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).
- Auscultation (listening) of the heart [due todifferential diagnosis: heart failure (cardiac insufficiency)]
- Examination of the lungs
- Auscultation of the lungs [due todifferential diagnoses:
- Bronchial asthma
- Bronchial carcinoma (lung cancer)
- Bronchiectasis (synonym: bronchiectasis; permanent outpouching of the bronchi as a result of the destruction of mainly elastic wall fibers).
- Bronchocentric granulomatosis – granulomatous disease characterized by primary involvement of the bronchial or bronchiolar wall.
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Exacerbation of chronic bronchitis – acute exacerbation of chronic bronchitis.
- Exogenous allergic alveolitis (hypersensitivity pneumonitis) – farmer’s lung, bird breeder’s lung, etc.
- Influenza infections Upper and lower respiratory tract infections, unspecified.
- Influenza (flu)
- Papillomatosis – occurrence of multiple benign neoplasms, mostly in the respiratory tract.
- Pneumonia (pneumonia)
- Sinusitis (sinusitis)]
- 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 (e.g. 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 pleural effusion, pneumothorax, 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 [e.g., in emphysema; box tone 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. 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). The result is, the number “99” is barely audible to absent over the diseased part of the lung, because the low-frequency sounds are strongly attenuated]
- Auscultation of the lungs [due todifferential diagnoses:
- If necessary, ENT medical examination [due topossible differential diagnosis: sinusitis].
Square brackets [ ] indicate possible pathological (pathological) physical findings.
