EXAMINATION OF URINARY CASE

PURPOSE AND IMPORTANCE OF PHYSICAL EXAMINATION IN RENAL CASES

1. Early detection of renal abnormalities and related systemic conditions
2. Assessment of renal function through observation of urine output and specific gravity
3. Evaluation of hemodynamic status through blood pressure measurement
4. Identification of signs of urinary tract infection or obstruction
5. Assessment of renal tenderness and guarding
6. Detection of masses or stones in the kidney

ROLE OF EXAMINATION IN ASSESSMENT OF RENAL FUNCTION

1. Estimation of glomerular filtration rate through serum creatinine levels
2. Measurement of blood urea nitrogen (BUN)
3. Evaluation of urine output and specific gravity
4. Assessment of electrolyte imbalance

DETECTION OF ABNORMALITIES AND RELEVANT CLINICAL SIGNS

1. Flank pain or tenderness
2. Hematuria (blood in the urine)
3. Proteinuria (protein in the urine)
4. Pyuria (pus in the urine)
5. Nausea and vomiting

CONTRIBUTION OF PHYSICAL EXAMINATION TO DIFFERENTIAL DIAGNOSIS

1. Differentiation between renal and non-renal causes of abdominal pain
2. Identification of underlying conditions such as diabetes or hypertension
3. Evaluation of secondary effects of renal disease

ABDOMINAL EXAMINATION WITH SPECIAL REFERENCE TO KIDNEYS

1. Palpation of the kidney through the flank
2. Assessment of kidney size and tenderness
3. Evaluation of the costovertebral angle (CVA) tenderness

TECHNIQUES OF KIDNEY PALPATION

1. The patient should be in a supine position
2. The examiner's hand should be placed on the patient's flank
3. The kidney should be palpated through the abdominal wall

ASSESSMENT OF KIDNEY SIZE

1. Normal kidney size is approximately 10-12 cm in length
2. Enlargement of the kidney may indicate underlying conditions such as polycystic kidney disease
3. Atrophy of the kidney may indicate conditions such as chronic kidney disease

ASSESSMENT OF RENAL TENDERNESS

1. Tenderness in the flank or CVA region may indicate renal pathology
2. Assessment of renal tenderness may involve gentle palpation or percussion
3. Presence of guarding may indicate severe pain or underlying infection

DETECTION OF RENAL MASSES

1. Renal masses may be palpable through the abdominal wall
2. Imaging studies such as ultrasound or CT scan may be necessary for accurate diagnosis
3. Presence of a renal mass may indicate underlying conditions such as cancer or cysts