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).
- Skin, mucous membranes, and sclerae (white part of the eye) [alopecia (hair loss); exanthema (rash)]
- Auscultation (listening) of the heart [meningitis (meningitis); myopericarditis (inflammation of the muscle and outer layer of the heart)]
- Examination of the lungs (due tosymptom or possible sequelae).
- Auscultation (listening) 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 the word “99” several times in a low voice, 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]
- Palpation (palpation) of the abdomen (abdomen) (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?)
- Inspection and palpation of the genitals (penis and scrotum (scrotum); assessment of pubescence (pubic hair), penis (penile length: between 7-10 cm when flaccid; presence of: Indurations (tissue hardening), anomalies, phimosis / foreskin constriction?) and testicular position and size (if necessary by orchimeter); if necessary, the painfulness compared to the opposite side or where is the punctum maximum of pain) [due topossible orchitis (testicular inflammation)].
- Digital rectal examination (DRU): examination of the rectum (rectum).
- Inspection (viewing).
- If necessary, urological examination [due topossible secondary disease: orchitis (testicular inflammation)].
- If necessary, ENT medical examination [due tosymptom or possible sequelae: parotitis (parotid gland inflammation)]
- If necessary, neurological examination [due topossible sequelae: Meningitis (meningitis)Meningoencephalitis (combined inflammation of the brain (encephalitis) and the meninges (meningitis))]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
