hey everyone it's Sarah threader nurari and.com and in this video I going to show you how to check for Costo vertebral tenderness also known as CVA tenderness this is found in patients who may have a kidney infection because what has happened is that the kidney becomes inflamed from the infection and then when you take your hand put it on the back and thump or percuss it will cause the patient tenderness so let me show you how to do that okay so what you want to do is you want to find the last rib posteriorly and that is the 12th rib so if you fill in between the ribs be about right here and then you're going to find the spine and underneath the 12th rib and between the spine is that Costo vertebral angle and about right here is where your left kidney is located and over here is where your right kidney is located so what we're going to do is we're going to take our hand and we're just going to put it over here we're going to make a fist and we're going to thump our hand and we're going to ask the patient if they have any pain okay did you have any pain with that no okay and then we're going to do it to the other side do you have any pain no okay and if they had pain that would indicate a possible kidney infection thank you so much for watching and don't forget to subscribe to our channel for more videos