A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; furthermore:
- Inspection (viewing) of skin and mucous membranes [possible symptoms:
- Upper influence congestion (OES): congestion of the veins of the head and upper limbs due to compression of the vena cavae.
- Horner symptomatology (Horner syndrome) – Horner triad consisting of: Pupillary constriction (miosis), drooping of the upper eyelid (ptosis) and an apparently sunken eyeball (pseudoenophthalmos).
- Pemberton’s sign – fainting with swelling of the face and upper influence congestion of the external jugular veins (jugular vein; jugular vein), which occurs when lifting the arms]
- Inspection and palpation (palpation) of the neck region, etc. [Enlargement of the thyroid gland; a goiter moves when swallowing; a visible goiter can be assumed from a volume of about 40 ml; pressure pain? (Indication for thyroiditis de Quervain or an abscess/encapsulated pus cavity].
- Auscultation (listening) of the heart [due topossible sequelae: Cardiac hypertrophy (heart enlargement; also called “goiter heart”)]
- Auscultation of the lungs [stridor (whistling breathing sound)]
- Inspection (viewing) of skin and mucous membranes [possible symptoms:
- Cancer screening
- If necessary, neurological examination [due topossible secondary diseases: Horner symptomatology (Horner syndrome; Horner triad) – pupil constriction (miosis), drooping of the upper eyelid (ptosis) and an apparently sunken eyeball (pseudoenophthalmos)].
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.