A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Skin and mucous membranes
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Inspection and palpation (palpation) of the neck [due topossible cause or differential diagnosis: hypothyroidism (hypothyroidism)].
- Examination of the abdomen
- Percussion (tapping) of the abdomen
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
- Palpation of the abdomen, etc. (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
- Percussion (tapping) of the abdomen
- Inspection of the anus incl. digital rectal examination (DRU): examination of the rectum (rectum) [due topossible causes:
- Anal fissure (tears in the mucosa of the anus (anus)).
- Anal stricture (narrowing of the anus)
- Hemorrhoids
- Rectocele (outpouching of the intestine)
- Rectal prolapse (prolapse of the rectum)]
- Inspection (viewing).
- Cancer screening [due topossible causes or differential diagnoses:
- Colon carcinoma (colon cancer)]
- If necessary, gynecological examination [due todifferential diagnosis:
- Descensus (pelvic floor subsidence).
- If necessary, neurological examination [due topossible causes or differential diagnoses:
- Dementia
- Parkinson’s disease
- Multiple sclerosis (MS) (neurological disease that can cause paralysis and spasticity)]
- If necessary, psychiatric examination [due topossible causes:
- Anxiety
- Depression]
[due todifferential diagnoses:
- See under causes and moreover: eating disorders]
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.