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Samenvatting Pediatrie
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Inzicht in de podologie bij specifieke doelgroepen
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Inzi cht i n podol ogi e bi j specifi eke doel groepen;Pediatri e
Inhoudsopgave
1. Zwangerschap ................................................................................................................................... 6
1.1. Mogelijke problemen bij de MOEDER tijdens de zwangerschap t.h.v ol ....................... 6
1.2. Mogelijke problemen bij de MOEDER tijdens de zwangerschap t.h.v de voeten ........ 6
1.2.1. Oedeem .............................................................................................................................. 6
1.2.2. Veranderingen in de morfologie van de voet ............................................................... 6
1.2.3. Veranderingen in het stappatroon .................................................................................. 6
1.2.4. Evenwichtsproblemen ....................................................................................................... 7
1.2.5. Veranderingen ter hoogte van de nagels ...................................................................... 7
2. Ontwikkeling van de voet ................................................................................................................ 7
2.1. Embryonale fase .................................................................................................................... 7
2.2. Foetale ontwikkeling ............................................................................................................. 7
3. Positie van de foetus voor bevalling ............................................................................................... 8
3.1. Normale positie voor bevalling ............................................................................................ 8
3.2. Sterrekijker ............................................................................................................................... 8
........................................................................................................................................................ 8
3.3. Stuitligging .............................................................................................................................. 8
3.4. Dwarsligging ........................................................................................................................... 8
4. T er mi n ol ogi e t er mi jn zwa nge r schap ......................................................................... 8
4.1. premature baby’s ................................................................................................................. 8
4.2. meerlingen ............................................................................................................................. 9
5. De ge b oo rt e ........................................................................................................................ 9
5.1. Soorten bevallingen .............................................................................................................. 9
5.1.1. Natuurlijke bevalling ........................................................................................................... 9
5.1.2. Keizersnede ......................................................................................................................... 9
5.2. Antropometrische data van de pasgeborene ................................................................. 9
5.2.1. Gewicht ............................................................................................................................... 9
5.2.2. Lengte .................................................................................................................................. 9
5.2.3. Schedelomtrek .................................................................................................................... 9
6. Be sch ri jvi n g van d e p a sg eb or en e ........................................................................... 10
6.1. huid........................................................................................................................................ 10
6.2. Nagels ................................................................................................................................... 10
6.3. Fontanel ................................................................................................................................ 10
6.3.1. Grote fontanel .................................................................................................................. 10
6.3.2. Kleine fontanel .................................................................................................................. 10
6.4. De voetzool .......................................................................................................................... 10
6.5. De tastzin .............................................................................................................................. 11
6.6. De glimlach .......................................................................................................................... 11
7. H ou di n g v an de p asg eb or ene .................................................................................. 11
7.1. normale duur/ positie in de baarmoeder ........................................................................ 11
7.2. Bij baby’s in stuitligging ....................................................................................................... 11
7.3. Bij premature baby’s ........................................................................................................... 11
8. On de rz o ek van d e p a sge b ore ne ............................................................................. 12
8.1. APGAR SCORE ..................................................................................................................... 12
8.1. APGAR score ........................................................................................................................ 12
8.2. Primitieve reflexen ............................................................................................................... 12
Onderverdeling primitieve reflexen; ........................................................................................ 13
Samenvatting Pediatrie 2019-2020 1
, 8.2.1. Competents for survival AT birth ..................................................................................... 13
8.2.2. Competents for development AFTER birth .................................................................... 14
8.2.3. Een restgroep: ................................................................................................................... 17
8.3. Hielprik ................................................................................................................................... 19
9. Op v ol gi n g van de b ab y – k i n d ................................................................................. 20
10. Pat h ol o gi e ........................................................................................................................ 20
10.1. Congenitale heupdysplasie ............................................................................................. 20
10.1.1. Etiologie ........................................................................................................................... 21
10.1.2. Klinische kenmerken ....................................................................................................... 21
10.1.3. Behandeling .................................................................................................................... 22
1. Groei van de voet ........................................................................................................................... 24
2. Ossificatie ......................................................................................................................................... 24
2.1. Einde verbeningsproces ..................................................................................................... 25
3. Biomechanische evolutie van het onderste lidmaat ................................................................. 25
3.1. De wervelzuil ........................................................................................................................ 25
3.2. De heup ................................................................................................................................ 25
3.3. Os femur ............................................................................................................................... 26
3.3.1. Femorale anteversiehoek ................................................................................................ 27
3.2.2. Femorale retroversie......................................................................................................... 29
3.3.3. Femorale incilnatiehoek .................................................................................................. 29
3.4. De tibia – De knie ................................................................................................................ 30
3.4.1. Ontwikkeing/ evolutie van het kniegewricht ................................................................ 30
3.5. De voet ................................................................................................................................. 32
4. Evolutie van het gangpatroon ....................................................................................................... 33
4.1. Gangpatroon van een één-jarig kind .............................................................................. 34
4.2. Gangpatroon van een 2-jarig kind ................................................................................... 35
4.3. Gangpatroon van een kind van 3 à 4 jaar ...................................................................... 35
4.4. gangpatroon van een zevenjarig kind ............................................................................. 36
4.5. De 5 determinanten van de mature gang volgens sutherland .................................... 36
4.6. Invloed van schoenen op het gangpatroon ................................................................... 36
1. Pes planus: klinische kenmerken .................................................................................................. 38
1.1. Classificatie pes planus ....................................................................................................... 38
1.2. Functionele OF structurele pes planus? ............................................................................ 38
1.3. Classificatie pes planus ....................................................................................................... 38
2. Functionele pes planus................................................................................................................... 39
2.1. Etiologie ................................................................................................................................ 39
2.2. Predisponerende factoren ................................................................................................. 39
2.3. Klinische kenmerken ............................................................................................................ 41
2.4. Afwijkingen in het gangpatroon ........................................................................................ 41
2.5. Flexibele pes planus: classificatie volgens Valmassy ...................................................... 41
2.5. Aanvullende testen ............................................................................................................. 42
2.6. Enkele visie’s op een rijtje ................................................................................................... 42
2.6.1. Visie 1 ................................................................................................................................. 42
2.6.2. Visie 2 ................................................................................................................................. 44
2.6.3. Visie 3 ................................................................................................................................. 44
2.6.4. Visie 4 ................................................................................................................................. 44
2.7. Behandeling starten of niet? .............................................................................................. 44
2.7.1. Jonge kinderen: geen behandeling .............................................................................. 44
Samenvatting Pediatrie 2019-2020 2
, 2.7.2. Voetboog ontwikkeld vanaf 5 à 6 jaar .......................................................................... 44
2.7.3. Stretchen posterieure keten ............................................................................................ 45
2.7.4. Blootvoets lopen ➔ Stimulatie proprioceptie ............................................................... 45
2.8. Podologische behandeling, een leidraad ....................................................................... 45
2.9. Wanneer behandelen met podologische zooltherapie? .............................................. 45
2.10. Wat we wel weten... ......................................................................................................... 46
2.11. Besluit .................................................................................................................................. 47
3.Podologische behandeling pes planus (conclusie) .................................................................... 48
3.1. Functionele pes planus behandeling ............................................................................... 48
3.2. Podologische zooltherapie bij kinderen ........................................................................... 48
4. Structurele pes planus .................................................................................................................... 49
1. Ligamentaire laxiteit ....................................................................................................................... 57
2. In-toeïng ........................................................................................................................................... 59
2. Heup (in-toeïng) .............................................................................................................................. 60
3. Onderbeen/ voet (in-toeïng) ......................................................................................................... 62
4. Behandeling (in-toeïng) ................................................................................................................. 63
5. Metatarsus adductus ...................................................................................................................... 65
1. Pes cavus ......................................................................................................................................... 70
2. Vaak voorkomende hulpvragen in de podologische praktijk ................................................. 72
H o o r c o l l e g e 6 : H e t o p g r o e i e n d e k i n d - L e e f t i j d s g e b o n d e n k e n m e r k e n . 81
1. Leeftijds gebonden kenmerken .................................................................................................... 82
H o o r c o l l e g e 7 : P o d o p e d i a t r i s c h o n d e r z o e k .............................................................. 85
1. Podopedriatische consultatie ........................................................................................................ 86
2. Anamnese ........................................................................................................................................ 87
3. Inspectie en observatie .................................................................................................................. 88
4. Klinisch en biomechanisch onderzoek ........................................................................................ 90
5. Heup en BL ....................................................................................................................................... 92
6. Knie ................................................................................................................................................... 94
7. Voet................................................................................................................................................... 94
8. Aanvullende testen ......................................................................................................................... 97
9. Ganganalyse ................................................................................................................................... 97
10. Educatie ......................................................................................................................................... 99
11. Schoen inspectie ......................................................................................................................... 101
Samenvatting Pediatrie 2019-2020 3
, 12. Schoen educatie ......................................................................................................................... 102
13. Schoenadvies per doelgroep .................................................................................................... 103
14. Afronding van een consult ......................................................................................................... 107
Hoorcollege 8: Podopediatrische b e h a n d e l i n g ................................................... 108
1. Wanneer een kind met een FFP doorverwijzen naar de podoloog? ...................................... 109
2. Wanneer en bij wie starten met een zooltherapie voor pes planus? ..................................... 109
3. Wanneer en bij wie wie starten met een zooltherapie voor in-toeing? ................................. 112
4. Educatie ......................................................................................................................................... 114
5. Schoenadvies bij zooltherapie .................................................................................................... 114
6. Wanneer een kind doorverwijzen naar de orthopedisch voetchirurg? ................................. 115
H o o r c o l l e g e 9 : O n t w i k k e l i n g s s t o o r n i s s e n ................................................................. 117
1. Mijlpalen van Shirley ..................................................................................................................... 118
2. Hypotonie ....................................................................................................................................... 118
3. Ontwikkelingsstoornissen: Algemeen ......................................................................................... 121
4. DCD - Developmental coordination disorder ............................................................................ 122
5. Autisme spectrum stoornis ........................................................................................................... 129
6. Toe walking .................................................................................................................................... 134
7. ADHD ............................................................................................................................................... 138
8. HSP – HOOGSENSITIEF ................................................................................................................... 139
1. Studie van de normale ontwikkeling .......................................................................................... 143
Samenvatting Pediatrie 2019-2020 4
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