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
- 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?
- Mobility testing of the spine
- Genitals and anal region
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Examination of the abdomen (belly)
- Auscultation of the abdomen [vascular or stenotic sounds?, bowel sounds?]
- Percussion (tapping) of the abdomen:
- [Ascites (abdominal fluid): phenomenon of the fluctuation wave. This can be triggered as follows: if one taps against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand on it (undulation phenomenon); flank attenuation.
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of the tapping sound due to enlarged liver or spleen, tumor, urinary retention?
- Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
- Palpation (palpation) of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation.
- If necessary, dermatological examination
- If necessary, gynecological examination
- If necessary, ENT medical examination
- If necessary, neurological examination
- If necessary, orthopedic examination
- If necessary urological examination
- Health check (as an additional follow-up measure).
