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).
- Auscultation (listening) of the heart [in cor pulmonale loud second heart sound above the pulmonary valve]
- Examination of the lungs
- Auscultation (listening) of the lungs [tachypnea (excessive respiratory rate); idiopathic pulmonary fibrosis (IPF): sclerosiphonia (dry crackle rattle) over the basal lung segments: basal inspiratory crackle rattle (basal and latero-basal; strongest at the end of inspiration (inhalation); nothing is heard in the expiratory phase (exhalation phase)) if necessary. later “cork rub”; raised lung borders]
- Percussion (tapping) of the lungs [eg, in emphysema; box sound in pneumothorax].
- 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. e.g., pneumonia) the consequence is, the number “99” is better understood on the diseased side than on the healthy side; with decreased sound conduction (attenuated: e.g., atelectasis, pleural rind; severely attenuated or absent: with pleural effusion, pneumothorax, emphysema). The result is, the number “99” is barely audible over the diseased lung area to absent, because the low-frequency sounds are strongly attenuated
- Palpation (palpation) of the abdomen (abdomen).
- Cancer screening
Square brackets [ ] indicate possible pathological (pathological) physical findings.
