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Surginal Procedures > Gynecology and Genitourinary Surgery > Flashcards

Gynecology and Genitourinary Surgery Flashcards

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1
Q

List the 6 main structures of the female reproductive system.

A 
Vulva
Vagina
Cervix
Uterus
Tubes
Ovaries
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2
Q

List the 4 supporting ligaments of the uterus:

A

Round, broad, cardinal, uterosacral ligaments

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3
Q

List the 3 parts of cervix:

A

Internal os; external os; endocervical canal

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4
Q

List 4 parts of the uterus:

A

Fundus, cornua, body (corpus), cervix

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5
Q

List the three layers of the uterine body

A

Endometrium, myometrium, perimetrium

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6
Q

Adnexa

A

new term meaning accessory structures: Tubes and Ovaries

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7
Q 
Physiology of the:
Vulva
Vagina
Cervix
Uterus
Tubes
Ovaries
A

Vulva–Facilitate sexual intercourse
Vagina –Intercourse; menstrual discharge, and delivery of infant
Cervix–Holds developing fetus inside uterus
Uterus–Support developing embryo/fetus
Tubes–Fertilization, peristalsis of zygote (fertilized ovum) to uterus
Ovaries–Store, mature, and release ovum “egg”

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8
Q 
menstrual;
Dyspareunia
PID 
(CIS)
Dysplasia
Intraepithelial
Neoplasia
Pruritus
A 
Pertaining to to the menses or menstruation
Difficult or painful sexual intercourse
Pelvic inflammatory disease
Carcinoma in situ 
Condition; ill, bad, or poor; growth
Pertaining to; within; epithelium
Condition; new; growth
Severe itching
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9
Q

Ectopic pregnancy

A

A fertilized egg attached outside the uterus

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10
Q

Define D&C

A

Dilation of the cervix and curettage of the uterus

Gradual expansion of the cervical opening to provide access to the uterus to remove a tissue sample

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11
Q

Anatomy/Physiology of D&C

A 
Vagina
Cervix
Internal os
External os
Endocervical canal
Uterus
Endometrium (inner layer)
Physiology: Reproduction; conception and growth of infant
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12
Q

Pathophysiology/Indication for D&C

A 
diagnostic for:
DUB: dysfunctional uterine bleeding
     Dysmenorrhea, amenorrhea
     Menorrhagia, hypermenorrhea
     Metrorrhagia
Assessment of infertility
treatment for: 
Miscarriage (D&E)
Uterine polyps (called a polypectomy)
Post partum bleeding (D&C)
Retained placenta (D&E)
Abnormal uterine bleeding (ablation)
Uterine cancer (place radium implants)
Retrieval of “lost” IUD
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13
Q

Procedure Steps D&C

A

Retract vagina (Auvard and Heaney or Sims)
Grasp cervix (Schroeder tenaculum)
Sound uterus (Sims uterine sound)
Take endocervical specimen (Kervorkian curette and telfa)
Dilate cervix (Hegars or Hanks)
FYI: May check for polyps (Randall stone forceps)
Curette uterine cavity (Sims curettes and telfa)
FYI: May clean out with Bozeman/raytex or stick sponge
Dress with OB pad

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14
Q

Define Conization of the Cervix

A

Removal of a cone-shaped piece of cervical tissue for diagnosis

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15
Q

Anatomy/Physiology of Conization of the Cervix

A 
Vagina
Cervix
Internal os
External os
endocervical canal
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16
Q

Pathophysiology/Indication for Conization of the Cervix:

A 
Cervical dysplasia (severe) AKA: Carcinoma in situ (CIN grade 3)
     Changes in cervical epithelium 
Cone biopsy checks to see if the changes have infiltrated to the cervix
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17
Q

Procedure Steps Conization of the Cervix

A

Place retractors (Auvard and Heaneys)
Grasp cervix with tenaculum (mark area with staining agent)
Excise cone (ESU, knife, laser, etc.)
Hemostasis (ESU), pack PRN, dress (NuGauze packing, peri pad)

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18
Q

Define Cervical Cerclage (Shirodkar)

A

Placement of a ligature at the internal os of the cervix

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19
Q

Anatomy and physiology of Cervical Cerclage (Shirodkar)

A

Vagina
Cervix
Internal os

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20
Q

Pathophysiology/Indication for Cervical Cerclage (Shirodkar)

A

Post-conceptional incompetent cervix

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21
Q

Procedure steps Cervical Cerclage (Shirodkar)

A 
Retract, grasp cervix
Incise anterior mucosa, retract bladderIncise posterior mucosa, place Allises
Place and tie ligature 
     5 mm Mersilene tape on huge needle
Close mucosa
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22
Q

Define Hysteroscopy/endometrial ablation

A

hysteroscopy-Visual exam, uterine cavity

Endometrial ablation-destruction of the inner layer of the uterus

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23
Q

Anatomy/physiology Hysteroscopy/endometrial ablation

A 
Vagina
Cervix
Internal os
External os
Endocervical canal
Uterus
Endometrium (inner layer)
Physiology: Reproduction; conception and growth of infant
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24
Q

Pathology/Indication Hysteroscopy/endometrial ablation

A

DUB
Hysteroscopy also used to Diagnose cause of infertility and Treatment for “lost” IUDs; intrauterine adhesions; intrauterine polyps

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25
Procedure steps Hysteroscopy/endometrial ablation
Retract, grasp cervix, sound uterus, dilate cervix Insert hysteroscope Distend uterine cavity, EUA Suction curettage of uterine cavity Insert balloon, apply heat to destroy endometrium (FYI: usually done without hysteroscopy) Remove instruments; clean patient, dress
26
Define diagnostic laparoscopy (GYN)
Visual exam of the abdominal cavity | With particular attention to the organs of the female reproductive system
27
Anatomy/physiology diagnostic laparoscopy
``` Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Ureters Physiology: Reproduction; conception/growth of infant ```
28
Pathology/indication diagnostic laparoscopy
diagnostic for:Unexplained gynecologic pain Assessment of infertility PID-Pelvic inflammatory disease Evaluation of masses such as ovarian cysts, ovarian mass, or fibroids
29
Procedure steps diagnostic laparoscopy
Place vaginal speculum, grasp cervix Apply uterine manipulator (change outer gloves) Lift abdominal wall (may use 2 towel clips) Make incision (umbilicus, 12 blade) Insert Veress needle; verify placement in peritoneal cavity; insufflate abdomen with CO2; (remove Veress needle) Insert 10/12mm trocar, laparoscope and camera Suprapubic incision; place 5mm port and insert accessory instruments (such as probe) EUA, treat PRN Could be tubal dye studies; remove ovarian cyst; do tubal ligation; laser endometriosis and other options I/H/desufflate/C/D Remove uterine manipulator
30
Define Oophorectomy (laparoscopic)
Excision of ovary through MIS technique
31
Anatomy/physiology Oophorectomy (laparoscopic)
``` Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology: Reproduction; conception/growth of infant ```
32
Pathology/indication Oophorectomy (laparoscopic)
Ovarian cyst Others, not common: Strangulated ovary Infection, adhesion, endometriosis (endometrioma)
33
Define Salpingectomy (laparoscopic)
Excision of uterine tube through MIS technique
34
Anatomy/physiology Salpingectomy (laparoscopic)
``` Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology of tubeObtain ovum, peristalsis of ovum, fertilization location and peristalsis of fertilized ovum to uterus ```
35
Pathology/indication Salpingectomy (laparoscopic)
Chronic salpingitis (PID)
36
Define Tubal pregnancy (laparoscopic)
AKA. ectopic pregnancy | Excision of a fertilized ovum that is seated outside the uterus, usually seated in the uterine tube; through MIS
37
Anatomy/physiology Tubal pregnancy (laparoscopic)
``` Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology: Reproduction; conception/growth of infant ```
38
Pathology/indication Tubal pregnancy (laparoscopic)
a fertilized ovum that is seated outside the uterus
39
Define Tubal sterilization (lap) (tubal ligation)
Occlusion/interruption of the uterine tubes through MIS technique
40
Anatomy/physiology Tubal sterilization (lap)
``` Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology: Reproduction; conception/growth of infant ```
41
Indication Tubal sterilization (lap)
Patient desire to be sterilized (i.e., to be made unable to conceive another child)
42
Define Abdominal Hysterectomy
Excision of the entire uterus through an open incision
43
Anatomy/physiology Abdominal Hysterectomy
``` Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters Physiology: reproduction ```
44
Pathology/indication Abdominal Hysterectomy
``` PID (causing chronic pelvic pain) Endometriosis (causing chronic pelvic pain) Large fibroids DUB (dysfunctional uterine bleeding) Uterine or cervical cancer ```
45
Define Tuboplasty
Surgical repair of uterine tubes with use of a microscope
46
Anatomy/physiology Tuboplasty
``` Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters Physiology: reproduction ```
47
Pathology/indication Tuboplasty
Tubal blockage d/t PID (pathology; PID may be more common than adhesions from previous surgery) Patient changed mind about fertility post tubal ligation (indication)
48
Define Myomectomy
Excision of uterine fibroids (AKA: myomas)
49
Anatomy/physiology Myomectomy
``` Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters Physiology: reproduction ```
50
Pathology/indication Myomectomy
Uterine fibroids affecting fertility; | AKA: fibromyoma; uterine leiomyoma
51
Define Vaginal Hysterectomy
Excision of uterus through an incision in the vaginal wall
52
Anatomy/physiology Vaginal Hysterectomy
``` Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters perineum Physiology: reproduction ```
53
Pathology/indication Vaginal Hysterectomy
Uterine prolapse Symptomatic uterine leiomyomas Endometriosis
54
Define A&P repair (colporrhaphy)
Anterior and Posterior repair Reconstruction of the anterior and posterior aspects of the vaginal vault suturing of the vagina walls
55
Anatomy/physiology A&P repair (colporrhaphy)
vagina, bladder, and/or rectum
56
Pathology/indication A&P repair (colporrhaphy)
Cystocele (anterior) herniation of the bladder into vagina Rectocele (posterior) herniation of the rectum into vagina Enterocele herniation of the intestine into
57
Define Robot laparoscopic hysterectomy
Excision of uterus through the vagina, with MIS techniques for dissection from pelvic cavity
58
Anatomy/physiology Robot laparoscopic hysterectomy
Vagina Cervix Internal os; External os; Endocervical canal Uterus Ligaments: round, broad, cardinal, uterosacral Uterine tubes Ovaries Bladder Ureters Physiology: Reproduction; conception/growth of infant
59
Pathophysiology/indication Robot laparoscopic hysterectomy
Absence of genital prolapse (ligaments too tight to pull uterus into vagina easily) Presence of intra-abdominal scarring Such as post c-section (bladder adhesions) or PID scars Large fibroids or adnexal massesCancer; endometrial or cervical
60
Procedure steps Robot laparoscopic hysterectomy
Insert a vaginal manipulator into the cervix and a vaginal balloon occluder into the vagina Establish laparoscopic access laparoscopic access Dock the robots and position the instruments in the robotic arms and through the ports Manipulate the uterus as the surgeon directed Transect the round ligament using bipolar cautery Identify the ureters Hydrodissect broad ligament; free bladder from uterus Transect the uterosacral and cardinal ligaments and blood vessels Open vaginal vault (FYI: colpotomy; will lose pneumoperitoneum) Move to vaginal approach, transect remaining attachments (including vessels), remove uterus; close vault Restore pneumoperitoneum to Irrigate surgical site with normal saline Achieve hemostasis Close incision and apply dressings (Dermabond, Steri-strips, Obi/peri pad)
61
Define Cesarean section
Delivery of a fetus (or fetuses) through abdominal and uterine incisions
62
Anatomy/physiology Cesarean section
``` Uterus Tubes & ovaries Bladder Cervix Uterine vessels (huge) Placenta; umbilical cord Physiology: reproduction ```
63
Pathology/indication Cesarean section
Elective Malpresentation (malposition) Fetus is not in correct position for delivery Cephalopelvic disproportion (CPD) fetus’ head is too big to pass through mother’s pelvic outlet multiple fetuses (quadruplets; quintuplets; etc.) Placenta previa A portion of the placenta is seated over the cervix Toxemia pre-eclampsia – hypertension, edema, proteinuria Eclampsia – all signs listed above plus seizures Active Herpes or presence of genital warts Some patients with diabetes Some previous C-sections Urgent Dystocia; AKA failure to progress Cervical dystocia: fails to soften to dilate and efface Uterine dysfunction: won’t contract effectually even with oxytocin Emergent Fetal distress Diagnosed by fetal heart rate/tone and blood chemistry (pH) Abruptio placenta (AKA: placental abruption) Placenta detaches before delivery; varying degrees from minor detachment to major detachment Prolapsed cord Umbilical cord drops out ahead of baby
64
Procedure steps Cesarean section
Using a #10 blade on a #3 knife handle a Pfannenstiel incision is made Achieve hemostasis PRN using ESU The incision is carried deeper with ESU and tissue forceps Fascia is identified and incised Goalet or Army-Navy retractors is used to retract the abdominal wall Superior edge of fascia is grasped (Kochers x 2), fascia is bluntly dissected from underlying rectus muscle ESU used on perforating vessels, transect septum, repeat on inferior edge of fascia Rectus abdominis muscles are separated at midline by blunt dissection Peritoneum is identified, grasped (hemostat x 2), and lifted Incise peritoneum and extend with Metzenbaum scissors Place self-retaining retractor for abdominal wall After open peritoneum: Separate bladder flap and retract it inferiorly Palpate the uterus to determine the fetal placement and position Incise uterus with knife, extend with bandage scissors The obstetrician places their hand into the uterus and manipulates the fetus Remove retractors, deliver baby’s head Clamp and cut cord the umbilical cord using Metzenbaum scissors or Lister bandage scissors, pass baby off to neonatal team Clamp uterine walls (Ring forceps or Penningtons) Deliver placenta, inspected it, and removed from the back table Close uterus in layers using absorbable sutures FYI: First closing count Suture to reattach bladder flap Irrigate the surgical site Achieve hemostasis Close the abdominal wall, followed by the skin Stiches or skin staplers may be used to lose the skin Dressings (ABD pad, 4x4 gauze or long tegaderm) and perineal pad is applied.
65
Define cystoscopy
Visual exam of the urinary bladder
66
Anatomy/physiology cystoscopy
``` Urethra Bladder Bladder trigone Ureters Ureteral orifices (openings) Physiology Storage and emptying of urine ```
67
Pathophysiology/indication cystoscopy
Diagnostic exam for: Recurrent UTI; hematuria Urinary retention Cystitis, tumors, fistulae, stones, incontinence
68
Define Ureteroscopy
Visual exam of ureter/s and renal pelvis
69
Anatomy/physiology Ureteroscopy
``` Urethra Bladder Bladder trigone Ureters Ureteral orifices (openings) Renal pelvis Physiology Transport of urine to bladder ```
70
Pathophysiology/indication Ureteroscopy
Ureteral obstruction due to calculi or strictures
71
Define ESWL
Extracorporeal shock wave lithotripsy | To crush stone using shockwaves outside the body
72
Anatomy/physiology ESWL
``` Urethra Bladder Bladder trigone Ureters Ureteral orifices (openings) Physiology Transport of urine to bladder ```
73
Pathophysiology/indication ESWL
Urinary calculus/calculi; kidney or ureteral
74
Define Cystectomy w/ileal conduit
Excision of bladder with diversion of urine into an isolated segment of bowel
75
Anatomy/physiology Cystectomy w/ileal conduit
Bladder, ureters, urethra Ileum and mesentery Physiology: evacuation of urine
76
Pathophysiology/indication Cystectomy w/ileal conduit
Bladder cancer
77
Procedure steps Cystectomy w/ileal conduit
I/H/D/R per Pfannenstiel incision; EUA Isolate bladder from attachments and excise bladder Identify, mobilize and transect ureters; (create mesenteric tunnel) Resect segment of ileum keeping mesenteric blood supply intact Re-anastomose original ileum; close mesentery Sew ureters into the isolated segment of ileum Bring ileal pouch to abdominal wall and create small ostomy Place ureteral catheters as stents; I/H/drain/C/D
78
Define Urethral-Vesical angle repair (Suburethral Sling)
Placement of a supportive device to correct improper urethrovesical (UV) angle
79
Anatomy/physiology Urethral-Vesical angle repair
``` Bladder Urethra Bladder neck Vagina Physiology: controlled release of urine from bladder ```
80
Pathophysiology/indication Urethral-Vesical angle repair
Female urinary incontinence d/t urethral hypermobility | Diagnostic tests: H&P; voiding cystometrogram
81
Define Nephrectomy
Excision of kidney
82
Anatomy/physiology Nephrectomy
``` Kidney; Gerota’s capsule/fascia Renal pelvis; ureter Renal artery and vein (renal pedicle) Vena cava and aorta Physiology of kidney: formation and excretion of urine ```
83
Pathology/Indication Nephrectomy
Renal cancer
84
Procedure steps Nephrectomy
Mark the incision site with a skin marker Using #15 blade on a #3 knife handle a flank incision is made Achieve hemostasis using ESU The incision is carried deeper through the fat, latissimus dorsi, external oblique, and internal oblique muscles Retract the skin, subcutaneous layers, and rib Incise the transverses abdomens fascia Expose the Gerota’s capsule by dissecting paranephric fat Isolate, clamp, cut, ligate ureter Isolate, clamp, triply ligate, cut renal artery then renal vein heavy silk ties - #1 or #2 Remove the kidney Close the incision by layer Gerota’s capsule External oblique muscle Skin Place a drain Apply dressings (4x4 gauze, Long tegaderm, ABD pad, and Surgical tape)
85
Define Kidney transplant
Placement of a living-related or cadaveric donor kidney into the recipient’s iliac fossa
86
Anatomy/physiology Kidney transplant
Donor kidney and pedicle, recipient’s iliac artery and vein, bladder, ureter Physiology of kidney: formation and excretion of urine
87
Pathophysiology/indication Kidney transplant
End-stage renal disease (pathology) | To restore renal function (indication)
88
Define Adrenalectomy (endoscopic)
Excision of one or both adrenal glands via MIS approach
89
Anatomy/physiology Adrenalectomy (endoscopic)
Adrenal gland, upper pole of kidney | Physiology: his is an endocrine gland, so the function is secretion of adrenal hormones
90
Pathophysiology/indication Adrenalectomy (endoscopic)
Hypersecretion Neoplasms Pheochromocytoma
91
Definition TURP | TUR/BT:
Transurethral resection of the prostate | Transurethral resection of bladder tumors
92
Anatomy/physiology TURP/ and bladder tumor
``` Prostate gland Penis Urethra Bladder neck Bladder Physiology: Secretion of seminal fluid ```
93
Pathophysiology/indication TURP/ and bladder tumor
``` TURP: Benign prostatic hypertrophy (BPH) (Hyperplasia) TURBT: Bladder tumors ```
94
Define Prostate seeding
Percutaneous implantation of radioactive seeds in prostate gland brachytherapy
95
Anatomy/physiology Prostate seeding
rectum, scrotum, and prostate | Physiology: secretion of seminal fluid
96
Pathophysiology/indication Prostate seeding
Stage A or B prostate cancer
97
Define Laparoscopic prostatectomy/robotic
Removal of the prostate gland through MIS approach with robotic assistance
98
Anatomy/physiology Laparoscopic prostatectomy/robotic
Prostate gland and capsule Seminal vesicles, rectum Penis, urethra, bladder neck, bladder Physiology: Secretion of seminal fluid
99
Pathophysiology/indication Laparoscopic prostatectomy/robotic
Prostate cancer
100
Procedure steps Laparoscopic prostatectomy/robotic
A 24 Fr Foley catheter is inserted into the patient Establish laparoscopic access • Dock the robots and position the instruments in the robotic arms and through the ports Replace the 30 degree camera with a 0 degree Grasp and pull the bowel superiorly Identify the rectum Incise the peritoneum Identify and divide the vas deferens and seminal vesicles and dissect gland Preserve the neurovascular bundle Replace the 0 degree camera with a 30 degree Incise the transverse peritoneum Divide the umbilical ligament Incise bladder neck, transect urethra distal to prostate A surgical entrapment bad is inserted through the sheath and the prostate is placed inside The specimen is remove Perform urethrovesical anastomosis and test it The sheaths are removed and each incision site is checked for hemostasis Desufflate A new Foley is inserted Each port site is closed and dressing is applied (derma bond, steri-trips).
101
Define Orchiectomy (scrotal)
Excision of one or both testes through a scrotal incision
102
Anatomy/physiology Orchiectomy (scrotal)
Scrotum Tunica vaginalis Testes Epididymis Spermatic cord: Vas deferens, Testicular vessels, Cremaster muscle Physiology: Reproduction; production of sperm and endocrine function to produce testosterone
103
Pathophysiology/indication Orchiectomy (scrotal)
Unilateral: Testicular cancer trauma, infection (both quite rare) Bilateral: Testosterone sensitive metastatic prostate cancer castration-resistant prostate cancer (CRPC) emerging
104
Define Hydrocelectomy
Excision of the tunica vaginalis to remove a fluid-filled sac surrounding the testis
105
Anatomy/physiology Hydrocelectomy
Scrotum, tunica vaginalis, testes, epididymis | Physiology: Reproduction; production of sperm and endocrine function to produce testosterone
106
Pathophysiology/indication Hydrocelectomy
A fluid-filled sac surrounding the testis called a hydrocele
107
Define Orchiopexy
Fixation or suspension of testis
108
Anatomy/physiology Orchiopexy
Scrotum, tunica vaginalis, testes, epididymis | Physiology: Reproduction; production of sperm and endocrine function to produce testosterone
109
Pathophysiology/indication Orchiopexy
Cryptorchidism (undescended testis/testes)
110
Define Penectomy
Excision of the penis (all or part)
111
Anatomy/physiology Penectomy
Penis, urethra, corpora, ligaments and dorsal vessels, perineum, scrotum Physiology: reproduction and urination
112
Pathophysiology/indicationPenectomy
Penile cancer
113
Define Circumcision
Excision of the foreskin of the glans penis
114
Anatomy/physiology Circumcision
urethra, Penis and foreskin | scrotum
115
Pathophysiology/indication Circumcision
Phimosis (foreskin can’t be retracted) Balanoposthitis (inflammation with discharge) Paraphimosis (foreskin can’t be reduced back) Patient request
116
Define Penile prosthesis insertion
Placement of a device to enable sexual penetration
117
Anatomy/physiology Penile prosthesis insertion
Penis, urethra, corpora, ligaments and dorsal vessels, perineum, scrotum Physiology: reproduction and urination
118
Pathophysiology/indication Penile prosthesis insertion
Organic sexual impotence d/t physiologic cause such as: Nerve damage post-prostatectomy Priapism, Peyronie’s disease, trauma HTN/blood pressure medication; Diabetes; and more
119
Ectopic pregnancy
A pregnancy in which the fertilized egg implants outside the uterus.
120
Pfannenstiel steps
Incision made with 10 blade on #3 handle, hemostasis, deepen with ESU and tissue forceps Fascia is identified, incised, and incision extended Small retractor placed in lateral corners to view Superior edge of fascia is grasped (Kochers x 2), fascia is bluntly dissected from underlying rectus muscle ESU used on perforating vessels, transect septum, repeat on inferior edge of fascia Rectus abdominis muscles are separated at midline by blunt dissection Peritoneum is identified, grasped (hemostat x 2), and lifted Incise peritoneum and extend with Metzenbaum scissors (FYI: caution don’t damage bladder inferiorly) Place self-retaining retractor for abdominal wall
121
TAH BSO
Total abdominal hysterectomy with bilateral salpingooophorectomy
122
RSO
right salpingooophorectomy
123
LSO
eft salpingooophorectomy
124
LAVH
laparoscopic-assisted vaginal hysterectomy
125
VBAC
Vaginal birth after cesarean
126
Anatomy and Physiology of GU
Kidneys: filter waste from the body by excretion of urine Adrenal glands: part of the endocrine system Ureters: Peristalsis to carry urine to bladder Urinary bladder: Reservoir for urine bladder trigone: Ureteral orifices (openings) and the urethral orifice Urethra: Exit of urine from body
127
list 5 anatomic features of the kidney
Perirenal fat – serves to protect kidneys Fascia renalis (Gerota’s capsule)– keeps kidneys in position Hilum – concave area where vessels enter/exit Renal artery and vein – blood supply to kidneys Together with nerves + lymph vessels are called the pedicle Renal pelvis and calyces – funnel for urine
128
UPJ | UVJ
- ureteropelvic junction | - ureterovesical junction
129
Male Reproductive System Anatomy/physiology
Prostate gland: Production of alkaline fluid for sperm viability Testes: Produce sperm and secrete hormones (reproductive & endocrine) Epididymis (head, body, tail): Seminal fluid secretion Vas deferens: Sperm transport to seminal vesicle Penis: Urination and reproduction
130
Three vascular bodies of the penis
``` corpora cavernosum (2) Spongiosum ```
131
``` UA UTI PSA BUN KUB IVU RU ```
``` Urinalysis urinary tract infection prostate specific antigen blood urea nitrogen x-ray of kidneys, ureters, bladder intravenous urogram retrograde urogram ```
132
Sterile water is used for? Saline is used for? TURP use either
``` Cystoscopy and RU Sterile water is hypotonic Basic ureteroscopy Saline is isotonic, but is electrolytic 3% Sorbitol or 1.5% Glycine ```
133
Incisions used in GU: state purpose for each
Inguinal Orchiopexy; radical orchiectomy Scrotal Vasectomy; testicular biopsy; simple orchiectomy; orchiopexy Pfannenstiel (provided): Open procedures on the bladder such as cystectomy Gibson Placement of donor kidney (still extraperitoneal) Flank Access to adrenal glands, kidney, and proximal ureter FYI: can be subcostal, transcostal, or intercostal depending upon location of kidney (high-lying or low-lying); note that the left kidney is positioned higher than the right kidney because liver is on the right side Lumbar Adrenalectomy; renal biopsy; small low-lying kidney for nephrectomy
134
Ostomy
to create an opening
135
Pyelo
renal pelvis
136
Otomy
cutting into

Surginal Procedures (14 decks)

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