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 and mucous membranes [rashes?]
- Inspection and palpation (palpation) of lymph node stations* [lymph node enlargement; changes in draining regions such as redness, cutaneous lesions, or pain]
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Palpation of the abdomen (abdomen) (tenderness?, tapping pain?, coughing pain?, guarding tension?, hernial orifices?, renal bearing tapping pain?) [Hepatosplenomegaly (liver and spleen enlargement)?
- Inspection (viewing).
- Cancer screening
* Notes on palpation findings (palpation findings):
- Soft, well-displaced and pressure-dolent lymph node enlargement → often in inflammation.
- Small, hard, painless, displaced lymph nodes – sign of old healed lymphadenitis (lymphadenitis).
- Hard, painless, with the surrounding tissue “caked” lymph nodes → malignant (malignant) changes (eg, metastases).
Important lymph node regions are:
- Lymph nodes of the head area: Nodi lymphatici retroauriculares, Nodi lymphatici parotidei, Nodi lymphatici occipitales, Nodi lymphatici submandibulares, Nodi lymphatici submentales.
- Cervical lymph nodes (cervical lymph nodes): Nodi lymphatici cervicales superficiales, Nodi lymphatici cervicales profundi.
- Axillary lymph nodes (axillary lymph nodes).
- Inguinal lymph nodes (inguinal lymph nodes).
- Mediastinal lymph nodes (lymph nodes located in the mediastinum (mediastinum: space bounded by the sternum and thoracic spine and on both. Sides bounded by the lungs) are located).
Square brackets [ ] indicate possible pathological (pathological) physical findings.