Urinary System: Summary Stage 2018 Coding Manual V2.0
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Female Urethra
OBJECTIVES: • By the end of this lecture, student should understand the anatomical structure of urinary system. General Information Waste products of metabolism are toxic (CO2, ammonia, etc.) Removal from tissues by blood and lymph Removal from blood by Respiratory system And Urinary system Functions of the Urinary System Elimination of waste products Nitrogenous wastes Toxins Drugs Functions of the Urinary System Regulate homeostasis Water balance Acid-base balance in the blood Electrolytes Blood pressure Organs of the Urinary system Kidneys Ureters Urinary bladder Urethra Kidneys Primary organs of the urinary system Located between the 12th thoracic and 3rd lumbar vertebrae. Right is usually lower due to liver. Held in place by connective tissue [renal fascia] and surrounded by thick layer of adipose [perirenal fat] Each kidney is approx. 3 cm thick, 6 cm wide and 12 cm long Regions of the Kidney Renal cortex: outer region Renal medulla: pyramids and columns Renal pelvis: collecting system Kidneys protected by three connective tissue layers Renal fascia -Attaches to abdominal wall Renal capsule: -Surrounds each kidney -Fibrous sac -Protects from trauma and infection Adipose capsule -Fat cushioning kidney Nephrons Each kidney contains over a million nephrons [functional structure] • Blood enters the nephron from a network that begins with the renal artery. • This artery branches into smaller and smaller vessels and enters each nephron as an afferent arteriole. • The afferent arteriole ends in a specialized capillary called the Glomerulus. • Each kidney has a glomerulus contained in Bowman’s Capsule. • Any cells that are too large to pass into the nephron are returned to the venous blood supply via the efferent arteriole. -
Urinary Tract Eod Stage & Treatment
2/20/2020 SHRI VIDEO TRAINING SERIES 2018 DX forward Recorded 2/2020 URINARY TRACT EOD STAGE & TREATMENT PRESENTED BY LORI SOMERS, RN IOWA CANCER REGISTRY 1 BLADDER C670‐C679 EOD PRIMARY TUMOR EOD REGIONAL LYMPH NODES EOD METASTASIS 2 1 2/20/2020 EOD • General Coding instructions, 32 pg pdf • https://seer.cancer.gov/tools/staging/2018‐ EOD‐General‐Instructions.pdf • Timing rules • What to include re clinical or path findings • Rules re neoadjuvant therapy • Discrepancies between op/path 3 BLADDER EOD PRI TUMOR • Note 1: Two main types of bladder cancer – Flat (sessile) • Called in situ when tumor has not penetrated basement membrane – Papillary type • Called noninvasive when tumor has not penetrated basement membrane 4 2 2/20/2020 EOD PRI TUMOR • Note 2: Noninvasive papillary transitional carcinoma: Pathologists use many descriptive terms for noninvasive papillary TCC. Frequently the path report does not contain a definitive statement of non‐invasion. – Non‐invasion can be inferred from microscopic description – List of terms in SEER*RSA schema 5 Definite statements non‐invasion ‘for papillary TCC’ • Noninfiltrating • Noninvasive • No evidence of invasion • No extension into lamina propria • No stromal invasion • No extension into underlying supporting tissue • Neg lamina propria and superficial muscle • Neg muscle and (subepithelial) connective tissue • No infiltrative behavior/component 6 3 2/20/2020 Inferred descriptions of non‐invasion ‘for papillary TCC’ • No involvement of musc propria and no mention of subepthelium/submucosa • No statement of invasion (microscopic description present • (Underlying) tissue insufficient to judge depth of invasion • No involvement of muscularis propria • Benign deeper tissue • Microscopic description problematic (non‐invas vs superficial invas) • Frond surfaced by transitional cell • No mural infiltration • No evid of invasion (no sampled stroma) • Confined to mucosa 7 EOD PRI TUMOR Note 3: Noninvasive (in situ) flat transitional cell carcinoma: . -
The Kidneys (Nephros)
THE KIDNEYS (NEPHROS) Functions 1. Removal of excess water, salts and products of protein metabolism 2. Maintenance of PH 3. Production and release of erythopoietin, which controls blood cell production 4. Synthesis and release of renin to influence blood pressure 5. Production of 1, 25-hydroxycholecalciferol (activated form of vitamin D) for control of calcium metabolism. There are 2 kidneys in the body, one on either side of the median plane. The kidneys are bean-shaped about 10cm long, 5cm wide and weigh about 150g. The kidneys are intra-abdominal extending from T12-L3. The left kidney is about 1cm higher than the right one, owing to the large right lobe of the liver. The kidneys lay retroperitoneally on the posterior abdominal wall against Psoas major muscle. Each kidney is covered by a tough fibrous renal capsule. This is surrounded by fat known as perirenal /perinephric fat. The latter is enclosed in a renal fascia which attaches it firmly to the posterior abdominal wall. However, the renal fascia is flexible enough to allow kidneys shift slightly as the diaphragm moves during respiration. The kidney has • Anterior and posterior surfaces • Medial and lateral borders • Superior and inferior poles The lateral border is convex and lies against psoas major muscle. The medial border is concave. The hilus/hilum is a prominent medial indentation on this border. It’s a point of entry for the renal artery, renal nerves and exit for the renal vein and renal pelvis. From anterior to posterior are the; renal vein, renal artery and renal pelvis. The posterior surface of the superior pole is related to the diaphragm while the anteromedial surface to the suprarenal gland. -
Urinary System
OUTLINE 27.1 General Structure and Functions of the Urinary System 818 27.2 Kidneys 820 27 27.2a Gross and Sectional Anatomy of the Kidney 820 27.2b Blood Supply to the Kidney 821 27.2c Nephrons 824 27.2d How Tubular Fluid Becomes Urine 828 27.2e Juxtaglomerular Apparatus 828 Urinary 27.2f Innervation of the Kidney 828 27.3 Urinary Tract 829 27.3a Ureters 829 27.3b Urinary Bladder 830 System 27.3c Urethra 833 27.4 Aging and the Urinary System 834 27.5 Development of the Urinary System 835 27.5a Kidney and Ureter Development 835 27.5b Urinary Bladder and Urethra Development 835 MODULE 13: URINARY SYSTEM mck78097_ch27_817-841.indd 817 2/25/11 2:24 PM 818 Chapter Twenty-Seven Urinary System n the course of carrying out their specific functions, the cells Besides removing waste products from the bloodstream, the uri- I of all body systems produce waste products, and these waste nary system performs many other functions, including the following: products end up in the bloodstream. In this case, the bloodstream is ■ Storage of urine. Urine is produced continuously, but analogous to a river that supplies drinking water to a nearby town. it would be quite inconvenient if we were constantly The river water may become polluted with sediment, animal waste, excreting urine. The urinary bladder is an expandable, and motorboat fuel—but the town has a water treatment plant that muscular sac that can store as much as 1 liter of urine. removes these waste products and makes the water safe to drink. -
The Urinary System Dr
The urinary System Dr. Ali Ebneshahidi Functions of the Urinary System • Excretion – removal of waste material from the blood plasma and the disposal of this waste in the urine. • Elimination – removal of waste from other organ systems - from digestive system – undigested food, water, salt, ions, and drugs. + - from respiratory system – CO2,H , water, toxins. - from skin – water, NaCl, nitrogenous wastes (urea , uric acid, ammonia, creatinine). • Water balance -- kidney tubules regulate water reabsorption and urine concentration. • regulation of PH, volume, and composition of body fluids. • production of Erythropoietin for hematopoieseis, and renin for blood pressure regulation. Anatomy of the Urinary System Gross anatomy: • kidneys – a pair of bean – shaped organs located retroperitoneally, responsible for blood filtering and urine formation. • Renal capsule – a layer of fibrous connective tissue covering the kidneys. • Renal cortex – outer region of the kidneys where most nephrons is located. • Renal medulla – inner region of the kidneys where some nephrons is located, also where urine is collected to be excreted outward. • Renal calyx – duct – like sections of renal medulla for collecting urine from nephrons and direct urine into renal pelvis. • Renal pyramid – connective tissues in the renal medulla binding various structures together. • Renal pelvis – central urine collecting area of renal medulla. • Hilum (or hilus) – concave notch of kidneys where renal artery, renal vein, urethra, nerves, and lymphatic vessels converge. • Ureter – a tubule that transport urine (mainly by peristalsis) from the kidney to the urinary bladder. • Urinary bladder – a spherical storage organ that contains up to 400 ml of urine. • Urethra – a tubule that excretes urine out of the urinary bladder to the outside, through the urethral orifice. -
Urogenital Kit Identification Guide
Urogenital System 1 Table of Contents Page 3 - Male Urinary Bladder Page 4 - Testicle Page 5 - Female Urogenital System: Anterior Page 6 - Female Urogenital System: Lateral Page 7 - Female Urinary Bladder: Pelvic structures Page 8 - Vagina Page 9 - Female External Genitalia Page 10 - External Bi-sected Kidney Page 11 - Interior Bi-sected Kidney Page 12 - Bi-sected Kidney Vasculature Page 13 - Interior Kidney: The Nephron ***Sample does not include all pages provided in the full identification guide Disclaimer: No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, mechanical, electronic, photo-copying, recording, or otherwise without the prior written permission of the publisher. For information address Experience Anatomy, 101 S. Tryon, Suite 2700, Charlotte, NC 28280 2 Male Urinary Bladder Ureters Fundus of Vas Deferens Urinary Bladder Detrusor Muscle Rugae Ampulla of Vas Deferens Body Seminal Vesicles Apex of Ureter Urinary Urinary Ureteric Bladder Bladder Orifice Base of Apex of Prostate Prostate Ligamentous urachus (Median Prostatic Umbilical Ligament) Urethra 3 Testicle Vas Deferens Testicular (Ductus Deferens) artery Genital br. of Pampiniform Genitofemoral nerve Plexus Spermatic Cord Internal Spermatic Fascia Epididymis Appendix of Testis Septa (tunica albuginea) Visceral Layer of Tunica Vaginalis Seminal vesicle lobules Parietal Layer of Tunica Vaginalis 4 Adrenal (Suprarenal) Gland Inferior Vena Cava Female Urogenital System: Abdominal Aorta Anterior Right Renal -
Post Mortem Examination of the Urinary System
Post Mortem Examination of the Urinary System System examination Figure 1 Figure 2 Place kidney on a flat surface and apply dorsal pressure with your hand (Figure 1). While applying this dorsal pressure use a sharp knife to cut through the kidney from cortex to renal pelvis and butterfly open the organ. Examine the cortical, medullary, and renal pelvic architecture and determine the consistency of the organ by grasping a 1 cm slice between the index finger and thumb and applying pressure (Figure 2). Figure 3 Using a pair of forceps to hold the capsule, strip it from the cortical surface (Figure 3). In normal circumstances, the capsule should strip fairly easily. In chronic renal lesions, there may be capsular fibrosis with surface adhesions which makes stripping more difficult. Figure 4 Figure 5 Urinary bladder is initially examined in situ to observe any abnormalities on the serosal aspect as well as any evidence of pathology in the ureters (Figure 4). An incision is made through the bladder wall to open the bladder and reveal the mucosal surface for examination, or the bladder is turned inside out through the incision to observe the surface (Figure 5). Renal and Urinary Bladder Non-Lesions Pale kidneys Figure 6 In cat’s kidneys are pale tan or even light cream in colour. Cortical vessels are prominent and lie in grooves in the subcapsular surface (Figure 6). These two features on normal findings in feline species. Renal pelvic mucus Figure 7 Tenacious mucus is often found in the renal pelvis of the horse (arrows) and pig. -
Laboratory 8 - Urinary and Reproductive Systems
Laboratory 8 - Urinary and Reproductive Systems Urinary System Please read before starting: It is easy to damage the structures of the reproductive system as you expose structures associated with excretion, so exercise caution as you do this. Please also note that we will have drawings available as well to help you find and identify the structures described below. The major blood vessels serving the kidneys are the Renal renal artery and the renal pyramid vein., which are located deep in the parietal peritoneum. The renal artery is a branch of the dorsal aorta that comes off Renal further caudal than the cranial pelvis mesenteric artery. Dissect the left kidney in situ, dividing it into dorsal and ventral portions by making a frontal section along the outer periphery. Observe the renal cortex renal medulla (next layer in) renal pyramids renal pelvis ureter (see above diagram) The kidneys include a variety of structures including an arterial supply, a venous return, extensive capillary networks around each nephron and then, of course, the filtration and reabsorption apparatus. These structures are primarily composed of nephrons (the basic functional unit of the kidney) and the ducts which carry urine away from the nephron (the collecting ducts and larger ducts eventually draining these into the ureters from each kidney. The renal pyramids contain the extensions of the nephrons into the renal medulla (the Loops of Henle) and the collecting ducts. Urine is eventually emptied into the renal pelvis before leaving the kidneys in the ureters. The ureters leaves the kidneys medially at approximately the midpoint of the organs and then run caudal to the urinary bladder. -
Kidney in an Effort to Aid Health Information Management Coding Professionals for ICD-10, the Following Anatomy Tip Is Provided with an Educational Intent
Anatomy Tip Kidney In an effort to aid Health Information Management Coding Professionals for ICD-10, the following anatomy tip is provided with an educational intent. The kidneys are the main part of the urinary system and are a pair of organs; right and left; located in the back of the abdomen. Each kidney is about 4 or 5 inches long. • The kidneys are surrounded by three layers of tissue: • The renal fascia is a thin, outer layer of fibrous connective tissue that surrounds each kidney (and the attached adrenal gland) and fastens it to surrounding structures. • The adipose capsule is a middle layer of adipose (fat) tissue that cushions the kidneys. • The renal capsule is an inner fibrous membrane that prevents the entrance of infections. • There are three major regions inside the kidney: • The renal cortex borders the convex side. • The renal medulla lies adjacent to the renal cortex. It consists of striated, cone-shaped regions called renal pyramids (medullary pyramids), whose peaks, called renal papillae, face inward. The unstriated regions between the renal pyramids are called renal columns. • The renal sinus is a cavity that lies adjacent to the renal medulla. The other side of the renal sinus, bordering the concave surface of the kidney, opens to the outside through the renal hilus. The ureter, nerves, and blood and lymphatic vessels enter the kidney on the concave surface through the renal hilus. The renal sinus houses the renal pelvis, a funnel-shaped structure that merges with the ureter. • All the blood in our bodies passes through the kidneys several times a day. -
Chapter 24 Urinary System
LECTURE OUTLINE CHAPTER 24 Marieb The Urinary System Lecture Outline I. Functions of the urinary system A. Regulate fluid balance of the body B. Regulate ion concentrations in the blood C. Stabilize pH D. Conservation of nutrients, etc. II. Structures A. pair of kidneys B. pair of ureters C. urinary bladder D. urethra III. Kidney structure A. Size of bar of soap - high on body wall, under floating ribs B. Retroperitoneal - between the body wall and peritoneum C. Bean shaped D. Hilus - indentation E. Renal capsule - fibrous tunic F. Adipose capsule -protects kidney G. Renal fascia - anchors kidney to body wall, continuous with peritoneum H. Cortex - outer layer, granular appearing I. Medulla 1. renal pyramids - terminate with a papilla, make up lobes 2. columns between pyramids J. Pelvis 1. minor calyx - papilla empty into these which in turn drain into 2. major calyx - which empty into the pelvis IV. Nephron – functional unit of kidney A. Types of nephrons 1. cortical nephron - shorter, mostly in cortex of kidney, produce "standard" urine 2. juxtamedullary nephron - "juxta-next-to" the medulla - responsive to ADH, can concentrate urine B. Microscopic structure 1. renal tubule a. renal corpuscle = Bowman’s capsule (contains glomerulus) - receives filtrate i. capsular epithelium - simple squamous epithelium, forms capsule wall and is continuous with ii. glomerular epithelium - covers glomerulus III. podocyte cells with pedicels- forming iv. filtration slits 1 b. proximal convoluted tubule (PCT) - primarily reabsorptive c. loop of Henle (nephron loop) - contains thick (near cortex) and thin (near medulla) segments , water absorption and ion regulation i. descending limb ii.. loop of g Henle iii. -
Radioanatomy of the Retroperitoneal Space
Diagnostic and Interventional Imaging (2015) 96, 171—186 PICTORIAL REVIEW / Gastrointestinal imaging Radioanatomy of the retroperitoneal space ∗ A. Coffin , I. Boulay-Coletta, D. Sebbag-Sfez, M. Zins Radiology department, Paris Saint-Joseph Hospitals, 185, rue Raymond-Losserand, 75014 Paris, France KEYWORDS Abstract The retroperitoneum is a space situated behind the parietal peritoneum and in front Retroperitoneal of the transversalis fascia. It contains further spaces that are separated by the fasciae, between space; which communication is possible with both the peritoneal cavity and the pelvis, according to Kidneys; the theory of interfascial spread. The perirenal space has the shape of an inverted cone and Cross-sectional contains the kidneys, adrenal glands, and related vasculature. It is delineated by the anterior anatomy and posterior renal fasciae, which surround the ureter and allow communication towards the pelvis. At the upper right pole, the perirenal space connects to the retrohepatic space at the bare area of the liver. There is communication between these two spaces through the Kneeland channel. The anterior pararenal space contains the duodenum, pancreas, and the ascending and descending colon. There is free communication within this space, and towards the mesenteries along the vessels. The posterior pararenal space, which contains fat, communicates with the preperitoneal space at the anterior surface of the abdomen between the peritoneum and the transversalis fascia, and allows communication with the contralateral posterior pararenal space. This space follows the length of the ureter to the pelvis, which explains the communication between these areas and the length of the pelvic fasciae. © 2014 Éditions franc¸aises de radiologie. Published by Elsevier Masson SAS. -
The Distal Convoluted Tubule and Collecting Duct
Chapter 23 *Lecture PowerPoint The Urinary System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • Urinary system rids the body of waste products. • The urinary system is closely associated with the reproductive system – Shared embryonic development and adult anatomical relationship – Collectively called the urogenital (UG) system 23-2 Functions of the Urinary System • Expected Learning Outcomes – Name and locate the organs of the urinary system. – List several functions of the kidneys in addition to urine formation. – Name the major nitrogenous wastes and identify their sources. – Define excretion and identify the systems that excrete wastes. 23-3 Functions of the Urinary System Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Diaphragm 11th and 12th ribs Adrenal gland Renal artery Renal vein Kidney Vertebra L2 Aorta Inferior vena cava Ureter Urinary bladder Urethra Figure 23.1a,b (a) Anterior view (b) Posterior view • Urinary system consists of six organs: two kidneys, two ureters, urinary bladder, and urethra 23-4 Functions of the Kidneys • Filters blood plasma, separates waste from useful chemicals, returns useful substances to blood, eliminates wastes • Regulate blood volume and pressure by eliminating or conserving water • Regulate the osmolarity of the body fluids by controlling the relative amounts of water and solutes