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PathologyIIExam3ch10urinarych12reproductivech13bonesjoints.pptxXIII. DISEASE OF THE
URINARY SYSTEM
A. Terms dealing with urinary disturbances
1. Oliguria
- a decrease in the amount of urine excreted
- may indicate kidney failure
2. Anuria
- complete suppression of urine excretion
- indicates total kidney failure
3. Polyuria
- an increase in amount of urine excreted
- usually an indication of problems somewhere in the body other than the kidneys
- such as diabetes insipidus
4. Albuminuria
- the presence of albumin or protein in urine
- often associated with glomerulo-nephritis
- hemoglobin in the urine
- associated with hemolytic anemias
- that occur due to certain poisons, snake bites, and malaria
5. Hemoglobinuria
A. Terms dealing with urinary disturbances
6. Hematuria
- blood in the urine
- an important sign in tumors of the urinary system
- also associated with glomerulo-nephritis
- pus in the urine
- indicates a urinary tract infection
- sugar in the urine
- associated with diabetes mellitus (sugar diabetes)
7. Pyuria
8. Glycosuria
B. Uremia
- the toxic condition of excess urea and other nitrogenous wastes in the blood
- associated with renal insufficiency or failure
C. Disease of the kidney
1. Nephritis
- a general term for inflammation of the kidney
C. Disease of the kidney
2. Glomerulonephritis
- a form of nephritis in which the lesions affect primarily the glomeruli
- the glomeruli are the filtering capillaries of the kidney
C. Disease of the kidney
2. Glomerulonephritis
- a form of nephritis in which the lesions affect primarily the glomeruli
- the glomeruli are the filtering capillaries of the kidney
- often follows a previous streptococcal infection
- especially those of the upper respiratory tract
C. Disease of the kidney
3. Pyelitis
- inflammation of the renal pelvis
- the expanded upper part of the ureter
- inflammation of the kidney substance and pelvis
- most common kidney disease
4. Pyelonephritis
The two previous conditions are caused by pyogenic bacteria that enter the kidney by way of the bloodstream or due to bacteria that have ascended from the bladder after entering through the urethra.
C. Disease of the kidney
5. Hydronephrosis
- a collection of urine in the renal pelvis due to an obstructed outflow
C. Disease of the kidney
5. Hydronephrosis
- a collection of urine in the renal pelvis due to an obstructed outflow
- Hydroureters
- the ureters above an obstruction dilated with urine
C. Disease of the kidney
6. Nephrolithiasis
- the formation of renal calculi
- stones are also called kidney stones or nephroliths
D. Ureteritis
- inflammation of the ureters
- the tubes that carry urine from the kidneys to the urinary bladder
- causes constriction and narrowing
E. Cystitis
- inflammation of the urinary bladder
- usually occurs secondary to ascending urinary tract infections
This bladder at autopsy has been opened to reveal areas of hyperemia of the mucosa. This is acute cystitis.
F. Urethritis
- inflammation of the urethra
- the tube that carries urine from the urinary bladder to the outside of the body
--- Ureteritis, Cystitis, and Urethritis are all generally caused by infections with pyogenic bacteria that work their way up the urinary tract
G. Polycystic Kidneys
- a condition in which there is the formation of many cysts in or on the kidney
- can lead to a variety of renal problems:
- enlargement of the cysts compresses the surrounding renal tissue
- cysts are prone to infection
XIV. DISEASE OF THE FEMALE
REPRODUCTIVE SYSTEM
Most of the inflammations of the parts of the female reproductive tract are due to numerous bacterial infections that often are associated with STD’s to be discussed later
A. Uterus
- inflammation of the uterus
- inflammation of the inner lining of the uterus(endometrium)
1. Metritis
2. Endometritis
- inflammation of the mucous membrane of the cervix
- ectopic endometrium located in various sites throughout the pelvis or in the abdominal wall
3. Endocervicitis
4. Endometriosis
5. Preeclampsia
- could be caused by a condition called toxemia of pregnancy
- occurs in pregnant women usually during the third trimester
- can lead to convulsions, coma, and death (Eclampsia)
- there are not really any toxins in the body
- characterized by edema of the extremities and face, high blood pressure and high albuminuria
B. Fallopian (Uterine) Tubes
- inflammation of the fallopian tubes
1. Salpingitis
B. Fallopian (Uterine) Tubes
- inflammation of the fallopian tubes
- when a fertilized ovum attaches to the wall of the fallopian tube or abdominal surface
1. Salpingitis
2. Tubal, Ectopic or Extrauterine Pregnancy
- it may then calcify forming a lithopedion
- embryo will die from lack of blood supply
- or stone child
C. Ovaries
- inflammation of the ovaries
- numerous cysts on or in the ovaries
1. Oophoritis
2. Polycystic Ovaries
- a cyst containing elements of hair, teeth or skin
- commonly seen in the ovaries and testes
3. Dermoid Cysts
D. Vagina
- inflammation of the vagina
1. Vaginitis
- a gonococcal infection
- mechanical irritations such as tight panty hose
- chemical irritations and highly irritating uterine discharges
- yeast infections
- can be caused by:
1. Vaginitis
- caused by the fungus Candida albicans
- commonly seen as a complication of antibiotic therapy
- the normal flora bacteria of the vagina are destroyed, allowing the fungus to grow
- yeast infections
2. Puerperal Sepsis
- a condition of septicemia following childbirth
E. Breasts
- inflammation of the mammary glands
- caused by a hemolytic streptococcus
- infection is usually spread by contaminated obstetrical instruments
- Mastitis
F. Neoplasms
- a common tumor of the ovaries
1. Cystadenoma or cystadenocarcinoma
In this TAH-BSO specimen, the right ovary (on the left of the image) has been replaced by a solid serous carcinoma. The contralateral ovarian tumor is grossly cystic and could be termed a "cystadenocarcinoma.“ This cancer, which was discovered at exploratory laparotomy, apparently developed very rapidly; the patient had a normal pelvic ultrasound exam only 2 months before.
2. Uterine cancer
- cervical cancers are one of the most common malignancies of women worldwide
- most commonly affects the cervix
- usually squamous cell carcinomas
3. Leiomyoma of the uterus
- sometimes called a fibroid tumor
- also a very common tumor
4. Carcinoma of the breast
- another of the most common malignancies of women
- spreads rapidly through the surrounding tissues
- including the blood and lymph vessels in the area
4. Carcinoma of the breast
- another of the most common malignancies of women
- called a mastectomy
- spreads rapidly through the surrounding tissues
- including the blood and lymph vessels in the area
- often requires surgical removal of the breast and surrounding tissues
XV. DISEASE OF THE MALE
REPRODUCTIVE SYSTEM
A. Testes and Epididymis
- inflammation of the testes
- trauma
- as a complication of the mumps or other infectious diseases
- if this infection is serious enough, it may cause scarring, atrophy of the testes and sterility
- may be caused by
1. Orchitis
2. Cryptorchism or cryptorchidism
- failure of the testes or a testis to descend into the scrotum
sterility is often a consequence
- sperm cannot develop properly because of the higher temperature in the pelvic cavity
- in other words…
3. Epididymitis
- inflammation of the epididymis
- usually the result of a gonococcal infection
- severe cases could cause scarring and stop the passage of sperm
4. Varicocele
- varicose veins of the spermatic cord
- a fairly common occurrence
B. Prostate Gland
- inflammation of the prostate gland
- usually secondary to urethritis
- Muscle organ which surrounds the first part of the urethra
- often caused by Neisseria gonorrheae and Escherichia coli
1. Prostatitis
2. Benign Prostatic Hyperplasia
- an enlargement of the prostate gland in men 50 and over
2. Benign Prostatic Hyperplasia
- NOT an inflammatory condition
- an enlargement of the prostate gland in men 50 and over
- associated with a hormone imbalance
- the consequence of this is interference with the passage of urine
C. Scrotum
- the collection of serous fluid in the scrotum
- may be a complication of orchitis, epididymitis, or improper closure of the opening between the peritoneal cavity and the scrotum
1. Hydrocele
- the term can actually be used to mean the collection of serous fluid in any sacculated cavity of the body
D. Neoplasms
1. Carcinoma of the prostate
- common in older men
- metastasizes rapidly to bone and lymph nodes
2. Carcinoma of the testes
- tumors of the testes are usually malignant
- this most commonly affects men in their 20’s, 30’s and 40’s
Normal
Malignant
E. STD's
This section applies to both the male and female reproductive systems
1. Non-specific Urethritis (NSU)
- most often caused by a chlamydial organism
- one of the most common and widespread of the STD’s
2. Genital Herpes
- caused by the Herpes simplex II virus
- there is no cure
- a recurrent disease
- characterized by painful, itchy ulcerations or blisters on the genitals and surrounding areas
3. Gonorrhea
- characterized by suppuration
- caused by the bacterium Neisseria gonorrheae
- will lead to sterility if not properly treated
4. Syphilis
- caused by the spirochete Treponema pallidum
- characterized by three stages of development
- characterized by a genital ulceration called a chancre
- heals after about 4-6 weeks
a. Primary stage
b. Secondary stage
- characterized by a generalized red skin rash and mucous patches
- will last for 2 to 6 weeks
- small ulcerations on the mucous membranes
- these symptoms indicate the organism has spread throughout the body
c. Tertiary syphilis
- characterized by areas of necrotic tissue called gumma
- most commonly affected by this are the nervous and cardiovascular systems
Neurosyphilis
- can cause several conditions
a) damage to the brain causing mental deterioration and paralysis called
general paresis
b) degeneration of the posterior part of the spinal cord called
tabes dorsalis
2) Cardiovascular syphilis
- tends to affect the arteries
- especially the aorta
- causes inflammation, aneurysms and aortic insufficiency
Postmortem Conditions for both male and female reproductive system conditions
1.
2.
3.
4.
Rapid blood coagulation
Ascites
Edema
Infection
XVI. DISEASES OF THE
BONES & JOINTS
A. Bones
- inflammation of bone tissue
- the formation of cysts and fibrous nodules within bones
a. osteitis fibrosa cystica
- due to a hormone imbalance
1. Osteitis
- a chronic inflammation resulting in thickening and deformation
b. Paget’s Disease
- also known as osteitis deformans
- looks like an over-production of bone
Paget's disease of the humerus. Note how dense and wide the bone is. It is also patchy from areas of active bone turnover.
2. Osteomyelitis
- inflammation of bone marrow
- bacteria enter by way of broken bones or through the blood or lymph streams
| Osteomylitis of the Forearm |
| Case History: This 13 y.o. healthy teenager sustained a both bones (radius and ulna) forearm fracture, grade I open, playing football at summer camp. It was washed out and plated 3 days later. Clinical Course: He developed fever, chills, and drainage of the wound several weeks after treatment. He was referred shortly after given oral antibiotics, 6 weeks after injury, with the following presentation. |
This was the wound at presentation. Sero-purulent drainage from the mid-aspect of the wound required frequent dressing changes
Surgical Exploration:
The hardware was removed. Surgical findings revealed extensive fibrinous debris, purulence, dead bone (the white sequestrum), and a shell of new bone
3. Osteoporosis
- an increase in porosity or loss of bone density
- most commonly seen in women after menopause
- bone becomes brittle and tends to break more easily
4. Rickets
- the softening of bone in children
- bones stay soft and deformed
- Vitamin D is essential for absorption of calcium from the digestive tract
- due to a deficiency of vitamin D
- long, weight-bearing bones of the leg tend to be bent or “bowed”
5. Osteomalacia
- softening of bones due to faulty calcification in adulthood
- may also be due to a lack of vitamin D
6. Periostitis
- inflammation of the outer covering of bone (the periosteum)
- tuberculosis of the vertebral column
- produces a
humpbacked malformation
- usually due to bacterial infection
- vertebrae are destroyed and collapse
7. "Pott's Disease"
8. Achondroplasia
- causes a form of dwarfism
- a defect in the formation of cartilage in the growth centers of long bones
Twin brothers
9. Marfan's Syndrome
- leads to a form of giantism
- a hereditary condition of connective tissue and skeletal structures
10. Abnormal curvatures of the spine
- an abnormal posterior curvature of the spine
- a humpback
a. Kyphosis
b. Lordosis
- an abnormal anterior curvature of the spine
c. Scoliosis
- a lateral curvature of the spine in opposite directions
- causes an S-shaped curvature
11. Fractures
- a break that does not pierce the skin
a. Simple or Closed fracture
b. Compound or Open fracture
- a break in which at least a piece of the bone pierces the skin resulting in an open wound
- could also be a wound that leads to a bone that is broken
c. Comminuted fracture
- a break in which the bone is splintered or crushed
- there must be at least three pieces of bone to constitute this
d. Greenstick fracture
- a break in which the bone is cracked or broken on one side and bent on the other
B. Joints
- inflammation of a bursa
- small, sac-like structures that contain synovial fluid
- help to reduce friction in areas where a lot of movement occurs
1. Bursitis
2. Arthritis
- inflammation of a joint
- trauma
- tumors
- degenerative conditions of old age
- allergic reactions
- infectious agents
- bacteria, fungi, and viruses
- could result from:
- may be either acute or chronic
- Most common forms of arthritis:
- affects mainly women age 20-40
- an inflammatory disease
a. Rheumatoid arthritis
- a form of chronic arthritis
- there is usually bilateral involvement of the hands and wrists
- inability of joint movement
- in the later stages the joint may be destroyed and the bones fused together causing a permanent crippling
- Ankylosis
b. Osteoarthritis
- affects both men and women later in life
- a degenerative disease rather than inflammatory
- affects the larger, weight-bearing joints
- another chronic arthritis
- not usually bi-lateral
- thought to be associated with “wear and tear” on the joints
c. Gout
- an hereditary form of arthritis
- deposits urates of sodium crystals around certain joints
- the result of a metabolic problem with uric acid in the body
- causes an intense and painful inflammation
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EXAM # 3
