Summary
Samenvatting van het onderdeel CP en NMA van het OLOD neurogene spraak- en slikstoornissen.
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Samenvatting van het onderdeel CP en NMA van het OLOD neurogene spraak- en slikstoornissen.
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NEUROGENE SPRAAK- ENSLIKSTOORNISSEN
Inhoudsopgave
1. Ontwikkeling van het centraal zenuwstelsel............................................................................................... 3
Algemene ontwikkeling.........................................................................................................................................3
0 tot 4-5 weken.....................................................................................................................................................3
Embryo 24 dagen..................................................................................................................................................4
2. neuroanatomie.......................................................................................................................................... 7
De Hersenen..........................................................................................................................................................7
1. Cerebrum.......................................................................................................................................................7
2. Thalamus.......................................................................................................................................................9
3. Basale ganglia................................................................................................................................................9
4. Hersenstam...................................................................................................................................................9
5. Cerebellum..................................................................................................................................................10
3. Basisprincipes van de motorische ontwikkeling........................................................................................10
Normale motore ontwikkeling impliceert de integratie van het cZS..................................................................10
A. Normale tonus............................................................................................................................................10
B. Normale reciproke innervatie.....................................................................................................................11
C. Normale coördinatiepatronen....................................................................................................................11
Evolutie................................................................................................................................................................11
4. Personen met een neuromotorische handicap.......................................................................................... 12
Neuromusculaire aandoeningen.........................................................................................................................12
Centraal neurologische aandoeningen...............................................................................................................12
DEFINITIE CP........................................................................................................................................................13
Engelstalige definitie.......................................................................................................................................13
5. Incidentie en vormen en oorzaken van hersenschade...............................................................................14
CP........................................................................................................................................................................14
Vormen van hersenschade..................................................................................................................................14
1. Periventriculaire leucomalacie....................................................................................................................15
2. Intraventriculaire bloedingen......................................................................................................................15
3. Letsel in de basale kernen...........................................................................................................................15
4. Arteriële infarcten.......................................................................................................................................16
1
, Oorzaken van hersenschade...............................................................................................................................16
1. Prenatale oorzaken.....................................................................................................................................16
2. Perinatale oorzaken....................................................................................................................................17
3. Postnatale oorzaken....................................................................................................................................18
Prematuur/ dysmatuur.......................................................................................................................................18
6. classificatie.............................................................................................................................................. 18
1. Topografisch....................................................................................................................................................18
Topografisch/distributie..................................................................................................................................19
2. Klinisch beeld...................................................................................................................................................19
tonus................................................................................................................................................................20
3. ernst................................................................................................................................................................21
4. functionaliteit..................................................................................................................................................22
A. ICF................................................................................................................................................................22
B. GMFCS.........................................................................................................................................................22
C. macs............................................................................................................................................................23
D. CFCS.............................................................................................................................................................23
E. viking speach scale......................................................................................................................................24
F. EDACS..........................................................................................................................................................24
prognose.............................................................................................................................................................24
7. Neuromusculaire aandoeningen (deel 1)..................................................................................................25
nma.....................................................................................................................................................................25
A. de motorische voorhoorncel.......................................................................................................................26
B & C. de wortels en de plexus........................................................................................................................26
D. perifere zenuw............................................................................................................................................27
E. neuromusculaire overgang..........................................................................................................................27
f. de spier.........................................................................................................................................................27
voorkomen..........................................................................................................................................................27
Symptomen.........................................................................................................................................................28
8. Neuromusculaire aandoeningen (deel 2)..................................................................................................29
Voorhoorncel aandoeningen...............................................................................................................................29
1. Spinaal musculaire atrofie...........................................................................................................................29
2. Amyotrofische lateraal sclerose..................................................................................................................31
3. polio.............................................................................................................................................................31
Aandoeningen aan de zenuwwortels/plexus......................................................................................................31
1. Guillain Barré syndroom..............................................................................................................................31
2. Neuralgische amyotrofie.............................................................................................................................32
Aandoening in de perifere zenuwen...................................................................................................................32
1. Carpaal tunnel syndroom............................................................................................................................32
Aandoening in de neuromusculaire overgang....................................................................................................33
1. Myastenia gravis..........................................................................................................................................33
Aandoening van de spier.....................................................................................................................................34
2
, 1. Ziekte van Duchenne...................................................................................................................................34
2. Ziekte van Steinert......................................................................................................................................35
1. ONTWIKKELING VAN HET CENTRAAL ZENUWSTELSEL
ALGEMENE ONTWIKKELING
- a.d.h.v. Deze grafiek kan je eigenlijk zien hoe dat een baby vanaf de bevruchting ontwikkelt naar aan
aterm geboren kind (= een kind die op tijd geboren is).
- Waarom is dit belangrijk? Als je de normale ontwikkeling beter begrijpt is dit eigenlijk een
referentiepunt om nadien ook de abnormale ontwikkeling te begrijpen.
- Als we kijken naar het centraal zenuwstelsel dan zien we dat dit al heel vroeg in de ontwikkeling begint
te ontwikkelen. Dit is vanaf 3 weken na de bevruchting. Dit is zeer snel. Ook de ogen begin in een heel
vroeg stadium te ontwikkelen.
- Het zenuwstelsel is ook het langste in ontwikkeling en het blijft ook het langste kwetsbaar.
0 TOT 4-5 WEKEN
Embryo ontstaat uit platte schijf met drie lagen cellen
- Endoderm: interne organen (viscera)
- Mesoderm: skelet en spieren
- Ectoderm: zenuwstelsel en huid
Eerst neurale plaat
3
, - Uit elk van deze schijven gaan het uiteindelijk de organen, het skelet, die spieren en je zenuwstelsel en
huid ontwikkelen.
- Hier zie je dat de embryo met de 3 kiemlagen ontstaat.
- Geel = ectoderm
- Rood = mesoderm
- Blauw = endoderm
- Uit het endoderm worden de inwendige organen gevormd
- Uit het mesoderm worden het skelet en spieren gevormd
- Uit het ectoderm ontwikkelt het zenuwstelsel en de huid
- Video!! Zie leerpad: ontwikkeling van het CZS
- a.d.h.v. Video wordt er mooi geïllustreerd wat er juist gebeurt met die drie lagen. Die migreren
eigenlijk in een buis (neurale buis).
EMBRYO 24 DAGEN
- Een buis die craniaal (vanboven) niet gesloten is, dan
krijg je een kindje waarvan dat de hersenen niet
ontwikkelen.
- Als de neurale buis niet caudaal (onderaan) sluit, dan
krijg je een kind met spina bifida (= open rug)
4
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