The document describes how to palpate the kidneys. The kidneys are located retroperitoneally, with the upper poles at the T12 vertebra and lower poles at the L3 vertebra. The right kidney is lower than the left. When palpating the kidneys, they feel rounded with deep, resilient consistency and do not move with respiration. Renal tumors feel hard and nodular while hydronephrosis feels firm and soft. Palpation involves placing hands below the lower rib cage and above the upper quadrant and pushing the hands together to feel the lower pole as the patient breathes in and out.

1. PALPATION OF KIDNEY
Position
Retroperitoneal
Upper poles-T12 vertebra
Lower poles-L3vertebra
Right is lower than left
Clinical features
Rounded edges
Deep
Can insuinate fingers between
kidney and costal margin
Bimanually palpable
No movement with respiration
Tendency to buldge in loin
Consistency-normal resilient feel
Renal tumour-hard and
nodular
Hydronephrosis-firm and soft
 Renal angle tenderness-site of
maximal pain in angle between
12th
rib and sacrospinalis
muscle
fluctuation-large fluctuating mass
suggestive of hydronephrosis or
pyonephrosis
Palpation of Kidney
Place one hand posteriorly below
lower rib cage and the other over
upper quadrant
• Push two hands together firmly,
but gently as patient breathes out
• Feel for the lower pole as the
patient breathes in deeply
• Try to trap kidney between two
hands by delaying application
pressure until the end of
inspiration in this way kidney
slides up on expiration
• Confirm it is kidney by
Ballotability , and movement with
respiration
• Assess size, surface and
consistency
DR.VISHNU KARTHIK
DR. VISHNU KARTHIK .V