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).
- Inspection and palpation (palpation) of the neck [swelling of the parotid (parotid gland) unilateral or bilateral possible].
- Inspection and palpation of the thyroid gland [thyroiditis (inflammation of the thyroid gland)?]
- Auscultation (listening) of the heart [due topossible secondary disease: myocarditis (inflammation of the heart muscle)]
- Examination of the genitals
- Male (urological examination):
- 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 stenosis?) as well as the testicular position; if necessary, the painfulness compared to the opposite side or where is the punctum maximum of pain) [orchitis (testicular inflammation) – especially in men who fall ill after puberty].
- Woman (gynecological examination):
- Inspection
- Vulva (external, primary female sex organs), vagina (vagina).
- Cervix uteri (cervix), or portio (cervix; transition from the cervix (cervix uteri) to the vagina (vagina)), if necessary, taking a Pap smear (for early detection of cervical cancer).
- Palpation (bimanual; palpation with both hands) of the internal genital organs:
- Cervix uteri (cervix).
- Uterus (uterus) [Normal: anteflexed/angled anteriorly, normal size, no tenderness].
- Adnexa (appendages of the uterus, i.e., the ovary and uterine tube). [Normal: free; here possibly oophoritis (ovarian inflammation)]
- Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free].
- Pelvic walls [Normal: free]
- Douglas space (pocket-like bulge of the peritoneum (abdominal wall) between the rectum (rectum) at the back and the uterus (uterus) at the front) [Normal: clear].
- Examination of the mammae (breasts)
- Inspection
- Male (urological examination):
- Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?) [Pancreatitis (inflammation of the pancreas)?
- Inspection (viewing).
- Ophthalmologic examination [due topossible sequelae: Inflammation of the eyes, dacryoadenitis (lacrimal gland inflammation)]
- Gynecological examination in existing pregnancy [due topossible sequelae: abortion (miscarriage)].
- ENT medical examination [due topossible sequelae: sensorineural hearing loss].
- Neurological examination [due topossible sequelae:
- Encephalitis (inflammation of the brain).
- Meningitis (meningitis)
- Myelitis (inflammation of the spinal or bone marrow)]
- Urological examination [due topossible secondary diseases:
- Epididymitis (inflammation of the epididymis).
- Mastitis (inflammation of the mammary glands)
- Nephritis (inflammation of the kidneys)
- Oophoritis (ovarian inflammation)
- Orchitis (testicular inflammation) – can lead to male sterility after puberty]
Square brackets [ ] indicate possible pathological (pathological) physical findings.