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) [conjunctivitis (inflammation of the conjunctiva); exanthem (rash), uncharacteristic]
- Auscultation (listening) of the heart.
- Examination of the lungs
- Auscultation (listening) of the lungs [dry irritating cough; due topossible sequelae: pneumonia (pneumonia)].
- 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 (eg. 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 case of pleural effusion, pneumothorax, pulmonary 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 [eg. E.g. hypersonoric tapping sound in bronchial asthma, emphysema; box tone in pneumothorax]
- Vocal fremitus (testing of low frequency conduction; patient is asked to say 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). As a result, 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 [splenomegaly (splenomegaly)?]
- 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.
- Percussion (tapping) of the abdomen.
- Inspection (viewing).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
