
true capsule, renal fascia, peri renal fat
funnel shape uppermost end of the ureter
renal pelvis
two structures that compose the kidney pedicle
renal artery
renal vein
what space are the kidneys located in?
retroperitoneal space, between periotenum and back muscle
concave notch in the kidney through which the ureter, arteries and veins enter and exit
hilum notch
small triangular area near the mouth of the bladder, located between the ureteral orifice and urethra
trigone
largest metabolic waste constituent of urine?
urea
mucosal folds of the inner bladder
rugae
what what do the renal pyramids make up?
renal medulla
20-30cc of radiopaque dye is injected IV and time is noted when excretion begins from the kidneys
IV pyelogram or IV urogram
flat plate xray of the kidneys, ureters, bladder, demonstrating their size, shape, and location in relation to other pelvic organs
KUB
injection of radiopaque dye through a cystoscope using a ureteral catheter. Dye enters the ureters with back flow into the kidneys. done during a cystoscope
retrograde pyelogram
type of catheter whose primary function is to dilate narrow strictures of the urethra
filiforms and followers
BPH
benign prostate hyperplasia
is BPH a cancerous, malignant enlargement of the prostate?
no, false
what is hooked to the telescope?
light cord
what is hooked to the sheath?
irrigation
what is hooked to the working element?
bovie
irrigation tubing used in the cysto room that has 1 port
cysto tubing
irrigation tubing which has 2 ports, allowing 2 bags of fluid to be hung at 1 time
TUR tubing
alcohol, a bacteriostatic agent, is used for cleaning a cystoscope?
false
used to dilate the male urethra
van buren sounds
used to dilate female urethra
otis bougie
3 features a cysto table has that a regular OR table don’t have
wider, directly attached to xray, drainage pan attached
6 items you would find on a cysto set up?
lube, nipple, syringe, kelly, light cord, camera
sterile, isotonic, non hemolytic solution used during a TURP
sorbitol
where are the kidenys located?
under the dome of the diaphragm
are the kidneys located in the abd cavity?
NO
true capsule
smooth, transparent fibrous membrane INNERMOST LAYER
renal fascia
anchors kidney to surrounding structure- helps maintain position MIDDLE LAYER
peri renal fat
adipose tissue which acts as a cushion OUTERMOST LAYER
2 layers of kidneys
cortex, medulla
cortex of the kidney
outer layer
medulla of the kidney
inner layer, contains 8*12 renal pyramids
hilum notch
place where renal artery enters kidney and renal vein and ureter leave
renal calyces(calyx)
collect urine from renal pyramids
what does the renal vein drain directly into?
vena cava
what happens to the kidney pedicle during nephrectomy?
double clamped with pedicle clamp
what type of organ is the kdiney?
highly vascular
ureters
connect kidney to the bladder, peristalsis
space of retzius
area of tissue between symphsis pubis and bladder
urethra
transports urine out of body
functions of the urinary system
secretes unwanted waste, produces urea
urea
largest waste constituent of urine
where does urine formation take place?
nephrons
how much of urine is water?
95
GU surgeries male/females
male- reproductive and urinary tract
female-urinary tract ONLY
problems treated by urologist
incontinence, stones, tumors, cancer
open GU surgeries
performed in an OR room, involves incision
closed GU surgeries
performed in a cysto room, uses a scope
urinalysis
done prior to surgery, provides valuable info regarding function and health of urinary system
what does urinalysis measure?
cells, protein, sugar, clarity, specific gravity, pH
what is normally not in urine?
protein, sugar
creatinine level
most reliable indicator of renal diease
uric acid level
measures kidneys ability to excrete metabolic products
first study done when examining urinary tract?
KUB
urodynamic studies
measures urine flow rate, vlume, pressures, electrical activity of sphincter muscles
babcocks
graps ureters
russian TF
grasp calculi
ptts smith
incise ureter
knife for incising ureter
7 with #11 or #15 blade
suture using for GU procedures
chromic or vicrly SH q
what type of suture is never used on GU procedures?
non absorbable, provides as nucleus for stone formation
difference between urethral catheters and ureteral catheters?
urethral is larger
ureteral catheters
perform a retrograde pyelogram
j stent
flexible, placed using a guide wire, used to keep ureteral lumen open
irrigation during closed GU procedure
continuous irrigation, distends bladder wall
sterile water
cysto, retrograde pyelogram
sterile saline
cysto, retrograde pyelogram, bladder stone removal
when should sterile saline not be used?
with electrocautery
evacuators
irrigate bladder, aspirate stone fragments
iglesias
spring action-operates with 1 hand
mccarthy
need both hands to operate
electrodes
attach to resectoscope
how should the scopes never be cleaned?
by flash or autoclave
how many times should scopes be rinsed?
3 times with sterile water before used on patient
ST duty during cysto
watch irrigation level along with the nurse don’t let it ever run out
what should you do with the ports before sterilizing?
open all of the ports
what is a cysto?
visualization of the urethra, bladder neck/bladder, ureteral orifices, prostate in males
what can a cysto diagnosis?
stones, tumors
stones
composed of minerals and salts
staghorn stone
jagged edges
bladder stones
can be a size of an orange
symptoms of renal colic
intermittent intense pain
hydronephrosis symptoms
dull constant pain
predisposing factors of stones
kidney infections, urinary stasis
procedures to remove stones invasive
nephrolithotomy, ureterolithotomy
what should never be placed on a stone?
formalin since stone will dissolve
nephrectomy
removal of a kidney
pathology for nephrectomy
renal tumors, hydronephrosis, nephrosclerosis
radical nephrecomty
done for cancer
hemi nephrectomy
portion of kidney is removed
nephroureterectomy
removal of kiney and its’ entire ureter
lap nephrectomy
done for benign disease or living donor transplant
pyeloplasty
revision or plastic reconstruction of the renal pelvis
nephrostomy
catheter is placed into renal pelvis for temporary urinary diversion to outside of body
kidney dialysis
done for acute renal failure due to end stage renal diease
hemodialysis
use of an artifical kidney machine to cleans blood
AV shunt fistula
radial arty and cephalic vein
peritoneal dialysis
permanent soft catheter placed into peritoneal cavity for dialysis
kidney transplant
performed for end stage renal disease, pt is being kept alive by dialysis
is the kidney always removed when a new one is placed?
no unless it has cancer
where is the donor kidney transplanted?
iliac fossa
major post op problem after transplant?
rjection
hyperacute rejection
during surgery
acute rejection
first few months
chronic rejection
may occur years after transplant
what must the patient stay on after transplant?
immunosuppressive drugs for their lifetime, cyclosporine
reimplantation of ureter
indicated in children with high grade VUR
adrenal gland
releasing hormones in response to stress
pheochromocytoma
tumor which produces high bp
adrenalectomy
partial or total removal of one or both adrenal glands
positioning supplies for later position
tape, bean bag, pillow, axillary rolls
instrument used to strip the periosteum from the ribs during a nephrectomy
doyen rib raspatory
most common incision used for a nephrectomy
flank
suture used to repair kidney, ureter or bladder
chromic or vicryl
instrument used to remove a stone lodged in one of the renal calyces
randall stone forceps
legs during lateral position
top: straight
bottom: bent
procedure in which shock waves are used to fragment urological stones
shock wave lithotripsy
pyelolithotomy
incision of the renal pelvis of a kidney for removal of kidney stone
foley YV plasty
to create proper shape, for urinary drainage
2 kidney pedicle clamps which could be used to clamp the renal artery and vein during nephrectomy
herrick, satinsky
2 groups of pelvic lymph nodes that are removed during a radical retropubic prostatectomy and sent to pathology for analysis
external iliac, obturator, hypogastric
diagnostic procedure performed for patient’s with possible prostate cancer
prostate biopsy
blood test to aid in diagnosis of cancer for men
PSA
type of anesthesia most often used for a TURP
spinal
type of urinary diversion procedure
ilial conduate
retractor used for a bladder/prostate surgery
lone star retrac. with stays
lcoation of the surgical incision used for a suprapubic prostatectomy
low abd-transverse or longitudinal
4 different types of prostatectomies
suprapubic, retropubic, perineal, TURP
2 types of surgical procedures that can be performed to treat femal urinary stress incontinence
TBT sling, monarch
lack of control over urination
stress incontinence
used by the surgeon to intermittently remove prostatic tissue fragments during a TURP
ellick evacuatator
circumcision involves the removal of what structure?
foreskin
surgical procedure treats cryptorchidism
orchiopexy
procedure that reverses a male vasectomy
vasovasotomy
underside of the penis
hypospadius
topside of the penis
epispadius
surgery where the high ligation of the gonadal veins is done to reduce venous plexus congestion
varicocelectomy
orchiectomy
removal of one or both testes
what structure is excised when performing a hydrocelectomy
tunica vaginalis
other condition can be associated with child presenting with a hydrocele
inguinal hernia
what condition would a urethral meatotomy be performed for?
pinpoint meatus
Operations for urinary stress incontinence
Tighten and restore the anterior urethral vesicle angle
Vesicourethal suspension
Surgery/goal
Correct abnormal urethrovesical angle
GOAL: bring bladder and urethra into pelvis
Stamey procedure
Stamely needle carrier
Transvaginal sling with bone anchor
Uses a device that places bone anchor into pubic bone
What type of material can sling be?
Cadaver fascia
Implantation of prosthetic urethral sphincter
Done as last measure for patient
Artificial sphincter unit is placed abdominally
implantation of interstim sacral nerve stimulator
treats urinary urge incontinence
collagen injection
for intrinsic sphincter deficinecy
suprapubic cystolithotomy incision
opening made into the bladder through a low abd incision
suprapubic cystolithotomy
purpose/instruments/suture
removal of large stones
allises or babcocks
absorbable suture
suprapubic cystostomy
purpose
catheter inserted into bladder through abd wall
urethral strictures, long term urinary drainage
radical cystectomy with pelvic lymphadenectomy
total excision of urinary bladder and pelvic lymph nodes
bladder substitution
if bladder is well differentiated and not invasive into urethra, a neobladder may be created
turbt
resectoscope
several specimens
testes
in scrotum, produce testosterone
seminiferous tubules
where sperm is manufactured
epididymis
secretes seminal fluid
where sperm mature
vas deferens
provides an opening for the spermatic cord
seminal vesicles
unite with the vas deferens
produce seminal fluid
alkaline
enhances sperm motility
fructose
an energy source for sperma
ejaculatory duct
seminal vessels and vas deferens join to make the ejaculatory ducts
prostate
contracts during ejaculation to expulse sperm
cowpers gland
coats urethra just before ejaculation
penis
contains 3 masses of cavernous
distal end of penis
glans penis
semen
sperm and secretions of seminal vesciles, prostate, bulbourethral glands
orchiectomy
removal of testis or testes for cancer or torsion
testicular torsion
twisting of the spermatic cord, causes extreme pain
when is an orchiopexy performed?
after torsion is reduced
varicocelectomy
high ligation of gonadal veins of testes to lower congestion of gonadal veins
what is the most common surgery for male infertility?
varicocelectomy
spermatocelectomy
removal of a tumor mass
hydrocelectomy
excision of the tunica vaginalis, accum. of fluid due to trauma
phimosis
inability to retract foreskin due to stricture
orchiopexy
correction of an undescended testicle
cryptorchidism
testes develop near the kidney in fetal life
hypospadius repair
correction of the urethral meatus, found under penis
should infant be circumcised if having hypospadius repair?
no, they may use that skin
urethroplasty
reconstruction of urethra for strictures
penectomy
partial or tal removal of a cancerous penis
what is a vasovasostomy a reconstruction of?
vas deferens
penile implant
insertion of semi rigid implant for diabetes, hypertension
paraphimosis
foreskin becomes trapped behind the glans penis
where is the prostate located?
base of bladder neck
suprapubic prostatectomy
benign disease, incision made into bladder
simple retropubic prostatectomy
benign disease, bladder not entered
simple perineal prostatectomy
inverted u shaped incision between scrotum and rectum
advantages to simple perineal prostatectomy
easier control of bleeding
transurethral resection of prostate
only benign disease, leaving capsule intact
spinal anesthesia
radical retropubic prostatectomy with pelvic lymphadenectomy
organ confined prostate cancer, nerve sparing
core needle biopsy of prostate
diagnostic purposes
oliguria
small amounts of urine
statements about testes
located in abd in fetal life, descended by birth, cause sterility if undescended
wilms tumor
adenomyosarcoma of the kidney
routine instruments for nephrectomy
rib shears, elevators, strippers
cystometrography
assess the pressure response of the bladder to distention
kidney surgery that placement of a chest tube before closure
thoracoabdominal
what can you use for a av shunt?
artifical gortex graft for the shunt
solution for cystoscopy
sterile water
turb and turp requirements
resectoscope, irrigation
another name for vesical urethral suspension
raz procedure
resection of the prostate gland done through the urethra
turp
penile straightening and urethral reconstruction usually done in two or more stages
hypospadias repair
visual inspection of the interior of the bladder by means of an endoscope
cystoscopy
excision of the tunica vaginalis of the testis to remove the fluid filled sac
hydrocelectomy
ligation and partial excision of dilated veins in the scrotum
variococelectomy
surgical fixation of a floating or hypermobile kidney
nephropexy
incisions for nephrectomy
flank, thoracoabd, retroperitoneal
temporary diversion of urinary drainage by means of an external catheter which drains the kidney pelvis
nephrostomy
catheter used for straight urinary drainage
red robinson
Ileal conduit
Includes cystectomy with creation of pouch from portion of bowel to create a bladder pouch
Cysto anesthesia
Local with IV sedation
