PHYSICAL EXAMINATION OF URINE

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1. Physical Examination of Urine

2. Chemical Examination of Urine

3. Microscopic Examination of Urine

THREE PHASES OF URINALYSIS

PHYSICAL EXAMINATION OF URINE

Provides preliminary information concerning disorders such as

glomerular bleeding

liver disease

inborn errors of metabolism

urinary tract infection

PHYSICAL EXAMINATION OF URINE

Used to confirm or to explain findings in chemical and microscopic

areas of urinalysis

Volume | Color | Clarity (or transparency) | Odor | Foam Formation | Specific Gravity

Examination of the physical properties includes:

URINE VOLUME

Reflects the body’s state of hydration

- Fluid intake

- Fluid loss from non-renal sources

- Variations in the secretion of ADH

- Necessity to excrete increase amount of dissolved solids

FACTORS THAT INFLUENCE URINE VOLUME:

1200 – 1500 ml

NORMAL DAILY URINE OUTPUT

600 – 2000 ml

A range of ___________ in urine is considered normal

three to four times

Young children excrete about ____________ as much urine per kilogram of body weight compared with adults.

POLYURIA

OLIGURIA

ANURIA

NOCTURIA

CLINICAL CONDITIONS ASSOCIATED WITH URINE VOLUME

POLYURIA

increased urine volume greater than 2500 ml (2.5 L) /day.

- Excessive fluid intake

- Diuretic medicines (edematous patients)

- Diuretic drinks (tea, alcohol)

- Nervousness

- Diabetes (diabetes mellitus and insipidus)

POLYURIA is seen in cases of ???

OLIGURIA

decrease in urine output

1 mL/kg/hr
0.5 mL/kg/hr

400 mL/day

Oliguria is…

- less than ________ in infants

- less than ________ in children

- less than ________ in adults

- Dehydration (excessive loss of water due to vomiting,

diarrhea, perspiration or severe burns)

- Renal stones (partial obstruction)

- Renal tumors/Benign Prostatic Hyperplasia

Oliguria is seen in cases of ???

ANURIA

complete cessation of urine flow.

- Mercury poisoning

- Renal stones (complete obstruction)

- Renal tumors (complete obstruction)

Anuria is seen in cases of ????

NOCTURIA

Excretion of more than 500 mL of urine at night with a specific gravity of less than 1.018

- Increased water intake at night

- Pregnant women (normal)

Nocturia is seen in cases of ???

3:1

NORMAL DAY TO NIGHT RATIO

Roughly indicates the body’s degree of hydration

URINE COLOR

Gives a rough estimate of urine concentration

- Normal metabolic functions

- Physical activity

- Ingested materials

- Pathologic conditions

Color of urine varies from colorless to black and may be due to:

UROCHROME

UROERYTHRIN

UROBILIN

THREE PIGMENTS RESPONSIBLE FOR URINE COLOR

Thudichum (1864)

Urochrome is coined by ________

yellow pigment

main pigment responsible for yellow color of urine

UROCHROME

Product of endogenous metabolism

directly proportional

Urochrome production is ________________ to metabolic rate

UROCHROME

Give a rough estimate of urine concentration.

pale

dark

In urochrome….

- Dilute urine = ____ yellow

- Concentrated urine = ____ yellow

- Fever, Starvation, Thyrotoxicosis

- Prolonged standing of urine at room temperature

INCREASED UROCHROME IS OBSERVED IN:

pink pigment

responsible for the pink color of amorphous urates that can be visualized after refrigeration

UROCHROME

yellow pigment

UROERYTHRIN

pink pigment

UROBILIN

orange-brown pigment

UROBILIN

degradation product of urobilinogen imparting an orange- brown color to urine that is not fresh.

urobilinogen

not fresh.

UROBILIN

degradation product of _____ imparting an orange- brown color to urine that is ______