A comprehensive clinical examination is the basis for selecting further diagnostic steps:
General physical examination – including blood pressure, pulse, body weight, height; furthermore:
- Inspection
- Skin, mucous membranes and sclerae (white part of the eye).
- Lymph node stations (cervical, axillary, supraclavicular, inguinal) including palpation (palpation).
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Mobility testing of the spine
- Genitals and anal region
- Auscultation of the heart
- Auscultation of the lungs
- Examination of the abdomen
- Auscultation of the abdomen [vascular or stenotic sounds?, bowel sounds?]
- Percussion (tapping) of abdomen (note: solid mass cannot be excluded by resonance (the reason: bowel loops may be pushed forward); ascites (abdominal fluid): flank attenuation):
- [Ascites: Fluctuation wave phenomenon. This can be triggered as follows: tapping against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand (undulation phenomenon); flank attenuation.
- Meteorism (flatulence): hypersonoric tapping sound.
- Cholelithiasis (gallstones): tapping pain over the gallbladder region and the right lower ribcage.
- Attenuation of the knock due to enlarged liver or spleen, tumor, urinary retention?
- Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
- Palpation of the abdomen (tenderness?, tapping pain?, coughing pain?, guarding?, hernial orifices?, renal bed tenderness?).
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation: assessment of the prostate in size, shape and consistency.
- Gynecological examination – if pregnancy is suspected, lower abdominal tumor.
- Urological examination – for example, if enlarged bladder is suspected.
- Cancer screening
Square brackets [ ] indicate possible pathological (pathological) physical findings.
