Kidney & Ureter

Question 1

• drainage system
• removes urine, excess fluids, and metabolic waste

Answer 1

Urinary tract

Question 2

• Excretion of nitrous and other metabolic waste
• Regulation of water, electrolyte and acid-base balance
• Production of renin, prostaglandin, erythropoietin and Vit D3
• Glucogenesis

Answer 2

Kidney
(Physiology)

Question 3

When doing a kidney/urinary tract surgery..

• Patient position: ________ recumbency
• Surgeon position: ________ the kidney of interest
• Approach: _______

Answer 3

• Patient position: dorsal recumbency
• Surgeon position: opposite the kidney of interest
• Approach: ventral midline

Question 4

Removal of the whole kidney

Mas madali, one kidney lang need i-consider.

Answer 4

Total Nephrectomy

Question 5

Consider the function of the contralateral kidney because if not functioning well, then do ___ _______________

Answer 5

partial nephrectomy

Question 6

Removing a portion just a portion of the kidney (just the affected portion)

Answer 6

Partial Nephrectomy

Question 7

the ________ are non regenerative, hence, you cannot be uncertain with the procedures

Answer 7

nephrons

Question 8

before proceeding to any procedure, place a non-crushing tissue forceps or clamps over the ____ and the ____

Answer 8

artery, vein

Question 9

Two types of partial nephrectomy

Answer 9

1. Guillotine type
2. Incision type

Question 10

The blood vessels are closed, and identified if there are bleeding ones

this will be difficult because the arteries and veins have been occluded beforehand

Answer 10

Incision type

Question 10

Sutures are pre-placed through the parenchyma

Non-crushing tissue forcep – applied to both artery & vein

Cut the portion you have to remove

Close the parenchyma

Appose the kidney edges together

Capsules are kept intact (seal that would prevent leakage from the kidney)

Answer 10

Guillotine type

Question 10

Electrocoagulation is avoided

Answer 10

Partial nephrectomy

Question 11

To ensure the function of the contralateral kidney, undergo:

Answer 11

1. Biochemistry tests
2. Diagnostic imagings
3. Exploratory laparotomy

Question 11

Surgical opening of the kidney

Answer 11

Nephrotomy

Question 12

suture on
kidney parenchyma

placed on the renal cortex only

Answer 12

Horizontal mattress suture

Question 13

used to close the capsule

2 layers of capsule closure

Answer 13

simple continuous

Question 14

Incising the proximal portion of the ureter to approach the calculi located in the area

Difference bet. nephrectomy: no need to apply non-crushing forcep in vessels, because incision is in the proximal aspect of urethra (minimal bleeding)

Answer 14

Pyelolithotomy

Question 15

• Done to remove obstructive calculi lodged on the ureter itself
• Incision is made on the ureter
• Higher risk of postoperative leakage
• The procedure is risky because it involves making a transverse incision on the organ, but remember that the ureter is very small, so be careful not to transect it (refer to picture below)

Answer 15

Ureterotomy

Question 16

Recommended incision & closure for ureterotomy

Answer 16

longitudinal incision and transverse closure (so luminal size is larger)

Question 17

Closure pattern utererotmy

Answer 17

simple continuous or
Lembert pattern

Question 18

Advantage of transverse closure:

Answer 18

1. mas lumalaki yung luminal diameter
2. less risk of urinal stricture (hindi sasara butas)

Question 19

insertion of a urinary catheter

Answer 19

Catheterization

Question 20

• Urine sample collection
• Decompression of an enlarged urinary bladder

Answer 20

Cystocentesis

Question 21

(5) Types of Catheter

Answer 21

1. Rubber
2. Silicone
3. PVC
4. Stainless steel
5. Foley catheter

Question 22

Urethra is shorter, & bladder is larger. Therefore, blockage is more uncommon.

Answer 22

Female animals

Question 23

Opening of the urinary bladder

Answer 23

Cystotomy

Question 24

Cystotomy incision for male - female -

Answer 24

male - paramedian female - ventral midline

Question 25

location of Lazy vet procedure that's prone to urine spillage

Answer 25

ventral aspect of urinary bladder

Question 26

surgical incision of the urethra

Answer 26

Urethrotomy

Question 27

permanent opening created in cases of **recurrent urethral problems**

Answer 27

Urethrostomy

Question 28

(2) Types of Urethrotomy

Answer 28

1. Pre-scrotal 2. Perineal

Question 29

* Since it is temporary, castration may or may not be done. * Create an opening only | Do not close, let it granulate

Answer 29

Pre-scrotal urethrotomy

Question 30

usually not done, cuz most of the blockage are located at the os penis

Answer 30

Perineal urethrotomy

Question 31

Perineal urethrotomy post op problem they’ve encountered with closing the urethra is ___ ____

Answer 31

urine scalding | seen as bruising

Question 32

Urethrostomy most common site

Answer 32

pre-pubic

Question 33

(4) sites of Urethrostomy

Answer 33

1. Pre-scrotal 2. Scrotal 3. Perineal 4. Pre-pubic

Question 34

Since it is a permanent opening and we’ve seen someone that did not perform castration, the problem with that is whenever the animal would have the erection, the sutures attaching the skin and the urethral mucosa together get disrupted. If ____ urethrostomy will be performed, castration must be performed as well! (also true for cats)

Answer 34

Scrotal urethrostomy

Question 35

Theis soft and thin It will tear apart if you simply attach or appose it and the skin → will cause dehiscence and cause tearing of the urethra.

Answer 35

urethral mucosa

Question 36

It is important to include the ____ layer of the penis which will add integrity to the suture.

Answer 36

fibrous layer

Question 37

DO NOT incise this in urethrostomy

Answer 37

corpus cavernosum

Question 38

Feline Perineal Urethrostomy Animal position: ________ Surgical approach: _______

Answer 38

Animal position: **ventral** recumbency Surgical approach: **parapreputial**