HAPN23A – HUMAN ANATOMY AND PHYSIOLOGY

GENITOURINARY SYSTEM
MARK D. DUBLIN, DMD, LPT, MA
LYCEUM OF THE PHILIPPINES UNIVERSITY – MANILA
COLLEGE OF ARTS AND SCIENCES
 Objectives
After studying this chapter, you will be able to:
•Name the parts of the urinary system and discuss the function of each
part
•Name the common diagnoses, clinical procedures, and laboratory tests
used in treating disorders of the urinary system
•List and define the major pathological conditions of the urinary system
•Explain the meaning of surgical terms related to the urinary system
•Recognize common pharmacological agents used in treating the urinary
system

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Structure and Functions of Urinary System

Bladder Kidneys
•Also called the excretory system

•Maintains water balance

•Removes waste products from the blood

by excreting them in the urine Urinary System

Urethra Ureters

Meatus / Opening

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Kidneys
Kidneys
The kidneys are bean-shaped organs
located in the retroperitoneal portion
of the abdominal cavity on either side
of the vertebral column.

Two Primary Functions

•To form urine for excretion

•To retain essential substances the body needs in the process called reabsorption

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Parts of the Kidney
Kidneys filter about 1700 liters of blood daily
in the average adult. kidney
medulla

Parts of the kidneys

•Cortex hilum
-outer protective portion
•Medulla
-inner soft portion
•Hilum
-a depression located in the middle of the concave side of
the kidney where blood vessels, nerves, and the ureters
enter and exit the kidneys cortex

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Urine
Urine isProduction
produced by filtration of:
•water •sugar •creatine
•salts •urea •uric acid

Each kidney contains more than 1 million nephrons which are the functional units of the kidneys.

Blood Flow through the Kidneys

Blood enters through the renal artery arterioles
Each arteriole leads to a nephron renal corpuscle
(which has a group of capillaries called the glomerulus)

The glomerulus filters fluid from the blood and is the first place where urine is formed in
the kidneys.

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FLUID ABSORPTION IN THE DIGESTIVE SYSTEM
FLOW OF URINE (Fluid to Urine)

Structure and Function

•Blood flows through the glomerulus at a constant rate.

•Each glomerulus is surrounded by a capsule known as

Bowman’s capsule.

•Blood then passes into the renal tubules where some

substances are reabsorbed and the remaining become
urine.

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Ureters
Ureters

•A tube approximately 6 to 7 inches long attached to each kidney

•Made up of three layers of tissue
-smooth muscle
-fibrous tissue
-mucous layer

Peristalsis, a rhythmic contraction of the ureter smooth muscle which helps to move the urine
into the bladder.

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 Urinary Bladder Urinary Bladder

•Hollow, muscular organ that stores urine

•Sphincter muscles hold the urine in place
•Holds 300 to 400 milliliters of urine before
emptying
•Walls contain epithelial tissue that stretch to
A healthy bladder can hold about 2 cups of
allow the bladder to hold twice its capacity
urine before it's considered full. It takes your
body 9 to 10 hours to produce 2 cups of urine. •The trigone is a triangular area at the base of
That's about if you can wait and still be in the the bladder where the ureters enter, and the
safe zone without the possibility of damaging urethra exits
your organs.

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Urethra
Urethra
A tube of smooth muscle with a mucous lining that carries urine from the bladder to the
outside of the body.

Female Urethra Male Urethra

•Approximately 1.5 inches long •Approximately 8 inches long

•Opens through the meatus •Passes through three different regions:
-prostate gland
-membranous portion
Excreting urine is called voiding or micturition -penis

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PATHWAY OF SPERM

The seminal vesicles are paired ductal structures on the posterior-lateral aspect of
the base of the bladder and secrete fluid that will form part of the semen. This
fluid contains proteins, enzymes, mucus, and nutrients such as fructose.

The bulbourethral gland or Cowper's gland, which is homologous to the Bartholin's

gland in females, produces a pre-ejaculate that cleanses and lubricates the
urethra prior to the arrival of the semen.
Diagnostic, Procedures, and Laboratory
Terms
Urologists are physicians who specialize in disorders of the male and female
urinary tracts, and the male reproductive system.

Common Tests Characteristics of Urine

Urinalysis •Normal urine is straw-colored and clear

• Normal specific gravity (SG) range is
•Examination of the urine for its from 4.5 to 8.0
physical and chemical properties •Specific gravity measures the number of
•Obtained from clients who fill a wastes, minerals and solids present in the
specimen container or by urinary urine
catheterization

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Abnormal Findings in Urine
Blood Casts Glucose Albumin Ketones

Abnormal Findings
in the Urine

Phenylketones (PKU) Bilirubin

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 Urinalysis Results
For a urinalysis, your urine sample is evaluated in three ways: visual exam, dipstick test and microscopic exam.

Visual exam
A lab technician examines the urine's appearance. Urine is typically clear. Cloudiness or an unusual odor may indicate a
problem, such as an infection.
Blood in the urine may make it look red or brown. Urine color can be influenced by what you've just eaten. For example, beets
or rhubarb may add a red tint to your urine.

Dipstick test
A dipstick — a thin, plastic stick with strips of chemicals on it — is placed in the urine to detect abnormalities. The chemical
strips change color if certain substances are present or if their levels are above normal.
 Dipstick Test
• Acidity (pH). The pH level indicates the amount of acid in urine. Abnormal pH levels may indicate a kidney or urinary tract
disorder.
• Concentration. A measure of concentration, or specific gravity, shows how concentrated particles are in your urine. A higher-
than-normal concentration often is a result of not drinking enough fluids.
• Protein. Low levels of protein in urine are normal. Small increases in protein in urine usually aren't a cause for concern, but
larger amounts may indicate a kidney problem.
• Sugar. Normally the amount of sugar (glucose) in urine is too low to be detected. Any detection of sugar on this test usually
calls for follow-up testing for diabetes.
• Ketones. As with sugar, any amount of ketones detected in your urine could be a sign of diabetes and requires follow-up
testing.
• Bilirubin. Bilirubin is a product of red blood cell breakdown. Normally, bilirubin is carried in the blood and passes into your
liver, where it's removed and becomes part of bile. Bilirubin in your urine may indicate liver damage or disease.
• Evidence of infection. If either nitrites or leukocyte esterase — a product of white blood cells — is detected in your urine, it
may be a sign of a urinary tract infection.
• Blood. Blood in your urine requires additional testing — it may be a sign of kidney damage, infection, kidney or bladder
stones, kidney or bladder cancer, or blood disorders.
 During this exam, several drops of urine are viewed
with a microscope. If any of the following are
observed in above-average levels, additional testing
may be necessary:

• White blood cells (leukocytes) may be a sign of

an infection.
• Red blood cells (erythrocytes) may be a sign of
Microscopic kidney disease, a blood disorder or another
underlying medical condition, such as bladder
Exam cancer.
• Bacteria or yeasts may indicate an infection.
• Casts — tube-shaped proteins — may form as a
result of kidney disorders.
• Crystals that form from chemicals in urine may be
a sign of kidney stones.
 A urinalysis alone usually doesn't provide a definite diagnosis. Depending
on the reason your doctor recommended this test, abnormal results may or
may not require follow-up.

Your doctor may evaluate the urinalysis results along with those of other
tests — or order additional tests — to determine next steps.

Remember For example, if you are otherwise healthy and have no signs or symptoms
of illness, results slightly above normal on a urinalysis may not be a cause
for concern and follow-up may not be needed. However, if you've been
diagnosed with a kidney or urinary tract disease, elevated levels may
indicate a need to change your treatment plan.

For specifics about what your urinalysis results mean, talk with your doctor.
 Urinary
bladder Foley catheter

Types of Catheters - Foley

Types of Catheters

To urine container
Foley catheter

•An indwelling catheter held in place by

an inflated balloon in the bladder

Clip
Drain

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Types of Catheters - Condom Condom catheter

Types of Catheters Tube

Condom catheter
Leg collection
bag
•External catheter consisting of a rubber
sheath placed over the penis

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Blood Tests
Blood Tests

•Blood Urea Nitrogen (BUN)

•Creatinine Clearance Test

The presence of high amounts of urea or creatinine in the blood shows that the kidney is not
properly filtering these substances.

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Imaging Tests
Imaging Tests

•Cystoscopy
-tubular instrument used to examine
the bladder
•Intravenous Pyelogram
-x-rays of the urinary tract after a contrast
medium is injected into the bloodstream

•KUB
-x-ray of three parts of the urinary tract (kidney, ureter, and bladder)

•Renal Scan

-radioactive imaging used to diagnose kidney disorders

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 Dialysis solution
Urinary Tract Procedures
Urinary Tract Procedures

Dialysis Peritoneal
•Hemodialysis cavity
-the process of filtering blood outside the
body in an artificial kidney machine that
returns the blood back to the body after
Solution
filtering.
draining
out
Peritoneal dialysis (pictured)
-the insertion and removal of a dialysis
solution into the peritoneal cavity.
Catheter
Drained
solution

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ESWL
Extracorporeal Shock Wave Lithotripsy (ESWL)

-the breaking up of urinary stones by using

shock waves from outside the body

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Pathological Terms
Terms Used to Describe Difficulties in Urination

anuresis polyuria

•No urinary output •Excessive urination

dysuria incontinence

•Involuntary discharge of urine or feces

•Painful urination

enuresis oliguria

•Lack of bladder control •Scanty urination

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Surgical Terms
Parts of the urinary system may be surgically
removed

•Nephrectomy- removal of a kidney

•Ureterectomy- removal of a ureter
•Cystectomy- removal of the bladder

Surgical repair procedures

•Pyeloplasty- repair of the renal pelvis

•Cystoplasty- repair of the bladder
•Urethroplasty- repair of the urethra

A urostomy is the creation of an artificial opening in the abdomen through which

urine exits the body.

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Other Surgical Procedures
Other Surgical Procedures

Nephrolysis

•Removal of an adhesion in the kidney

Nephrolithotomy

•Removal of a kidney stone

Nephropexy

•Surgical fixation of the kidney

Nephrorrhaphy

•Suturing of a damaged kidney

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Pharmacological Terms
Medications used for urinary conditions assist to:

•Relieve Pain (analgesic)

•Relieve Spasms (antispasmodic)

•Inhibit the growth of microorganisms (antibiotic)

•Increase urine output (diuretic)

•Decrease urine output (antidiuretic)

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The End