Urinary incontinence physical examination: Difference between revisions
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===Genitourinary=== | ===Genitourinary=== | ||
* Genitourinary examination of patients with | * Genitourinary examination of patients with urinary incontinence: | ||
** Stress Test: | |||
* | *** If there's loss of urine while coughing or Valsalva maneuver indicates positive test. | ||
* | *** The test is done when the patient is in a dorsal position. If urine loss is not visible switch to squatting position. If still not visible then in standing position asking her to keep her feet on the ground at shoulder distance, lift the saree/gown and looking for urine loss on the floor in between her feet or trickling down of urine through the thighs.<ref name="urlUrinary incontinence in women">{{cite web |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878864/ |title=Urinary incontinence in women |format= |work= |accessdate=}}</ref> | ||
* | |||
===Neuromuscular=== | ===Neuromuscular=== | ||
Revision as of 02:55, 27 April 2021
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Urinary incontinence Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Urinary incontinence physical examination On the Web |
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American Roentgen Ray Society Images of Urinary incontinence physical examination |
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Risk calculators and risk factors for Urinary incontinence physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The physical examination will focus on looking for signs of medical conditions causing incontinence, such as tumors that block the urinary tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.[1]
Physical examination
Physical examination of patients with [disease name] is usually normal.
OR
Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Appearance of the Patient
- Patients with [disease name] usually appear [general appearance].
Vital Signs
- High-grade / low-grade fever
- Hypothermia / hyperthermia may be present
- Tachycardia with regular pulse or (ir)regularly irregular pulse
- Bradycardia with regular pulse or (ir)regularly irregular pulse
- Tachypnea / bradypnea
- Kussmal respirations may be present in _____ (advanced disease state)
- Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
- High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure
Skin
- Skin examination of patients with [disease name] is usually normal.
OR
-
Description (Adapted from Dermatology Atlas)
-
Description (Adapted from Dermatology Atlas)
HEENT
- HEENT examination of patients with [disease name] is usually normal.
OR
- Abnormalities of the head/hair may include ___
- Evidence of trauma
- Icteric sclera
- Nystagmus
- Extra-ocular movements may be abnormal
- Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
- Ophthalmoscopic exam may be abnormal with findings of ___
- Hearing acuity may be reduced
- Weber test may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
- Rinne test may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
- Exudate from the ear canal
- Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
- Inflamed nares / congested nares
- Purulent exudate from the nares
- Facial tenderness
- Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
Neck
- Neck examination of patients with [disease name] is usually normal.
OR
- Jugular venous distension
- Carotid bruits may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
- Lymphadenopathy (describe location, size, tenderness, mobility, and symmetry)
- Thyromegaly / thyroid nodules
- Hepatojugular reflux
Lungs
- Examine for chronic obstructive pulmonary disease or bronchitis[2]
Heart
- Check for signs of volume overload or congestive heart failure for example, rales and pedal edema[2]
Abdomen
- Abdominal examination of patients with [disease name] is usually normal.
OR
- Abdominal distension
- Abdominal tenderness in the right/left upper/lower abdominal quadrant
- Rebound tenderness (positive Blumberg sign)
- A palpable abdominal mass in the right/left upper/lower abdominal quadrant
- Guarding may be present
- Hepatomegaly / splenomegaly / hepatosplenomegaly
- Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
Back
- Back examination of patients with [disease name] is usually normal.
OR
- Point tenderness over __ vertebrae (e.g. L3-L4)
- Sacral edema
- Costovertebral angle tenderness bilaterally/unilaterally
- Buffalo hump
Genitourinary
- Genitourinary examination of patients with urinary incontinence:
- Stress Test:
- If there's loss of urine while coughing or Valsalva maneuver indicates positive test.
- The test is done when the patient is in a dorsal position. If urine loss is not visible switch to squatting position. If still not visible then in standing position asking her to keep her feet on the ground at shoulder distance, lift the saree/gown and looking for urine loss on the floor in between her feet or trickling down of urine through the thighs.[3]
- Stress Test:
Neuromuscular
- Examine for signs of dementia and alerted mental status like delirium [2].
- Examine for normal pressure hydrocephalus and Cerebral vascular accident [2]
- Examine for Spinal stenosis [2]:
- cervical stenosis can cause damage to detrusor upper motor neurons.
- lumbar stenosis can cause areflexia.
Extremities
- Examine joints for signs of arthritis and mobility restricion [2]
- Peripheral edema of lower extremities[2]