Medical Terminology CH 9

Medical Terminology
A LIVING LANGUAGE
Fifth Edition
CHAPTER 9
Urinary System
Medical Terminology: A Living Language, Fifth Edition

Bonnie F. Fremgen • Suzanne S. Frucht
Multimedia Directory
Slide 10 Urinary System Animation
Slide 22 Kidney Animation
Slide 69 Kidney Stone Video
Slide 73 Renal Failure Video
Slide 80 Urinalysis Video
Slide 88 Catheterization Video

Urinary System at a Glance
• Functions of Urinary System

 Maintain stable internal environment
 Remove waste products
 Adjust water and electrolyte levels
 Maintain correct pH

Urinary System at a Glance
• Organs of Urinary System

 Two kidneys
 Two ureters
 One urinary bladder
 One urethra

Urinary System
Illustrated

Urinary System Combining Forms
• azot/o – nitrogenous waste

• bacteri/o – bacteria
• cyst/o – bladder
• glomerul/o – glomerulus
• glycos/o – sugar, glucose
• keton/o – ketones
• lith/o – stone
• meat/o – meatus
• nephr/o – kidney
Urinary System Combining Forms
• noct/i – night
• olig/o – scanty
• protein/o – protein
• pyel/o – renal pelvis
• ren/o – kidney
• ureter/o – ureter
• urethr/o – urethra
• urin/o – urine
• ur/o – urine
Urinary System Suffixes
-lith stone
-lithiasis condition of stones
-ptosis drooping
-tripsy surgical crushing
-uria condition of the urine

Anatomy and Physiology
• Also called genitourinary system

• Consists of
 Two kidneys
 Two ureters
 One urinary bladder
 One urethra

Urinary System Animation
Click on the screenshot to view an animation of the urinary system.

The animation may take a moment before playing.
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Function
• Main function is to filter and remove

waste products from blood
• Metabolic processes produce waste
• Blood becomes toxic if waste builds up
• Waste materials are called urine
• Urine is then removed from body

Homeostasis
• Responsible for homeostasis

 Maintain proper balance of water and
chemicals in body
• Regulate levels of electrolytes
 Sodium
 Potassium
 Chloride
 Bicarbonate
• Maintain pH
Waste Removal
• Waste is removed through system of

blood vessels and tubules
 Called the nephron
 More than 1 million make up each kidney
 Produce urine
• Urine drains from kidney through
ureters to bladder, into urethra, and
then out of body

Kidneys
• Located behind
peritoneum
 Retroperitoneal
• Concave area on
edge of center
called hilum
 Renal artery enters
 Renal vein leaves
 Ureter leaves

Figure 9.1
Kidney structure. Longitudinal section showing the renal artery entering and the renal
vein and ureter exiting at the hilum of the kidney.

Internal Structure of Kidneys
• Cortex
 Outer portion
• Medulla
 Inner portion
• Pyramids
 Triangular shaped
structures in
medulla
• Papilla
 Tip of each renal
pyramid

Figure 9.2
Longitudinal section of a kidney illustrating the internal structures.

Internal Structures of the Kidneys
• Calyx
 Small open area
that receives urine
from each papilla
• Renal pelvis
 Large open area
that receives urine
from each calyx
 Empties into ureter

Figure 9.2
Longitudinal section of a kidney illustrating the internal structures.

Nephron
• Functional unit of kidney

• Microscopic
• More than 1 million nephrons in each
kidney
• Consists of
 Renal corpuscle
 Renal tubules

Renal Corpuscle
• Two parts:
 Glomerulus
 Glomerular or
Bowman’s capsule
• Blood flows through
glomerulus
• Substances filtered
from blood and enter
glomerular capsule

Kidney Animation
Click on the screenshot to view an animation demonstrating renal blood flow.
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Renal Tubules
• Four sections:
 Proximal
convoluted tubule
 Loop of Henle
 Distal convoluted
tubule
 Collecting tubule

Renal Tubules
• Filtrate flows
through renal
tubules to
complete urine
production process

Figure 9.3
The structure of a nephron.

Three Stages of Urine Production
• Urine is produced as filtrate moves

through renal tubules
• Three stages:
 Filtration
 Reabsorption
 Secretion

Filtration
• Between
glomerulus and
Bowman’s capsule
• Filtrate is produced
 Water
 Glucose
 Amino acids
 Wastes
• Filtrate enters
renal tubules
Reabsorption
• As filtrate moves
through renal
tubules
 Water & desirable
molecules are
reabsorbed
 Returned to blood
in peritubular
capillaries

Reabsorption
through renal
tubules
 Waste &
undesirable
molecules remain in
renal tubules

Secretion
through renal
tubules
 Additional waste
products removed
from blood in
peritubular
capillaries
 Added to filtrate in
renal tubules

Figure 9.7
The three stages of urine production: filtration, reabsorption, and secretion.

Ureters
• Urine drains from

renal pelvis into
ureters
• Extend from renal
pelvis to urinary
bladder
• Lined with mucous
membranes

Figure 9.4
The ureters extend from the kidneys to the urinary bladder.

Urinary Bladder
• Elastic muscular
sac
 Smooth muscle
tissue
 Lined with mucous
membrane
 Folded into rugae
• Lies in base of
pelvis
 Behind pubic
symphysis
Figure 9.5
The structure of the urinary bladder.

Urinary Bladder
• Receives urine from ureters

• Stores urine
 Holds 250 mL of urine
• Excretes through urethra
• Involuntary muscle action causes:
 Bladder to contract
 Internal sphincter to relax
• Voluntary muscles control external
sphincter
Urethra
• Tubular canal lined with mucous

membrane
 1½ inches long in females
 8 inches long in males
• Carries urine from bladder to outside of
body
• External opening is called urinary
meatus

Urethra
• Releasing urine from body is called

 Micturition
 Voiding
 Urination

Figure 9.6A
The male urethra extends from the urinary bladder in the floor of the pelvis through the
penis to the urinary meatus.

Figure 9.6B
The much shorter female urethra extends from the urinary bladder to the floor of the
pelvis and exits just in front of the vaginal opening.

Urine
• Normally straw colored to clear

• 95% water
• Contains:
 Excess water
 Excess electrolytes
 Toxins
 Nitrogen wastes

Urine
• Normal 24-hour output 1,000 to 2,000

mL
• Acidic, specific gravity varies
 1:001 to 1:030

Table 9.1
Values for Urinalysis Testing

Table 9.2
Abnormal Urinalysis Findings

Additional Combining Forms
• bi/o – life
• carcin/o – cancer
• corpor/o – body
• hem/o – blood
• hemat/o – blood
• necr/o – death
• neur/o – nerve
• peritone/o – peritoneum
Additional Combining Forms
• py/o – pus
• ven/o – vein

Additional Suffixes
• -al pertaining to
• -algia pain
• -ar pertaining to
• -ary pertaining to
• -cele protrusion
• -eal pertaining to
• -ectasis dilated
• -ectomy surgical removal
Additional Suffixes
• -emia blood condition

• -genic produced by
• -gram record
• -graphy process of recording
• -ic pertaining to
• -itis inflammation
• -logist one who studies
• -logy study of
Additional Suffixes
• -lysis to destroy
• -malacia softening
• -megaly enlarged
• -meter instrument to measure
• -oma tumor
• -ory pertaining to
• -osis abnormal condition
• -ostomy create a new opening
Additional Suffixes
• -otomy cutting into

• -ous pertaining to
• -pathy disease
• -pexy surgical fixation
• -plasty surgical repair
• -rrhagia abnormal flow condition
• -sclerosis hardening

Additional Suffixes
• -scope instrument to visually

examine
• -scopy process of visually
examining
• -stenosis narrowing
• -tic pertaining to

Additional Prefixes
• an- without
• anti- against
• dys- abnormal, difficult
• extra- outside of
• hydro- water
• intra- within
• poly- many
• retro- backward
Anatomical Terms
cystic pertaining to the urinary bladder

renal pertaining to the kidney
ureteral pertaining to a ureter
urethral pertaining to the urethra
urinary pertaining to urine

Building Anatomical Terms
• Cystic
cyst/o + -ic
 Pertaining to the bladder
• Renal
ren/o + -al
 Pertaining to the kidney

Building Anatomical Terms
• Urethral
urethr/o + -al
 Pertaining to the urethra
• Ureteral
ureter/o + -al
 Pertaining to a ureter

Medical Specialties
Branch of medicine involved in diagnosis

nephrology and treatment of diseases and disorders of
the kidney. Physician is a nephrologist.
Branch of medicine involved in diagnosis
and treatment of diseases and disorders of
urology
the urinary system (and male reproductive
system). Physician is a urologist.

Signs and Symptoms
complete lack of urine production and lack

anuria
of urine excretion
azotemia nitrogenous waste in the bloodstream
bacteriuria presence of bacteria in the urine
stone formed within an organ from mineral
calculus
salts
cystalgia urinary bladder pain

Figure 9.8
Sectioned kidney specimen illustrating extensive renal calculi.
(Dr. E. Walker/Science Photo Library/Photo Researchers, Inc.)

Signs and Symptoms
cystolith bladder stone

cystorrhagia profuse bleeding from urinary bladder
diuresis increased formation and secretion of urine
dysuria difficult or painful urination
involuntary discharge of urine; also called
enuresis
bed-wetting at night
greater urge to urinate; no increase in
frequency
total volume of urine
glycosuria presence of sugar in the urine

Signs and Symptoms
hematuria presence of blood in the urine

decrease in force of urine stream, often
hesitancy
with difficulty initiating the flow
presence of ketones in the urine; occurs
ketonuria when body burns fat instead of glucose
for energy
nephrolith kidney stone
nephromalacia kidney is abnormally soft
nephromegaly kidney is enlarged

Signs and Symptoms
nephrosclerosis kidney tissue has become hardened

having to urinate frequently during the
nocturia
night
oliguria producing too little urine
producing an unusually large volume
polyuria
of urine
proteinuria presence of protein in the urine
pyuria presence of pus in the urine

Signs and Symptoms
renal colic pain caused by a kidney stone

narrowing of a passageway in the
stricture
urinary system
accumulation of waste products in the
uremia
bloodstream
ureterectasis ureter is stretched our or dilated
ureterolith stone in the ureter
ureterostenosis ureter has become narrow

Signs and Symptoms
urethralgia urethral pain

urethrorrhagia profuse bleeding from the urethra
urethrostenosis urethra has become narrow
feeling the need to urinate
urgency
immediately
urinary
involuntary release of urine
incontinence
urinary retention inability to fully empty the bladder

Figure 9.9
Healthcare worker draining urine from a bladder catheter bag.

Building Signs & Symptoms Terms
• Anuria
an- + -uria
 Condition of being without urine
• Cystolith
cyst/o + -lith
 Bladder stone

Building Signs & Symptoms Terms
• Glycosuria
glycos/o + -uria
 Condition of sugar in the urine
• Nephromegaly
nephr/o + -megaly
 Enlarged kidney

Kidney Pathology
acute tubular damage to renal tubules due to

necrosis (ATN) toxins in the urine; results in oliguria
damage to glomerular capillaries
diabetic
due to high blood sugar of diabetes
nephropathy
mellitus
inflammation of the kidney; more
glomerulonephritis
permeable to protein and blood cells
distention of renal pelvis due to
hydronephrosis
accumulation of urine in the kidney

Kidney Pathology
nephritis kidney inflammation

presence of calculi in the kidney;
nephrolithiasis
solidification of salts in the urine
nephroma kidney tumor
general term for presence of kidney
nephropathy
disease
downward displacement of the kidney;
nephroptosis
floating kidney

Kidney Stone Video
Click on the screenshot to view a video on the topic of kidney stones.

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Kidney Pathology
nephrotic damage to glomerulus; protein appears

syndrome (NS) in the urine
polycystic formation of multiple cysts within the
kidneys kidney; destroys normal kidney tissue
pyelitis renal pelvis inflammation

Figure 9.10
A polycystic kidney on the left compared to a normal kidney on the right.
(Simon Fraser/Royal Victoria Infirmary, Newcastle/Photo Researchers, inc.)

Kidney Pathology
inflammation of renal pelvis and

pyelonephritis kidney; common type of kidney
disease
renal cell
cancerous tumor of renal tubule cells
carcinoma
inability of kidneys to filter wastes;
renal failure
results in uremia
malignant kidney tumor; most often
Wilm’s tumor
found in children

Renal Failure Video
Click on the screenshot to view a video on the topic of renal failure.

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Urinary Bladder Pathology
cancerous tumor arising from cells

bladder cancer lining bladder; symptom is
hematuria
bladder neck
obstruction blockage of bladder outlet; often
caused by enlarged prostate gland
(BNO)
cystitis urinary bladder inflammation
protrusion of the urinary bladder
cystocele
into wall of vagina

Urinary Bladder Pathology
inflammation and irritation of

interstitial cystitis
bladder
neurogenic loss of nervous control; leads to
bladder retention
urinary tract infection of any organ of urinary

infection system; usually from bacteria;
begins with cystitis and may ascend
(UTI) into ureters and kidneys

Building Pathology Terms
• Polycystic
poly- + cyst/o + -ic
 Pertaining to having multiple pouches
(cysts)
• Pyelonephritis
pyel/o + nephr/o + -itis
 Inflammation of renal pelvis and kidney

Building Pathology Terms
• Carcinoma
carcin/o + -oma
 Cancerous tumor
• Cystocele
cyst/o + -cele
 Protrusion of the bladder

Clinical Laboratory Tests
blood urea blood test to evaluate kidney function by

nitrogen measuring level of nitrogenous waste
(BUN) (urea) in the bloodstream
clean catch urine sample obtained after cleaning off
specimen the urinary meatus and collecting sample
(CC) in midstream
test of kidney function; amount of
creatinine
creatinine in bloodstream is compared to
clearance
amount in the urine

Clinical Laboratory Tests
urinalysis physical, chemical, and microscopic

(U/A, UA) examination of urine
urine culture test for bacterial infection; attempt to

& sensitivity grow bacteria on a culture medium in
order to identify it; then determine which
(C&S) antibiotics it is sensitive to
instrument to measure specific gravity of
urinometer
urine

Urinalysis Video
Click on the screenshot to view a video on the topic of urinalysis.

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Diagnostic Imaging
cystogram X-ray record of the bladder

contrast dye is placed in bladder and then
cystography
X-ray is taken; outlines bladder
excretory dye is injected into bloodstream; X-ray
urography traces the dye as it moves through organs
(EU) of the urinary system
intravenous
pyelography injecting a dye into a vein and then taking
an X-ray to outline the renal pelvis
(IVP)

Diagnostic Imaging
kidneys, ureters, abdominal X-ray showing the

bladder (KUB) kidneys, ureters, and bladder
nephrogram X-ray record of the kidney
pyelogram X-ray record of the renal pelvis
retrograde dye is inserted through the urethra
pyelogram to outline the bladder, ureters, and
(RP) renal pelvis
voiding dye is placed in the bladder; X-ray
cystourethrograph taken to visualize the urethra while
y (VCUG) patient is voiding

Figure 9.11
Color enhanced retrograde pyelogram X-ray. Radiopaque dye outlines urinary bladder,
ureters, and renal pelves.
(Clinique Ste. Catherine/CNRI/Science Photo Library/Photo Researchers, Inc.)

Endoscopic Procedures
instrument used to visually examine

cystoscope
urinary bladder
cystoscopy visual examination of the urinary bladder
(cysto) using a cystoscope
instrument used to visually examine
urethroscope
urethra

Building Diagnostic Terms
• Urinometer
urin/o + -meter
 Instrument to measure urine (specific
gravity)
• Nephrogram
nephr/o + -gram
 Record of the kidney

Building Diagnostic Terms
• Pyeloography
pyel/o + -graphy
 Process of recording the renal pelvis
• Cystoscope
cyst/o + -scope
 Instrument to visually examine bladder

Medical Treatments
flexible tube inserted into the body;

catheter commonly through urethra into
bladder
catheterization insertion of a tube through urethra
(cath) and into the urinary bladder
extracorporeal
shockwave use of ultrasound waves to break up
lithotripsy renal calculi
(ESWL)

Catheterization Video
Click on the screenshot to view a video on the topic of catheterization.

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Figure 9.12
Extracorporeal shockwave lithotripsy, a non-invasive procedure using high frequency
sound waves to shatter kidney stones.

Medical Treatments
hemodialysis use of artificial kidney machine to

(HD) filter the blood
removes wastes using chemically
peritoneal
balanced solutions placed into
dialysis
peritoneal cavity

Figure 9.13
Patient undergoing hemodialysis. Patient’s blood passes through hemodialysis machine
for cleansing.

Figure 9.14
Peritoneal dialysis. Chemically balanced solution is placed into the abdominal cavity to
draw impurities out of the bloodstream. It is removed after several hours.

Surgical Treatments
cystectomy surgical removal of the bladder

cystopexy surgical fixation of the bladder
cystoplasty surgical repair of the bladder
cystostomy create a new opening into the bladder
cystotomy cutting into the bladder
lithotomy cutting into (to remove) a stone
lithotripsy crushing a stone in the bladder or urethra
meatotomy incision into the meatus

Surgical Treatments
nephrectomy surgical removal of a kidney

incision to directly remove stones
nephrolithotomy
from the kidney
nephropexy surgical fixation of a kidney
nephrostomy create a new opening into a kidney
nephrotomy cutting into a kidney
pyeloplasty surgical repair of the renal pelvis
renal transplant surgical placement of a donor kidney

Figure 9.15
Figure illustrates location utilized for implantation of donor kidney.

Building Therapeutic Terms
• Extracorporeal
extra- + corpor/o + -eal
 Pertaining to outside the body
• Lithotripsy
lith/o + -tripsy
 Surgical crushing of a stone

Building Therapeutic Terms
• Cystotomy
cyst/o + -otomy
 Cutting into the bladder
• Nephropexy
nephr/o + -pexy
 Surgical fixation of a kidney

Urinary System Pharmacology
treats bacterial
antibiotic Cipro, Macrobid
infections
prevent or reduce
Ditropan,
antispasmodic bladder muscle
Prostigmine
spasms
increases volume of
diuretics Lasix, Aldactone
urine

Urinary System Abbreviations
AGN acute glomerulonephritis

ARF acute renal failure
ATN acute tubular necrosis
BNO bladder neck obstruction
BUN blood urea nitrogen
cath catheterization

Cl– chloride
CRF chronic renal failure
C&S culture and sensitivity

continuous ambulatory peritoneal
CAPD
dialysis
CC clean catch urine specimen
cysto cystoscopy
ESRD end-stage renal disease

ESWL extracorporeal shockwave lithotripsy

EU excretory urography
GU genitourinary
HCO3– bicarbonate
HD hemodialysis
H 2O water
I&O input and output

IPD intermittent peritoneal dialysis

IVP intravenous pyelogram
K+ potassium
KUB kidney, ureter, bladder
mL milliliter
Na+ sodium
NS nephrotic syndrome

pH acidity or alkalinity
RP retrograde pyelogram
SG, sp.gr. specific gravity
U/A, UA urinalysis
UC urine culture
UTI urinary tract infection
VCUG voiding cystourethrography

Combining Forms Match Up
1. cyst/o a. sugar
2. glycos/o b. stone
3. lith/o c. kidney
4. nephr/o d. scanty
5. olig/o e. bladder


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Medical Terminology

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• Functions of Urinary System

Medical Terminology: A Living Language, Fifth Edition

• Organs of Urinary System

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• azot/o – nitrogenous waste

Medical Terminology: A Living Language, Fifth Edition

• Also called genitourinary system

Medical Terminology: A Living Language, Fifth Edition

Click on the screenshot to view an animation of the urinary system.

• Main function is to filter and remove

Medical Terminology: A Living Language, Fifth Edition

• Responsible for homeostasis

• Waste is removed through system of

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• Functional unit of kidney

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Click on the screenshot to view an animation demonstrating renal blood flow.

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• Urine is produced as filtrate moves

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• Urine drains from

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• Receives urine from ureters

• Tubular canal lined with mucous

Medical Terminology: A Living Language, Fifth Edition

• Releasing urine from body is called

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• Normally straw colored to clear

Medical Terminology: A Living Language, Fifth Edition

• Normal 24-hour output 1,000 to 2,000

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

• -emia blood condition

• -otomy cutting into

Medical Terminology: A Living Language, Fifth Edition

• -scope instrument to visually

Medical Terminology: A Living Language, Fifth Edition

cystic pertaining to the urinary bladder

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition

Medical Terminology: A Living Language, Fifth Edition