urinary system 泌尿系統(tǒng)課件

urinarysystemStructureKidney－formurine

Ureter－conducturinefromkidneystobladderUrinarybladder－receivesandstoresurineUrethra－conductsurinefrombladdertoexteriorofbody(discharged)sphinctermuscle—helpkeepurinefromleakingposteriorabdominalwallshowingthekidneysanduretersinsituThemainfunctionsoftheurinarysystemisdischargedoutwastesandexcessivefluidsintheprocessofmetabolismofourbody,tokeepthebalanceandstabilityoftheinternalenviroment.

bladder

Generalfeature－pyramidalinshapewhenempty,having

Apex膀胱尖

Fundus膀胱底

Bodyofbladder膀胱體

Neck膀胱頸

tuberculosisandtumorprimarysiteuretericorificeinternalurethralorificeposteriorNormalvolumofbladderadult：350-500mlmaxium：800mlnewborn：1／10ofadultseminalcoliculusejaculatoryductdeferensseminalvesicleUrethra

尿道

★

FemaleurethraRelatively

shorter(about3-5cmlong),widerandstraightmediansagittalsectionofmale/femalepelvisfemaleurinateurinate,ejaculatebladderuterusurethraovaryvaginaurethraprostateureterbladderglanspenisscrotumUrineformation1.Glomerularfiltration2.renaltubuleandcollectingductreabsorption3.renaltubuleandcollectingductsecretion,excretionUrea,togetherwithwaterandotherwastesubstanceslikeinorganicsaltformstheurine.Urinaryexcretionkidneys----ureters----bladder----urethral----outofbodyMicturitionsignificance:exhaustthebody'swaste,regulatebodywaterandsaltbalance,maintainthephysiologicalfunctionofnormaltissuecellsCommondiseasesARFacuterenalfailureCKDchronickidneydiseaseUTIurinarytractinfectionsinsipidus尿崩癥uremia/toxuriaICinterstitialcystitisBPHbenignprostatichyperplasiapyelonephritisglomerulonephritisacutecystitis---congestionofbladdermucosamembraneAcutecystitis

Oftensuddenlyonset,Whenpassingurine,thepatientwillhavesomesymptomeslikeburningpain,requentmicturition,oftenwithurgenturinatio.Whenitcomestourinaryincontinence,frequentandurgenturinationoftenparticularlyevident,anhourcanreachmorethan5~6times,eachtimetheurinevolumeisonlyafewdrops,evenmicturitionterminalcanhavelowerabdominalpain.Urineiscloudyandsometimeswithblood,whichareoftenhappeninend-stage..Adenovirusinfectionmayleadtohemorrhagiccystitisinchildren,however,viralcystitisrarelyfoundinAdults.

Thecourseofacutecystitisisshort,sothatthesymptomeswoulddisappearinoneweeksiftreatedtimely.Diagnosis:mostofthesymptomesofacutecystitisaretypical,notdifficulttobediagnosed.Thepatientwillbedefinitelydiagnosedaccordingtothehistoryofurinaryfrequency,urgency,andurinatingpain.Theurineroutinechecksindicatevisibleredbloodcells,puscellsandurinebacterialcountsmorethan100,000permilliliterinculture

Themaincomplicationofacutecyctitisisinfectionthatascendstothekidneys.Childrenwithvesico-ureteralrefluxandpregnantwomenareespeciallypronetothiscomplication.Patientspronetorecurrentboutsofacutecystitisshouldbeevaluatedforfactorsthatmaycontributetoenhancedsusceptibility,andtheseshouldbecorrectedwheneverpossible.Failingthis,antimicrobialprophylaxismayneeded.

GeneraltreatmentIncludingproperrest,drinkplentyofwatertoincreaseurineoutput,payattentiontonutrition,avoidspicyfood.Patientswithbladderirritationsymptomscanberelievedbyantispasmodicdrugs.while,patientswithasymptomaticbacteriuriadoesnotrequireconvulsatiostherapy.AntibiotictherapyisthemaintreatmentforUrinarytractinfection..Patientsshouldmakechoicesbasedondrugsensitivitytestanddoctor'sprescribtion.Glomerulonephritis

(腎小球腎炎)

Glomerulonephritisisatypeofkidneydiseasecausedbyinflammationoftheinternalkidneystructures.Also,itcanbecausedbyseveraldifferentdiseasestates,includingsomesystemicimmunedisease.itcanalsoresultfromageneontheXchromosomepassedonfromcarriermotherswhohavenofeatures,orminimalfeaturesoftheproblem,totheirsons.Acommoncauseofglomerulonephritisisfromastreptococcalinfection,suchasstrepthroatorupperrespiratoryinfection.1.Providebestrestduringtheacutephase.2.Performpassiverangeofmotionexercisesforthepatientonbedrest.3.Allowthepatienttoresumenormalactivitiesgraduallyassymptomssubside.4.Consultthedieticianaboutadiethighincaloriesandlowinprotein,sodium,potassium,andfluids.5.Protectthedebilitatedpatientagainstsecondaryinfectionbyprovidinggoodnutritionandhygienictechniqueandpreventingcontactwithinfectedpeople.6.Checkthepatient’svitalsignsandelectrolytevalues.7.Monitorintakeandoutputanddailyweight.8.Reportperipheraledemaortheformationofascites.9.Explaintothepatienttakingdiureticsthathemayexperienceorthostati