The patient was woken up by abdominal pain located in his right lower quadrant,

Question

The patient was woken up by abdominal pain located in his right lower quadrant, in the right groin and radiating into his right testicle. He was transported to the hospital. He reports that his pain is a “10” on a 1 to 10 scale. He is nauseated but has not vomited. The patient is normal weight and otherwise healthy. Upon palpation his abdomen is soft with mild tenderness in the right lower quadrant. Following the discovery of blood in his urine he is diagnosed with a ureteral obstruction, a computed tomography scan shows a calcified stone in the right ureter at the ureterovesical junction.

Guiding Questions

Answer the questions below and submit as a Microsoft Word document or PDF. DUE Friday by 11:59 pm.

1. The ureterovesical junction (where the ureter passes through the wall of the bladder) is a common site for kidney stones to become impacted. Can you propose two additional sites where kidney stones are likely to become impacted based on the anatomy of the ureters?

2. This patient was advised to increase his water intake to prevent subsequent kidney stones. Why would an increased fluid intake lower his chances for a repeat incident?

Explanation / Answer

Answers

1)The other two common sites for kidney stones are Ureteropelvic junction (ureteric junction of renal pelvis / UPJ) junction between renal pelvis posterior part of ureter and the ureteral crossing of the iliac vessels- when the ureter crosses over the iliac vessel

2) The doctor advised to drink plenty of water so that, urine can get clear and the stone can pass out through urine. Drinking less water is the main reason for the formation of kidney stones. The water in the body helps in maintaining the pH of the urine and also dilutes the crystal forming substances of urine like uric acid and calcium oxalate. Intake of less water increases the content of uric acid in urine makes the urine more acidic in nature and that leads to formation of kidney stone.

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