To determine the type of pathology of the kidneys and urinaryThe bladder uses a variety of examination methods, which include palpation of the kidneys, percussion and examination. Each type of diagnosis has its own characteristics and gives a certain set of information.

Palpation of the kidneys

So, more in detail. Palpation of the kidney in a healthy person does not give results, as they are not probed. This procedure can be carried out only if there is a pathology of the organs. Or very thin people.

Palpation of the kidneys is carried out in two positions: lying and standing. In the supine position, the muscles of the abdominal press are lowered and relaxed, as a result of which the procedure is facilitated. Standing at inspection, it is possible to probe a mobile kidney which has displacement downwards under the weight.

Palpation of the kidney is done with both hands. The patient lies down on the couch on his back, his legs should be straight, his arms free to be placed on his chest. In this position, the muscles of the abdominal press relax as much as possible, breathing becomes smooth and calm. The doctor is to the right of the patient. He puts his left hand under the waist, just below the last rib in such a way that it is located near the spine. When examining the left kidney, place the arm under the back, behind the spine.

The right hand of the doctor is located on the abdomen somewhat below the costal arch outward from the rectus muscles. On exhalation the expert immerses a hand in an abdominal cavity in a direction to fingers of the left arm or hand.

Further. When palpation of the kidneys, during the rapprochement of the hands, the patient is invited to inhale. Very deep. As soon as he exhales, the specialist can feel the omission of the kidney, the edge of which will approach the right arm and pass under her fingers. If the organ has a strong increase, the doctor will be able to completely palpate its front wall, find both poles. This method of examination allows you to determine the shape and size of the organ.

There is also a technique for palpation of the kidneys in positionpatient lying on his side. In this case, the procedure is carried out according to the same rules as in the position on the back. But when the patient is placed on his side, the doctor sits, and the patient should be turned to face him. His body tilts slightly forward, muscles relax. At inspection in this case it is possible to find out a nephrosis. In the first stage of the ailment, only the lower pole of the organ is probed. On the second, the whole organ is easily detected. In the third stage of nephrosis, the organ is freely displaced in any direction. Sometimes during palpation, there is soreness.

Sometimes, during the procedure, you canconfuse an organ with a filled portion of the colon, an enlarged right lobe of the liver or a tumor. To prevent this, you should know the shape of the organ: it resembles a bean with a smooth surface. The kidneys are characterized by a rise upward and a return to their original position. After the palpation in the urine appears protein and an admixture of erythrocytes.

You can see the patient in a standing position. In this case, the doctor sits opposite the patient, and the patient stands before the specialist, leaning forward slightly and folding his arms over his chest. The doctor puts his hands in the same way as when examining the kidneys from behind.

results

During kidney palpation in children and adults with an enlarged organ, the following pathologies can be assumed:

• nephritis;
• hydronephrosis;
• hypernephroma;
• anomaly of development in the form of a lowered kidney.

All very seriously. In addition to palpation, the percussion of the organ is assessed. Read more.

Percussion

In order. That the doctor could establish the diagnosis more precisely, it is necessary to spend a palpation and percussion of kidneys. The latter method of examination allows us to detect changes in sound over the organ.

Normally, a tympanic sound is heard. This is due to the fact that the kidneys are covered by the intestine. If you hear a dull sound, then this indicates a sharp increase in the organ. In this case, the intestinal loops move apart.

Symptom of Pasternatsky

Great value in the survey hasdefinition of Pasternatsky's symptom. This is a method of shaking, in which the soreness of the organ is evaluated. During the procedure, the doctor is behind the patient. The left hand places on the area of ​​the twelfth rib and slightly to the left of the spine. The rib of the palm of the other hand is applied a short, gentle blow to the left arm. Depending on the severity of the pain, the type of symptom is determined: positive, mild, negative.

Positive symptom Pasternatsky determinedwith ICD, pyelonephritis, paranephritis and some other ailments. It is worth noting that the patient can feel pain when osteochondrosis, rib disease, lumbar muscles. Less often the pain arises from pathologies of the gallbladder, pancreatitis and other ailments.

Palpation of the bladder

The next moment. Palpation of the kidneys and the bladder is performed to identify a variety of pathologies. I.e. To examine the bladder, the patient is lying down. In this case, the doctor has a long arm on his stomach. When immersed in the abdominal cavity, a fold is formed, directed towards the navel. This action is performed several times, gradually moving the hand to the frontal articulation.

Normally, an empty bladder for palpationUnavailable, since it is located behind the bosom. A full body is felt. With inflammation, the bladder is probed outside the womb. The patient may feel pain when pressing.

Percussion of the bladder

To determine the upper border of the bladder,the percussion method is applied. During this type of diagnosis, the doctor has a finger-plemsimeter (which knocks) horizontally to the organ. Tapping is carried out along the middle line, from top to bottom, starting from the level of the navel and ending with the pubis.

With an empty bladder tympanicsound that persists to the lone articulation. In the case of an organ overflow in the region of the upper boundary, the sound transition into a blunt one. This place is marked as the upper border.

Conclusion

Physiological methods of diagnosis allowTo reveal the most various pathologies of kidneys and a bladder. With their help determine the size, location of organs, as well as the presence of liquids in them. After the examination, palpation and percussion, urine tests are mandatory. The OAM is mandatory.