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 (viewing) of the skin
- [Face: erythema (redness of the skin), slightly purplish; tearful facial expression; edema of the periorbital region (swelling at the side and below the orbit), also possible on the forehead and cheeks
- Extremities: erythema with scaling; lichenoid (lichen-like) papules; telangiectasias (vascular veins).
- Nails: nail fold changes]
- Auscultation (listening) of the heart [for possible involvement].
- Examination of the lungs (due topossible involvement):
- Auscultation (listening) of the lungs [wg possible involvement].
- Bronchophony (checking 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]
- 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., pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; with decreased sound conduction (attenuated: e.g., atelectasis, pleural rind; severely attenuated or absent: with pleural effusion, pneumothorax, 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]
- Weakness of movement [sluggish gait, powerless hand grip].
- Inspection (viewing) of the skin
- Cancer screening – due to association with tumor disease [carcinomas of the gastrointestinal tract (gastrointestinal tract), female breast, ovaries (ovaries), uterus (uterus), lung, prostate, non-Hodgkin’s lymphoma]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
