Samenvatting van volledige lessenreeks en handboek m.u.v. deel over slikstoornissen bij kinderen (geen leerstof).
Bevat ook nota's van Masterclass neurologische spraak, taal en slikstoornissen
Bachelor In De Logopedische En Audiologische Wetenschappen
Zorgtraject: Slikstoornissen (E0F53A)
All documents for this subject (1)
Seller
Follow
jolien2000
Reviews received
Content preview
DYSFAGIE
Handboek voor de klinische praktijk
Jolien Van Baelen
,INHOUD
1. Dysfagie: definitie en classificatie ................................................................................................................. 6
1.1. Definitie .................................................................................................................................................. 6
1.1.1. Algemene aspecten van slikken ....................................................................................................... 6
1.2. Classificaties ........................................................................................................................................... 7
1.2.1. Indeling volgens leeftijd .................................................................................................................. 7
1.2.2. Indeling volgens fase ....................................................................................................................... 7
1.2.3. Indeling volgens etiologie ............................................................................................................... 8
1.2.4. Indeling volgens probleemgebied (kinderen) .................................................................................. 9
1.2.5. Klinische indeling (kinderen) ........................................................................................................ 10
1.2.6. Besluit classificaties ...................................................................................................................... 10
1.3. ICF ........................................................................................................................................................ 11
2. De impact van een slikstoornis .................................................................................................................... 12
2.1. Gevolgen van dysfagie op sociaal, psychologisch en medisch vlak..................................................... 12
2.2. Prevalentie ............................................................................................................................................ 12
2.3. Historiek ............................................................................................................................................... 12
2.4. Besluit ................................................................................................................................................... 13
3. Kernbegrippen ............................................................................................................................................. 13
3.1. Kruising luchtweg en voedselweg ........................................................................................................ 13
3.2. Premature lekkage ................................................................................................................................ 13
3.3. Residu / stase, regurgitatie .................................................................................................................... 13
3.4. Laryngale penetratie en aspiratie .......................................................................................................... 13
4. Evidence Based Practice.............................................................................................................................. 15
1. Anatomie en fysiologie van de normale slikact ........................................................................................... 16
1.1. Inleiding................................................................................................................................................ 16
1.2. Anatomie .............................................................................................................................................. 17
1.2.1. Orale fase ....................................................................................................................................... 17
1.2.2. Faryngeale fase .............................................................................................................................. 17
1.2.3. Oesofageale fase ............................................................................................................................ 18
1.3. Fysiologie ............................................................................................................................................. 19
1.3.1. Orale fase ....................................................................................................................................... 19
1.3.2. Faryngeale fase .............................................................................................................................. 20
1.3.3. Oesofageale fase ............................................................................................................................ 21
1.4. Ademhaling en slikken ......................................................................................................................... 21
1.4.1. Anatomie en fysiologie.................................................................................................................. 21
1.4.2. Slikapneu ....................................................................................................................................... 21
1.4.3. Hoest .............................................................................................................................................. 22
1.5. De speekselklieren ................................................................................................................................ 22
1.5.1. Anatomie van de speekselklieren .................................................................................................. 22
Error! Use the Home tab to apply Kop 1 to the text that you want to appear here.
Pagina 1 van 177
, 1.6. Neur(on)ale controle van het slikken.................................................................................................... 22
1.6.1. Hogere neurale controle................................................................................................................. 22
1.6.2. Central Pattern Generator / hersenstam ......................................................................................... 23
1.6.3. Perifere neuromusculaire mechanismen / craniale zenuwen ......................................................... 23
1. Diagnostiek .................................................................................................................................................. 25
1.1. Inleiding................................................................................................................................................ 25
1.1.1. Multidisciplinair gebeuren ............................................................................................................. 25
1.1.2. Rol van de logopedist .................................................................................................................... 27
1.1.3. Terminologie ................................................................................................................................. 27
1.2. Stap 1: Signalen voor de verwijzer ....................................................................................................... 29
1.3. Stap 2: Anamnese en dossierinzage...................................................................................................... 29
1.3.1. Voorgeschiedenis........................................................................................................................... 30
1.3.2. Huidige ziektegeschiedenis ........................................................................................................... 31
1.3.3. Klachten patiënt / omgeving .......................................................................................................... 31
1.4. Stap 3: Screenings en protocollen ........................................................................................................ 32
1.4.1. Inleiding ......................................................................................................................................... 32
1.4.2. Sensitiviteit, specificiteit ............................................................................................................... 32
1.4.3. Screening (verpleegkundigen) ....................................................................................................... 32
1.5. Stap 4: Diagnostisch onderzoek (logopedisten) ................................................................................... 40
1.5.1. Inleiding ......................................................................................................................................... 40
1.5.2. Formulier voor diagnostisch onderzoek ........................................................................................ 41
1.5.3. Dysfagieonderzoek bij patiënten met een tracheacanule ............................................................... 54
1.6. Onderzoeksprotocollen; gestandaardiseerd / genormeerd slikonderzoek: overzicht ............................ 55
1.6.1. Gestandaardiseerd diagnostisch slikonderzoek: MASA ................................................................ 65
1.7. Voedselevaluatie: MISA....................................................................................................................... 65
1.8. Stap 5: Instrumentele onderzoeken....................................................................................................... 66
1.8.1. Fiberoptic Endoscopic Evaluation of Swallowing (FEES)............................................................ 67
1.8.2. VideoFluoroscopische Evaluatie van het Slikken (VFES) ............................................................ 77
1.8.3. VFES vs. FEES ............................................................................................................................. 82
1.8.4. Andere instrumentele onderzoeken ............................................................................................... 82
1.9. Stap 6: Schalen en vragenlijsten rond ernst, outcome en quality of life ............................................... 87
1.9.1. Bestaande schalen en vragenlijsten ............................................................................................... 87
1.9.2. Ernstschalen: Ernstschaal dysfagie ................................................................................................ 88
1.9.3. Penetratie-aspiratieschalen: Penetration Aspiratie Scale (PAS) .................................................... 89
1.10. Stap 7: Adviezen en dieetaanbevelingen ............................................................................................ 90
2. Behandeling ................................................................................................................................................. 91
2.1. Inleiding................................................................................................................................................ 91
2.1.1. Multidisciplinaire samenwerking .................................................................................................. 91
2.1.2. Aandachtspunten tijdens maaltijden / revalidatie .......................................................................... 91
Error! Use the Home tab to apply Kop 1 to the text that you want to appear here.
Pagina 2 van 177
, 2.2. Medische behandeling .......................................................................................................................... 93
2.2.1. Medicatie ....................................................................................................................................... 93
2.2.2. Chirurgische mogelijkheden .......................................................................................................... 93
2.2.3. Alternatieve voedingswijzen ......................................................................................................... 96
2.2.4. Tracheacanules ............................................................................................................................ 102
2.2.5. Discussiepunten bij de medische behandeling ............................................................................ 107
2.3. Logopedische behandeling ................................................................................................................. 110
2.3.1. Rol van de logopedist .................................................................................................................. 110
2.3.2. Doel van sliktherapie ................................................................................................................... 110
2.3.3. Terminologie rond sliktherapie ................................................................................................... 111
2.3.4. Voorwaarden om te kunnen starten met slikbehandeling ............................................................ 113
2.3.5. Principes van neurale en musculaire plasticiteit .......................................................................... 113
2.3.6. Effectiviteit van sliktherapie ........................................................................................................ 115
2.3.7. Revalidatietechnieken .................................................................................................................. 115
2.3.8. Compensatietechnieken ............................................................................................................... 126
2.3.9. Overzicht ..................................................................................................................................... 136
2.3.10. Prothesen ................................................................................................................................... 137
2.3.11. Biofeedback ............................................................................................................................... 138
2.3.12. Enkele aandachtspunten binnen de revalidatie .......................................................................... 139
3. Materiaal .................................................................................................................................................... 140
3.1. Bekers ................................................................................................................................................. 140
3.2. Borden ................................................................................................................................................ 141
3.3. Bestek ................................................................................................................................................. 141
3.4. Antislip ............................................................................................................................................... 141
3.5. Slabben ............................................................................................................................................... 141
3.6. Medicatie-inname ............................................................................................................................... 141
3.7. Houdingscorrectie............................................................................................................................... 142
3.8. Consistentieaanpassingen ................................................................................................................... 142
1. Inleiding..................................................................................................................................................... 144
1.1. Hersenletsels ....................................................................................................................................... 144
1.1.1. Kenmerken volgens localisatie van het letsel .............................................................................. 145
1.2. Degeneratieve neurologische ziektebeelden ....................................................................................... 148
1.3. Oncologische problematiek ................................................................................................................ 148
1.3.1. Chirurgie ...................................................................................................................................... 149
1.3.2. Voedelconsistentie ....................................................................................................................... 153
1.3.3. Chemo-radiotherapie ................................................................................................................... 153
1.4. Gastroenterologische stoornissen ....................................................................................................... 155
2. Alfabetische lijst van specifieke problemen .............................................................................................. 156
2.1. Achalasia ............................................................................................................................................ 156
Error! Use the Home tab to apply Kop 1 to the text that you want to appear here.
Pagina 3 van 177
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller jolien2000. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $6.97. You're not tied to anything after your purchase.
