Urinalysis-Physical Examination

Introduction to Urinalysis in Chiropractic Settings

  • The urinalysis is a valuable tool in chiropractic clinics.

    • It has minimal barriers to entry for usage in clinics.

    • Offers significant chemical and physiological information in clinical situations.

Purpose of Urinalysis

  • Can be instrumental in diagnosing various conditions based on changes in urination patterns.

  • Examples of conditions that may prompt urinalysis include:

    • Changes in urination:

    • A child who was previously potty-trained suddenly begins to wet the bed again.

      • Possible causes:

      • Physical trauma

      • Emotional trauma

      • Urinary tract infection (UTI)

      • Onset of type 1 diabetes (indicated by symptoms like excessive thirst, frequent urination)

    • Changes in urine color:

    • Unusual color changes in urine warrant further investigation.

    • Screening for conditions:

    • Urinalysis can test for UTIs, types of diabetes, liver function issues (gallstones, liver dysfunction), prostate cancer indications in men with unexplained lower back/rib pain.

Components of a Complete Urinalysis (EUA)

  1. Physical Examination of Urine

    • Assessment of urine's color, clarity, and odor.

  2. Chemical Examination of Urine

    • Test strips used to analyze ten different indicators:

      • Specific gravity: measures concentration of urine.

      • pH: indicates acidity/alkalinity of urine.

      • Blood presence: indicates hematuria.

      • White blood cell presence: indicates infection or inflammation.

      • Bacteria presence: indicates potential infection.

      • Bilirubin presence: signals liver dysfunction.

  3. Microscopic Examination of Urine

    • Cells present in the urine are analyzed after centrifugation.

    • This step typically performed in a laboratory setting, not in chiropractic clinics.

Physical Examination Details

Urine Color

  • Normal urine color range:

    • Yellow (straw to amber).

    • Darker colors may indicate dehydration.

  • Abnormal Colors and Their Implications:

    • Milky appearance: may indicate pus or bacteria presence, or nephrotic syndrome (fat in the urine).

    • Reddish/pinkish: indicates blood in urine.

    • Bright red urine usually indicates significant bleeding in the urinary tract (thus evident color).

    • Yellow foam: indicates bile pigmentation, potentially correlates with liver disease (e.g., hepatitis).

    • White foam: can indicate excess protein in urine, suggesting conditions leading to proteinuria.

    • Green/light brown: suggests bile pigments, indicating liver dysfunction.

    • Coca-Cola color: unequivocally abnormal, indicating significant hemolysis, often due to acute glomerular nephritis.

Appearance and Clarity

  • Normal urination should be relatively clear.

    • Slight cloudiness may be acceptable, but significant turbidity is a concern.

  • Possible causes of turbidity include:

    • White blood cells (infection)

    • Mucus, bilirubin, protein

    • Dehydration or certain supplements

    • Abnormality indicates underlying issues but does not specify a diagnosis.

Odor of Urine

  • Normal urine has an aromatic smell, which can change based on diet or health status.

  • Abnormal odors indicating varying issues:

    • Ammonia smell: suggests urine retention; often described as old urine or cleaning supplies.

    • Fruity smell: suggests ketones, indicative of type 1 diabetes mellitus.

    • Stale water smell: may suggest advanced kidney disease.

    • Foul smell: indicates excessive bacteria, suggesting urinary tract infections.

Conclusion

  • Overall, urinalysis provides essential insights into patient health, revealing potential underlying conditions that warrant further testing. Through careful evaluation of physical, chemical, and microscopic properties of urine, healthcare providers, particularly in chiropractic settings, can better diagnose and understand various health issues.