Genitourinary Flashcards
(177 cards)
1
Q
function of urinary system
A
filter blood
create and excrete urine
2
Q
organs of male GU system
A
testes
vas/ductus deferens
seminal vesicles
ejaculatory ducts
penis
3
Q
6 paired male reproductive organs
A
testes
epididymides
seminal vesicles
ejaculatory ducts
bulbourethral glands
vas deferens (seminal ducts)
4
Q
describe the kidneys
A
remove waste/filter blood
BP
hematopoiesis
vitamin D
regulate fluid balance
pH
5
Q
location of kidneys
A
retroperitoneal space
either side of T12-L3
right lower than left
6
Q
blood supply to kidneys
A
renal artery
7
Q
renal parenchyma
A
nephron-Gerota’s capsule
external cortex, inner medulla
8
Q
perirenal fat pad and fascia renalis
A
fatty areolar tissue
position and protect kidneys
9
Q
hilum of kidney
A
medial side
concave where renal artery and vein enter, ureter, and lymphatics
10
Q
renal pedicle
A
lymphatics of the kidney
11
Q
renal pelvis
A
funnel structure posterior to vascular pedicle
divides into calyces
12
Q
adrenal gland
A
retroperitoneal on top of the kidneys
hormones
13
Q
adrenal regions
A
medulla: epinephrine, norepinephrine
cortex: steroids, hormones, cortisol, aldosterone, androgens
14
Q
ureters
A
penal pelvis to bladder
25-30cm 4-5mm diameter
retroperitoneal
15
Q
ureteral action to propel urine
A
peristalsis
16
Q
3 areas of calculi in ureters
A
UPJ: ureteropelvic junction
UVJ: ureterovesical junction
ureteral point crossing over external iliac vessels
17
Q
urinary bladder
A
hollow muscular
anterior pelvic cavity
18
Q
capacity of bladder
A
600-800mL
19
Q
trigone of bladder
A
triangle forms base
orifices of ureters in the neck
20
Q
blood supply of bladder
A
superior, middle, inferior vesical arteries
21
Q
urethra
A
internal urethral orifice to outside
22
Q
male urethra
A
20-25cm
23
Q
female urethra
A
3-5cm
6-8mm in diameter
24
Q
why are females prone to UTI
A
less distance to travel
25
verumontanum
elevation in prostatic urethra where seminal ducts enter
26
prostate gland
donut shaped at base of bladder neck
27
prostate and urethra
surrounds urethra
28
lobes in prostate
4-5
29
weight of healthy prostate
20-30g
30
true prostatic capsule
separates prostate and seminal vesicles from rectum
31
surgical capsule
outer ring of normal tissue surrounding hyperplastic inner tissue
TURP
32
blood supply to prostate
pudendal, hemorrhoidal, inferior vesical arteries (from internal iliac arteries)
prostatic venous plexus --> vesical plexus --> internal iliac veins
33
BPH
increased size of prostate
34
who is affected by BPH
men over 50
35
two most common methods of diagnosing BPH
rectal exam
prostate specific antigen blood test
36
BPH vs. prostate cancer
BPH: limited to prostate
cancer: malignant spread to skeletal system/lungs
37
penis
shaft: corpus spongiosum houses urethra
corpora cavernosa: 2 lateral
root with crura
38
vascular bodies for erection
corpus spongiosum urethrae
2 corpora cavernosa
39
prepuce (foreskin)
mucous membrane covering glans
40
scrotum
sac protecting testes
epididymides located within
41
tunica vaginalis
smoothing glistening membrane sac covering testes
42
testes
paired ovoid in scrotum
4-5cm long
3cm wide
2cm thick
testosterone, endocrine glands
43
epididymides
long convoluted duct --> vas deferens
final maturation and storage of sperm
44
vasa deferentia
paired continuations of epididymides --> ejaculatory ducts via peristalsis
45
spermatic cord
suspends testes in scrotum
vas deferens, vessels, cremaster muscle, nerves, lymphatics
46
ejaculatory ducts
paired tubes formed by union of seminal vesicles and vas deferens
sperm to urethra
47
seminal vesicles
paired at base/fundus of bladder and prostate
nourish sperm
48
bulbourethral glands
mucous secretions into urethra on either side of membranous and bulbar urethra
49
intravenous pyelogram/urogram
enhancement of KUB
contrast into a vein into kidney
50
retrograde pyelogram/urogram
contrast into ureters with a cystoscope
51
KUB
anterior to posterior x-ray for size, shape, position, stones
52
PSA blood test
prostate specific antigen
53
digital rectal exam
finger up rectum to check prostate size
54
topical anesthetic for cystoscopy
viscous lidocaine jelly
55
topical anesthetic for male
into urethra after prep and drape with urojet
56
topical anesthetic for female
cotton applicator into urethral meatus
57
why use sterile irrigation for cystoscopy
distend, visualize
58
irrigating fluid for simple surgical cysto
sterile water
distilled water
CHECK
59
irrigating fluid for TURP
3% sorbitol
1.5% glycine
60
special irrigating fluid in TURP
isotonic and nonelectrolytic to allow electrical transmission
61
4 components of a urologic endoscope
sheath
obturator
telescope
light source
62
3 types of urologic endoscopes
Brown-Buerger cystoscope
McCarthy Panendoscope
Wrappler Cystourethroscope
63
resectoscope
electrical current to excise tissue from bladder, urethra, prostate
64
4 types of resectoscope
Iglesias
Nesbit
Baumrucker
Stern-McCarthy
65
Bugbee electrode
in Brown-Buerger or Wrappler to fulgurate bladder tumors, control bleeding, ureteral meatotomy
66
evacuator
attach to endoscope to irrigate the bladder and aspirate stone fragments
67
2 types of evacuator
Ellik: double bowl glass w/ trap
Toomey: syringe with wide opening
68
suprapubic bladder drainage
drain bladder from incision in suprapubic region
uremia, nurogenic bladder, urinary retention
69
4 self-retaining catheters for suprapublic bladder drainage
Pezzer, Malecot, Foley, Bonanno
70
cystoscopy
endoscopic examination of the bladder
71
indications for cysto
hematuria
retention
UTI
cystitis
stones
72
why is cysto class 2
outside world
disinfection vs. sterilization
73
peri-urethral-transurethral collagen injection
intrinsic sphincter deficiency (F)
after prostatectomy (M)
helps hold pee
74
transurethral ureteropyeloscopy
exam of ureters and renal pelvis
diagnose/remove stones
75
urethral meatotomy
enlargement of urethral meatus to relieve stenosis
76
urethral dilation and urethrotomy
dilation of urethra to open stricture
77
phillips filiforms and followers, van buren sounds, McCarthy sounds, otis urethrotome
urethral dilation and internal urethrotomy for stricture
78
urethroplasty
reconstruction of the urethra
stricture, fracture, narrow segments
79
penectomy
partial or total removal of cancerous penis
80
deep dosral and emissary vein ligation
ligation of deep dorsal vein of penis
vascular compromised impotence
81
hydrocele
accumulation of fluid in scrotum
excision of tunica vaginalis
82
varicocele
high ligation of gonadal veins to reduce backflow
83
spermatocele
lobulated intrascrotal mass on head of epididymides
84
vasectomy
remove a section of vas deferens for sterilization
85
no scalpel vasectomy
fixation w/o entering scrotal sac
86
what reverses vasectomy
vasovasostomy
87
orchiectomy
removal of testicles
88
unilateral orchiectomy
cancer
trauma
infection
89
bilateral orchiectomy
metastatic carcinoma of prostate
90
TURP
endoscopic resectoscope
leaves capsule intact removes hyperplastic inner tissue
91
why TURP
BPH
92
TURP for malignancy?
no
93
why 30cc 3 way foley
stop bleeding
empty bladder
irrigation
94
hematuria catheter
3 way foley for blood clots
reinforced for vigorous aspiration
95
simple suprapubic prostatectomy
removal of prostate transvesically
96
pros and cons of suprapubic prostatectomy
surgical correction of bladder at same time
hemorrhage
97
suprapubic prostatectomy for malignancy?
no it would seed the bladder
98
self retaining bladder retractor for suprapubic prostatectomy
omni tract
99
simple retropubic prostatectomy
remova all hypertrophic prostate through anterior prostatic capsule by extravesical approach
100
pros of simple retropubic prostatectomy
excellent exposure of prostate and bladder neck
controllable bleeding
101
retropubic prostatectomy for malignancy?
yes
102
simple perineal prostatectomy
removal of prostatic adenoma through perineum
biopsy and radical excision to follow
103
pros and cons of perineal prostatectomy
good anastomosis and bleeding control
preservation of bladder neck
can make fistulas and can't biopsy iliac and obturator nodes
104
perineal prostatectomy for malignancy?
yes
105
nerve sparing radical retropubic prostatectomy
removal of entire gland, capsule, and seminal vesicles
106
pros of nerve sparing retropubic prostatectomy
spare neurovascular bundles to preserve potency
107
2 self retaining abdominal retractors for retropubic prostatectomy
bookwalter
wishbone
108
radical perineal prostatectomy
same as simple w/ lymph nodes through separate incision
109
what accompanies radial perineal prostatectomy
laparoscopic or low abdominal lymph node dissection
110
2 self retainers for perineal prostatectomy
thompson
omnitract wishbone 2150
111
TURBT
removal of bladder tumor w/ resectoscope
sterile water to burst cancer cells
112
suprapubic cystostomy
opening into bladder through a low abdominal incision for drain tubes
113
suprapubic cystolithotomy
removal of bladder stones
114
vesicourethral suspension
correction of stress incontinence caused by abnormal urethrovesical angle
115
Marshall-Marchetti-Krantz procedure
bladder and urethra into pelvis by suturing vaginal tissue to back of symphysis pubis
116
Burch procedure
nonabsorbable 0 suture into cooper ligament on each side of bladder neck
117
transvaginal bladder neck suspension Pereyra
neck elevated from anterior rectus sheath passed blindly down retropubic space out vagina
118
transvaginal bladder neck suspension Stamey
suture placed urethrovesical junction of ant. rectus fascia to vagina
119
2 types of transvaginal suspensions
TVT sling, TVT sling w/ bone anchor
120
TVT sling
tension free vaginal tape
hypermobility
intrinsic sphincter deficiency
stress incontinence
121
graft for TVT sling
polypropylene mesh tape
122
bladder augmentation enterocystoplasty
enlarge bladder with bowel
reflux incontinence
detrusor hyperactivity
chronic contracted bladder
neuropathic bladder
123
radical cystectomy
remove bladder and pelvic nodes
malignancy or papillary tumors
124
bladder substitution
creation of new bladder
after cystectomy for carcinoma
125
5 bladder substitutions
right colocytoplasty
sigmoidocystopasty
orthotopic ileocolic neobladder
ileocecal bladder
ileoascending
126
ileal conduit
urine flow diverted to an isolated bowel
incontinent division
127
continent urinary division
control of urination
128
4 continent divisions
Kock pouch
Indiana pouch
Camey ileocystoplasty
Meriz
129
3 incisional approaches to the kidney
CHECK
130
percutaneous nephrolithotomy
break kidney stones with nephroscope
131
litholapaxy
crushing stones in bladder
132
Hendrickson-Bigelow lithotrite in litholapaxy
pass in urethra to bladder to crush stone
133
extracorporeal shock wave lithotripsy
noninvasive externally applied acoustic pulse
134
urolithiasis
kidney stones
135
nephroureterectomy
remove kidney + ureter
tumors
hydroureteronephrosis
136
heminephrectomy
remove portion of kidney
upper or lower pole condition
137
nephrectomy
removal of a kidney
UPJ with hydronephrosis
138
position for nephrectomy
lateral
139
when do laparoscopic nephrectomy
benign disease
140
2 laparoscopic approaches for nephrectomy
transabdominal
extraperitoneal
intraperitoneal
141
radical nephrectomy
remove kidney, perirenal fat, adrenal gland, gerota's capsule, periaortic nodes
142
why do radical nephrectomy
parenchymal neoplasm
143
radical vs regular nephrectomy
renal pedicle ligated before mobilizing kidney
gerota's capsule removed en bloc w/ kidney
144
adrenalectomy
removal of 1 or both adrenal glands
145
4 indications for adrenalectomy
hypersecretion
neoplasm
carcinoma of prostate or breast
146
3 positions for adrenalectomy
lateral
supine
prone
147
kidney transplant
living-relative or cadaveric donor into iliac fossa
148
why do renal transplant
restore function to maintain life in end-stage renal disease
149
position for donor kidney
left lateral
150
position for recipient kidney
supine
151
where is kidney placed
right renal/iliac fossa
152
where are renal blood vessels anastomosed
renal vein to iliac vein
renal artery to internal iliac artery
153
solutions to preserve kidney
cold saline
lactated ringers
154
renal dialysis
extracorporeal removal of waste from blood
155
peritoneal dialysis
peritoneum filters blood
156
abdominal catheter for peritoneal dialysis
Tenckhoff
CAPD
157
ureterostomy
opening into ureter for drainage to another point
158
ureterectomy
remove a ureter
159
ureterneocystostomy
division of distal ureter from blader to reimplant w/ submucosal tunnel
160
ureterolithotomy
incision into ureter to remove a stone
161
nephrostomy
opening into kidney for temp or permanent urine drainage
162
nephrotomy
incision into kidney over collecting system with a calculus
163
pyelolithotomy
removal of stone through renal pelvis
164
pyelostomy
opening into renal pelvis to remove stones or for collecting
165
circumcision
removing foreskin from glans
166
3 common indications for circ
phimosis
balanoposthitis
papaphimosis
167
orchiopexy/orchidopexy
move undescended testicles into scrotum
168
why perform orchiopexy
cryptorchidism
169
cryptorchidism
undescended testicles
170
3 devices for circ
gomio clamp
hollister
plastibell
171
retractile testes
testicle can move between scrotum and groin
172
age for orchiopexy
5-6
173
hypospadius
meatus on underside of penis or perineum
174
epispadius
meatus of upper penis/dorsum
175
chordee
downward curvature of penis
176
hypospadius and epispadius repair
move meatus to the apex of the glans
177
methods of hypo/epispadius repair
meatoplasty
glanuloplasty
orthoplasty-release chordee
urethroplasty
skin cover
scrotoplasty
