L3 Kidney renal examination Flashcards
Main complaints of kidney dieses
1-Pain
2- Urinary Disorders
3-Discoloration of urine
4-Edema
5-Headache, dizziness, palpitations, pain in the region of the heart (increase in blood pressure)
6-Fever
7-Urea smell from the mouth
8- Itchy skin
9-Nausea
10-Vomiting
11- Hemorrhages on the skin
12-Decreased vision
explain the Pain in kidney diseases and its mechanism
–Pain
* During the questioning it is necessary to establish:
* localization of pain
* irradiation of pain
* character
* duration
* intensity
* provoking factors
* factors that relieve pain
* accompanying symptoms Pain
* In various kidney diseases, the nature, intensity and
duration of pain depend on a combination of three main
mechanisms:
1) muscle spasm of the ureter;
2) stretching of the renal cavity system (pyelocaliceal);
3) stretching renal capsule.
explain the Urolithiasis disease Pain
(local spasm of the smooth muscles of the ureter, with obstruction of the ureter with a stone - stretching of the
renal pelvis with urine)
- acute paroxysmal pain (renal colic)
- pain intense, unbearable
- localization - in the lower back or along the ureter, radiating to the inguinal region, to the genitals
explain the Pyelonephritis pain
inflammation of the mucous membrane of the renal
pelvis, impaired passage of urine and distension of the
renal pelvis)
- intense pain
- localization in the lumbar region,
- the intensity gradually increases, then weakens
explain the Glomerulonephritis Pain
(parenchymal kidney disease - inflammatory
swelling of the kidney tissue, gradual distension of
the renal capsule)
- pain is not intense, dull, aching
- constant, long
- pain symmetrical, bilateral
explain Kidney infarction pain
(rapid and significant distension of the renal
capsule)
- intense pain,
- begins acutely, long
explain the paranephritis
intense constant pain in the lumbar region,
radiating in the hypochondrium - with purulent
inflammation of the perirenal tissue
what is the pain charechtarstic of diseases
of the bladder
- Pain in the suprapubic region - observed in diseases
of the bladder.
what is the pain charechtarstic inflammation of the urethra
Pain during urination, burning sensation in the
urethra occurs with inflammation of the urethra.
what is the Provoking factors of pain and , Factors that relieves pain
–Provoking factors
1-Hypothermia
2-Fast walk
3-Running
4-Lifting weights
5-Act of urination
–Factors that relieves pain
1-Horizontal position (this improves blood flow to the kidneys)
2-Forced position (bringing the legs to the stomach while
lying on the side - paranephritis)
3-Taking antispasmodic drugs
4- Applying a heating pad to the pain site
Urinary Disorders types:
Urinary Disorders
* this is a change in the amount and daily rhythm of
urine excretion:
* Polyuria
* Oliguria
* Anuria
* Nocturia
* Pollakiuria
* Stranguria
* Ishuria
explain the Diuresis
–total amount of urine, excreted during 24 hours’ period is called diurnal urine excretion.
-Diuresis: is a condition in which the kidneys filter too much bodily fluid. That increases your urine production and the frequency with which you need to use the bathroom.
–Its volume ranges from 1000 to 2000 ml, though it
can increase or decrease depending on
physiological conditions, the amount of consumed
liquids, diet, nature of work, temperature, air
humidity or presence of some diseases. 60-80% of
the daily urine amount normally excretes during
the daytime - a period between 8 AM and 8 PM.
Diurnal urinal excretion may decrease in physical
exertion, hot weather or abundant perspiration
explain the Diuresis
–total amount of urine, excreted during 24 hours’ period is called diurnal urine excretion.
-Diuresis: is a condition in which the kidneys filter too much bodily fluid. That increases your urine production and the frequency with which you need to use the bathroom.
–Its volume ranges from 1000 to 2000 ml, though it
can increase or decrease depending on
physiological conditions, the amount of consumed
liquids, diet, nature of work, temperature, air
humidity or presence of some diseases. 60-80% of
the daily urine amount normally excretes during
the daytime - a period between 8 AM and 8 PM.
Diurnal urinal excretion may decrease in physical
exertion, hot weather or abundant perspiration
explain the Polyuria
–Polyuria (> 2000 mL/day voided) may be caused by
1-renal origin - with damage to the renal tubules; in
the recovery stage of acute renal failure
2-extrarenal origin - with abundant fluid intake,
diabetes mellitus and diabetes insipidus, at low
ambient temperatures, with a decrease in edema
after taking diuretics.
explain the Oliguria
–decrease in daily urine (<500 ml / day) duo to :
1-physiological oliguria (not less than 800 ml per day) -
limited drinking regimen, increased sweating, physical
activity
2-profuse diarrhea, uncontrollable vomiting, fluid
retention in patients with heart failure, burn disease
(shock stage), shock (of any etiology)
3-impaired renal function (glomerulonephritis, uremia,
etc.)
explain the Anuria
–a sharp decrease (<50 ml per day) or complete cessation of urine excretion
* Secretory anuria: marked disorder of
glomerular filtration (shock, acute blood loss
- a sharp drop in filtration pressure in the
glomeruli; uremia - death of more than 70- 80% of nephrons)
explain the Nocturia
- voiding during the night duo to :
1-various kidney diseases,
2-prostatic hypertrophy,
3- heart failure
explain the Ishuria
- Excretory anuria (ishuria):
impaired separation of urine with preserved renal function - paresis of the bladder
muscles, an increase in the size of the prostate gland,
urethral stricture.
explain the Stranguria
- Stranguria - soreness during urinating (a
sign of inflammation of the bladder and / or
urethra)- painful urination - Pain appears at the end of urination (with
maximum bladder contraction) with (cystitis-bladder ) - Pain appears at the beginning and during
urination with (urethritis)
explain the Pollakiuria, oligakiuria
- Norma: urination frequency - 4-7 times per day
- Pollakiuria - frequent urination (intake of large amounts of
fluid, inflammation of the urinary tract, severe prostate
adenoma) - Oligaciuria is a rare urination (limited fluid intake, the
formation and strengthening of edema of any origin due to
fluid retention in the body; significant extrarenal fluid loss -
intense sweating, indomitable vomiting, diarrhea; oliguria
with glomerulonephritis, uremia)
explain the Discoloration of urine
–urine of red-brown color or red (admixture of
blood) - with glomerulonephritis, urolithiasis, kidney tumor;
–pale yellow (almost colorless) - with polyuria;
–clouded - from admixture of leukocytes, mucus, blood.
explain the Hematuria (blood in the urine)
—-Painless
-cancer of the urinary tract
-glomerunephritis
- prostatic disease
-polycystic disease ( ovum syndrome long period ) ,
- hydronephrosis ( stretch of one of the kidneys or both
—-Painful
-ureteral calculi ( stones in the ureteral )
-bladder infections or lithiasis.
explain the Edema
- Pathogenesis:
- 1) a decrease in oncotic pressure of the plazma
as a result of a decrease in the total amount of
blood protein (albumin); - 2) increased capillary permeability;
- 3) activation of the RAAS, which occurs when
the pulse pressure decreases in the renal arteriole-carrying glomeruli; - 4) decrease in glomerular filtration
- Renal edema first appears on the face, on the eyelids, under the eyes
- in the morning “Face nephritis”; in the future they can spread to the body, sometimes anasarca can develop, fluid can accumulate in the cavities (abdominal, pleural, pericardial); combined with pallor of the skin, complaints of thirst, decrease in urine output.
—Edema in renal diseases including generalized -
anasarca (with glomerulonephritis, nephrotic syndrome, renal failure)
explain the Headache, dizziness, pain in the heart,
palpitations, shortness of breath in the renal dieses
- due to an increase in blood pressure. Arterial
hypertension is often found in kidney disease
(glomerulonephritis, chronic pyelonephritis). There
is often a significant increase in BP, especially
diastolic.
