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    Examination of Renal System

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    Harshit Bhardwaj
    The document discusses examination of the urinary system, including the kidneys, ureters, urinary bladder, and urethra. It describes physical examination techniques like inspection, palpation, and percussion to examine the kidneys and urinary system. It also discusses urinalysis and possible abnormalities that can be detected. The physical examination section provides details on different palpation methods for the kidneys and tests for urinary incontinence.

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    © All Rights Reserved
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    Examination of Renal System

    Uploaded by

    Harshit Bhardwaj
    1K views56 pages
    The document discusses examination of the urinary system, including the kidneys, ureters, urinary bladder, and urethra. It describes physical examination techniques like inspection, palpation, and percussion to examine the kidneys and urinary system. It also discusses urinalysis and possible abnormalities that can be detected. The physical examination section provides details on different palpation methods for the kidneys and tests for urinary incontinence.

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    The document discusses examination of the urinary system, including the kidneys, ureters, urinary bladder, and urethra. It describes physical examination techniques like inspection, palpation, and percussion to examine the kidneys and urinary system. It also discusses urinalysis and possible abnormalities that can be detected. The physical examination section provides details on different palpation methods for the kidneys and tests for urinary incontinence.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    1K views56 pages

    Examination of Renal System

    Uploaded by

    Harshit Bhardwaj
    The document discusses examination of the urinary system, including the kidneys, ureters, urinary bladder, and urethra. It describes physical examination techniques like inspection, palpation, and percussion to examine the kidneys and urinary system. It also discusses urinalysis and possible abnormalities that can be detected. The physical examination section provides details on different palpation methods for the kidneys and tests for urinary incontinence.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 56

    Examination of Urinary system.

    Kidneys, Urethers, Urinary bladder and Urethra; Methods of


    assessment. Basic data of Urine analysis and it’s possible
    abnormalities.
    Structure of Nephron
    Physical Examination of Urinary System
    • Inspection
    • Palpation
    • Percussion
    • Inspect patient generally for muscle wasting and edema. Periorbital Edema and
    • Facial puffiness. Pale Skin. Look for Central, peripheral and peritoneal dialysis
    catheter. A mass that is visible in the upper abdominal area may be difficult to palpate if
    soft, as with hydronephrosis. Fullness in the costovertebral angle may be consistent with
    cancer or perinephric infection. The presence and persistence of indentations in the skin
    from lying on wrinkled sheets suggest edema of the skin secondary to perinephric abscess.
    Physical Examination of Urinary System
    • Palpation
    • The kidneys lie rather high under the diaphragm and lower ribs and are therefore
    well protected from injury. Because of the position of the liver, the right kidney is
    lower than the left. The kidneys are difficult to palpate in men because of (1)
    resistance from abdominal muscle tone and (2) more fixed position than in women,
    moving only slightly with change of posture or respiration. The lower part of the
    right kidney can sometimes be felt, particularly in thin patients, but the left kidney
    usually cannot be felt unless it is enlarged or displaced.
    • The most successful method of renal palpation is carried out with the patient lying
    in the supine position on a hard surface. The kidney is lifted by one hand in the
    costovertebral angle (CVA). On deep inspiration, the kidney moves downward; the
    other hand is pushed firmly and deeply beneath the costal margin in an effort to
    trap the kidney. When successful, the anterior hand can palpate the size, shape, and
    consistency of the organ as it slips back into its normal position.
    Physical Examination of Urinary System
    • Method of palpation of the kidney. The posterior hand lifts the kidney upward. The
    anterior hand feels for the kidney. The patient then takes a deep breath; this causes the
    kidney to descend. As the patient inhales, the fingers of the anterior hand are plunged
    inward at the costal margin. If the kidney is mobile or enlarged, it can be felt between the
    two hands.
    Physical Examination of Urinary System
    • Alternatively, the kidney may be palpated with the examiner standing behind the seated
    patient. At other times, if the patient is lying on one side, the uppermost kidney drops
    downward and medially, making it more accessible to palpation.
    Perlman and Williams (1976) described an effective method of identifying renal anomalies
    in newborns. The fingers are placed in the costovertebral angle, with the thumb anterior
    and performing the palpation.

    • An enlarged renal mass suggests compensatory hypertrophy (if the other kidney is absent
    or atrophic), hydronephrosis, tumor, cyst, or polycystic disease. However, a mass in this
    area may also represent a retroperitoneal tumor, spleen, lesion of the bowel (eg, tumor,
    abscess), lesion of the gallbladder, or pancreatic cyst. Tumors may have the consistency of
    normal tissue ...
    Physical Examination of Urinary System
    Physical Tests to detect Urinary Incontinence
    Ask the patient to do the old jump-into-the-pool move: pinch the nose and close
    the mouth, then order to breathe out hard, and ask if right away there is a hard
    time holding in urine.
    Pelvic Exam. This is another type of stress test. It is done with a full bladder.
    While sitting up ask the patient to cough. When patient lying down, gently check
    out pelvic organs. Test the muscle strength in that area, too.
    Rectal Exam: do this exam at the same time you perform your pelvic exam. Use a
    gloved, lubricated finger to feel inside the rectum. look for blockage that might
    be causing the problem.
    Physical Examination of Urinary System
    Percussion
    Physical Examination of Urinary System
    History
    • Ask about difficulties during urination:
    • Dysuria
    • Urgency
    • Frequency, Polyuria
    • Nocturia.
    • Ask about suprapubic pain.
    • Urinary Incontinence, Hematuria, Flank pain and uretheral colic.
    Urinalysis

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