Urogenital System Pathology Flashcards
1
Q
Anatomy: Renal
A
- Kidneys
~ Situated just below the twelith
thoracic vertebrae and above the
third lumbar vertebrae.
~ Filters the blood of waste products.
~ Produces concentrated urine to
excrete the waste products (urea,
creatine, acids and salts).
2
Q
Anatomy: Ureters, Bladder, Urethra
A
- Ureters: Vessel which carries urine from the kidney to the bladder.
- Bladder: Receptacle for urine from the kidneys.
- Urethra: Vessel which carries urine from the bladder for elimination.
3
Q
Anatomy: Male Genitalia
A
- Prostate Gland
~ Surrounds the neck of the bladder
and the urethra.
~ Secretes fluid that is a component of
semen. - Spermatic Cord - Group of vessels.
~ Carry sperm from the testicles to the
urethra.
~ Provide blood andnervous supply to
the testes.
4
Q
Monorchidism
A
- Absence of one testicle
~ Congenital in 1 in 5000
~ Can also be due to trauma.
~ May exclude athlete from contact
sports.
> Due to a chance of trauma to only
testicle = no kids
5
Q
Scrotal and Testicular Trauma: S&S and Management
A
- Pain
- Bruising
- Effusion
- Muscle Spasm: Cremaster
~ Muscle responsible for contracting
testicles up into body - Management
~ Persistent pain and effusion require a
referral
6
Q
Testicular Torsion
A
- Spermatic cord twists compressing arteries and veins causing ischemia in the affected testicle
- Cause
~ Trauma
~ Coughing or Vomiting
~ Developmental
7
Q
Testicular Torsion: S&S and Management
A
- S&S
~ Same as trauma except:
> Persistent pain
> Testicle is higher on rotated side - Management
~ Most common cause of testicle loss
~ 80-100% salvage rate if seen < 6
hours.
~ Near 0% salvage rate if seen > 6
hours.
8
Q
Anatomy: Female Genitalia
A
- Ovaries: Produces ovum and hormones (estrogen and progesterone).
- Uterus: Reproduction organ for containing and nourishing the embryo.
9
Q
General S&S of Underlying Condition: Hematuria
A
- Blood in urine
~ Indicates either kidney or bladder
pathology
~ Usually caused by infection or direct
blow - Very serious
10
Q
General S&S of Underlying Condition: Pain
A
- Kidneys, Ureters and Bladder
~ May refer pain to the ipsilateral lower
back or abdomen. - Prostate
~ May refer pain to the lower back or
scrotum. - Uterus
~ May refer pain to the middle and low
back. - Ovaries
~ May refer pain to the lower abdomen
and sacrum.
11
Q
General S&S of Underlying Condition: Hemospermia
A
- Blood in semen
12
Q
Urinary Tract Infection
A
- Bacterial infections typically of bacteria that contaminate the perianal and genital areas and gain access through the urethra.
- Cystitis
~ Infection affects bladder only - Pyelonephritis
~ Infection of kidney
13
Q
Urinary Tract Infection: Predisposing Factors
A
- Any condition that impairs free drainage of urine
~ Stagnation allows for multiplication of
bacteria - Injury to the lining of the urinary tract
~ Permits bacteria to invade tissue
> Rare but may be caused by a
kidney stone
14
Q
Urinary Tract Infection: S&S
A
- Pain in Area of Infection
- Frequent Urination
- Pain with Urination
- Hematuria
15
Q
Urinary Tract Infection: Prevention
A
- Free urine flow, large urine volume and complete emptying of the bladder protect against infection.
~ Flushes bacteria from the system - Acidic urine is also protective
16
Q
Post Infection Glomerulonephritis
A
- Glomeruli become inflamed following infection elsewhere. (strep).
~ Antibodies produced to fight pathogen
bind to the pathogen and this complex
gets trapped in the glomerulus
inducing an inflammatory reaction.
~ Antibodies produced to fight
pathogen bind to the glomerular
capillaries and cause inflammation.
17
Q
Post Infection Glomerulonephritis: Effect of Inflammation
A
- Causes swelling and possible blockage of glomeruli.
- Leukocytes associated with inflammation can cause damage to the glomeruli.
- Inflammation of the filtration system
18
Q
Post Infection Glomerulonephritis: S&S
A
- Decreased filtration/urine production,
- Hypertension
- Hematuria
~ Urinary Casts: mass of RBCs and
protein molded to shape of the
tubules
19
Q
Renal Calculi (Kidney Stone)
A
- Cause
~ Majority caused by excess calcium
salts and it uric acid in the blood
~ Excess is filtered and removed at the
kidney and stones can form.
20
Q
Renal Calculi (Kidney Stone): Predisposing Factors
A
- Increased concentration of calcium salts in the blood.
- Urinary Tract Infection
~ Reduces solubility of the salts/uric
acid or bacteria can serve as a site for
crystallization - Urinary Tract Obstruction
~ Due to stagnation of urine
~ Also predisposes to infection - Peeing too often or too little
21
Q
Renal Calculi (Kidney Stone): S&S and Management
A
- Pain
~ Sudden, severe ipsilateral lower back
> Renal colic
> W/out trauma
~ Pain may radiate to the abdomen and
or groin - Hematuria: if calculi injure the ureter.
- Fever and Fatigue: If infection is present.
- Management
~ Increased Fluid Intake: Clear stones
and prevent new ones. (Painful)
~ Ultrasonic Disintegration/Lithotripsy
(painful)
~ Endoscopic Removal
22
Q
Acute Renal Failure
A
- Sudden loss of the ability of the kidneys to excrete wastes and concentrate urine
23
Q
Acute Renal Failure: Causes
A
- Inadequate Blood Flow to the Kidney
~ Low Blood Pressure
> CHF
> Massive Hemorrhage
> Dehydration
> Extreme Endurance Sports
• blood is needed elsewhere
resulting in low BP - Injury to the Internal Structures of the Kidney
~ Trauma
~ High Blood Pressure - Obstruction of Urinary Outflow
~ Tumor
~ Stone
24
Q
Acute Renal Failure: S&S and Management
A
- S&S
~ Decreased or No Urine Output
> Sudden Weight Gain
> Generalized Edema
> Hypertension
~ Altered Mental State: confusion,
seizure, coma - Management
~ Identify and treat any reversible
causes of the kidney failure.
~ Rest the kidney.
> Limit Fluids, protein and
potassium
25
Q
Sports Hematuria
A
- Blood in urine associated with sport participation
~ Usually found during urinalysis.
~ Less often seen by athlete while
urinating.
~ Usually not a concern if caused by
sports activity.
26
Q
Sports Hematuria: Cause
A
- Traumatic
~ Participation in contact sports. - Non-Traumatic
~ During endurance activity blood is
diverted away from non-essential
organs to the muscles.
> Can cause a degree of hypoxia in
the kidney leading to low level
damage
27
Q
Relative Energy Deficiency in Sport (RED-S)
A
- Hormonal/physiological consequences of low energy availability.
- Energy Expenditure (EE) > Energy
Availability (EA) - Common sports affected:
~ Wrestling
~ Dance
~ Distance runners
~ Figure skating
28
Q
Female Athlete Components
A
Disordered Eating/Exercise (1)
/ \
Amenorrhea (2a) Osteoporosis (2b)
29
Q
Female Athlete Components: Caloric Imbalance
A
- Often caused by disordered eating/excessive exercise
~ Low supply of calories leads to
decreased pituitary hormone release
(FSH and LH)
30
Q
Female Athlete Components: Amenorrhea
A
- Decreased pituitary hormone release leads to decreased estrogen and progesterone production from the ovaries leading to amenorrhea
31
Q
Female Athlete Components: Osteoporosis
A
- Normal estrogen levels inhibit osteoclast activity
~ Diminished estrogen levels lead to
increased osteoclast activity
decreasing bone density - Requires a few months of caloric imbalance
32
Q
Male Athlete Components
A
Disordered Eating/Exercise (1) —> Hyothalamic-Pituitary-Gonadal Supression (2) —> Osteoporosis (3)
33
Q
Male Athlete Components: Disordered Eating/Exercise
A
- Caloric imbalance often caused by disordered eating/excessive Exercise
~ Increased severity required when
compared to female athlete.
~ Low supply of calories leads to
decreased FSH and LH
34
Q
Male Athlete Components: Hypothalamic-Pituitary-Gonadal Suppression
A
- Decreased LH leads to lower levels of testosterone production
~ Libido
~ Muscle Mass
~ Mood - Decreased FSH leads to lower sperm content
35
Q
Male Athlete Components: Osteoporosis
A
- Normal testosterone levels inhibit osteoclast activity
~ Diminished testosterone levels lead to
increased osteoclast activity decreasing
bone density - Requires a few months of decreased testosterone levels
36
Q
RED-S S&S
A
- Weight Loss
- Fatigue
- Stress Fractures
- May show signs of eating disorder (anorexia or bulimia).
37
Q
Anorexia
A
- Person with abnormal body image that is obsessed with weight loss and greatly limits caloric intake and exercises excessively to lose weight.
- Signs
~ Drops weight to about 20% below
normal.
~ Denies Feeling Hungry
~ Exercises Excessively
~ Feels despite proof to the contrary.
~ Withdraws from social activities.
38
Q
Bulimia
A
- Person with abnormal body image that is obsessed with weight loss who binges and purges food to lose weight.
- Signs
~ Makes excuses to go to the bathroom
immediately after meals.
~ Eats huge amounts of food, but
doesn’t gain weight.
~ Uses laxatives or diuretics.
~ Withdraws from social activities.
39
Q
RED-S Management
A
- Normalize eating habits/exercise levels.
- Prescription of birth control pill or hormones to ensure estrogen and progesterone levels
- Treatment/counseling for eating disorder
