4/20/11 Class Notes

Urinary System

Today’s lecture

                Matula

                                Pot or flask L.

                                Made of glass so you can see through them.

                                Urine is the product of perpulation of the blood. It’s getting sort of purified.  If it doesn’t get completely purified then the color will be different colors.  People who practiced medicine were monks.  Sometimes did it out of charity for the poor or would charge for the rich.  The pope tried to purify the catholic church who said that lets stop sending the monks out to get educated and stop them from touching feces and urine.  Medicine and religion started separated one from the other.

                Uroscopy wheels and medical diagnosis

                                16-20 matula’s on a wheel.  The circles are connected to what’s happening in the kidney.  Green urine, blue urine, yellow, orange, red, cloudy.  The colors are factual.  But their connection was to humors.  Green urine is a type of urinary infection. 

                                Systematic always, matula, cloudy or sentiment if it’s higher it’s in the head, if it’s lower it’s in the lower body.  Signs had to be analogous to parts in the bodies

                Urochromatic terms

                                Urocyanin –blue urine

                                Uroerythrin -red

                                Uromelanin-black

                                Uroporphyrin-purple/indigo

                                Urorrhodin-rose colored urine

                                Uroxanthin- yellow urine

                                Urofuscin- fuscia –redish brown

                Urinalysis

                                Leukocytes, Nitrite, urobilinogen, protein, pH, blood, specific gravity, ketone, bilirubin, glucose

                Symptomatic terms-uria

                                Pyuria –pus urine

                                Azoturia-nitrogen waste urine

Albuminuria-protein in urine

Aciduria-pH level in urine

Hematuria-blood in urine

Hypersthenuria-excessively strong urine

Ketosuria-presense of ketone

Urobilinuria-presence of urobilinogen

Glucosuria-too much sugar in urine

                                Anuria-without urine

                                Dysuria-difficult to urine

                                Nocturia or nycturia- bathroom at night

                                Oliguria- limited amounts

                                Polyuria-too much urine

                Therapeutic terms

                                Dialysis (Gr. Dialysis-separating, a loosing of one from another, dissolution) kidney failure

                                                Hemodialysis – separating the blood.  Pump blood through the machine and purifies blood and pumps it back in. 

                                                Peritoneal dialysis- separating the peritoneal.  Take a sack that has glucose and salt in it.  Pulls out the stuff that shouldn’t be in your blood.  Not as effective as hemodialysis.

Terms

                Void

                Urination meaning just urination

                Micurition (L. micturire-to desire to urinate)just urination

Symptomatic terms

                Is there a difference between incontinence and enuresis?

                                Incontinence(L. in = not + continere= to confine, hold)

                                In ability to retain urine, semen or feces though loss of sphincter…etc

Enursis (gr. En= in + ourein=to make water)

                Involuntary discharge of urine after the age of bladder control.

                                Nocturnal enuresis-bed wetting

                                Diurnal enuresis- urinary stress incontinence.

Treatment for nocturnal enuresis

                Kegel exercises.

                                Excersies where you strengthen the pineal muscles.

Diagnostic terms

                Which term(s) is associated with nitrogenous waste in the blood.

                                Azotemia and uremia

Lithiasis-formulation of calculi

                Calculus-L.=little stone

Calculi and the roman abacus

                Abacus means counting table.  You used stones on a stick.  Calculus is the idea of moving the stones on the abacus. 

Utereroscopy and stent

Location of calculi

Extracorporeal(outside of body) lithotripsy (breaking down/crushing stone)

                ‘simple’ stones too large to pass through

                Ultrasound shock waves crush stones

                Smaller pieces pass out of the body in urine

Intracorporeal lithotripsy (inside of body) breaking down/crushing stone)

                Something on the end to break up the stones

Lithotomy (incision of the stone)

                Nephrolithotomy (incision in the kidney to remove the stone)/ ureterolithotomy (incision of the ureter to remove the stone)

Ancient treatments for calculi in the urinary tract

                Hippocratic Oath (5^th-4^th BC)

                                ‘I will not cut, even for a stone, but I will leave such procedures to the practitioners of that craft’

                Practicing similar to the person teaching them but would still do cuts.

                                If I tell you you’re going to die and then practice on you people will think my medical practices were bad.

Medications for calculi

                Dioscorides De Materia Medica (1^st AD)

                                Medicinal Herbs

                                Parts of plants which dissolve urinary stones

                Roman catheter

                                Male catheter to drain the bladder made of lead

                                Same with female.

Surgery (chirugia + for stones)

                Celsus, De Medicina (1^st AD)

                                Manually moving the stone

                                Excision of stones from the bladder/urethra