A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Inspection and palpation (palpation)
- Lymph node stations (cervical, axillary, supraclavicular, inguinal).
- Thyroid gland
- Spine
- Mammae (mammary glands) [due topossible paraneoplastic signs: Gynecomastia (enlargement of the male mammary gland), pubertas praecox (premature onset of puberty)]
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Examination of the abdomen
- Percussion of the abdomen/examination of the abdomen by tapping the abdominal wall with the fingers.
- [Ascites (abdominal fluid): phenomenon of fluctuation wave. This can be triggered as follows: if one taps against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand on it (undulation phenomenon); flank attenuation.
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of the tapping sound due to enlarged liver or spleen, tumor, urinary retention?
- Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
- Palpation of the abdomen (tenderness?, tapping pain?, coughing pain?, guarding?, hernial orifices?, renal bed tenderness?).
- Percussion of the abdomen/examination of the abdomen by tapping the abdominal wall with the fingers.
- Inspection of genitals [due topossible paraneoplastic signs:
- Pubertas praecox (puberty beginning too early).
- Health check (as an additional follow-up measure).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
