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) [due tosymptoms:
- Exanthema (skin rash), unspecified.
- Petechial (punctate) skin bleeding.
- Small skin bleeding under the nails
- Facial swelling, especially around the eyelids.
- Conjunctivitis (conjunctivitis)]
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Skin, mucous membranes, and sclerae (white part of the eye) [due tosymptoms:
- Auscultation (listening) of the heart [due topossible secondary disease: myocarditis (inflammation of the heart muscle)].
- Examination of the lungs (due topossible secondary disease pneumonia (pneumonia)).
- Auscultation (listening) of the lungs
- Bronchophony (checking the conduction 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 conduction due to pulmonary infiltration/compaction of lung tissue (e.g. e.g. in pneumonia) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in case of decreased sound conduction (attenuated or absent: e.g. in pleural effusion, pneumothorax, emphysema). 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 [e.g., in emphysema; box tone in pneumothorax]
- 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 lung tissue (e. e.g., pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; with decreased sound conduction (attenuated: e.g., atelectasis, pleural rind; severely attenuated or absent: with pleural effusion, pneumothorax, emphysema). The result is, the number “99” is barely audible to absent over the diseased part of the lung, because the low-frequency sounds are strongly attenuated]
- Palpation (palpation) of the abdomen (abdomen) (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?)
- Inspection (viewing).
- If necessary, neurological examination [due tosymptoms:
- Myalgia (muscle pain)
- Cephalgia (headache)
- Visual disturbances, especially diplopia (double vision, double images).
- Central nervous disorders, unspecified]
[due topossible sequelae:
- Encephalitis (inflammation of the brain).
- Coma, unspecified
- Seizures
Square brackets [ ] indicate possible pathological (pathological) physical findings.
