kidney palpation

A kidney test is an auxiliary test used to check if the abdomen and kidneys are normal. Check the kidneys, usually with two hands palpation. Can take a supine position or standing position. When the lying position palpates the right kidney, the patient's legs flex and breathe deeply. The physician stands on the right side of the patient and holds the right lower back from the back with the left palm. The right palm is placed flat on the right waist, and the finger flank is roughly parallel to the right rib to the deep upper palpation. The hands are in contact with the kidneys when the patient inhales. Basic Information Specialist classification: urinary examination classification: other examinations Applicable gender: whether men and women apply fasting: not fasting Tips: Patients actively cooperate with the doctor, please relax when checking. Normal value Under normal circumstances, the kidneys are generally difficult to reach, and sometimes the right kidney is exposed. When the body is thin, the kidney is more likely to be touched when the kidney is drooping, the kidney is moving away, or the kidney is compensatory. Clinical significance Abnormal results: 1. Possible lesions when touching the kidney: normal kidneys are not easily accessible. The kidney that can be touched may be a kidney ptosis, a kidney move, a kidney enlargement or a lump. 1) Kidney drooping and kidney: When the deep inhalation can touch more than 1/2 of the kidney, it is the kidney droop. Sometimes the right kidney sag is easy to be mistaken for hepatomegaly, and the left kidney sag is easy to be mistaken for splenomegaly. If the renal ptosis is obvious and can move in all directions of the abdominal cavity, it is called the kidney. 2) Kidney enlargement: found in hydronephrosis or empyema, kidney tumor, polycystic kidney disease. When the kidney is hydronephrosis or empyema, the texture of the kidney is soft and elastic, sometimes fluctuating. Polycystic kidneys are irregularly shaped and have a sac. Kidney tumors have an uneven surface and a hard texture. The characteristics of renal enlargement are as follows; 1 The shape of the kidney is still kidney-shaped, that is, the outer edge of the hunchback and the blunt upper and lower poles. There are no spleen and no sharp tongue edges. 2 The kidney is in front of the intestine, so the front of the percussion is drum sound. There is no intestinal tube between the liver, gallbladder and spleen surface and the abdominal wall, so the surface is percussed as voiced sound. 3 In the lower back, the kidney voiced area is inwardly extended and the spine is dulled; the kidney voiced area is outward, and the spleen or ovarian cyst is dulled with a longitudinally narrow colonic drum sound zone. 4 In addition to the forward and downward development of the renal enlargement, it is characterized by the development of the lateral side, that is, the waist, so that the curve of the waist depression of the normal person disappears or protrudes. Other organ masses have this feature. 5 right kidney enlargement can sometimes develop upwards, top to the right, causing the liver to rotate, that is, the posterior edge of the liver rises, the lower front edge of the liver descends, and covers the front of the right kidney. 6 swollen kidneys can move up and down with breathing movement, or they can be pushed slightly, unless they are fixed by infiltration of inflammation. 7 In the anterior part of the abdomen, the right kidney voiced area is separated from the liver voiced area by the colonic drum area. 8 swollen kidneys and lumps from the pelvis, the gap between the ribs and the ribs still exists, and can reach into the fingers. The liver, gallbladder, card swollen or lumps have no gaps with the quarter. 9 Kidney tumors are mostly developed downwards, but rarely reach the axillary fossa (unless huge hydronephrosis and hydatid cysts), and will not reach into the basin. Conversely, the intra-potential mass develops upward from the pelvis and can still touch the inner part of the pelvis during anal or vaginal examination. 2. When the kidneys and urinary tract have inflammation or other diseases, tender points may appear in some areas. Commonly used 1) The rib point (pre-kidney point) is at the intersection of the outer edge of the rectus abdominis and the rib arch on both sides, and the position on the right side is slightly lower, which is equivalent to the location of the renal pelvis. 2) Upper ureteral point: the outer edge of the rectus abdominis on the umbilical level; 3) Middle ureteral point: the outer edge of the rectus abdominis in the anterior superior iliac spine, equivalent to the second stenosis of the ureter. 4) Rib ridge point: the apex of the angle between the 12th rib of the back and the spine (the rib angle). 5) Rib waist point: the apex of the 12th rib and the outer edge of the lumbar muscle (rib waist); when the kidney or ureter is damaged, the above tender points often have different degrees of tenderness. Regular physical examination items for people who need to be examined, abnormal abdominal kidneys. Precautions Requirements for examination: 1 In order to avoid the abdominal muscle tension of the examinee, the examiner may first place the palm on the abdominal wall, so that the examinee can adapt to the moment and then palpate the examination; 2 the test can simultaneously talk with the examinee, transfer Its attention, reduce abdominal muscle tension; 3 various palpation techniques should be combined with different examination sites, flexible application. Inspection process Palpation method: The palpation of the kidney is generally performed by two-hand palpation. Other methods include counter-attack palpation, lateral lying palpation, sitting palpation, and floating palpation: 1. Two-hand palpation method: If the right kidney is palpated, the patient is supine, the legs are slightly bent, the doctor is on the right side of the patient, the right palm is placed under the patient's right rib rib arch, and the left palm is placed against the patient's right rear waist. As the patient's breathing movement gradually presses the right hand to the deep part of the abdominal cavity, and the left abdominal wall is pushed forward with the left hand, the kidneys can be touched when the two hands cooperate with each other. If not touched, let the patient inhale deeply and let the kidneys fall. If most of the kidneys can be touched, they can be caught between the hands, sometimes only touching the lower poles of the kidneys. 2. Counter-attack palpation: When palpating with both hands, the hand on the abdomen is pressed down and the lump does not move. When the hand in the back waist is rhythmically moved forward, the hand on the abdomen may have a hard and elastic kidney impulse. a feeling of. 3. Pediatric palpation method: the patient is lying on the side, the upper leg is flexed, the lower leg is straight, and the examiner is palpable. When the patient is deeply inhaled, the two hands are relatively palpated. 4. Sitting palpation method: the patient sits on the back chair, the abdominal muscles relax, and the hands are shoulders. The examiner held the waist in one hand, with the thumb against the upper pole of the drooping kidney and the other hand palpation. 5. Float and palpation: the patient stands or sits. The examiner placed one hand on his abdomen and the other hand on the waist. When the hand of the waist suddenly lifted up, the hand of the abdomen felt a lump impulse. This method is applicable to the pyogenic pyogenic mass of the renal pelvis without adhesion. Not suitable for the crowd Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention.