SUR 104 unit 4

what does genitourinary surgery include?

three common approaches used in GU surgery

surgery performed through a flexible or rigid fiberoptic endoscope inserted through the external urethra, providing direct visualization and access to the lower urinary tract

surgery performed through an open incision in the abdomen or flank

closed surgery performed using percutaneous endoscopic techniques (laparotomy)

where does retroperitoneal cavity lie?

serous membrane covering the retroperitoneal cavity on the anterior side

primary organs for filtration of blood

where are the kidneys located?

which kidney sits lower than the other?

how are the kidneys supported?

2 main tissue layers that make up the kidney

covered with strong fibrous tissue and contains portions of the microscopic tubules that filter the blood

composed of 8 to 12 large collecting areas (renal pyramids)

notched area on the medial side of each kidney

filtering units in the kidneys

how many nephrons are present in each kidney?

capillary structure within the kidney that allows nephron to communicate with the vascular system to filter blood

where is the capillary network of each nephron contained?

how much fluid can the glomerulus filter per minute and what is this called?

specific regions of the tubule system

what are formed by the precipitation of specific salts?

decreased or no urinary output

diseases in which kidney stones are seen

how are calculi reduced?

paired organs that lie on the medial side of the upper kidney

what do the adrenal glands secrete?

how is blood supplied to each adrenal gland?

how long is each ureter?

segmental contraction and relaxation of the ureter's muscular layer

4 tissue layers of the bladder

distal portion of the bladder

micturation

what are the sphincter muscles of the bladder neck controlled by?

urethral opening

mucous-secreting glands located on each side of the urethra just inside the meatus

parts of the male urethra

layered tissue sac that encases the testicles

folds in the skin of the sacrum

male reproductive cells

fibrous membrane enclosing testicles

smallest units of male ductal system

primary male sex hormone

convoluted duct that secretes seminal fluid

liquid substance that gives sperm mobility through male reproductive tract

joins epididymis with ejaculatory duct

paired structures that secrete approximately 60% of the semen

surrounds urethra and secretes alkaline fluid that contributes to seminal fluid

glands that secrete mucus, which contributes to the total volume of the semen

what procedure is performed in patients with chronic end-stage renal disease?

what is kidney dialysis?

2 types of kidney dialysis

dialysis in which blood is shunted into a heparinized machine

how long does hemodialysis normally last and how many times is it performed?

major vein and artery are anastomosed by an implanted artificial graft for access to the vascular system during hemodialysis

dialysis in which a Silastic tube is implanted in the suprapubic peritoneal space and dialysis solution is instilled into the catheter

stones formed by crystalline mineral and salts precipitated from filtrate produced in the kidney

greatest risk factor for cancer of the kidney?

primary cancer of the kidney arises from?

causes of end-stage renal disease

most common tumors in children, arising in kidney

overproduction of glucocorticoid

most common form of urinary tract cancer

traumatic injury to the bladder occurs most often when?

loss of sphincter control at the bladder neck

UTI is commonly caused by?

age-related enlargement of the prostate gland

congenital anomaly in which one or both testicles fail to descend into scrotum in fetal life

urethra open on top side of the penis or may be exposed along the full length

urethra fails to develop fully, resulting in urethral shortening and displacement of urethral meatus

cancer that originates in the squamous cells of the glans or foreskin

cancer that arises from the germ cell of the testicle

rotation of the testicle related to congenital anomaly or as a result of vigorous activity in young males - medical emergency

enlarged, dilated veins in the scrotum

primary function of the urinary system

how much urine do the kidneys produce per day?

main components of urine

ratio of the density of urine compared to water

primary protein component of the blood

measures rate of creatinine clearance from the blood

how is GFR measured?

test that assesses the elimination of urea from the liver

preferred method for imaging tumors of the kidney

what is a noncontrast helical CT used to diagnose?

what is IV urography used for?

radiograph of kidney, ureters and bladder

what is KUB used for?

test that provides images of the bladder while it is emptying

radiographic test commonly used in the diagnosis of tumors

radiographic test used to detect metastasis arising from primary tumor of prostate

how is retrograde ureteropyelogram performed?

radiographic test used for patients ineligible for CT or other forms of radiographic exposure

ureters require what type of instruments?

what types of instruments are used to occlude vessels and for blunt dissection?

what is the direct forward cystoscope used for?

what is the right-angle cystoscope for?

sizes of Brown-Buerger cystoscope

most common Brown-Buerger cystoscope size for adults

hollow tube that serves as a passageway for the instruments used during cystoscopy and resection

transurethral, electrosurgical instrument used to remove small fragments of tissue, cutting and coagulating target tissue inside the bladder

most common type of resectoscope

urinary catheter sizes

purposes for urinary catheterization

used to apply pressure against a tissue or opening

surgery of the distal GU system performed with operative cystourethroscope

when is basic cystoscopy performed?

small incision made in the internal urethra to release scar tissue or other stricture

small incision is made in urethral meatus to relieve stricture

most common complications of cystoscopic procedures

most common cause of urinary obstruction

specialized instrument that grasps and crushes renal stone

procedure in which the prostate is removed with a resectoscope inserted through urethra

nonmalignant enlargement of the prostate gland

2 ways in which the prostate can enlarge

backward flow of urine

in what position is the patient placed for TURP procedure?

during TURP, what type of irrigation fluid is used?

after resection, how long does Foley catheter remain?

possible postop complications of TURP

congenital downward curvature of the penis

principle of hypospadius repair

2 types of penile implants available

where is cylinder from the penile implant placed during insertion?

ligation of the veins of the testes to reduce venous backflow of blood into internal spermatic veins, done to improve spermatogenesis

vascular abnormality in which the pampiniform venous plexus of the scrotum is dilated

benign, fluid-filled sac that develops in the anterior testis

surgical removal of one or both testicles

twisting of the testis, resulting in ischemia and necrosis

removing section of vas deferens and sealing the free ends, preventing the movement of sperm through the ejaculatory ducts

surgical anastomosis of vas deferens to restore continuity after vasectomy

insertion of suprapubic catheter into the bladder for drainage through a percutaneous or open approach

total or partial removal of the bladder, most often to treat bladder cancer

second most common cancer of the GU system

for what is cystectomy indicated?

procedure in which a functional bladder is constructed with a loop of bowel that is brought out of the abdominal wall

suspension of the bladder neck and urethra to the cartilage of the pubic symphysis to treat urinary stress incontinence in the female

what is overflow incontinence caused by?

procedure in which bladder neck is held in suspension with biosynthetic strip or fascia graft which is attached to abdominal wall

removal of a prostatic adenoma through a perineal approach

initial tests to diagnose prostate cancer

why is suprapubic prostatectomy performed?

removal of tissue or organ without previous fragmentation or dissection

distention of renal pelvis and proximal ureter caused by obstruction in ureter and reflux of kidney filtrate

reconstruction of the ureter at the level of the renal pelvis

procedure of the ureter

reconstruction of the ureter

anastomosis of the ureter with another hollow structure to provide continuity

crossing of one ureter to another to create an anastomosis between the two ureters

reimplantation of the ureter in the bladder

large stones in the kidney or upper ureter are removed percutaneously through nephroscope

what type of irrigation solution is used to flush the operative site during nephroscopy?

surgical removal of one kidney