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 [failure to thrive]; further:
- Inspection (viewing).
- Skin, mucous membranes, and sclerae (white part of the eye) [Icterus prolongatus (= jaundice (jaundice) > 14 days persisting)]
- Auscultation (listening) of the heart.
- Examination of the lungs (due topossible secondary diseases).
- Auscultation of the lungs [chronic bronchitis with productive cough (sputum): dry to moist rales (RGs) audible over various fields].
- Bronchophony (checking the transmission of high-frequency sounds; the patient is asked to pronounce the word “66” several times in a pointed voice while the doctor listens to the lungs)[increased sound conduction due to pulmonary infiltration/compaction of the 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. 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). 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) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?) [meconium ileus – intestinal obstruction in newborns; usually the first sign of cystic fibrosis]
- 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 [rectal prolapse (rectal prolapse)]
- Pulmonological examination if necessary
- If necessary, examination by an otolaryngologist [if chronic rhinosinusitis (simultaneous inflammation of the nasal mucosa (“rhinitis”) and the mucosa of the paranasal sinuses (“sinusitis“)), pharyngitis (pharyngitis) or laryngitis (laryngitis)] is suspected.
- Inspection (viewing).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
