Check-up examinations - what you should know about it
What are check-up examinations?
The check-up examinations include various examinations by the family doctor, which are used for the early detection of common diseases. The check-up examinations are covered by the health insurance company from the age of 35 and are then reimbursed every two years. In addition to a detailed anamnesis, i.e. a consultation with a doctor, this includes many different examinations. These are listed and explained for you below.
The physical exam
After a detailed consultation with a doctor, in which, among other things, the medical history and health risk factors are clarified, a complete physical examination takes place. All organ systems such as the heart, lungs, abdomen and nervous system are thoroughly examined. The doctor uses a fixed scheme for this. First there is a visual inspection of the respective body region. Then the various body structures are assessed in more detail by means of a touch and touch examination. When examining the nervous system in particular, there are many tests that are easy to perform, but they are very informative. The background of these examinations is that pathological changes should be recognized early and then their course should be observed in a structured manner. During the visual inspection, the doctor also pays attention to the complexion. As an extended physical examination, the BMI (Body Mass Index) is calculated, which is made up of body weight and height and is a good progress parameter.
Read more on the topic here: Physical examination - what is it and what does it entail?
Listening to the heart and lungs
Listening to the heart and lungs is formally part of the physical examination. This simple examination can provide important information about potential diseases, which is why it is presented separately here. When listening to the heart, which is called auscultation in technical terms, all four heart valves are monitored together and then individually. The stethoscope can be used to assess whether individual valves no longer close completely and thus whether blood is flowing in the wrong direction (insufficiency) or whether the flaps no longer open properly (Stenosis). Both lead to an increased burden on the heart. The carotid arteries are also monitored in order to draw conclusions about pathological changes in the heart or the carotid arteries themselves. The lungs are eavesdropped on in several places. This examination can be used to determine whether the lungs are fully expanded. During this examination it is important to always make a side comparison between the right and left lung. Striking noises when inhaling and exhaling suggest a range of diseases. Pneumonia, for example, would produce a fine rattling noise.
Blood pressure measurement and determination of the pulse rate
The measurement of blood pressure is part of every check-up examination, as it can be carried out quickly and easily and provides information on whether the blood pressure is in the normal range or deviates from it. When measuring blood pressure, an arm cuff is first inflated either electronically or manually until it completely suppresses the blood flow in the arm artery. The air is then slowly released from the cuff and two values are determined, which are then given as the systolic and diastolic values. The systolic value is given first and separated from the diastolic value by an oblique cut. The unit is millimeters of mercury (mmHg).
Normal blood pressure is around 120/80 mmHg. From a blood pressure of 140/90 mmHg one speaks of high blood pressure. It is important that the blood pressure is measured at rest. You should sit still for 10 minutes before the measurement, otherwise the values could be falsified. Untreated high blood pressure can trigger significant long-term damage to a wide variety of organs, which is why it may be necessary to adjust blood pressure by means of lifestyle changes and possibly medication. During the blood pressure measurement, the pulse rate can also be measured and certain properties and qualities of the pulse are recorded.
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Which laboratory tests are included?
As part of the check-up, blood is taken and various blood values are determined. On the one hand, the glucose value in the blood is of particular interest. Glucose is a type of sugar that is colloquially known as blood sugar. This value is best determined soberly, as this is the best informational value. This means that about 8 to 10 hours before the scheduled blood draw one should not eat anything and should only drink small amounts of fluids. If the glucose value exceeds a specified limit, there is a possibility that diabetes mellitus is present, the so-called diabetes. If this is suspected, additional tests will be performed to confirm or rule out the diagnosis. The total cholesterol value is also determined. Cholesterol is a blood fat, which in too high concentrations can cause damage to the blood vessels. Especially when a high cholesterol level is paired with high blood pressure. With this combination, the risk is one arteriosclerosis elevated. The arteriosclerosis is a hardening or calcification of the blood vessels, which is associated with a narrowing of the vessels.
Further information can be found here: Laboratory values - which should I know?
Urine diagnostics - what is examined?
In addition to taking blood, a urine sample is also analyzed. Urine in the morning is best for this. Using common urine test strips, also called urine stix, various components in the urine can be measured. It can be determined whether there is blood in the urine. Blood in the urine does not always turn it reddish, so a test strip must be used to detect non-visible blood components. Blood in the urine can indicate stones in the urinary tract or inflammation. In addition, the content of proteins in the urine is determined. An excessive amount of protein in the urine can indicate kidney disease, but must be clarified more precisely using other laboratory methods.
The level of glucose in the urine can also be determined. This is a good way to get more information about your sugar metabolism in addition to drawing your blood.Elevated glucose levels in the urine are normal during pregnancy or if you have known kidney disease. However, if the glucose level in the urine is increased without an explanatory underlying disease being present, further diagnostics should be carried out in the direction of a Diabetes mellitus be initiated. The three urine components mentioned above play the greatest role in the check-up examination. The test strips can be used to measure many other components of the urine.
Read more on the subject here: Urine test - what does it say?
Extended check-up examinations
In addition to the basic diagnostics, the family doctor can also carry out special examinations. These are useful if the previous examinations revealed abnormalities. By default, however, they are not part of the check-up examinations.
EKG - what does it say?
If abnormalities are noticed during the physical examination or while listening to the heart, the examining doctor can also perform an EKG (electrocardiogram). The examination can be done quickly and is painless. During an EKG examination, electrodes are attached to various parts of the chest, as well as to the hands and legs. These electrodes can be used to record the electrical activity of the heart.
In addition, the heart rate and heart rhythm are recorded during this examination. Based on the characteristic curves obtained as a result of the examination, conclusions can be drawn about the contraction of the atria and the ventricles. In addition to the normal ECG examination, an ECG can also be recorded over 24 hours. This is then called a long-term EKG. Recording over a longer period of time can be helpful if you are looking for certain malfunctions of the heart that only occur sporadically. You can also do a stress ECG, with the patient sitting on a bicycle ergometer while the doctor takes an ECG.
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The pulmonary function examination
The pulmonary function examination gives the examiner information about the various lung volumes and can reveal abnormal changes in breathing. During the examination, the patient must use a special measuring device (Pneumotachograph) perform various breathing movements in the mouth. For example, an interesting measurement is the exhalation rate after a full inhalation. Although the examination can be carried out quickly and easily, its quality largely depends on how well the patient works. On the basis of the patient's breathing, various curves are recorded by a computer, from which one can read off whether there have been changes in the lung volumes or whether the breathing movement is restricted.
The examination is also carried out, for example, in patients with asthma, chronic diseases of the lungs or tumors in the lungs. An extension of the pulmonary function examination is similar to the EKG, the ergospirometry, i.e. a pulmonary function examination under stress. For this examination, the patient is physically stressed by means of a bicycle ergometer and other measured values can be recorded, such as the oxygen uptake and the release of carbon dioxide.
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Sonography and blood flow measurement of the legs
Sonography is a non-invasive imaging diagnostic that can be used in a wide variety of ways. If there are abnormalities in the abdominal organs or vessels during the regular check-up examinations, sonography can help to obtain more detailed information. The organs in the abdomen, such as the liver, gallbladder, pancreas or kidneys, can be examined with this method. The large vessels in the abdomen can also be assessed in this way and it can look for signs of arteriosclerosis are sought, one should suspect by measuring blood pressure and determining the cholesterol value that this vascular change could be present.
There is also a suspicion that a Diabetes mellitus could be present or if this is already known, you can measure the blood flow in the legs with the ultrasound. For this examination, one looks for the vessels in the legs using the ultrasound image and uses a special method to measure (Duplex sonography) how fast the blood flows through the vessels. This can help in assessing whether there is already a restriction in the blood flow to the feet or legs due to diabetes or other pre-existing conditions.
Read more on the subject here: Sonography - All information on the subject
Examination of bowel movements
If there is justified suspicion, the stool can be examined for bacteria, fungi, parasites or environmental toxins. It is important that in the case of conventional gastrointestinal diseases, as a rule, no stool examination is necessary, as this has no consequence for the therapy and is therefore only a waste of resources. However, if you have gastrointestinal complaints after traveling abroad or if you suspect that there is a reportable infection, a stool examination may be useful. As part of colon cancer screening, which is recommended for men and women aged 50 and over, stool tests are performed for hidden blood. The blood is often not visible, but can be detected with a test. If the test is positive for blood, it can be a sign of colon cancer and should be investigated further.
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