Chelsye Marviyouna Dearianto

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Assessment of the Urinary System

The urinary system is a system that works as a process of blood filtering /
filtration so that the blood is free from substances that are no longer used by
the body (excretion) and absorbs substances that are still used by the body
(reabsorption).

Substances that are not used by the body dissolve in water and are excreted
in water form of urine (urine).

The urinary system can be said to be the body's cooperation system that
aims for internal balance or homeostasis. However, the main function of the
urinary system is as blood plasma filtration, excretion of unused substances,
and reabsorption of used substances by the body.
ANATOMY AND PHYSIOLOGY

The urinary system consists of:

1. The kidneys, which function to remove urine secretions
2. Ureters, which carry urine from the kidneys to the bladder
3. The bladder, which acts as a reservoir
4. Urethra, which functions to remove urine from the bladder.
ANAMNESIS

Anamnesis is an interview with a client aimed at early detection of the

disease the client may suffer with a systematic process of collecting data /
information about the client, including the client's strengths and
weaknesses.

Data collected from clients (autoanamnesa)

Dara collected from other people (alloanamnesa), namely from family,
closest people, society.
A systematic history includes:
1. The main complaint of the
patient
2. Current medical history
3. Past medical history
4. Family medical history
5. Social health history
6. Medication history
7. Perceptual - cognitive patterns
PHYSICAL EXAMINATION
inspection, palpation, percussion and auscultation.

1. Inspection, that is see and evaluate patient visually and is the oldest
method used to assess / assess patients. Inspections on the urinary
system include:
The general state of the urinary system
The state of the urinary system localists (kidney, bladder, genetalia,
rectum, etc.)
Use of assistive devices such as: condom catheter, folleys catheter,
silicone catheter or urostomy or supra pubic catheter.
 PHYSICAL EXAMINATION
inspection, palpation, percussion and auscultation.

2. Palpation, that is touching or feeling by hand. Palpation

of individual structures, both on the surface and in the
body cavity, especially in the abdomen, will provide
information about the position, size, shape, consistency
and mobility / movement of the anatomical components
as well as to assess the state of the fluid in the body space.
The 3 types of palpation are light, medium and deep
palpation
 PHYSICAL EXAMINATION
inspection, palpation, percussion and auscultation.

3. Percussion is an examination with pat the surface body lightly

and sharply, to determine the position, size and density of the
structure or the fluid or air beneath it.

If a structure passes more air (eg lungs) will produce a louder,

lower and longer sound
More structure solid (eg thigh muscles), which produce a softer,
taller and shorter sound.
 PHYSICAL EXAMINATION
inspection, palpation, percussion and auscultation.

4. Auscultation is a skill to hear body sounds in the

lungs, heart, blood vessels and the inside / abdominal
viscera.

On examination of the urinary system, some abnormal

sounds that may be found are bruit sounds which are an
indication of renal artery stenosis.
Examination physical examination of the patient
includes an examination of the patient's general
condition and urological examination.
a. Kidney Examination

The presence of enlargement of the waist or upper abdomean

area must be considered when inspecting this area. This
enlargement can be caused by hydronephrosis or a tumor in the
retroperitonial area. Palpation is done bimanually (with two
hands). The left hand is placed at the corner of the costo-
vertebrae to lift the kidney up, while the right hand feels the
kidney from the front. Percussion, which is a kidney knock
examination is done by giving a knock at the costovertebral
angle.
b. Examination of jars

Bulibuli examination should pay attention to the presence of

lumps or scar tissue from the incision / surgery in the
suprasiymphysis. The mass in the area can be a malignant
bulibule tumor or a bulb that is completely filled with urinary
retention. With palpation and percussion, the upper limit of the
bulb can be determined.
c. Examination of external genetalia

On examination of the external genetalia, it was noted that there

were penile abnormalities such as micropenis, macropensi,
hypospadias, chordae, epispadia, stenosis of the external urethral
meatus, phimosis, fistula urethralcutaneous, and penile tumors.
Severe anterior urethral stricture can result in fibrosis of the
corpus spongiosum palpable on palpation ventral to the penis, a
hard tissue known as spongiofibrosis.
d. Examination of the scrotum and its contents

Note the enlargement of the scrotum, a feeling of pain when

touched, or the presence of hypoplasia of the scrotal skin (a
marked decrease in the number of cells in the tissue resulting in a
decrease in tissue or organs, as a result the organ becomes
stunted) which is often found in cryptorchidism. To distinguish
between a solid mass and a cystic mass in the scrotal contents, a
transillumination examination of the scrotal contents can be
performed.
e. Plug in the rectum (RectalToucher)

Digital rectal examination involves inserting the index finger

(which has been given a lubricant) into the rectal opening. On
this examination, assessed (1) anal sphincter tone and bulbo-
cavernous reflex (BCR), (2) the presence of a mass in the rectal
lumen, and (3) assessing the state of the prostate. Assessment of
the bulbo-cavernous reflex is assessed by sensing the presence of
an ani clamp reflex on the fingers due to pain stimulation given
to the glans penis. In women who are married, vaginal plugs can
also be done to assess the possibility of abnormalities in the
female genitalia, such as masses in the cervix, blood in the
vagina, and masses in the bladder.
f. Neurological examination

Neurological examination is aimed at looking for the possibility

of neurological disorders resulting in abnormalities in the
urogenital system, such as motor neuron lesions or peripheral
nerve lesions which are the cause of bulibulineurogen.
f. Neurological examination

Neurological examination is aimed at looking for the possibility

of neurological disorders resulting in abnormalities in the
urogenital system, such as motor neuron lesions or peripheral
nerve lesions which are the cause of bulibulineurogen.
 DIAGNOSTIC EXAMINATION

LABORATORY RADIOLOGY
• Urine • Ultrasound
• Blood • X-ray Examination and Other Imaging
• Intravenous Urography (Excretory Unogram or
Intravenous Pyelogram).
• Retrograde Pyelonography
• Infusion Drif Pyelography
• Cystogram
• System program
• Renal angiography
THANK YOU