Chapter 21, urolithiasis

pain

urine flow is blocked

streching of renal capsule

a stone getting stuck in the lumen of the ureter, pain occurs as stone is moving through ureter

• idiopathic
• heredity
• males more often than females

• usually start in tubule or papillae
• nidus forms
• nidus gets trapped in calyx
• nidus attracts other crystals
• grows into a stone

• high urinary concentration of stone-forming substances
• urinary tract infection
• metabolic factors-gout, hyoercalcemia
• immobility

urine stasis

cellular debris from an infection may form a nidus

calcium

a hyperactive parathyroid gland

• flank pain
• nausea, vomiting
• cool moist skin
• rapid pulse
• pain spasm

• KUB
• IVP
• CT scan

to analyze the stone and find the content and predisposing factors

• small stones pass
• extracorporeal shock wave lithotripsy-break up large stones
• laser lithotripsy
• drugs to dissolve
• treat underlying cause
• adjust pH by fluid intake
• increase fluid intake
• pain killers/morphine/narcotic analgesics

large stone that forms in the renal calyces and pelvis that resembles deer antlers

renal failure

good