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
- Auscultation (listening) of the heart
- Auscultation of the lungs [due todifferential diagnosis: bronchial asthma].
- Palpation (palpation) of the abdomen (abdomen) (pressure pain?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
- Inspection (viewing).
- Neurological examination* [due toDifferential diagnoses: epilepsy; idiopathic tetany – in neurasthenics, psychopathies; meningoencephalitis – combined inflammation of the brain (encephalitis) and meninges (meningitis); central (brain-related) tetany – in hypothalamic lesions (injuries in the area of the hypothalamus/section of the diencephalon in the area of the optic nerve junction)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.
* The following signs may indicate tetany:
- Chvostek’s sign – after tapping the facial nerve trunk (1-2 cm in front of the earlobe/jaw joint), there is a subsequent contraction (twitching) of the facial muscles.
- Erb sign – increased galvanic (electrical) excitability of motor nerves.
- Fibularis sign – tapping of the superficial fibular nerve (fibular nerve) behind the head of the fibula results in brief foot pronation (foot elevation and inward rotation of the foot)
- Schulze tongue phenomenon – by tapping the tongue comes to the dent / bulge formation.
- Trousseau sign – pawing that occurs by compressing the upper arm (e.g., after inflating a blood pressure cuff beyond systolic blood pressure).
