Auscultation of the renal arteries: how research is conducted and for what it is needed
Mar 07, 2018
An important role in modern medicine plays auscultation of the renal arteries. The connection of the arteries of this vital organ with the aorta occurs at the level of the 1st and 2nd lumbar bands.
The specialist listens for arteries from both the front and back sides. Listening is held alternately.
Auscultation of the renal arteries suggests that the patient is in a horizontal position during the study. Laying the patient on a hard surface and "armed" with a stethoscope, the specialist applies the instrument close to the wall of the peritoneum. The side is allowed to retreat no more than 2-3 centimeters.
After this, the patient:
- Breathes in.
- Exhales( full).
- Delays breathing for a while.
With the help of the device, the expert gently presses against the abdominal wall and "drowns" it in the abdomen of the subject.
Auscultation of the renal arteries from the back side suggests a slightly different approach. So, the patient changes the position of the body, moving from the couch to a chair. The doctor places the instrument in the lumbar region( just below the 12th rib, in the immediate vicinity of his free edge).
If the doctor observes the presence of systolic sound phenomena in the actual area, this may indicate deformity of the renal artery by stenosis.
The relevance of the
method Auscultation of the kidneys plays an important role in diagnosing patients suffering from vascular anomalies of topical organs.
For the most part of people at risk, listening to systolic sound phenomena occurs at the front, along a horizontal line. This line passes exactly through the navel.
The sensitivity of the sound phenomena of the renal arteries, which are heard from the front, is very high. Despite this, there are some problems with their specificity. So, false-positive results are often observed. Their frequency is at least thirty percent. This is relevant for people who have been diagnosed with hypertension.
Specificity of systolic sound phenomena for vascular anomalies of the actual organs is one hundred percent. At the same time, the percentage of their sensitivity does not rise above 10.
In a modern clinic, a mediocre auscultation of the renal arteries is used. This allows the specialist to determine the location of the sound phenomena, regardless of the position of the patient's body.
This is relevant for serious anomalies.
Why the stethoscope? Most often, a stethoscope is used in the study. This tool is a closed system in which the main conductor of noise is air. The principle of the instrument is as follows:
- after the doctor has applied a stethoscope to the patient's skin, the surface begins to act in a membrane fashion;
- acoustic features of the skin directly depend on the level of pressure;
- if the pressure is increased, then the noise is of a high frequency;
- in case of strong pressure, inhibition of the vibration of the actual tissues is observed.
Often the study uses a binaural instrument equipped with special funnels and a rubber tube. The ends of the funnels are inserted into the hearing organs of a specialist.
The binaural method of research is exceptionally convenient. This is especially true for children and people suffering from complex anomalies.
Auscultation of the renal arteries is not performed with a stethoscope alone. In a modern clinic, phonendoscopes are widely used. The main difference between these ergonomic tools is the presence of special membranes on the funnel and capsule.
How diagnostics are organized
While listening to the artery of the organ in front of the patient is in a horizontal position. He lies face up on a comfortable hard surface. The doctor has the instrument 3-centimeter above the navel and at a similar distance to the side. This is a projection on the abdominal wall of the location of the confluence in the aorta of the vessels of the actual organ.
The procedure is as follows:
- The person makes a full breath.
- Then the patient exhales air and for some time holds his breath.
- The doctor gently presses the front of the peritoneal wall with a tool.
- After immersion deep into the stethoscope, a specialist listens to the arteries of the organ being examined.
When the organization of the arteries of the organ from the posterior part is assumed, the patient moves to the sitting position. In this case, the tool is located exactly under the 12th rib, near its edge.
An alarming symptom is the appearance in the actual areas of systolic sound phenomena. This indicates that stenosis progresses in the arteries of the organ under investigation.
After diagnosis, the specialist appoints the patient appropriate treatment.Like the article? Share with friends and acquaintances: