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 and mucous membranes
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Auscultation (listening) of the heart [due tosecondary diseases: Endocarditis (pericarditis); pericarditis (pericarditis)]
- Examination of the lungs
- 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 physician listens to the lungs)[increased sound transmission due to pulmonary infiltration/compaction of lung tissue (e.g. in pneumonia) (differential diagnosis/possible sequelae) the consequence is, the number “66” is better understood on the diseased side than on the healthy side; in case of reduced sound conduction (attenuated or absent: e.g. in pleural effusion (differential diagnosis/possible sequelae). 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 transmission 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) (differential diagnosis/possible sequelae) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; in case of reduced sound conduction (strongly attenuated or absent: in pleural effusion) (differential diagnosis/possible sequelae). 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?) [due tosecondary disease: pancreatitis (inflammation of the pancreas)]
- Digital rectal examination (DRU): palpation by finger: assessment of prostate size, shape and consistency [prostatitis (inflammation of the prostate)]
- Inspection (viewing).
- Gynecological examination [vaginitis / colpitis (vaginitis); cervicitis (cervicitis); adnexitis (inflammation of the so-called adnexa (Engl.: appendages), ie, the fallopian tubes and ovaries; z. T. abscesses and septicemia].
- Urological examination [prostatitis (prostatitis), urethritis (urethritis)]
- If necessary, neurological examination [due topossible secondary diseases: Meningitis (meningitis); myelitis (spinal meningitis); polyradiculitis (inflammation of multiple nerve roots)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.