Kidney Stones and How to Remove Them Kidney Stones and How to Remove Them

Kidney stones and how to remove them Kidney stones and how to remove them

Kidneys Diagnosis ESWL (Extracorporeal shock wave lithotripsy) is Pain is part of human consciousness and is an invaluable aid to Initial diagnosis is based on symptoms but this may be followed a non-invasive treatment of survival. It tells us when something is wrong with our body. All pains by , or X-ray, ultrasound scans intravenous pyelogram (IVP) kidney stones using sound are different; back pain, toothache, bruising or headache. There are even a to give a more detailed picture of the size, number CT scan waves to break up the even phantom pains where people who have had limbs amputated and location of the stones. This is always carried out prior to stone. Somewhat like the feel pain in the limb even although it is no longer there. One of the surgical intervention. opera singer hitting just the worst pains is that associated with kidney stones. It is described right note and causing the as similar to being stabbed with a knife, agonising or excruciating. Boston Scientifi c has supported the production of this lesson. Types of kidney stones wine glass to shatter. There However, a vivid description is ‘exquisitely painful’, as it gives an We are a leading innovator of medical solutions that improve Knowing the type of kidney stone helps determine the cause and may are various arrangements of indication of the uniqueness of the pain. the health of patients around the world. Our products and give clues on how to reduce the risk of getting more kidney stones. the apparatus but in general technologies are used to diagnose or treat a wide range of The Greek physician Hippocrates fi rst described the symptoms of Types of kidney stones include: the patient, dressed in a kidney stones in 400 BC as follows: hospital gown, lies on medical conditions, including heart, digestive, pulmonary, Calcium stones make up the majority of kidney stones usually in the a water-fi lled cushion. vascular, urological, women’s health, and chronic pain ‘...an acute pain is felt in the kidney, the loins, the fl ank and the form of either calcium oxalate or calcium phosphate. High energy shock (sound) conditions. We continue to innovate in these areas and are extending our innovations into new geographies and testis of the affected side. With the urine sand is passed; as the Struvite stones form in response to a urinary tract infection where waves are focused on the stone for about an hour and these break high-growth adjacency markets. sand passes along the ureter, it causes severe pain which is bacteria produce ammonia which builds up in the urine and causes the stone into small pieces. This is non-invasive, apart from the relieved when it is expelled; then the same sufferings begin again.’ the formation of magnesium ammonium phosphate which forms possible use of a catheter to help remove the debris, but there With approximately 23,000 employees and 12 manufacturing the stone. These stones can grow quickly and become quite large, can be a certain amount of bruising and bleeding caused by the facilities around the world and market presence in 100 What are kidney stones? blocking the ureter and causing it to distend. It is the swelling of shock waves. The patient is normally conscious and, if there are no countries, Boston Scientifi c is dedicated to transforming lives the ureter that causes the sudden pain, complications, can go home shortly afterwards. through innovative medical solutions that improve the health Kidney stones, sometimes called renal sometimes with little warning. of patients around the world. calculi, are lumps of hard, crystalline mineral material that form within the kidney or urinary Uric acid stones can form in people who RIRS (retrograde intrarenal With corporate headquarters in Marlborough, Massachusetts tract. The medical term for having them is don’t drink enough fl uids or who lose too surgery) which is a and major operations in North and South America, Boston nephrolithiasis. About one in every 20 people much fl uid, eat a high-protein diet, or those procedure for performing Scientifi c has established three key strategic sites in Ireland will be affected at some time in their life, usually who have gout. Certain genetic factors surgery within the kidney — Clonmel, Cork and Galway — employing in excess of 3,500 between the ages of thirty to fi fty. They are may also increase the risk of developing using a viewing tube called employees across the broad range of activities in which the more common in Asians and Caucasians than uric acid stones. a fi bre-optic endoscope. company is involved. in Africans or African Americans. The scope is passed Cystine stones form in people with through the urethra and a hereditary disorder that causes the bladder and then through Boston Scientifi c in Clonmel Causes of kidney stones kidneys to excrete too much of certain the ureter into the pelvis of The Clonmel operation is responsible for the production of Kidney stones form for three main reasons: amino acids especially cysteine. the kidney, depending on implantable pacemakers and defi brillators that offer life-saving This type of stone is not very common. 1. The urine may contain more crystal-forming the location of the stone(s). therapy for patients suffering from cardiac arrhythmias and substances than the fl uid in it can dissolve. Other, rarer types of kidney stones can The stone is viewed through heart failure. It currently employs more than 900 people, also occur. the scope and can then many of whom specialise in a range of engineering disciplines 2. The urine may lack the substances that be manipulated, crushed e.g. Electrical, Mechanical, Biomedical, Material Science, prevent crystals from sticking together. by an ultrasound probe, Treatments Quality, R&D and Industrial along with other functional areas 3. In response to a urinary tract infection. evaporated by a laser probe such as Supply Chain, Human Resources, Finance, Process Most kidney stones pass on their own with or grabbed by small forceps Development, IT and Manufacturing. time, and only a small proportion need or in a basket and removed. is probably the most important surgical intervention. Boston Scientifi c Clonmel actively promotes and participates Dehydration If the stone is causing a blockage this will cause urine to back up into risk factor for kidney stone formation. The two most likely causes of in the local community through initiatives such as their The initial treatment is to give analgesics (pain killers) and the kidney where it will cause pain. More importantly it will damage dehydration are taking lots of strenuous exercise or living in a hot Schools Programme where BSC facilitates local students on signifi cantly increase the volume of water consumed. In some cases the kidney, and in severe cases can lead to the loss of the kidney. climate and not drinking enough water. Dietary factors also play a work experience and sponsors a Student of the Year Award in medication is given to increase the amount of urine produced; these In this case a stent is put in place to bypass the stone and allow the part. For example, people who take large doses of vitamin C, often local schools, culminating in an opportunity for summer work. are called diuretics. Other drugs, called alpha-blockers, relax the urine to escape before permanent damage is done. in the belief that it will prevent disease, have a 20% higher risk of BSC is actively involved in Junior Achievement activities, with muscles of the ureter allowing the stone to pass through more easily These procedures are carried out by a specialist urologist under developing stones. Eating foods rich in such as rhubarb can over 19 employees delivering programmes in the region. oxalates and with less pain. general or spinal anaesthesia. The recovery time with both these also be a contributory factor. Find out more about Boston Scientifi c at If this is not suffi cient to cause the stone(s) to pass though the ureter, methods is very short. A family history of kidney stones is also a signifi cant risk factor, www.bostonscientifi c.com to the bladder and out through the urethra then surgical techniques Some ‘home remedy’ advocates suggest that lemon juice drinks are especially in this part of the world. People with certain medical may be used. Open surgery may be required but this can cause an effective preventative and cure. It is more probably the increased conditions (e.g. gout), or those who take some medications, such prolonged pain and has a long recovery time. Nowadays the two intake of water with the lemon juice that produces the effects. Find this and other lessons on www.sta.ie as those used in chemotherapy, are also at an increased risk of most common procedures are considerably less invasive. developing stones. Kidney stones and how to remove them Kidney stones and how to remove them

Kidneys Diagnosis ESWL (Extracorporeal shock wave lithotripsy) is Pain is part of human consciousness and is an invaluable aid to Initial diagnosis is based on symptoms but this may be followed by a non-invasive treatment of survival. It tells us when something is wrong with our body. All pains , or even X-ray, ultrasound scans intravenous pyelogram (IVP) kidney stones using sound are different; back pain, toothache, bruising or headache. There are a to give a more detailed picture of the size, number and CT scan waves to break up the even phantom pains where people who have had limbs amputated location of the stones. This is always carried out prior to surgical stone. Somewhat like the feel pain in the limb even although it is no longer there. One of the intervention. opera singer hitting just the worst pains is that associated with kidney stones. It is described right note and causing the as similar to being stabbed with a knife, agonising or excruciating. Boston Scientific has supported the production of this lesson. Types of kidney stones wine glass to shatter. There However, a vivid description is ‘exquisitely painful’, as it gives an We are a leading innovator of medical solutions that improve Knowing the type of kidney stone helps determine the cause and may are various arrangements of indication of the uniqueness of the pain. the health of patients around the world. Our products and give clues on how to reduce the risk of getting more kidney stones. the apparatus but in general technologies are used to diagnose or treat a wide range of The Greek physician Hippocrates first described the symptoms of Types of kidney stones include: the patient, dressed in a kidney stones in 400 BC as follows: hospital gown, lies on medical conditions, including heart, digestive, pulmonary, Calcium stones make up the majority of kidney stones usually in the a water-filled cushion. vascular, urological, women’s health, and chronic pain ‘...an acute pain is felt in the kidney, the loins, the flank and the form of either calcium oxalate or calcium phosphate. High energy shock (sound) conditions. We continue to innovate in these areas and are extending our innovations into new geographies and testis of the affected side. With the urine sand is passed; as the Struvite stones form in response to a urinary tract infection where waves are focused on the stone for about an hour and these break high-growth adjacency markets. sand passes along the ureter, it causes severe pain which is bacteria produce ammonia which builds up in the urine and causes the stone into small pieces. This is non-invasive, apart from the relieved when it is expelled; then the same sufferings begin again.’ the formation of magnesium ammonium phosphate which forms possible use of a catheter to help remove the debris, but there With approximately 23,000 employees and 12 manufacturing the stone. These stones can grow quickly and become quite large, can be a certain amount of bruising and bleeding caused by the facilities around the world and market presence in 100 What are kidney stones? blocking the ureter and causing it to distend. It is the swelling of shock waves. The patient is normally conscious and, if there are no countries, Boston Scientific is dedicated to transforming lives the ureter that causes the sudden pain, complications, can go home shortly afterwards. through innovative medical solutions that improve the health Kidney stones, sometimes called renal sometimes with little warning. of patients around the world. calculi, are lumps of hard, crystalline mineral material that form within the kidney or urinary Uric acid stones can form in people who RIRS (retrograde intrarenal With corporate headquarters in Marlborough, Massachusetts tract. The medical term for having them is don’t drink enough fluids or who lose too surgery) which is a and major operations in North and South America, Boston nephrolithiasis. About one in every 20 people much fluid, eat a high-protein diet, or those procedure for performing Scientific has established three key strategic sites in Ireland will be affected at some time in their life, usually who have gout. Certain genetic factors surgery within the kidney — Clonmel, Cork and Galway — employing in excess of 3,500 between the ages of thirty to fifty. They are may also increase the risk of developing using a viewing tube called employees across the broad range of activities in which the more common in Asians and Caucasians than uric acid stones. a fibre-optic endoscope. company is involved. in Africans or African Americans. The scope is passed Cystine stones form in people with through the urethra and a hereditary disorder that causes the bladder and then through Boston Scientific in Clonmel Causes of kidney stones kidneys to excrete too much of certain the ureter into the pelvis of The Clonmel operation is responsible for the production of Kidney stones form for three main reasons: amino acids especially cysteine. the kidney, depending on implantable pacemakers and defibrillators that offer life-saving This type of stone is not very common. 1. The urine may contain more crystal-forming the location of the stone(s). therapy for patients suffering from cardiac arrhythmias and substances than the fluid in it can dissolve. Other, rarer types of kidney stones can The stone is viewed through heart failure. It currently employs more than 900 people, also occur. the scope and can then many of whom specialise in a range of engineering disciplines 2. The urine may lack the substances that be manipulated, crushed e.g. Electrical, Mechanical, Biomedical, Material Science, prevent crystals from sticking together. by an ultrasound probe, Treatments Quality, R&D and Industrial along with other functional areas 3. In response to a urinary tract infection. evaporated by a laser probe such as Supply Chain, Human Resources, Finance, Process Most kidney stones pass on their own with or grabbed by small forceps Development, IT and Manufacturing. time, and only a small proportion need or in a basket and removed. is probably the most important surgical intervention. Boston Scientific Clonmel actively promotes and participates Dehydration If the stone is causing a blockage this will cause urine to back up into risk factor for kidney stone formation. The two most likely causes of in the local community through initiatives such as their The initial treatment is to give analgesics (pain killers) and the kidney where it will cause pain. More importantly it will damage dehydration are taking lots of strenuous exercise or living in a hot Schools Programme where BSC facilitates local students on significantly increase the volume of water consumed. In some cases the kidney, and in severe cases can lead to the loss of the kidney. climate and not drinking enough water. Dietary factors also play a work experience and sponsors a Student of the Year Award in medication is given to increase the amount of urine produced; these In this case a stent is put in place to bypass the stone and allow the part. For example, people who take large doses of vitamin C, often local schools, culminating in an opportunity for summer work. are called diuretics. Other drugs, called alpha-blockers, relax the urine to escape before permanent damage is done. in the belief that it will prevent disease, have a 20% higher risk of BSC is actively involved in Junior Achievement activities, with muscles of the ureter allowing the stone to pass through more easily These procedures are carried out by a specialist urologist under developing stones. Eating foods rich in such as rhubarb can over 19 employees delivering programmes in the region. oxalates and with less pain. general or spinal anaesthesia. The recovery time with both these also be a contributory factor. Find out more about Boston Scientific at If this is not sufficient to cause the stone(s) to pass though theureter , methods is very short. A family history of kidney stones is also a significant risk factor, www.bostonscientific.com to the bladder and out through the urethra then surgical techniques Some ‘home remedy’ advocates suggest that lemon juice drinks are especially in this part of the world. People with certain medical may be used. Open surgery may be required but this can cause an effective preventative and cure. It is more probably the increased conditions (e.g. gout), or those who take some medications, such prolonged pain and has a long recovery time. Nowadays the two intake of water with the lemon juice that produces the effects. Find this and other lessons on www.sta.ie as those used in chemotherapy, are also at an increased risk of most common procedures are considerably less invasive. developing stones. KidneyKidney stones stones andand how how to to remove remove them them Kidney stones and how to remove them

SyllabusSyllabus References References StudentStudent Activities Activities ExaminationExamination Questions Questions DidDid You You Know? Know? TheThe main main syllabus syllabus references references for for the the lesson lesson are: are: • • KidneyKidney stones stones range range in in size size from from single single microscopic microscopic crystals crystals 1.1. FindFind out out where where else else in in the the body body stones stones form, form, and and if ifit itis is LeavingLeaving Certificate Certificate BiologyBiology (OL) (OL) 2013, 2013, Q. Q.6 6 possiblepossible to to treat treat them them using using lithotripsy. lithotripsy. If Ifit itis is not not possible, possible, toto jagged jagged lumps lumps composed composed of of interlocked interlocked crystals crystals measuring measuring LeavingLeaving Certificate Certificate BiologyBiology TheThe diagram diagram shows shows a avertical vertical section section through through a ahuman human kidney. kidney. whywhy is is it itnot not possible. possible. overover a acentimetre centimetre across. across. In In 2009 2009 a akidney kidney stone stone of of 1.1 1.1 kg kg • • TheThe Excretory Excretory System System in in the the Human: Human: Role Role of of the the excretory excretory NameName the the parts parts labelled labelled A, A, B Band and C. C. andand over over 17 17 cm cm across across was was removed removed from from a aman man in in Hungary. Hungary. systemsystem in in homeostasis. homeostasis. 2.2. FindFind out out where where lithotripsy lithotripsy is is carried carried out out in in Ireland. Ireland. • • OverOver 200 200 compounds compounds have have been been found found in in kidney kidney stones. stones. 3.3. FindFind out out where where mobile mobile lithotripsy lithotripsy units units are are located located and and how how a)a) Name Name the the organ organ that that is is • • MacrostructureMacrostructure and and basis basis function function of of the the urinary urinary excretory excretory TheThe most most common common ones ones are: are: systemsystem in in humans humans (kidney, (kidney, ureters, ureters, urinary urinary bladder, bladder, and and theythey differ differ from from the the standard standard hospital hospital unit. unit. attachedattached to to the the kidney kidney by by • • CalciumCalcium Oxalate: Oxalate: CaC CaCOO . H. HOO and and CaC CaCOO . 2H. 2HOO urethra).urethra). Role Role of of the the kidney kidney in in regulating regulating body body fluids. fluids. 4.4. FindFind out out how how the the shock shock waves waves are are generated generated and and focused. focused. partpart C. C. 2 24 4 2 2 2 24 4 2 2 • • IdentificationIdentification of ofthe the site site of offiltration. filtration. Reabsorption Reabsorption in inthe the • • MagnesiumMagnesium Ammonium Ammonium Phosphate: Phosphate: MgNH MgNHPOPO 5.5. WhatWhat methods methods are are used used to to find find the the location location of ofkidney kidney stones? stones? b)b) Name Name one one substance substance 4 4 4 4 cortex,cortex, in in the the medulla medulla and and renal renal pelvis. pelvis. Description Description of of the the excretedexcreted by by the the kidneys. kidneys. • • CalciumCalcium Phosphate: Phosphate: Ca Ca(PO4)(PO4).x(OH).x(OH).y(CO.y(CO) ) pathwaypathway of of urine urine from from the the kidney kidney to to the the urethra. urethra. WhatWhat are are the the advantages advantages and and disadvantages disadvantages of of the the various various 1010 6 6 2 2 3 x+y3 x+y methods?methods? c)c) NameName the the site site in in the the • • CalciumCalcium Phosphate, Phosphate, Hydroxyl Hydroxyl Form: Form: Ca Ca10(PO4)10(PO4)6(OH)6(OH)2 2 LeavingLeaving Certificate Certificate Physics Physics kidneykidney where where filtration filtration 6.6. AnalgesicsAnalgesics are are the the most most frequent frequent form form of of treatment. treatment. Find Find out out • • CalciumCalcium Hydrogen Hydrogen Phosphate Phosphate Dihydrate: Dihydrate: CaHPO4.2H CaHPO4.2H2O2O • • VibrationsVibrations and and sound sound (p. (p. 31) 31) howhow these these reduce reduce the the pain. pain. takestakes place. place. • • UricUric Acid: Acid: C C5H5H4N4N4O4O3 3 ScienceScience and and Technology Technology in in Action Action is is also also widely widely used used by by 7.7. EndoscopesEndoscopes are are used used for for RIRS. RIRS. They They can can have have various various d)d) Suggest Suggest one one possible possible treatment treatment for for kidney kidney failure. failure. TransitionTransition Year Year classes. classes. attachmentsattachments to to carry carry out out particular particular functions functions in in the the break-up break-up and/orand/or retrieval retrieval of of stones. stones. Find Find out out what what these these attachments attachments BiographicalBiographical Notes Notes areare and and any any aspects aspects of of their their design design that that help help do do the the job job LeavingLeaving Certificate Certificate BiologyBiology LearningLearning Outcomes Outcomes (hint(hint nitinol nitinol is is one one useful useful material). material). (HL)(HL) 2008, 2008, Q. Q. 15 15 (b) (b) & & (c) (c) ClaudeClaude Dornier Dornier (1884 (1884 - 1969)- 1969) 8.8. EWRSEWRS is is totally totally non-invasive non-invasive under under normal normal circumstances. circumstances. TheThe diagram diagram shows shows the the structure structure ClaudeClaude Dornier Dornier was was born born in in Bavaria Bavaria in in 1884 1884 OnOn completion completion of of this this lesson, lesson, students students should should be be able able to: to: AreAre there there any any problems problems associate associate with with its its use? use? ofof a anephron nephron and and its its associated associated andand graduated graduated from from the the Technical Technical University University bloodblood supply. supply. • • DescribeDescribe what what a akidney kidney stone stone is is and and its its composition composition 9.9. FindFind out out what what home home remedies remedies are are suggested suggested for for the the inin Munich Munich in in 1907. 1907. He He was was an an aircraft aircraft treatmenttreatment of of kidney kidney stone stone and and suggest suggest a apossible possible medical medical builderbuilder and and became became involved involved in in fundamental fundamental • • KnowKnow that that about about 10% 10% of of people people will will suffer suffer from from kidney kidney stones stones (i)(i) Name Name the the parts parts A, A, B, B, C, C, D, D, E E reasonreason why why the the might might help. help. You You might might also also find find out out the the researchresearch and and design design of of aircraft. aircraft. He He was was atat some some time time in in their their life life andand F. F. possiblepossible dangers dangers involved involved in in these these treatments. treatments. involvedinvolved in in the the design design of of struts struts for for the the • • OutlineOutline the the factors factors likely likely to to cause cause the the formation formation of of kidney kidney stones stones (ii)(ii) From From which which blood blood vessel vessel is is A A ZepplinZepplin and and later later on on strengthening strengthening metals metals • • HaveHave a abasic basic understanding understanding of of the the range range of of treatments treatments derived?derived? usedused in in building building stressed-skin stressed-skin planes. planes. available,available, including including lithotripsy lithotripsy and and surgery surgery (iii)(iii) Where Where in in the the kidney kidney is is B B DuringDuring his his research research he he concluded concluded that that pitting pitting of of metal metal surfaces surfaces • • DistinguishDistinguish between between the the two two major major forms forms of of lithotripsy. lithotripsy. True/FalseTrue/False Questions Questions located?located? ofof planes planes as as they they approached approached the the sound sound barrier barrier was was caused caused by by (iv)(iv) Give Give the the part part of of the the nephron nephron thethe shockwave shockwave created created in in front front of of droplets droplets of of water. water. Later Later a agroup group a)a) Lithotripsy Lithotripsy uses uses ultra-sound. ultra-sound. T T FF inin which which each each of of the the following following ofof about about 25 25 people people working working in in the the Dornier Dornier medical medical laboratories laboratories takestakes place: place: filtration, filtration, reabsorption reabsorption of ofamino amino acids. acids. investigatedinvestigated the the possible possible use use of of shock shock waves waves to to break break up up kidney kidney GeneralGeneral Learning Learning Points Points b)b) Most Most kidneys kidneys stones stones pass pass without without treatment. treatment. T T FF stones.stones. As As a aresult result of of extensive extensive collaboration collaboration between between the the Dornier Dornier c)c) AnalgesicsAnalgesics relax relax muscles. muscles. T T FF (v)(v) Give Give two two features features of of the the nephron nephron that that aid aid filtration. filtration. researchresearch laboratory laboratory and and a agroup group of of doctors doctors from from several several hospitals hospitals TheseThese are are additional additional relevant relevant points points which which d)d) Dehydration Dehydration is is the the most most common common cause cause of of kidney kidney thethe first first extracorporeal extracorporeal shock shock wavewave lithotripter lithotripter waswas produced produced areare used used to to extend extend knowledge knowledge and and facilitate facilitate discussion. discussion. (vi)(vi) Name Name a agroup group of of biomolecules biomolecules in in the the blood blood which which are are too too stones.stones. T T FF largelarge to to pass pass through through the the filtration filtration system system of ofthe the nephron. nephron. aroundaround 1980. 1980. It Itrevolutionised revolutionised the the treatment treatment of of kidney kidney stones stones • • TheThe common common symptom symptom of of kidney kidney stones stones is is pain pain in in the the lower lower e)e) Most Most kidney kidney stones stones are are calcium calcium compounds. compounds. T T FF andand is is now now the the mainstay mainstay of of treatment treatment around around the the world. world. back,back, groin groin and and testes, testes, and and we we have have been been aware aware of of it itfor for (c)(c) f) f) UrinaryUrinary tract tract infections infections always always cause cause kidney kidney stones. stones. T T FF thousandsthousands of of years years (i)(i) Suggest Suggest two two situations situations which which may may result result in in a adrop drop in in the the water water g)g) Open Open surgery surgery is is the the best best treatment treatment for for most most kidney kidney • • MostMost kidney kidney stones stones pass pass on on their their own own and and only only large large stones stones contentcontent of of the the blood. blood. stones.stones. T T FF needneed medical medical intervention intervention ReviseRevise The The Terms Terms h)h) Diueretics Diueretics increase increase urine urine production production which which is is more more (ii)(ii) When When the the water water content content of of the the blood blood drops drops a ahormone hormone is is • • LithotripsyLithotripsy uses uses sound sound waves waves to to break break up up kidney kidney stones stones to to likelylikely to to cause cause stones. stones. T T FF released.released. Name Name this this hormone hormone and and the the endocrine endocrine gland gland from from CanCan you you recall recall the the meaning meaning of of the the following following terms? terms? makemake then then small small enough enough to to pass pass through through the the ureter ureter and and into into whichwhich it itis is secreted. secreted. RevisingRevising terminology terminology is is a apowerful powerful aid aid to to recall recall and and retention. retention. thethe bladder bladder and and then then out out through through the the urethra. urethra. i) i) X-raysX-rays are are used used to to diagnose diagnose and and locate locate kidney kidney stones. stones. T T FF • • TheThe main main cause cause of of kidney kidney stones stones is is dehydration dehydration caused caused j) j) RIRSRIRS is is slightly slightly invasive. invasive. T T FF (iii)(iii) Give Give a aprecise precise target target area area for for this this hormone. hormone. How How does does the the alphaalpha blockers, blockers, analgesic, analgesic, CAT CAT scan, scan, catheter, catheter, dehydration, dehydration, hormonehormone reach reach the the target target area? area? byby either either strenuous strenuous exercise exercise or or excess excess sweating sweating in in a awarm warm k)k) ESWLESWL can can cause cause bruising bruising in in the the area area of of the the stone. stone. T T FF cysteine,cysteine, diuretic, diuretic, endoscope, endoscope, ESWl, ESWl, invasive, invasive, IVP, IVP, lithotripsy, lithotripsy, litotripter,litotripter, nephrolithiasis, nephrolithiasis, oxalate, oxalate, pelvis, pelvis, renal renal calculi, calculi, RIRS, RIRS, climateclimate with with insufficient insufficient waterwater intake intake l) l) LithotripsyLithotripsy can can be be used used to to help help mend mend broken broken bones. bones. T T FF (iv)(iv) Explain Explain the the role role of of the the hormone hormone at at its its target target area, area, when when the the shockshock wave, wave, stent, stent, ultra ultra sound, sound, ureter, ureter, urethra, urethra, urologist, urologist, X-ray. X-ray. • • BacterialBacterial infection infection can can cause cause the the rapid rapid growth growth of of kidney kidney waterwater content content of of the the blood blood is is low. low. stonesstones which which have have a aparticular particular composition. composition. CheckCheck your your answers answers to to these these questions questions on on www.sta.ie. www.sta.ie. CheckCheck the the Glossary Glossary of of terms terms for for this this lesson lesson on on www.sta.ie www.sta.ie KidneyKidney stones stones andand how how to to remove remove them them Kidney stones and how to remove them

SyllabusSyllabus References References StudentStudent Activities Activities ExaminationExamination Questions Questions DidDid You You Know? Know? TheThe main main syllabus syllabus references references for for the the lesson lesson are: are: • • KidneyKidney stones stones range range in insize size from from single single microscopic microscopic crystals crystals 1.1. Find Find out out where where else else in in the the body body stones stones form, form, and and if ifit itis is LeavingLeaving Certificate Certificate Biology Biology (OL) (OL) 2013, 2013, Q. Q.6 6 possiblepossible to to treat treat them them using using lithotripsy. lithotripsy. If Ifit itis isnot not possible, possible, toto jagged jagged lumps lumps composed composed of of interlocked interlocked crystals crystals measuring measuring LeavingLeaving Certificate Certificate Biology Biology TheThe diagram diagram shows shows a avertical vertical section section through through a ahuman human kidney. kidney. whywhy is isit itnot not possible. possible. overover a acentimetre centimetre across. across. In In 2009 2009 a akidney kidney stone stone of of 1.1 1.1 kg kg • • TheThe Excretory Excretory System System in in the the Human: Human: Role Role of of the the excretory excretory NameName the the parts parts labelled labelled A, A, B Band and C. C. andand over over 17 17 cm cm across across was was removed removed from from a aman man in inHungary. Hungary. systemsystem in in homeostasis. homeostasis. 2.2. Find Find out out where where lithotripsy lithotripsy is iscarried carried out out in in Ireland. Ireland. • • OverOver 200 200 compounds compounds have have been been found found in inkidney kidney stones. stones. 3.3. Find Find out out where where mobile mobile lithotripsy lithotripsy units units are are located located and and how how a)a) Name Name the the organ organ that that is is • • MacrostructureMacrostructure and and basis basis function function of of the the urinary urinary excretory excretory TheThe most most common common ones ones are: are: systemsystem in in humans humans (kidney, (kidney, ureters, ureters, urinary urinary bladder, bladder, and and theythey differ differ from from the the standard standard hospital hospital unit. unit. attachedattached to to the the kidney kidney by by • • CalciumCalcium Oxalate: Oxalate: CaC CaCOO . H. HOO and and CaC CaCOO . 2H. 2HOO urethra).urethra). Role Role of of the the kidney kidney in in regulating regulating body body fluids. fluids. 4.4. Find Find out out how how the the shock shock waves waves are are generated generated and and focused. focused. partpart C. C. 2 24 4 2 2 2 24 4 2 2 • • IdentificationIdentification of ofthe the site site of offiltration. filtration. Reabsorption Reabsorption in inthe the • • MagnesiumMagnesium Ammonium Ammonium Phosphate: Phosphate: MgNH MgNHPOPO 5.5. What What methods methods are are used used to to find find the the location location of ofkidney kidney stones? stones? b)b) Name Name one one substance substance 4 4 4 4 cortex,cortex, in in the the medulla medulla and and renal renal pelvis. pelvis. Description Description of of the the excretedexcreted by by the the kidneys. kidneys. • • CalciumCalcium Phosphate: Phosphate: Ca Ca(PO4)(PO4).x(OH).x(OH).y(CO.y(CO) ) pathwaypathway of of urine urine from from the the kidney kidney to to the the urethra. urethra. WhatWhat are are the the advantages advantages and and disadvantages disadvantages of of the the various various 10 10 6 6 2 2 3 x+y3 x+y methods?methods? c)c) Name Name the the site site in in the the • • CalciumCalcium Phosphate, Phosphate, Hydroxyl Hydroxyl Form: Form: Ca Ca10(PO4)10(PO4)6(OH)6(OH)2 2 LeavingLeaving Certificate Certificate Physics Physics kidneykidney where where filtration filtration 6.6. Analgesics Analgesics are are the the most most frequent frequent form form of of treatment. treatment. Find Find out out • • CalciumCalcium Hydrogen Hydrogen Phosphate Phosphate Dihydrate: Dihydrate: CaHPO4.2H CaHPO4.2H2O2O • • VibrationsVibrations and and sound sound (p. (p. 31) 31) howhow these these reduce reduce the the pain. pain. takestakes place. place. • • UricUric Acid: Acid: C 5CH54HN44NO4O3 3 ScienceScience and and Technology Technology in in Action Action is isalso also widely widely used used by by 7.7. Endoscopes Endoscopes are are used used for for RIRS. RIRS. They They can can have have various various d)d) Suggest Suggest one one possible possible treatment treatment for for kidney kidney failure. failure. TransitionTransition Year Year classes. classes. attachmentsattachments to to carry carry out out particular particular functions functions in in the the break-up break-up and/orand/or retrieval retrieval of of stones. stones. Find Find out out what what these these attachments attachments BiographicalBiographical Notes Notes areare and and any any aspects aspects of of their their design design that that help help do do the the job job LeavingLeaving Certificate Certificate Biology Biology LearningLearning Outcomes Outcomes (hint(hint nitinol nitinol is isone one useful useful material). material). (HL)(HL) 2008, 2008, Q. Q. 15 15 (b) (b) & &(c) (c) ClaudeClaude Dornier Dornier (1884 (1884 - 1969)- 1969) 8.8. EWRS EWRS is istotally totally non-invasive non-invasive under under normal normal circumstances. circumstances. TheThe diagram diagram shows shows the the structure structure ClaudeClaude Dornier Dornier was was born born in inBavaria Bavaria in in1884 1884 OnOn completion completion of of this this lesson, lesson, students students should should be be able able to: to: AreAre there there any any problems problems associate associate with with its its use? use? ofof a anephron nephron and and its its associated associated andand graduated graduated from from the the Technical Technical University University bloodblood supply. supply. • • DescribeDescribe what what a akidney kidney stone stone is isand and its its composition composition 9.9. Find Find out out what what home home remedies remedies are are suggested suggested for for the the in inMunich Munich in in1907. 1907. He He was was an an aircraft aircraft treatmenttreatment of of kidney kidney stone stone and and suggest suggest a apossible possible medical medical builderbuilder and and became became involved involved in infundamental fundamental • • KnowKnow that that about about 10% 10% of of people people will will suffer suffer from from kidney kidney stones stones (i)(i) Name Name the the parts parts A, A, B, B, C, C, D, D, E E reasonreason why why the the might might help. help. You You might might also also find find out out the the researchresearch and and design design of of aircraft. aircraft. He He was was atat some some time time in in their their life life andand F. F. possiblepossible dangers dangers involved involved in in these these treatments. treatments. involvedinvolved in inthe the design design of of struts struts for for the the • • OutlineOutline the the factors factors likely likely to to cause cause the the formation formation of of kidney kidney stones stones (ii)(ii) From From which which blood blood vessel vessel is isA A ZepplinZepplin and and later later on on strengthening strengthening metals metals • • HaveHave a abasic basic understanding understanding of of the the range range of of treatments treatments derived?derived? usedused in inbuilding building stressed-skin stressed-skin planes. planes. available,available, including including lithotripsy lithotripsy and and surgery surgery (iii)(iii) Where Where in in the the kidney kidney is isB B DuringDuring his his research research he he concluded concluded that that pitting pitting of of metal metal surfaces surfaces • • DistinguishDistinguish between between the the two two major major forms forms of of lithotripsy. lithotripsy. True/FalseTrue/False Questions Questions located?located? ofof planes planes as as they they approached approached the the sound sound barrier barrier was was caused caused by by (iv)(iv) Give Give the the part part of of the the nephron nephron thethe shockwave shockwave created created in infront front of of droplets droplets of of water. water. Later Later a agroup group a)a) Lithotripsy Lithotripsy uses uses ultra-sound. ultra-sound. T TF F inin which which each each of of the the following following ofof about about 25 25 people people working working in inthe the Dornier Dornier medical medical laboratories laboratories takestakes place: place: filtration, filtration, reabsorption reabsorption of ofamino amino acids. acids. investigatedinvestigated the the possible possible use use of of shock shock waves waves to to break break up up kidney kidney GeneralGeneral Learning Learning Points Points b)b) Most Most kidneys kidneys stones stones pass pass without without treatment. treatment. T TF F stones.stones. As As a aresult result of of extensive extensive collaboration collaboration between between the the Dornier Dornier c)c) Analgesics Analgesics relax relax muscles. muscles. T TF F (v)(v) Give Give two two features features of of the the nephron nephron that that aid aid filtration. filtration. researchresearch laboratory laboratory and and a agroup group of of doctors doctors from from several several hospitals hospitals TheseThese are are additional additional relevant relevant points points which which d)d) Dehydration Dehydration is isthe the most most common common cause cause of of kidney kidney thethe first first extracorporeal extracorporeal shock shock wave wave lithotripter lithotripter was was produced produced areare used used to to extend extend knowledge knowledge and and facilitate facilitate discussion. discussion. (vi)(vi) Name Name a agroup group of of biomolecules biomolecules in in the the blood blood which which are are too too stones.stones. T TF F largelarge to to pass pass through through the the filtration filtration system system of ofthe the nephron. nephron. aroundaround 1980. 1980. It Itrevolutionised revolutionised the the treatment treatment of of kidney kidney stones stones • • TheThe common common symptom symptom of of kidney kidney stones stones is ispain pain in in the the lower lower e)e) Most Most kidney kidney stones stones are are calcium calcium compounds. compounds. T TF F andand is isnow now the the mainstay mainstay of of treatment treatment around around the the world. world. back,back, groin groin and and testes, testes, and and we we have have been been aware aware of of it itfor for (c)(c) f) f) UrinaryUrinary tract tract infections infections always always cause cause kidney kidney stones. stones. T TF F thousandsthousands of of years years (i)(i) Suggest Suggest two two situations situations which which may may result result in in a adrop drop in in the the water water g)g) Open Open surgery surgery is isthe the best best treatment treatment for for most most kidney kidney • • MostMost kidney kidney stones stones pass pass on on their their own own and and only only large large stones stones contentcontent of of the the blood. blood. stones.stones. T TF F needneed medical medical intervention intervention ReviseRevise The The Terms Terms h)h) Diueretics Diueretics increase increase urine urine production production which which is ismore more (ii)(ii) When When the the water water content content of of the the blood blood drops drops a ahormone hormone is is • • LithotripsyLithotripsy uses uses sound sound waves waves to to break break up up kidney kidney stones stones to to likelylikely to to cause cause stones. stones. T TF F released.released. Name Name this this hormone hormone and and the the endocrine endocrine gland gland from from CanCan you you recall recall the the meaning meaning of of the the following following terms? terms? makemake then then small small enough enough to to pass pass through through the the ureter ureter and and into into whichwhich it itis issecreted. secreted. RevisingRevising terminology terminology is isa apowerful powerful aid aid to to recall recall and and retention. retention. thethe bladder bladder and and then then out out through through the the urethra. urethra. i) i) X-raysX-rays are are used used to to diagnose diagnose and and locate locate kidney kidney stones. stones. T TF F • • TheThe main main cause cause of of kidney kidney stones stones is isdehydration dehydration caused caused j) j) RIRSRIRS is isslightly slightly invasive. invasive. T TF F (iii)(iii) Give Give a aprecise precise target target area area for for this this hormone. hormone. How How does does the the alphaalpha blockers, blockers, analgesic, analgesic, CAT CAT scan, scan, catheter, catheter, dehydration, dehydration, hormonehormone reach reach the the target target area? area? byby either either strenuous strenuous exercise exercise or or excess excess sweating sweating in in a awarm warm k)k) ESWL ESWL can can cause cause bruising bruising in in the the area area of of the the stone. stone. T TF F cysteine,cysteine, diuretic, diuretic, endoscope, endoscope, ESWl, ESWl, invasive, invasive, IVP, IVP, lithotripsy, lithotripsy, litotripter,litotripter, nephrolithiasis, nephrolithiasis, oxalate, oxalate, pelvis, pelvis, renal renal calculi, calculi, RIRS, RIRS, climateclimate with with insufficient insufficient water water intake intake l) l) LithotripsyLithotripsy can can be be used used to to help help mend mend broken broken bones. bones. T TF F (iv)(iv) Explain Explain the the role role of of the the hormone hormone at at its its target target area, area, when when the the shockshock wave, wave, stent, stent, ultra ultra sound, sound, ureter, ureter, urethra, urethra, urologist, urologist, X-ray. X-ray. • • BacterialBacterial infection infection can can cause cause the the rapid rapid growth growth of of kidney kidney waterwater content content of of the the blood blood is islow. low. stonesstones which which have have a aparticular particular composition. composition. CheckCheck your your answers answers to to these these questions questions on on www.sta.ie. www.sta.ie. CheckCheck the the Glossary Glossary of of terms terms for for this this lesson lesson on on www.sta.ie www.sta.ie