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Samenvatting klinisch abdominaal onderzoek
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Samenvatting klinisch abdominaal onderzoek
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ABDOMINAAL ONDERZOEK1 INHOUD
2 Oppervlakte anatomie ...................................................................................................................... 3
3 Anamnese ......................................................................................................................................... 4
3.1 Systeem anamnese (zie eerder) .......................................................................................................... 4
3.2 Specifieke anamnese ........................................................................................................................... 5
3.2.1 Foetor/ halitose: ...................................................................................................................... 5
3.2.2 Slikstoornissen ......................................................................................................................... 5
3.2.3 Pyrosis = Pijnlijk, branderig gevoel (‘zure oprispingen’) ......................................................... 6
3.2.4 Dyspepsie/ indigestie = "zware maag'..................................................................................... 6
3.2.5 Nausea ..................................................................................................................................... 6
3.2.6 Braken...................................................................................................................................... 7
3.2.7 Winderigheid: .......................................................................................................................... 7
3.2.8 Stoelgangspatroon .................................................................................................................. 7
3.2.9 Anaal bloedverlies ................................................................................................................... 8
3.2.10 Mictiefrequentie...................................................................................................................... 8
3.2.11 Dysurie..................................................................................................................................... 9
3.2.12 Incontinentie ........................................................................................................................... 9
3.2.13 Abdominale pijn .................................................................................................................... 10
4 Inspectie .......................................................................................................................................... 12
4.1 Algemene richtlijnen klinisch onderzoek .......................................................................................... 12
4.2 Inspectie Contouren abdomen.......................................................................................................... 12
4.3 Inspectie huid .................................................................................................................................... 14
5 Auscultatie ...................................................................................................................................... 16
6 Percussie ......................................................................................................................................... 17
6.1.1 Percussie lever....................................................................................................................... 17
6.1.2 Percussie mild........................................................................................................................ 17
6.1.3 Percussie ASCITES: ‘Shifting Dullness’ ................................................................................... 18
7 palpatie ........................................................................................................................................... 19
7.1.1 Oppervlakkige palpatie.......................................................................................................... 19
7.1.2 Diepe palpatie ....................................................................................................................... 20
7.1.3 Palpatie van organen ............................................................................................................. 20
7.1.4 Speciale technieken ............................................................................................................... 23
1
,2
, 2 OPPERVLAKTE ANATOMIE
• Een aantal anatomische plaatsen die men gebruikt om de buik onder te verdelen voor klinisch
OZ:
1. Ribbenboog
2. Inguinaal kanaal (bij ligament van poupart): Deze lijnt de onderkant van de buik af
3. De umbilicus (= navel) in de middenlijn van de buik
4. De buik is veel minder beschermd dan de borstkas (geen ribbekas) . Wel zijn hier een
aantal spieren gelegen die zich voornamelijk concentreren onmiddellijk lateraal van
de middenlijn = M. vastus lateralis (six-pack)
▪ Bij oudere personen zullen deze spieren sterk verzwakt zijn tot zelf bijna
onbestaand.
• Anatomie van de organen in de buik; Heel wat klachten van buikpijn zullen te maken hebben
met de dikke darm (het colon).
3
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