Genitourinary System

• Urinary System for Male & Female

• Reproductive System for Male

Purpose of the Urinary System

• Regulate composition of the extracellular fluids of the body

• Removes harmful substances in urine

– Nitrogenous wastes

– Excess electrolytes

Purpose of the Urinary System

• Hormones

– Kidneys secrete Erythropoietin

• Acts on bone marrow to stimulate production of red blood cells

Structures of the Urinary System

How it works

• Renal Artery

– Carries blood that contains waste to the Kidneys

• Renal Vein

– Carries clean blood away from Kidneys

• Urine

– Formed from the waste left by the blood

How it works

How it works

• Nephron

– 1 million nephrons

– Constant adjustment & regulation of contents of blood plasma

• http://www.youtube.com/watch?v=C-Ub0Df44Wk

How it Works

• Renal Pelvis

– Urine is moved here once clean blood leaves Kidney

• Ureters:

– 10-12in long, use peristaltic waves to move urine from Kidney to Bladder

How it Works

How it works

• Bladder

– Temporary reservoir

– Rugae-expand as bladder fills

• Urethra

– Women 1.5 inches

– Men 7-8 inches

How it works

How it works

• http://www.youtube.com/watch?v=nJVbFIIycKo

Male Reproductive System

• Purpose

– Produce, maintain & transport sperm

– Produce the male hormone testosterone

Anatomy

• Scrotum: external sac

– Holds two testes: secrete testosterone • Each has numerous small

tubes called seminiferous tubules which produce sperm

Anatomy

• Epididymis: single tightly coiled tube laying over the superior surface of each testis

– Stores sperm once it leaves the seminiferous tubules

Anatomy

• The Epididymus forms into the Vas Deferens: carries the sperm to the Seminal Vesicle

Anatomy

• The Vas Deferens joins the seminal vesicle

– Nutrients to maintain sperm viability

– Produces approximately 60% of the seminal fluid

• Ejaculatory Duct: at the end of the seminal vesicle & Vas Deferens

Anatomy

• Ejaculatory duct passes through the Prostate Gland

– Secretes alkaline substance, accounts for about 30% of seminal fluid

– Protects sperm from acidity of vagina

Anatomy

• Bulbourethral Glands: produce alkaline fluid necessary to keep sperm alive

Anatomy

• During Ejaculation

– Sphincter at base of bladder closes

• Preventing urine from being expelled with semen

• Preventing semen from entering the bladder

Anatomy

• Penis

– Glans penis: enlarged tip of the penis

– Urethral orifice (meatus)

– Prepuce (foreskin)

Vocabulary

• Andr/o

• Balan/o

• Epididym/o

• Perine/o

• Prostat/o

• Spermat/o, sperm/o

• Varic/o

• Vas/o

• Vesicul/o

• Orch/o, orchi/o, orchid/o, test/o

Anorchidism

• Congenital absence of one or both testes

Aspermia

• Failure to form or ejaculate semen

Balanitis

• Inflammation of the skin covering the glans penis

Epispadias

• Malformation in which the urethra opens on the dorsum of the penis

Hypospadias

• Developmental anomaly in which the urethra opens on the underside of the penis, or in extreme cases, on the perineum

Erectile Dysfunction (ED)

• Repeated inability to initiate or maintain an erection sufficient for sexual intercourse

Hydrocele

• Accumulation of serous fluids in a saclike cavity, especially the testes and associated structures

Phimosis

• Stenosis or narrowing of preputial orifice so that the foreskin cannot be retracted over the glans penis

Testicular Torsion

• Testicles become lose and twist on themselves cutting off blood flow

• This is an emergency

– Surgery within 5 hrs to save testicle

Clamydia

Gonorrhea

Specialties

• Urology: branch of medicine concerned with male & female urinary disorders & diseases & male reproductive system

• Urologist: Physician who specializes in genitourinary disorders

Specialties

• Nephrology: Branch of medicine concerned with diseases of the Kidneys

• Nephrologist: Physician who specializes in diseases of the Kidneys

Cystitis

• Bladder infection

– Often caused by pooling of urine in the bladder leading to a bacteria breeding ground

Pyelonephritis

• Bacteria invades the renal pelvis and kidney tissue

– Often resulting from and untreated bladder infection

Symptoms of Pyelonephritis

• Pyuria: Large quantities of white blood cells in the urine

• Hematuria: Red blood cells in the urine

Glomerulonephritis

• Condition that causes the glomerular walls to become inflamed

Nephrolithiasis

• Stones (calculi) may form in any part of the urinary tract (urolithiasis), but most arise in the kidney

– Dissolved urine salts begin to solidify

Nephrolithiasis

• Colic: intense throbbing pain caused by the movement of the stone through the urinary tract

• Urine backflows into the renal pelvis causing them to dilate (reflux)

Nephrolithiasis Treatment

• Extracorporeal Shock Wave Lithotripsy (ESWL): calculi are pulverized using ultrasonic waves

• Percutaneous Nephrolithotomy (PCNL): Cut into skin and use a nephroscope to remove stone

Benign Prostatic Hyperplasia

• Prostate gland enlarges and decreases the urethral lumen

Cryptorchidism

• Failure of the testes to descend into the scrotal sac prior to birth

– Often descend by the end of the first year

Acute Tubular Necrosis (ATN)

• The tubular portion of the nephron is injured by a decrease in blood supply or after ingestion of toxic chemicals

Anuria

• Absence of urine production or urinary output

Bladder Neck Obstruction (BNO)

• Blockage at base of the bladder that reduces or prevents urine from passing into the urethra

Chronic Renal Failure

• Renal failure that occurs over a period of years, in which the kidneys lose their ability to maintain volume and composition of body fluids

Dysuria

• Painful or difficult urination, commonly described as a “burning sensation” while urinating

Urinary Issues

• Enuresis: Involuntary discharge of urine

• Frequency: Voiding urine at frequent intervals

• Hesitancy: Involuntary delay in initiating urination

Nocturia

• Excessive or frequent urination after going to bed

Oliguria

• Diminished capacity to form and pass urine, resulting in inefficient excretion of the end products of metabolism

Urgency

• Feeling of the need to void immediately

Digital Rectal Examination (DRE)

• Screening test that assesses the rectal wall surface for lesions or abnormally firm areas that might indicate cancer

Electromyography (EMG)

• Measures the contraction of muscles that control urination using electrodes placed in the rectum and urethra

Testicular self-examination (TSE)

• Self-examination of the testes for abnormal lumps or swelling in the scrotal sac

Urethroscopy/Cystoscopy

• Endoscopy of the urethra or urinary bladder using a specialized endoscope, typically for lithotripsy

Blood Urea Nitrogen (BUN)

• Test that determines the amount of urea nitrogen, a waste product of protein metabolism, present in a blood sample

Culture and Sensitivity (C&S)

• Test that determines the causative organism of a disease and how the organism responds to various antibiotics

Prostate-specific antigen (PSA)

• Blood test used to detect prostatic disorders, especially prostatic cancer

Semen Analysis

• Test that analyzes a semen sample for volume, sperm count, motility, and morphology to evaluate fertility or verify sterilization after a vasectomy

Urinalysis (UA)

• Battery of tests performed on a urine specimen, including physical observation, chemical tests, and microscopic evaluation

Voiding cystourethrography

• Radiological examination of the bladder and urethra performed before, during, and after voiding using a contrast medium to enhance imaging

Dialysis

• Medical Procedure used to filter toxic substances from the patient’s bloodstream, such as excess electrolytes and nitrogenous wastes

Hemodialysis

• Method of removing waste substances from the blood

Peritoneal

• Removal of toxic substances from the body by perfusing the peritoneal cavity with a warm, sterile chemical solution

Circumcision

• Removal of all or part of the foreskin, or prepuce, of the penis

Orchidectomy

• Removal or one or both testes, also called orchiectomy

Urethrotomy

• Incision of the urethral stricture

Vasectomy

• Excision of all or a segment of the vas deferens

Abbreviations

• BUN

• C&S

• ED

• GU

• HTN

• K

• Na

• pH