A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; furthermore:
- Inspection (viewing).
- Skin and mucous membranes
- Examination of the lungs:
- Auscultation (listening) of the lungs [due todifferential diagnoses: bronchiectasis (synonym: bronchiectasis; congenital or acquired dilation of the bronchi); lung abscess (encapsulated collection of pus in the lungs)]
- Bronchophony (testing 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]
- 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.g. e.g. in pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; in case of reduced sound conduction (attenuated: e.g. atelectasis, pleural rind; strongly attenuated or absent: in case of pleural effusion, pneumothorax, pulmonary emphysema). As a result, 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).
- ENT medical examination – including epipharyngoscopy (reflection of the nasopharynx) [sinusitis (sinusitis); tonsil stones].
- Psychiatric examination [halitophobia – sign of psychiatric disorders in which the patient is afraid of bad breath; pseudohalitosis – sign of psychiatric disorders in which bad breath is perceived only by the affected person]
- Dental examination (dental and periodontal status).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
