Examination of the Urinary System Flashcards
Upper urinary tract
Kidneys
Examination of the kidneys
History
Physical exam
Lab exams
Diagnosing
Kidneys- History
PU/PD Oliguria/ anuria Apathy/ weakness Dehydration Poor haircoat Hypertension symptoms- blindness Thrombosis Immunosuppression
Kidneys- Physical exam
Technique
Description
Result/ abnormal findings
Physical exam- technique
Deep palpation of abdomen in standing position One or two hands - lateral and caudal Dogs- left Cats- both Ureters- NOT palpable
Physical exam- description
Location Size Shape Pain Surface Consistency Structure Symmetry
Physical exam- abnormal findings
Enlarged
Smaller than usual
Pain
Specific signs only in advanced cases
Causes of enlarged kidneys
Tumours Hydronephrosis PKD PSS FIP, FeLV
Causes of small kidneys
Renal fibrosis
Renal dysplasia
Causes of pain in the kidneys
acute nephritis
Kidneys stones
Tumor
Specific signs only in advanced cases
Halitosis- uraemic breath
Uraemic ulcers- tongue
Kidneys- lab exams
Glomerular function
Tubular function
Tests for glomerular function
GFR
Urinary protein
Proteinuria
GFR
Urea/ creatinine
SDMA
Exogenous and endogenous clearance
Urinary protein/ proteinuria
Dipstick Sulpho-salicylic acid UPC MAU Sediment!!!
Tubular function tests
Specific gravity- refractometer Glycosuria Mild proteinuria Urine sediment Fractional clearance of electrolytes
Examination of the lower urinary tract
Bladder
Urethra
Prostate
Examination of the bladder
History Physical exam Description Abnormal findings Additional
Bladder- History
Dysuria- difficulty Stranguria- painful Hematuria Pollakiura- only small amount at a time Incontinence
Bladder- Physical exam
Inspection Palpation (abdominal)
Bladder- description after the physical exam
Location Size-empty, moderately filled, full, dilated Shape Pain Surface Wall thickness Bladder content
Bladder- abnormal findings
Dilation- acute is usually urethral obstruciton, chronic is innervation problem
Pain- cystitis, stones
Abnormal surface- stones
Thickened wall- cystitis/ tumours
Additional exams of the lower urinary tract
Rectal- prostate in males
Catherization for urethral obstruction
US, Radiography, Contrast exams, Cystoscopy
Urinalysis
Additional- urinalysis
Sediment is NB for lower UTI
Stones always abnormal, crystals can be normal
Urethra exam in females
Vaginal exam
Inspection
Palpation
Catherization
Urethra exam in males
Palpation- rectally
Inspection and palpation- perineum, prepuce and penis
Catherization
Exam of the prostate
Palpation Imaging methods- US Urinalysis Prostatic fluid exam Cytology Biopsy
Palpation of the prostate
Abdominally or rectal digitally Size Shape Symmetry Consistency Pain
