A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
- Inspection (viewing).
- Skin, mucous membranes and sclerae (white part of the eye).
- Examination of the lungs
- Auscultation (listening) of the lungs [due todifferential diagnoses: bronchial asthma; chronic bronchitis (inflammation of the bronchi); chronic obstructive pulmonary disease (COPD)].
- Bronchophony (checking the transmission of high-frequency sounds; the patient is asked to pronounce the word “66” several times in a pointed voice while the physician listens to the lungs)[increased sound transmission due to pulmonary infiltration/compaction of lung tissue (e.g. in pneumonia) (because of possible sequelae) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in case of reduced sound conduction (attenuated or absent): e.g. in pleural effusion, pneumothorax) (because of possible sequelae). The result is, the number “66” is barely audible to absent over the diseased part of the lung, because the high-frequency sounds are strongly attenuated]
- Percussion (tapping) of the lungs [eg, box tone in pneumothorax (due topossible sequelae)]
- Vocal fremitus (checking the conduction of low frequencies; the patient is asked to pronounce the word “99” several times in a low voice while the physician places his hands on the patient’s chest or back)[increased sound conduction due to pulmonary infiltration/compaction of the lung tissue (due toe.g. in pneumonia) (because of possible sequelae) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; in case of reduced sound conduction (strongly attenuated or absent: in pleural effusion, pneumothorax) (because of possible sequelae). The consequence is, the number “99” is barely audible to absent over the diseased part of the lung, because the low-frequency sounds are strongly attenuated]
- Inspection (viewing).
- If necessary, neurological examination [due topossible sequelae: Hypoxic encephalopathy (brain damage due to oxygen deprivation); seizures]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
