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.
- Examination of the abdomen
- Percussion (tapping) of the abdomen
- [Ascites (abdominal fluid): phenomenon of fluctuation wave. This can be triggered as follows: if one taps against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand on it (undulation phenomenon); flank attenuation.
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of the tapping sound due to enlarged liver or spleen, tumor, urinary retention?
- Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
- Cholelithiasis (gallstones): tapping pain over gallbladder region and right lower rib]
- Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
- Percussion (tapping) of the abdomen
- Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation: assessment of the prostate in size, shape and consistency.
- Ophthalmologic examination [glaucoma case].
- Gynecological examination [in case of pregnancy; vomiting in the morning]
- ENT medical examination [torsional vertigo?, tinnitus (ringing in the ears)?; neuronitis vestibularis, Meniere’s disease (disease of the inner ear characterized by attacks of torsional vertigo); labyrinthitis (inflammation of the inner ear)]
- Neurological examination (meningismus?; headache?) [due todifferential diagnoses: cerebral abscess, cerebral hemorrhage, brain tumor, hydrocephalus (hydrocephalus; pathological expansion of the liquid-filled fluid spaces (cerebral ventricles) of the brain)]
- Psychiatric examination [due todifferential diagnoses: anorexia nervosa (anorexia), bulimia nervosa (binge eating disorder), depression]
- Urological examination [uremia (occurrence of urinary substances in the blood above normal values), urolithiasis (urinary stones)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.