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 and mucous membranes
- Inspection and palpation (palpation) of the lymph node stations (cervical, axillary, supraclavicular, inguinal).
- Auscultation (listening) of the heart [due tosymptom: thoracic pain (chest wall pain/chest pain)]
- Examination of the lungs
- Auscultation (listening) of the lungs [due tosymptoms:
- Dyspnea (shortness of breath)
- Possibly pneumonia (pneumonia)
- Giemen
- Hemoptysis (coughing up blood)
- Irritative cough]
- 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. 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]
- Auscultation (listening) of the lungs [due tosymptoms:
-
- Palpation of the abdomen (tenderness?, tapping pain?, coughing pain?, guarding tension?, hernial orifices?, renal bearing tapping pain?).
- Inspection (viewing).
- Health check (as an additional follow-up measure).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
