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Urinary - Learning Objectives m-u {After reading this...

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Unformatted text preview: Learning Objectives m-u ..__.,___.._ ..-.__._._ »- {After reading this chapter. the student should be able to: i-'- 1. Describe thegross r. the urinary bladder. CHAPTER 13: The {binary Tract 317 andmierosce-picanatomyoftheunnarytractasndthepflncipal hmfiorisofthekidneysand 2. mangemmmfiomflmmmfimmmofwfimwmm , 3. Discuss the pathogenesis. clinical cause. and eutcente of pestsu-ep'tococcal and crescentic gamer-alonephritis 1-;- 4. Discuss three (gases of nephrotzic syxridrmne- "' 5- Compare the pathogenesis of aafiemldciamnicgzralfafliue.. i. 6- Describe the patl'iologic dmangesinthekichieycausedbycflabetes i. 7.Listfourtypesofrenalstones, mkhtheirpfifltogmefisarfidesuibefiaedinkalsmomflwproduce 8. List five causes of urinary obstruction. i 9. Compare the pathology and clinical mptorn‘s of acute and chronic pyelonephrifisa #10-Discussfl1eefiologyandpafl169enesisofcysfifish1mmandm. ‘ 1].. Define acute mbular necrosis and describe its pathogenesis and We. ti312. Describe the pat-hole? and clinical features of renal cell cardnem We’ minor; and transitional cell carci— ' noma of the renal l .13- Describe the pathology and clinical features of bladder cancer. _ The urinary tract r-runpriscs 1hr: kidneys. the ureters- Iho urinary bladder. and the urethra (Figure 13-l). Diseases affecting the kirlneys are usually treated by ne};lunlagists. whereas urot'ugz'sis generally lrt‘ul renal 111“}an and IlIusl ul- the diseases {If the lliwvl-I' urinary tram. Normal A atomy and Physiology The )rinaarx- lunctiun of the urinary tract i-_: thf-Vlrfl'ngtinn and excretion of urine. [Irine is Ionned by ultraliltralinn nl' b 00 n 'idnf'ys Frnln [hr-r kidneys .‘_ the urine ‘llows into the 1'8:11Ll collecting systctn [renal 1: elites and pelvis) and passes through the ureters IJBl’ttl't‘ it rent. hes the urinal-v bladder. The urinary bladder serves as a receptai. ll‘ lor tl'li' urine. The urine is stored in the urinary bladder 101‘ $1. verul hours and then discharged fronl the bud}: through lhv urethra. rlfil‘IP rtlrnlatiun of urine in iht‘ kidneys is auctintplished in the nepliron. wwhich represents the basic l'unctinnal unit of each kidney: The kidne {-(JIllaiIi _'dIl_[)TD_Kifllalf‘l¥ 2.5 tnillion HF!:1]IDI;S. each of whn: ll consists vi a glnlnnru— has. tubules. and collecting ducts grigiire 1-3 2:2). T he gIUIneI-Ldus consists of specialized capillaries that are modified so that they allow selective passage of fluids and enlnlnc rrnvn rlIn ll1llr‘irl 'nr-nn tl-Ir- Inn-n."- “1' II":- nnnlnr-nn "I‘lxik- ghnueruli is annually resurlled and returned In llw lfll'n ['ulatinll. Bel‘ziuse the JIriInary filtrate is runnc‘nlratird in the tubules. only :1 snlall [un'lion (If it is l-‘JL'I'I'I‘IL'CI us urine. .-'\[1pl‘nxitnate-l_v 1.5 L uf urine is Irxi-rt-Iml daily. “’hiuh rep- resl-r‘lls less-:- lllun lilo/n nl' ll'll‘ liluud vullnne liilrt'vrl ll11‘nugh 1hr glunivruli. [11 cnnlrusl to [he (tull‘IpIr-x histology nl' II'II- kidneys. the excretory purliuu ul' the urinnr'} Iran-1 i5- J‘PIELIJ'VRLV simple. rellet-Ijng its fill]l'[il1' function. The (Talil't‘hi. pelves. unficrs. urinary bladder. and Illlfl-il 11F the Ill'i’lEli'u are lined by l.ran~ sitiunul epilhulhnn. ‘l‘lw transitional epilhelilun is *n'alrr— prunf“ and can ‘willlstand INT-lunged exposure to urine. External In [his Utilitllt‘lial layer. Ihflse organs consist of con“ neutivr‘ tissue and stlunuth IUIISCIC cells. Transitional epithes lium and [he sinuuth lllllf-lf‘lllfll' “all can expand. allowing the bladder [1:1 stun“ urine. IThe snluoth muscle in the- bladder “-11” is inlpurtant for extrusion of urine during r11.i(.'.turitinr1 As nienliunr-(l. lilt' urinur‘v tract primarilv has an exrre— liar} lunc-tinn. ln addiliun- the kidney,r has secretorv func— Iinns: it secretes rerun. a horrnone that raises blond pressure. and Frj'Thf‘Opuf't’fi-fi'. the growth factor that stimu— lates the production of red blood cells (HBCS) in the hour- lllal’l‘(]“-'. also useful. especially in the case of early lesions. such as metastases} have only a 1.3% 5-year survival. rareimmla in sin: or mullil‘oc‘al ilal lesions. A Review Questions 4—1. Explain how urine is formed and excreted. --2. Describe the principal porlions of the nephron and explain how they function. 3. What is the functional significance of transitional epithelium? 4. Describe the effects of various hormones on the kidney. 5. Which hormones and grewth factors does the kidney produce? -6. List the most important symptoms of kidney disease 7. How common are renal developmental disorders, and which one of them' is the most common? 8. Correlate the pathology of autosomal dominant polycystic kidneyr disease with the clinical features of this-7. disease. 9. Classify glomerular diseases. -10. List the most important immunologic glomerular diseases. - 11. List the most important metabolic glomerulopathies. a: 1.2. Explain how circulatory disorders affect glomeruli. 13. List the four most important syndromes related to glomerular diseases. .514. Compare nephrotic and nech syndrome. #5. Explain the pathogenesis of acute glomerulonephritis and correlate the pathologie and clinical findings. disease. 15; Expiain the pathogenesis of crescentic glomerulonephrilis and relate the pathologic and clinical findings _" CHAPTER 13: 1299 Urinary Tract 335 -_"~‘; Explain the pathogenesis of menlhranous nephmpathy and relate the pathologic and clinical findings in this disease- _ What is lipoid nephrnsis, and how is it diagnosed? . What do most fonns of chronic proliferative glemerulonephrifis have in common? What is the cause of end—stage kidney' disease, and how d'oes it present clinically? How does difihetes melljtus affect the kidneys? List the four most common fDI'ITIS of kidney stones. Compare ascending and descending urinary tract infection and list tile most common predisposing conditions for these infections. Compare the pathologic and clinical 1Features of acute and chronic pyclonephritis- Compare the causes of cystitis in men and women and in young and old people. Compare the pathologist: and clinical features of acute and chronic cystitis. Explain how circulatory collapse causes renal tubular necrosis. Explain the effects of hypertension on the kidneys. List three cornmon tumors of the lumen-y tract- '33. Compare renal cell carcinomas and Wflms’ tlu'nor. "31. Compare Transitional cell carcinoma of the renal pelvis and renal cell carcinoma. How common is carcinoma of the urinary bladder? '33. Correlate the macmscopic and microscopic features of urinary bladder carcinoma with the clinical features of this tumor. 534. What are the typical symptoms of urinary bladder carcinema? 5:35. What is the outcome of treatment of urinary bladder carcinoma? ...
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