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 [hypersalivation (synonyms: sialorrhea, sialorrhea, or ptyalism; increased salivation)]
- Throat
- Aisle
- Akinesia (immobility, rigidity of movement).
- Bradykinesis – slowing of voluntary movements.
- Hypokinesia – amplitude reduction of voluntary movements.
- Marche à petit pas – small-step gait.
- Extremities (tone of limb muscles) [rigor (stiffness of muscles due to increase in muscle tone, which persists throughout movement during passive movement, unlike spasticity; cogwheel phenomenon: jerky yielding of muscle tone during passive movement of a limb)]
- Tremor
- Classic Parkinson’s tremor: appears with arms supported at rest with a frequency of about 4-6 Hz (higher frequencies possible in early stages of disease); also called pill tremor; seminal is the decrease in amplitude at the onset of voluntary movements; can be activated by mental occupation or emotion
- Rarely occurring: holding tremor (mean frequency of 5-7 Hz, as in essential tremor), which can often coexist with rest tremor, and action tremor (8-12 Hz).
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
- Inspection (viewing).
- Neurological examination [due todifferential diagnoses.]
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
