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; further:
- Inspection (viewing).
- Auscultation (listening) of the heart [tachycardia (heartbeat too fast: > 100 beats per minute)].
- Examination of the lungs (due topossible secondary diseases).
- Auscultation (listening) of the lungs [due tosymptom: dyspnea (shortness of breath)].
- 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. 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]
- Abdominal (stomach) examination [hepatosplenomegaly (liver and spleen enlargement)?
- Percussion (tapping) of the abdomen.
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of 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 (palpation) of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
- Percussion (tapping) of the abdomen.
- If necessary, neurological examination [due tosymptoms: seizures or other neurological manifestations (rare)].
- If necessary, urological examination [due toSymptom: oliguria (decreased urine volume of 100-500 ml/d)] [due toPossible sequelae: acute renal failure].
Square brackets [ ] indicate possible pathological (pathological) physical findings.
