GenitalUrinary System

1
Genital-Urinary System

• Renal System Part 1

2
Behavioral Objectives

• Review the anatomy and physiology of the
  genito-urinary systems
• Describe the physical assessment of the GU
  systems
• Discuss the application of the nursing process as
  it relates to patients with disorders of the GU
  system
• Describe the purpose and methods for collecting
  sterile and clean-catch urine specimens.
• Discuss the importance of monitoring and
  maintaining intake and output and appropriate
  documentation
• Discuss common diagnostic tests, procedures and
  related nursing responsibilities for the patient
  with GU disorders.
• Explain the purpose of dialysis and differentiate
  between peritoneal and hemodialysis

3
Introduction

• Essential to life
• Every head to toe assessment must include
• upper and lower urinary tract function

4
Anatomy Kidneys

• Kidneys
• Location
• Two
• Posterior wall of the abdomen
• Base of the rib cage
• Surrounded by renal capsule

5
Anatomy Kidney

• Two distinct regions
• Renal parenchyma
• Renal Pelvis

• Renal parenchyma
• Renal Pelvis

6
Renal parenchyma

• Cortex
• Nephrons
• Glomerulus
• Bowmans capsules
• Proximal convoluted tubule

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• Medulla
• Loops of Henle
• Distal convoluted tubules
• Collecting tubules
• Peritubular capillaries
• Function
• Drain urine
• from the nephron
• to the renal pelvis

8
Anatomy Kidney

• Renal pelvis
• Urine passes to the ureter ? bladder
• Renal artery
• Renal Vein

9
Blood flow threw the kidney

• Aorta ?
• Renal artery ?
• The afferent arteriole ?
• Glomerulus
• Capillary bed responsible for glomerular
  filtration ?
• Efferent arteriole ?
• Venules and veins.

10
Anatomy Ureters

• Urine nephrons ? ureter,
• a long narrow muscular tube renal pelvis ?
  bladder
• Two
• Upper urinary tract

11

• 3 narrowed areas
• promotes efflux
• prevents reflux
• micturition ?
• Narrow areas close off ?
• Urine will not enter the bladder ?
• Finish voiding ?
• Narrow area will re-open ?
• Urine can again drain into the bladder

12

• lining urothelium
• prevents reabsorption of urine
• The movement of urine is facilitated by
  peristaltic waves

13
Anatomy Bladder

• Muscular, hollow sac located just behind the
  symphysis pubis.

14

• Normal bladder capacity
• 300-600 ml of urine
• Hypovolemic shock
• Temporarily clamping the Foley drainage tubing
  after 750 ml of urine
• Detrusor muscle

15

• Neck of the bladder
• Smooth muscle
• Internal urinary sphincter
• Involuntary control

16
Anatomy Urethra

• Carries urine from the bladder expels it from
  the body
• External urinary sphincter
• voluntary control

17
Physiology of the Urinary System

• Responsible for
• Urine formation
• Excretion of waste products
• Regulation of electrolytes, acid and water
• Auto-regulation of blood pressure

18
Physiology of the Urinary System

• Urine formation
• The nephrons form urine through a complex 3-step
  process
• Glomerular filtration
• Tubular reabsorption
• Tubular secretion

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Glomerular filtration

• Most of the blood, except
• large molecules
• blood cells,
• forced out of the blood ? capillaries of the
  glomerulus ? Bowmans capsule.
• High capillary BP in the glomerulus.

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Tubular reabsorption

• As the filtrate ? first parts of the tubular
  structure
• Electrolytes
• Glucose
• Water
• reabsorbed back into the capillaries