INSPECTION

This method has provided limited data

Skin color
You can discover the presence of depressions or
bumpson one or both sides of the abdomen
Expression of unilateral or bilateral renal
enlargement
Also cutaneous fistulas, edemas, etc
 Palpation

The kidneys are usually not palpable. There are classic

maneuvers

Guyon maneuver

Is the procedure most widely due to its

semiologicalvalue
Patient is placed supine, with the semiflexionados
lower limbs and separate knees.
the hand has is put lower below the last rib
The left hand if it is felt the right kidney
The other hand on the rectus abdominis is
palpable smoothly following the breath and
gaining depth in each breath to reach the kid ney
after 5 to 6 breaths.
Manuver Glenard

Placing a hand like clip

covering the flank of the
patient with forward
thumb and other
fingers back; the free
hand is placed over the
rectus abdominis and
makes the compression of
the abdomen; first
hand makes capturing
and perceives the escape
of the kidney the tactile
sensations and rally are
not correctly perceiving
you.
This method is useful for
ectopic kidneys or grown
Petit maneuver

In the anterior region must not forget that all sound

abdominal tumor is the kidney, explains why the body is
deep rejects to the intestine, while liver spleen and
colostomy may be in contact with the abdominal wall
without interposition of loops of intestine.
Inspection

the patient has appreciated right or wrong

Are there any obvious abnormalities of the face e.g.
facial weakness, drooping mouth
Are there any obvious abnormalities elsewhere The
Cranial Nerves
I-Olfatory

Test the sense of smell in each nostril

with coffee or some other distinct
smell

II OPTIC NERVE

Check acuity usirg Snellen chart and

colour vision using Ishihara plates
III/IV/VI Oculomotor, Trochlear &
abducens nerves

Near and light reaction (as tested

above) -the efferent pathways of
the accomodation reaction pass
through the oculomotor nerve.

V- TRIGEMINAL NERVE Sensory - using cotton wool touch

each of the 3 divisions (ophthalrnic,
maxillary and mandibular)

Examine the muscles of facial

VII- facial
expression
VIII- vestibulocochlear

Isolated lesions of IX are very unusual

and are difficult to test foro

XI- Accessory
Examine the sternomastoid and upper
fibres of the trapezius by asking the
patient to

Examine the tongue for wasting and

XII- Hypogloso fasciculations (if found and
combined with brisk jaw jerk when
testing V suggestive but not
diagnostic of Motor Neurone Disease