general
During inspection of the lumbar region, what physical changes may indicate kidney pathology?
Swelling, asymmetry, or visible masses may suggest inflammation or enlargement of the kidney.
What is the purpose of inspecting the lumbar region during kidney examination?
To detect asymmetry, swelling, or visible enlargement that may indicate kidney pathology.
What is the main purpose of kidney palpation during physical examination?
To assess the size, shape, position, mobility, and tenderness of the kidneys.
Where is kidney percussion usually performed?
In the costovertebral angle area between the 12th rib and the spinal сolumb
What is the main purpose of auscultation in the examination of the urinary system?
To detect vascular murmurs or bruits over the renal arteries that may indicate stenosis or other vascular abnormalities.
How is the kidney ballottement test (Guyon’s method) performed and what does a positive result indicate?
The examiner places one hand on the lumbar region and taps with the other hand on the anterior abdominal wall; a palpable kidney suggests enlargement or descent.
How can scars or deformities in the lumbar region be interpreted during kidney inspection?
They may suggest previous surgery, trauma, or chronic kidney disease.
In what patient position is bimanual palpation of the kidneys usually performed?
In the supine position, with the patient breathing deeply and muscles relaxed.
What is the clinical significance of Pasternatsky’s (costovertebral angle) tenderness test?
Pain during gentle tapping indicates kidney inflammation or pyelonephritis.
Where are the renal arteries auscultated?
On the anterior abdominal wall, approximately 2–3 cm above and lateral to the umbilicus on both sides.
Why is costovertebral angle tenderness (Pasternatsky’s symptom) tested, and what does a positive sign indicate?
It’s tested to check for kidney inflammation; pain upon percussion suggests pyelonephritis or other renal pathology.
Why is it important to compare both lumbar regions during inspection of the kidneys?
To identify any asymmetry that might suggest unilateral kidney enlargement or inflammation.
How is bimanual kidney palpation performed?
One hand is placed under the lumbar region and the other on the anterior abdominal wall; during deep inspiration, the lower pole of the kidney may be felt between the hands.
What sound is normally heard during percussion over the kidney area?
A tympanic or slightly dull sound, depending on surrounding bowel gas.
What does the presence of a systolic bruit over the renal artery suggest?
Renal artery stenosis or narrowing.
What information can percussion of the suprapubic area provide in urinary system examination?
It helps determine bladder fullness or urinary retention by detecting dullness over the distended bladder.
What changes in skin color can be observed in patients with chronic kidney disease?
The skin may appear pale, grayish, or yellowish due to anemia and toxin accumulation.
What is the significance of tenderness during kidney palpation?
It suggests inflammation, infection, or stone formation (e.g., pyelonephritis or renal colic).
How can percussion help differentiate between bladder distension and lower abdominal mass?
Bladder dullness disappears after urination, while an abdominal mass remains.
Why is auscultation of the abdominal aorta important during urinary system examination?
To rule out aneurysms or vascular murmurs that may affect renal blood flow.
What does tenderness during deep palpation in the suprapubic region usually indicate?
It may indicate cystitis or inflammation of the urinary bladder.
How does renal edema differ from cardiac edema during facial inspection?
Renal edema appears first on the face (especially eyelids), while cardiac edema begins in the lower limbs.
What does a palpable kidney usually indicate in adults?
Kidney enlargement, displacement, or abnormal mobility (nephroptosis).
Why is gentle percussion preferred when assessing the kidneys?
To avoid pain and to detect tenderness accurately without causing discomfort.
What additional area can be auscultated if renovascular hypertension is suspected?
The flank or lumbar region where renal artery branches may be heard.