Discussion

QueenR
Chapter7.pptx

The Language of Medicine 12th edition

Davi-Ellen Chabner

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Chapter 7 Urinary System

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Chapter Goals (Slide 1 of 2)

Name essential organs of the urinary system and describe their locations and functions.

Identify common pathological conditions.

Recognize how urinalysis is used and interpreted as a diagnostic test.

Define urinary-system-related combining forms, prefixes, and suffixes.

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Chapter Goals (Slide 2 of 2)

List and explain clinical procedures, laboratory tests, and abbreviations that pertain to the urinary system.

Understand medical terms in their proper contexts, such as medical reports and records.

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Chapter 7 Lesson 7.1

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Introduction (Slide 1 of 2)

Nitrogenous wastes

Urea

Creatinine

Uric acid

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Why is nitrogenous waste excreted from the body in a soluble rather than gaseous form?

By what medium does urea travel to the kidneys?

Introduction (Slide 2 of 2)

Functions of the kidney

Filter nitrogenous wastes to form urine; about 200 quarts of blood are filtered every day to form 2 quarts of urine

Maintain proper balance of water, electrolytes (sodium, potassium), and acids

Release hormones:

Renin: enzyme important in adjusting blood pressure

Erythropoietin (EPO): hormone that stimulates red blood cell production in the bone marrow

Calciferol: active form of vitamin D necessary for the absorption of calcium from the intestine

Degrade and eliminate hormones from the bloodstream

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The kidneys also adjust the amount of water and electrolytes for proper muscle and nerve function.

Are there other important functions performed by the kidneys?

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Anatomy of the Major Organs (Slide 1 of 4)

Organs of the male urinary system:

Kidney

Ureter

Urinary bladder

Urethra

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Have students name the organs of the urinary system labeled 1-4 in the figure.

What is the size and weight of a normal kidney?

What function is performed by the ureters?

What function is performed by the urinary bladder?

What function is performed by the urethra?

Anatomy of the Major Organs (slide 2 of 4)

Organs of the male urinary system

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Have students name the organs of the urinary system labeled 1-4 in the figure.

What is the size and weight of a normal kidney?

What function is performed by the ureters?

What function is performed by the urinary bladder?

What function is performed by the urethra?

Anatomy of the Major Organs (slide 3 of 4)

Organs of the female urinary system:

Kidney

Ureter

Urinary bladder

Urethra

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How does the female urinary system differ from the male urinary system?

What is the trigone? What function does it perform?

What is micturition?

Anatomy of the Major Organs (slide 4 of 4)

Female urinary system

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How does the female urinary system differ from the male urinary system?

What is the trigone? What function does it perform?

What is micturition?

QUICK QUIZ (Slide 1 of 8)

1. What is voiding?

Nitrogenous waste

Urination

Outer section of the kidney

Triangular area in the bladder

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The correct answer is B: urination.

How Kidneys Produce Urine (Slide 1 of 12)

Blood enters the kidneys through the right and left renal arteries

Arterioles carry blood to the capillaries

Glomeruli filter the blood

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The renal artery branches into smaller arteries, arterioles, and glomeruli located throughout the cortex of the kidneys.

What is a glomerulus?

There are approximately one million glomeruli in the cortex of each kidney.

How does the kidney regulate blood pressure?

Why is maintenance of proper blood pressure important to the kidneys’ function?

How Kidneys Produce Urine (Slide 2 of 12)

Blood enters the kidneys through the right and left renal arteries

Arterioles carry blood to the capillaries

Glomeruli filter the blood

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The renal artery branches into smaller arteries, arterioles, and glomeruli located throughout the cortex of the kidneys.

What is a glomerulus?

There are approximately one million glomeruli in the cortex of each kidney.

How does the kidney regulate blood pressure?

Why is maintenance of proper blood pressure important to the kidneys’ function?

How Kidneys Produce Urine (Slide 3 of 12)

Glomerulus and glomerular/Bowman capsule

Blood passes through the glomeruli

Glomerular (Bowman) capsule surrounds each glomerulus

Renal tubule is attached to each Bowman capsule

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What functions do the glomerulus, Bowman capsule, and renal tubule perform in the production of urine?

Why don’t proteins and blood cells usually appear in the urine?

What is the process of reabsorption?

What is secretion?

What substances make up urine? (Note: These substances become toxic if allowed to accumulate.)

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How Kidneys Produce Urine (Slide 4 of 12)

Glomerulus and glomerular/Bowman capsule

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What functions do the glomerulus, Bowman capsule, and renal tubule perform in the production of urine?

Why don’t proteins and blood cells usually appear in the urine?

What is the process of reabsorption?

What is secretion?

What substances make up urine? (Note: These substances become toxic if allowed to accumulate.)

How Kidneys Produce Urine (Slide 5 of 12)

Three steps in the formation of urine

Glomerular filtration (water, sugar, wastes, salts)

Tubular reabsorption (water, sugar, sodium)

Tubular secretion (acids, potassium, drugs)

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What functions are performed in each of the three steps in the formation of urine?

The combination of a glomerulus and a renal tubule is called a nephron. There are more than one million nephrons in a kidney.

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How Kidneys Produce Urine (Slide 6 of 12)

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What functions are performed in each of the three steps in the formation of urine?

The combination of a glomerulus and a renal tubule is called a nephron. There are more than one million nephrons in a kidney.

The glomerulus and a renal tubule combine to form a unit called a nephron.

How Kidneys Produce Urine (Slide 7 of 12)

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How Kidneys Produce Urine (Slide 8 of 12)

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QUICK QUIZ (Slide 2 of 8)

Approximately how many nephrons are in a kidney?

100,000,000

10,000,000

1,000,000

100,000

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The correct answer is C: one million.

All collecting tubules lead to the renal pelvis.

Calyces or calices are small, cuplike regions of the renal pelvis; the term comes from the Greek, kalux, meaning a cup or case surrounding a flower bud.

How Kidneys Produce Urine (Slide 9 of 12)

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Notice how secretion and reabsorption are functions of the same organs.

Cup-like regions in the renal pelvis are called calyces or calices.

Where do all connecting tubules lead?

The renal pelvis narrows to form the ureter.

To which organ does the ureter lead?

How Kidneys Produce Urine (Slide 10 of 12)

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Notice how secretion and reabsorption are functions of the same organs.

Cup-like regions in the renal pelvis are called calyces or calices.

Where do all connecting tubules lead?

The renal pelvis narrows to form the ureter.

To which organ does the ureter lead?

Functions of the Kidneys

Remove nitrogenous wastes

Balance water and electrolytes

Release hormones

Degrade and eliminate hormones

How Kidneys Produce Urine (Slide 11 of 12)

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How is urine flow from the bladder to the urethra controlled?

What triggers the need to urinate?

Urine finally exits the body through the urinary meatus.

How Kidneys Produce Urine (Slide 12 of 12)

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How is urine flow from the bladder to the urethra controlled?

What triggers the need to urinate?

Urine finally exits the body through the urinary meatus.

Vocabulary (Slide 1 of 14)

Term
arteriole
calyx or calix
catheter
cortex
creatinine
electrolyte

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Vocabulary (Slide 2 of 14)

Term Meaning/Definition
arteriole Small artery
calyx or calix Cuplike collecting region of the renal pelvis; the term comes from the Greek, kalux, meaning a cup or case surrounding a flower bud
catheter Tube for injecting or removing fluids
cortex Outer region of an organ
creatinine Nitrogenous waste excreted in urine
electrolyte Chemical element that carries an electrical charge when dissolved in water.

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Vocabulary (Slide 3 of 14)

Term
erythropoietin (EPO)
filtration
glomerular capsule
glomerulus
hilum

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Vocabulary (Slide 4 of 14)

Term Meaning/Definition
erythropoietin (EPO) Hormone secreted by the kidney to stimulate production of red blood cells by bone marrow; -poietin means a substance that forms
filtration Process whereby some substances pass through a filter
glomerular capsule Enclosing structure surrounding each glomerulus; also called Bowman capsule
glomerulus Tiny ball of capillaries in the kidney
hilum Depression in the part of an organ where blood vessels and nerves enter and leave; comes from the Latin meaning a small thing

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Vocabulary (Slide 5 of 14)

Term
kidney
meatus
medulla
nephron

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Vocabulary (Slide 6 of 14)

Term Meaning/Definition
kidney One of two bean-shaped organs that filter nitrogenous waste from the bloodstream to form urine
meatus Opening or canal
medulla Inner region of an organ; the term comes from the Latin, medulla, meaning marrow
nephron The functional unit of the kidney where filtration, reabsorption, and secretion take place

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Vocabulary (Slide 7 of 14)

Term
nitrogenous waste
potassium (K+)
reabsorption
renal artery

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Vocabulary (Slide 8 of 14)

Term Meaning/Definition
nitrogenous waste Substance containing nitrogen and excreted in urine; examples are urea, uric acid, and creatine
potassium (K+) An electrolyte regulated by the kidney
reabsorption Renal tubules return materials necessary to the body back into the bloodstream
renal artery Blood vessel that carries blood to the kidney

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Vocabulary (Slide 9 of 14)

Term
renal pelvis
renal tubules
renal vein

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Vocabulary (Slide 10 of 14)

Term Meaning/Definition
renal pelvis Central collection region in the kidney
renal tubules Microscopic tubes in the kidney where urine is formed after filtration
renal vein Blood vessel that carries blood away from the kidney

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Vocabulary (Slide 11 of 14)

Term
renin
sodium (Na+)
trigone
urea

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Vocabulary (Slide 12 of 14)

Term Meaning/Definition
renin Enzyme secreted by the kidney that raises blood pressure
sodium (Na+) An electrolyte regulated in the blood and urine by the kidneys; a common form of sodium is sodium chloride (salt)
trigone Triangular area in the urinary bladder
urea Major nitrogenous waste excreted in urine

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Vocabulary (Slide 13 of 14)

Term
ureter
urethra
uric acid
urinary bladder
urination (voiding)

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Vocabulary (Slide 14 of 14)

Term Meaning/Definition
ureter One of two tubes leading from the kidneys to the urinary bladder
urethra Tube leading from the urinary bladder to the outside of the body
uric acid Nitrogenous waste product excreted in the urine
urinary bladder Hollow, muscular sac that holds and stores urine
urination (voiding) Process of expelling urine; also called micturition

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Terminology: Structures (Slide 1 of 6)

Combining Form
cali/o, calic/o
cyst/o
glomerul/o
meat/o

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Terminology: Structures (Slide 2 of 6)

Combining Form Meaning
cali/o, calic/o calyx (calix); cup-shaped
cyst/o urinary bladder
glomerul/o glomerulus
meat/o meatus

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Terminology: Structures (Slide 3 of 6)

Combining Form
nephr/o
pyel/o
ren/o
trigon/o

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Terminology: Structures (Slide 4 of 6)

Combining Form Meaning
nephr/o kidney
pyel/o renal pelvis
ren/o kidney
trigon/o trigone

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Terminology: Structures (Slide 5 of 6)

Combining Form
ureter/o
urethr/o
vesic/o

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Terminology: Structures (Slide 6 of 6)

Combining Form Meaning
ureter/o ureter
urethr/o urethra
vesic/o urinary bladder

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Terminology: Substances and Symptoms (Slide 1 of 6)

Combining Form
albumin/o
azot/o
bacteri/o
dips/o

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Terminology: Substances and Symptoms (Slide 2 of 6)

Combining Form Meaning
albumin/o albumin
azot/o nitrogen
bacteri/o bacteria
dips/o thirst

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Terminology: Substances and Symptoms (Slide 3 of 6)

Combining Form
kal/o
ket/o, keton/o
lith/o
natr/o
noct/o
olig/o

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Terminology: Substances and Symptoms (Slide 4 of 6)

Combining Form Meaning
kal/o potassium
ket/o, keton/o ketone bodies
lith/o stone
natr/o sodium
noct/o night
olig/o scanty

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Terminology: Substances and Symptoms (Slide 5 of 6)

Combining Form or Suffix
-poietin
py/o
-tripsy
ur/o
-uria
urin/o

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Terminology: Substances and Symptoms (Slide 6 of 6)

Combining Form or Suffix Meaning
-poietin substance that forms
py/o pus
-tripsy to crush
ur/o urea
-uria urination; urine condition
urin/o urine

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Urinalysis (Slide 1 of 2)

Tests Included in a Urinalysis

Color

Appearance

pH

Protein

Glucose

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Colorless urine = large amount of water in the urine. Smoky-red or brown = presence of blood in the urine.

Normal pH is 6.5 (slightly acidic).

Protein test looks for albumin, which indicates a leak in the glomerular membrane.

Glucose presence signals possibility of diabetes.

Urinalysis (Slide 2 of 2)

Tests Included in a Urinalysis (continued)

Specific gravity

Ketone bodies

Sediment

Phenylketonuria

Bilirubin

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Specific gravity reflects the amount of wastes and minerals.

Ketone bodies appear when the body breaks down fat.

Sediment are abnormal particles.

Phenylketonuria indicates a lack of enzyme, especially in infants. PKU test measures this.

Bilirubin results from a hemoglobin breakdown.

QUICK QUIZ (Slide 3 of 8)

In a urinalysis, what does the test of specific gravity reflect?

A. The chemical nature of urine

B. The presence of albumin

C. Blood in the urine

D. The amount of wastes, minerals, and solids in the urine

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The correct answer is D. Specific gravity compares the density of urine with that of water.

Chapter 7 Lesson 7.2

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Pathologic Conditions (Slide 1 of 5)

Kidney

Glomerulonephritis

Interstitial nephritis

Nephrolithiasis

Nephrotic syndrome

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Glomerulonephritis is the inflammation of the glomeruli within the kidney due to infection; it can lead to hypertension and renal failure if untreated.

What is interstitial nephritis?

What procedure might a physician recommend for a patient with nephrolithiasis?

Nephrotic syndrome is a collection of symptoms caused by excessive protein loss in urine.

Polycystic kidneys are a hereditary condition characterized by a progressive growth of cysts. There are two types of hereditary PKD. One type is usually asymptomatic until middle age and then is marked by maturia, urinary tract infections, and nephrolithiasis. The other type of PKD occurs in infants or children and results in renal failure.

Pathologic Conditions (Slide 2 of 5)

Kidney

Polycystic

kidney

disease (PKD)

PKD—The kidneys contain masses of cysts. Typically polycystic kidneys weigh 20 times more than their usual weight.

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Polycystic kidneys are a hereditary condition characterized by a progressive growth of cysts.

Pathologic Conditions (Slide 3 of 5)

Kidney

Pyelonephritis

Renal cell carcinoma

Renal failure

Renal hypertension

Wilms tumor

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Pyelonephritis is the inflammation of the lining of the renal pelvis and renal parenchyma.

Renal cell carcinoma is adult cancer of the kidney—2% of all adult cancers.

What occurs during renal failure?

How does renal hypertension differ from essential hypertension?

Wilms tumor is a malignant tumor of the kidney occurring in childhood and is an example of an eponym.

Pathologic Conditions (Slide 4 of 5)

Kidney

Renal cell

carcinoma

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Pathologic Conditions (Slide 5 of 5)

Urinary bladder

Bladder cancer

Associated conditions

Diabetes insipidus (DI)

Diabetes mellitus (DM)

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What risk factors are associated with bladder cancer?

Diabetes insipidus: Antidiuretic hormone is not secreted adequately or the kidney is resistant to its effect.

Diabetes mellitus: Insulin is not secreted adequately or not used properly in the body.

How does each of these conditions affect the kidneys?

QUICK QUIZ (Slide 4 of 8)

A term that means frequent (voluntary) urination at night is:

anuria

nocturia

diuresis

hematuria

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The correct answer is B: nocturia.

Laboratory Tests and Clinical Procedures (Slide 1 of 10)

Laboratory tests

Blood urea nitrogen (BUN)

Creatinine clearance test

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Which procedure tests for uremia?

Which test measures the rate at which creatinine is cleared from the blood?

What is azotemia?

What role do the kidneys play in BUN levels?

Laboratory Tests and Clinical Procedures (Slide 2 of 10)

Clinical procedures

X-ray Studies

CT urography

Kidneys, ureters, and bladder (KUB)

Renal angiography

Retrograde pyelogram (RP)

Voiding cystourethrogram (VCUG)

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How do these x-rays differ?

Which tests require contrast material?

Why is it important to measure the size of the kidneys (KUB)?

Which tests require urinary catheterization?

Why would someone have RP instead of IVP?

Laboratory Tests and Clinical Procedures (Slide 3 of 10)

CT-Computed tomography

The scan with contrast shows a benign cyst on the kidney.

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Laboratory Tests and Clinical Procedures (Slide 4 of 10)

Voiding cystourethrogram

(VCUG) showing a normal female urethra. The bladder is filled with contrast material, followed by x-ray imaging.

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Laboratory Tests and Clinical Procedures (Slide 5 of 10)

Clinical Procedures

Ultrasound examination

Ultrasonography: imaging urinary tract structures using high frequency sound waves

Radioactive studies

Radioisotope scan: image of kidney after injecting a radioisotope into the bloodstream

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What is hydronephrosis?

What might cause the kidney to be enlarged?

What can be diagnosed in the urinary system using sound waves?

Laboratory Tests and Clinical Procedures (Slide 6 of 10)

Clinical Procedures

Magnetic imaging

Magnetic resonance imaging (MRI) urography: A changing magnetic field produces images of an organ and surrounding structures in three planes of the body

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How is an MRI of the kidney performed?

Laboratory Tests and Clinical Procedures (Slide 7 of 10)

Other Clinical Procedures

Cystoscopy

Dialysis

Lithotripsy

Renal angioplasty

Renal biopsy

Renal transplantation

Urinary catheterization

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Cystoscopy allows for visual examination through a hollow metal tube.

What is the difference between hemodialysis and peritoneal dialysis?

What procedure might be required to remove kidney stones?

Describe the process of catheterization.

Laboratory Tests and Clinical Procedures (Slide 8 of 10)

Cystoscopy—direct visual examination of urinary bladder with an endoscope

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How is a cytoscopy performed?

Laboratory Tests and Clinical Procedures (Slide 9 of 10)

Hemodialysis (HD)

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Laboratory Tests and Clinical Procedures (Slide 10 of 10)

Continuous ambulatory peritoneal dialysis (CAPD)

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CAPD can be performed continuously by the patient without artificial support.

What other peritoneal dialysis procedures may be performed?

Abbreviations (Slide 1 of 6)

Abbreviation
ADH
AKI
ARF
BILI
BUN
CAPD
Cath
CCPD
CKD

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Abbreviations (Slide 2 of 6)

Abbreviation Meaning
ADH Antidiuretic hormone
AKI Acute renal injury
ARF Acute renal failure
BILI Bilirubin
BUN Blood urea nitrogen
CAPD Continuous ambulatory peritoneal dialysis
Cath Catheter; catheterization
CCPD Continuous cycling peritoneal dialysis
CKD Chronic kidney disease

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Abbreviations (Slide 3 of 6)

Abbreviation
CL-
CrCl
CRF
C & S
Cysto
eGFR
ESRD
ESWL
HCO3-
HD
IC

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Abbreviations (Slide 4 of 6)

Abbreviation Meaning
CL- Chloride, a kidney excretion
CrCl Creatinine clearance
CRF Chronic renal failure
C & S Culture and sensitivity testing
Cysto Cystoscopic examination
eGFR Estimated glomerular filtration rate
ESRD End-stage renal disease
ESWL Extracorporeal shockwave lithrotripsy
HCO3- Bicarbonate, an electrolyte conserved by the kidney
HD Hemodialysis
IC Interstitial cystitis, chronic inflammation of the bladder wall

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Abbreviations (Slide 5 of 6)

Abbreviation
IVP
K+
KUB
Na+
PD
pH
PKD
sp gr
UA
UTI
VCUG

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Abbreviations (Slide 6 of 6)

Abbreviation Meaning
IVP Intravenous pyelogram
K+ Potassium, an electrolyte
KUB Kidney ureter and bladder
Na+ Sodium, an electrolyte
PD Peritoneal dialysis
pH Potential hydrogen; degree of acidity or alkalinity
PKD Phenylketonuria
sp gr Specific gravity
UA Urinalysis
UTI Urinary tract infection
VCUG Voiding cystourethrogram

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QUICK QUIZ (Slide 5 of 8)

The abbreviation RP is associated with which of the following?

A. Fluid is injected into the peritoneal

cavity and then drained out.

B. Contrast is injected into the urinary

bladder and ureters, and x-rays are

taken of the urinary tract.

C. Nitrogenous wastes are removed from

the patient’s blood.

D. An electrolyte is secreted by renal tubules.

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78

The correct answer is B; this is the abbreviation for retrograde pyelogram.

Incorrect answer A is CAPD—continuous ambulatory periotoneal dialysis.

Incorrect answer C is HD—hemodialysis.

Incorrect answer D is K+ potassium.

Review Sheet: Combining Forms (Slide 1 of 10)

Combining Form
albumino/o
angi/o
azot/o
bacteri/o
cali/o, calic/o
cyst/o

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Review Sheet: Combining Forms (Slide 2 of 10)

Combining Form Meaning
albumino/o albumin (protein)
angi/o vessel (blood)
azot/o urea; nitrogen
bacteri/o bacteria
cali/o, calic/o calyx (calix); cup-shaped
cyst/o urinary bladder

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Review Sheet: Combining Forms (Slide 3 of 10)

Combining Form
dips/o
glomerul/o
glycos/o
hydr/o
isch/o
kal/o
ket/o; keton/o

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Review Sheet: Combining Forms (Slide 4 of 10)

Combining Form Meaning
dips/o thirst
glomerul/o glomerulus
glycos/o sugar
hydr/o water
isch/o to hold back; back
kal/o potassium
ket/o; keton/o ketones; acetones

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Review Sheet: Combining Forms (Slide 5 of 10)

Combining Form
lith/o
meat/o
natr/o
necr/o
nephr/o
noct/o
ogli/o

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Review Sheet: Combining Forms (Slide 6 of 10)

Combining Form Meaning
lith/o stone
meat/o meatus
natr/o sodium
necr/o death
nephr/o kidney
noct/o night
ogli/o scanty

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Review Sheet: Combining Forms (Slide 7 of 10)

Combining Form
py/o
pyel/o
ren/o
trigon/o
ur/o

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Review Sheet: Combining Forms (Slide 8 of 10)

Combining Form Meaning
py/o pus
pyel/o renal pelvis
ren/o kidney
trigon/o trigone
ur/o urine; urinary tract

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Review Sheet: Combining Forms (Slide 9 of 10)

Combining Form
ureter/o
urethr/o
urin/o
vesic/o

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Review Sheet: Combining Forms (Slide 10 of 10)

Combining Form Meaning
ureter/o ureter
urethr/o urethra
urin/o urine
vesic/o urinary bladder

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Review Sheet: Suffixes (Slide 1 of 8)

Suffix
-ectasis
-ectomy
-emia
-esis
-gram
-lithiasis

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Review Sheet: Suffixes (Slide 2 of 8)

Suffix Meaning
-ectasis stretching; dilation
-ectomy removal; excision
-emia blood condition
-esis condition
-gram record
-lithiasis condition of stones

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Review Sheet: Suffixes (Slide 3 of 8)

Suffix
-lithotomy
-lysis
-megaly
-ole
-osis
-pathy

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Review Sheet: Suffixes (Slide 4 of 8)

Suffix Meaning
-lithotomy incision for removal of a stone
-lysis breakdown
-megaly enlargement
-ole little; small
-osis condition
-pathy disease

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Review Sheet: Suffixes (Slide 5 of 8)

Suffix
-plasty
-poietin
-ptosis
-rrhea
-sclerosis
-stomy

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Review Sheet: Suffixes (Slide 6 of 8)

Suffix Meaning
-plasty surgical repair
-poietin substance that forms
-ptosis droop; sag
-rrhea flow; discharge
-sclerosis hardening
-stomy new opening (to form a mouth)

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Review Sheet: Suffixes (Slide 7 of 8)

Suffix
-tomy
-tripsy
-uria

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Review Sheet: Suffixes (Slide 8 of 8)

Suffix Meaning
-tomy process of cutting
-tripsy to crush
-uria urination

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Review Sheet: Prefixes (Slide 1 of 4)

Prefix
a-, an-
anti-
dia-
dys-

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Review Sheet: Prefixes (Slide 2 of 4)

Prefix Meaning
a-, an- not; without
anti- again
dia- complete
dys- bad; painful

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Review Sheet: Prefixes (Slide 3 of 4)

Prefix
en-
peri-
poly-
retro-

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Review Sheet: Prefixes (Slide 4 of 4)

Prefix Meaning
en- in; within
peri- surrounding
poly- many, much
retro- behind; back

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100

QUICK QUIZ (Slide 6 of 8)

The combining form dips/o means:

stone

scanty

thirst

water

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101

The correct answer is C: thirst.

QUICK QUIZ (Slide 7 of 8)

Which combining form means pus?

pyel/o

lith/o

ogli/o

py/o

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102

The correct answer is D: py/o.

QUICK QUIZ (Slide 8 of 8)

8. The combining form isch/o means:

scanty

to hold back; back

night

trigon

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103

The correct answer is B: to hold back.