1
Q
urinary system job
A
- responsible for removing toxic waste products and unnecessary fluid maintaining homeostasis
- acid base balance
- electrolyte balance
- control of blood pressure within rennin
- formation of RBCs
- activation of vitamin D
2
Q
constitutional signs of issues with urogenital system
A
- fever, chills
- fatigue, malaise
- anorexia, weight loss
3
Q
musculoskeletal differential diagnosis
A
- unilateral costovertebral tenderness
- low back, flank and inner thigh or leg pain
-ipsi shoulder pain
4
Q
upper UTI cluster
A
- unilateral costovertebral tenderness
- flank pain
- ipsi shoulder pain
- fever and chills
- skin hypersensitivity
- hematuria
- pyuria
- bacteriuria
- nocturia
5
Q
Upper urinary tract infection
–renal urethral
A
- information transmitted by renal and urethral pain receptors is relayed by sympathetic nerves that enter the spinal cord at T10-L1
- visceral and sensory nerves converge on some of the same neurons, when visceral pain fiber are stimulated, concurrent cutaneous nerve fiber stimulation occurs
6
Q
Upper Urinary Tract Infection
– Renal
A
- Renal pain is subsequently felt in the posterior subcostal and costovertebral regions
7
Q
Upper Urinary Infection
– Urethral
A
- felt in the groin and genital area
- with either renal or urethral pain radiation around the back into the flank into the lower abdominal quadrant and abdominal muscle spasm can be felt on the same side as the pain
8
Q
Pseudorenal Pain
A
- secondary to referral from radiculitis or irradiation of the costal nerves caused by costovertebral or costotransverse joints
- onset is usually acute with some type of traumatic history
9
Q
Lower Urinary tract infection
- bladder/Urethra
A
- pain almost always felt above the pubis or low in the abdomen
- usually characterized as urinary urgency or a sensation to void, or painful urination
10
Q
signs and symptoms of lower urinary tract infection in bladder/ urethra
A
- urinary freq
- urinary urgency
- LBP
- Pelvic/ lower abdominal pain
- dysuria
- hematuria
- pyuria
- bacteriuria
- dysparenunia
11
Q
dysuria
A
- painful burning or discomfort with urination
12
Q
nocturia
A
-getting up more than once at night for urination
13
Q
hematuria
A
- blood in the urine; pink or red tinted urine
14
Q
urinary problems
–frequency
A
- need to urinate or empty bladder more than once every 2 hours
15
Q
hesitancy
A
- weak or interrupted urine stream
16
Q
proteinuria
A
- protein in the urine; urine is foamy
17
Q
cystitis
A
- inflammation with infection of the bladder
- most often caused by bacterial infection
18
Q
-interstitial cystitis
A
- inflammation without infection
- considered more of an injury to the bladder resulting in constant irritation and rarely involves the presence of infection
- IC patients are often misdiagnosed with UTI/ cystitis for years before they are told that their urine cultures are negative
- antibiotics ar enot used in the treatment of IC. the cause of IC is unknown, though some suspect it may be autoimmune where the immune system attacks the bladder
19
Q
urethitis
A
- inflammation of the urethra
- most common symptoms is painful or difficult urination
- can be caused by bacteria or a virus
20
Q
renal and urinary problems risk factors
A
- age over 60
- personal or family hx of DM
- personal of family hx of kidney disease
- heart attack or stroke
- personal history of kidney stones, UTI, obstruction or autoimmune disease
- exposure to chemical drugs or environmental conditions
21
Q
obstructive disorders
A
- can occur anywhere along the urinary tract
- primary: occurring from inside the urinary tract
- – renal or uretal calculi
- – neoplasms
22
Q
renal calculi
A
- a kidney stone is a solid mass made up of tiny crystals.
- one or more stones can be in the kidney or ureter at the same time
- calcium most common. men ages 20-30. formed by oxalate present in spinach and vitamin C supplements.
- diseases of the small intestine increase your risk of these stones
23
Q
cystine stone
A
- can form in people who have cystinuria
24
Q
struvite stone
A
- are mostly found in women who have a urinary tract infection. these stones can grow very large and can block the kidney, ureter, or bladder
25
uric acid stones
- more common in men than in women.
| - they can occur with gout or chemotherapy
26
renal cell carcinoma
- accounts for approx 3% of adult malignancies and 90-95% of neoplasms arising from the kidney. this disease is characterized by a lack of early warning signs, diverse clinical manifestations, and resistance to radiation and chemotherapy
27
secondary obstructions
- occurring from outside the urinary tract
- - pressure from enlarge prostate
- abdominal aortic aneurysm
- pregnancy
- endometriosis
- neoplasm
- abdominal structures
28
obstruction of upper urinary tract
- pain depends of rapidity of onset
- acute spasmotic radiating pain
- mild, dull flank pain
- LBP
- hyperesthesia of dermatomes T10-L1
- nausea and vomiting
- fever and chills
- urge to urinate
- hematuria
- abdominal muscle spasm
29
incontinence
| --- overflow
- over distension of the bladder or the bladder cannot empty fully
- urethral blockage
30
Incontinence
| --- urge
- overactive bladder
- bladder oversensitivity from infection
- neurologic disorders
31
incontinence
| --- stress
- occurs when support for the bladder is weak or damaged but the bladder itself is normal
- relaxed pelvic floor
- incr abdominal pressure
32
incontinence
| --- functional incontinence
- confined to a wheelchair
33
renal failure
- occurs when the kidneys can no longer maintain homeostatic balances within the body.
- decr in glomerular filtration rate
- detected by incr serum creatinine level
34
acute renal failure
-acute: abrupt cessation of kidney function
35
chronic renal failure
- chronic: irreversible renal failure (end stage renal disease)
36
renal failure characterized by:
- characterized by abnormal body fluid levels, increased acid levels, abnormal calcium, phosphate, potassium levels, anemia, hematuria, proteinuria, cardiovascular problems
- toxic substances in the blood begin to compromise all other body systems
37
renal failure signs and symptoms
- impaired fluid and waste excretion
- urine volume decreased
- edema
- CHF
- extreme fatigue
- intolerance to normal ADLs
- decr exercise capacity
38
bladder cancer
- malignancy that starts in the bladder in the cell lining or transitional cells
- tumors classified by the way the grow
- strongly linked to cigarette smoking
- blood in the urine
- pain during urination
- urinary urgency
39
papillary tumor
- have a wart-like appearance and are attached to a stalk
40
non-papillary
tumors are much less common. however, they are more invasive and have a worse outcome
41
renal cell carcinoma
- type of kidney cancer that starts in the lining of very small tubes in the kidney
- most common type of kidney cancer in adults
- occurs most often in men ages 50-70
- exact cause is unkown
42
renal cancer signs and symptoms
- blood in the urine
- pain during urination
- urinary urgency
- flank pain
- lump or mass inside of abdomen
- weight loss
- fever
- general fatigue
43
renal cancer risk factors
- smoking
- obesity
- HTN
- long term dialysis
- gender
- occupation, coke over workers in iron and steel industry
44
pudendal neuralgia
- chronic pelvic pain lsting 3 or more months due to compression or dysfunction of pudendal nerve
45
symptoms of pudendal neuralgia
- sharp pain, numbness, tingling, burning, feeling of having foreign object around ssacrum
46
causes of pudendal neuralgia
- falls on sacrum, childbirth, cycling and surgeries
47
endometriosis
- occurs when endometrial tissue grows outside the uterus, commonly on the ovaries, fallopian tubes, or other pelvic organs
48
endometriosis symptoms
- pelvic pain, often associated with menstrual cycle, longer duration than typical
- LBP
- abdominal
- extras: painful sex, painful bowel or urination, excessive bleeding with menstruation or intermentrual bleeding, infertility, fatigue, diarrhea, constipation, bloating, nausea
49
endometriosis risk factors
- infertility/ never giving birth
- early menses
- late menopause
- short menstrual cycles (less than 27 days)
- higher levels of estrogen
- lower BMI
- family h of endometriosis
- any condition that prevents normal menstrual flow
- reproductive tract abnormalities
50
two types of ovarian cysts
- corpus luteum cyst
| - follicular cyst
51
corpus luteum cyst
- fluid accumulation in CL after release of egg
52
follicular cyst
- when follicule doesn't rupture or release egg, and continues to grow
53
dermoid cysts
- formed from embryonic cells
54
cystadenomas
- cysts on the surface of an ovary
55
ovarian torsion
-cysts grow large enough to cause ovary to move or twist, can decr or stop blood flow as well as sudden onset of pelvic pain, nausea vommitine
56
symptoms of ovarian cyst
- unilateral sharp or dull pelvic pain
- fullness or heaviness n your abdomen
- bloating
57
ovarian cysts- medical emergency
- sudden onset of severe abdominal or pelvic pain
- pain with fever or vomiting
- signs of shock (clammy skin, rapid breathing, lightheadedness or weakness
58
ovarian cysts risk factors
- hormonal problems
- pregnancy
- endometriosis
- a severe pevic infection
- previous ovarian cyst
59
Pregnancy related pain
| --relaxin
- peaks at 16 weeks
| - can stay circulating in body 3-6 months. linger if breast feeding
60
Pregnancy related pain
| --pelvic girdle pain
- sIJ mobility, pubic symphysis
61
Pregnancy related pain
| -ectopic pregnancy
- ipsi suprapubic, back, shoulder or neck stabbing pain, intermittent, variable, intensity
- abnormal vaginal bleeding
- gastrointestinal symptoms
- weakness, dizziness or fainting
62
Screening for appendicitis
| --- rebound tenderness
- pain is felt in the right lower quadrant when pressure is placed upon Mc Burney's point it is quickly released
- pain is noted with the rebound
63
screening for appendicitis
| -- rovsign sign
- deep palpation starting from the left iliac fossa upward
| - pain noted in the right iliac fossa due to bowel pushing to the right
64
Screening for appendicitis
| ---Psoas test 1
- the patient has to lie on his/her side, with the knees extended. from this position, the tester will try to passively extend the thigh
- positive is pain
65
Screening for appendicitis
| ---psoas test 2
- while supine, the tester asks the patient to actively flex the right thigh in the hip against the the therapist resistance
- positive is pain
66
screening for appendicitis
| -obturator test
- the patient lies on her/his back with the hip and knee both flexed at ninety degrees
- the examiner holds the patient's ankle with ine hand and the knee with the other hand
- the examiner internally rotates the hip by moving the patient's ankle away allowing the knee to move only inward.
-this is flexion and internal rotation of the hip
