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; further:
- Inspection (viewing).
- Skin, mucous membranes, oral cavity and sclerae (white part of the eye), abdominal wall, and inguinal region (groin area) [gingivostomatitis (inflammation of the mouth and gums)]
- Examination of the lungs (due topossible secondary diseases).
- Auscultation of the lungs
- 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 lung tissue (e.g., in pneumonia) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in the case of reduced sound conduction (attenuated or absent: e.g., in pleural effusion). 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]
- Voice fremitus (checking the transmission of low frequencies; the patient is asked to say several times in a low voice the word “99”, while the doctor puts his hands on the chest or back of the patient) [increased sound conduction due to pulmonary infiltration / compaction of lung tissue (eg, in pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; in the case of reduced sound conduction (greatly attenuated or absent: in pleural effusion). The consequence is, 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).
- Gynecological examination
- Inspection
- Vulva (external, primary female sex organs) [itching, tightness, burning pain, vesicle formation (around genitals and urethra), formation of small ulcers (skin ulcers), lymphadenopathy (swelling of regional lymph nodes)]
- Vagina (vagina) [increased discharge from the vagina (vagina), vulvovaginitis (inflammation of vagina)]
[due toPossible sequelae: Genital ulcers (skin ulcers in the genital area)]
- Palpation (bimanual; palpation with both hands) of the internal genital organs [Normal: unremarkable].
- Inspection
- Urological examination
- Inspection and palpation of the abdomen (belly), inguinal region (groin region), etc.
- Inspection and palpation of the genitals (penis and scrotum (scrotum)) [Itching, tightness, burning pain, vesicle formation (in the area of genitals and urethra), formation of small ulcers (skin ulcers)].
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with a finger by palpation: assessment of the prostate in size, shape and consistency [bacterial proctitis (rectal inflammation); prostatitis (prostatitis)]
[due topossible sequelae:
- Urethritis (urethritis)]
- If necessary, ophthalmological examination [due topossible secondary diseases:
- If necessary, dermatological examination [due todifferential diagnoses:
- Contact dermatitis (inflammation of the skin due to contact allergens such as certain clothing, nickel, etc.).
- Mollusca contagiosa (dell warts).
- Pemphigus vulgaris (blistering skin disease)]
[due topossible secondary diseases:
- Eczema herpeticatum (superinfected dermatosis (skin disease); usually occurs with coexisting atopic eczema (neurodermatitis)).
- Erythema exsudativum multiforme (synonyms: erythema multiforme, cocard erythema, disc rose) – in the upper corium (dermis) occurring acute inflammation, which leads to typical cocard-shaped lesions; a distinction is made between a minor and a major form]
- If necessary, neurological examination [wg.possible sequelae: meningitis (meningitis)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
