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).
- Skin, mucous membranes, and sclerae (white part of the eye) [exanthema (rash)?]
- Orienting dental status
- Knocking pain paranasal sinuses?
- Inspection and palpation (palpation) of the lymph node stations.
- Palpation of prominent bone points, tendons, ligaments; musculature; joint (joint effusion); soft tissue swelling; tenderness (localization!).
- Auscultation (listening) of the heart.
- Examination of the lungs
- Auscultation of the lungs [due todifferential diagnoses: pneumonia (pneumonia), bronchitis].
- 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 physician 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]
- 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.g. 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) including examination of the renal bearings (pressure pain?, knocking pain?, coughing pain?, defensive tension?, hernial gates?, renal bearing knocking pain?)
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation.
- Inspection (viewing).
- If necessary, gynecological examination [due todifferential diagnosis: endometritis (inflammation of the uterus)].
- Neurological examination [due todifferential diagnosis: neuralgia (nerve disease)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
