week 9 - GU Flashcards
describe the kidneys
- 2 bean shaped bodies situated behind the peritoneum
- asymmetrical; left slightly longer and narrower than right, right slightly lower than left
- lie in oblique plane
- normally extend from T12 to L3
describe the ureters
- 2 tubes 10” to 12” long
- retroperitoneal
- extend from renal pelvis
- enter bladder at ureteral orifice
- use peristalsis
describe the bladder
- musculo-membranous sac situated immediately posterior and superior to SP of pelvis
- serve as urine reservoir
describe the urethra
- carries urine from bladder to exterior of body
- about 1.5” long in females and
- 7” to 8” long in males
- sphincter at neck of bladder
preliminary film for micturating cystourethrography
bladder view for adult
after care of micturating cystourethrography
possibility of dysuria; analgesic may be prescribed to adults
pre procedural care for PCN/PCNL
- fasting for 4 hours
- empty bladder just before exam
prelim film for PCN/PCNL
supine AP of the renal area or KUB
complications of PCN/PCNL
- perirenal and intrarenal hemorrhage
- hematuria
- pneumothorax
- infection
- arteriovenous fistula
- puncture of adjacent organs
after care of PCN/PCNL
- vacuum bottle connected to drainage catheter
- CXR to exclude pneumothorax or haemo-pneumothorax
- bed rest for 12hrs
- BP and temp half-hourly for 6hrs
- urine cultures - ?infection
prelim films for a retrograde pyeloureterography
if done in X-ray dot: KUB
complications of retrograde pyeloureterography
- introduction of infection
- mucosal damage to the ureter
- perforation of the ureter or renal pelvis by the catheter
after care for retrograde pyeloureterography
- post anesthetic observation
- prophylactic antibiotics may be used
- inform the patient about the possibility of hematuria
pre preparation for HSG
- patient to abstain from intercourse between appt booking and at time of exam unless reliable method of contraception is used
- exam usually booked between 4th and 10th days in a regular 28-day cycle
preliminary film for HSG
coned AP view of pelvic cavity on request
complications of HSG
- bleeding from trauma to the uterus or cervix
- intravasation of CM
- infection
after care of HSG
- patient may have bleeding per vagina for 1-2 days and pain may persist for up to 2 weeks
after care for T-tube
- drain out CM remaining in the biliary system
- check no kinking of tubes
- secure tubing by tapes
patient preparation for PTBD
- NPO 4 hours before procedure
- premed include analgesia
- antibiotics before and for at least 3 days following
- iv fluid to avoid dehydration
preliminary film for PTBD
supine AP of the right side of abdomen
PTBD possible complications
- bleeding
- biliary and generalised sepsis
- bile leak with bile peritonitis or biloma
after care of PTBD
- flush the externally draining catheter with normal saline and exchange at 3 monthly intervals
- antibiotics for at least 3 days
Patient preparation for ERCP
- NPO 6 hours prior to procedure
- stop certain medications such as aspirin before procedure
- antibiotic cover
preliminary films for ERCP
- if done in endoscopy room: none
- otherwise, AP and RPO of upper abdomen
possible ERCP complications
Acute pancreatitis
Perforation
Cholangitis
possible complications for micturating cystourethrography
- pyelonephritis and renal scarring
- recurrent fever
