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Samenvatting Logopedie bij NAH
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Samenvatting van het vak Logopedie bij NAH, alle colleges, kennisclips en huiswerk samengevoegd
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SamevattingLogopedie bij niet aangeboren Hersenletsel
Inhoud
1. Niet aangeboren hersenletsel.....................................................................................................................................4
Pathologie van het zenuwstelsel.................................................................................................................................4
Gevolgen van NAH.......................................................................................................................................................4
NAH = complexe casuïstiek..........................................................................................................................................4
Beginsituatie cliënt......................................................................................................................................................4
Fase van revalidatie.....................................................................................................................................................4
ICF-niveaus..................................................................................................................................................................4
Samenwerking bij NAH................................................................................................................................................5
NAH en taal- en spraakstoornissen..............................................................................................................................5
2. SPRAAKAPRAXIE..........................................................................................................................................................5
Diagnostiek spraakapraxie...........................................................................................................................................5
Therapie...................................................................................................................................................................... 5
Verschillende therapiemogelijkheden.........................................................................................................................6
3. NEUROPSYCHOLOGISCHE FUNCTIESTOORNISSEN - NPFS...........................................................................................6
Stoornissen na hersenletsel.........................................................................................................................................6
Neglect........................................................................................................................................................................ 6
Hemianopsie................................................................................................................................................................6
Apraxie........................................................................................................................................................................ 7
Agnosie........................................................................................................................................................................7
Gedragsverandering na NAH.......................................................................................................................................7
Aanpak.........................................................................................................................................................................7
Levelt...........................................................................................................................................................................7
Ellis en young...............................................................................................................................................................7
Spraakproductiemodel (gebaseerd op Ellis en Young)................................................................................................9
Differentiaaldiagnose..................................................................................................................................................9
Spraakapraxie vs. Dysartrie.........................................................................................................................................9
Spraakapraxie vs. Fonologische stoornis.....................................................................................................................9
Diagnostiek; eenvoudig?!..........................................................................................................................................10
4. Hersenen................................................................................................................................................................... 11
5. NPFS en Logopedie ...................................................................................................................................................11
6. Neuromusculaire aandoeningen en degeneratieve aandoeningen...........................................................................11
Verschil...................................................................................................................................................................... 11
Oorzaak..................................................................................................................................................................... 12
Guillian-Barré............................................................................................................................................................12
, Myastenia gravis........................................................................................................................................................12
Welke spierziekten zijn er nog meer?........................................................................................................................12
7. Coma......................................................................................................................................................................... 12
Oorzaken coma..........................................................................................................................................................13
Glasgow Coma Scale..................................................................................................................................................13
Stadia bewustzijn.......................................................................................................................................................13
Verloop van coma......................................................................................................................................................14
8. Oncologie.................................................................................................................................................................. 14
Hersentumor.............................................................................................................................................................14
Primaire hersentumoren:..........................................................................................................................................15
Overig........................................................................................................................................................................ 15
Secundaire hersentumoren.......................................................................................................................................15
Hoofd-hals tumoren: kunnen ook weer allemaal primair of secundair zijn...............................................................15
Revalidatie na coma..................................................................................................................................................16
9. Laryngectomie en canules.........................................................................................................................................16
Totale laryngectomie.................................................................................................................................................16
Canule........................................................................................................................................................................ 17
Standaard canule.......................................................................................................................................................17
Canule met cuff.........................................................................................................................................................18
Gevensterde canule...................................................................................................................................................19
Spreekdopje..............................................................................................................................................................20
Filter/kunstneus........................................................................................................................................................20
Post IC-schaal............................................................................................................................................................20
Protocol: stappenplan van logopedist als je wil oefenen met eten, drinken, spreken..............................................20
Behandeling dysfagie bij een canule..........................................................................................................................21
Spraakrevalidatie bij een totale laryngectomie.........................................................................................................21
10. Normale veroudering..............................................................................................................................................21
Normale veroudering binnen het domein van logopedie..........................................................................................21
Dementie................................................................................................................................................................... 23
Vier fases................................................................................................................................................................... 23
Logopedische interventie..........................................................................................................................................23
Wat zou je als logopedist hiermee kunnen?..............................................................................................................24
Ziekte van Alzheimer.................................................................................................................................................24
Gedragsvariant FTD (fronto temporale dementie)....................................................................................................24
CBS symptomen.........................................................................................................................................................24
PSP symptomen (progressieve supranucleaire parese).............................................................................................24
Primair progressieve afasie (PPA)..............................................................................................................................25
Geschiedenis PPA......................................................................................................................................................25
Diagnose.................................................................................................................................................................... 25
, Histopathologie PPA..................................................................................................................................................25
Niet-vloeiende variant PPA........................................................................................................................................25
Semantische variant PPA...........................................................................................................................................26
Logopene variant PPA................................................................................................................................................26
Atrofie in de hersenen...............................................................................................................................................26
Overige symptomen in PPA.......................................................................................................................................26
ICF: welke onderdelen zou je behandelen?...............................................................................................................26
Behandeling PPA.......................................................................................................................................................26
Communicatieve therapie bij dementie....................................................................................................................27
11. vijfstappenplan afweergedrag slikken.....................................................................................................................29
12. Cognitieve communicatiestoornissen......................................................................................................................29
Links en rechts: anatomie..........................................................................................................................................29
.................................................................................................................................................................................. 29
Links en rechts: verschillen in verwerking(fysiologie/functie)...................................................................................30
Links en rechts: functionele verschillen.....................................................................................................................30
Stoornissen bij rechterhemisfeer letsel.....................................................................................................................30
Communicatiekenmerken.........................................................................................................................................31
Stoornissen lexico-semantiek:...................................................................................................................................31
Stoornissen macrostructuur......................................................................................................................................31
Stoornissen pragmatiek.............................................................................................................................................31
Stoornissen prosodie.................................................................................................................................................32
Bijkomende problemen.............................................................................................................................................32
Diagnostiek door logopedist......................................................................................................................................32
Prognose.................................................................................................................................................................... 32
13. Hoofd-halstumoren.................................................................................................................................................32
Speekselklierkanker...................................................................................................................................................32
Neus-keelholtekanker...............................................................................................................................................33
Hypopharynxkanker..................................................................................................................................................33
Tongkanker................................................................................................................................................................33
Mondkanker..............................................................................................................................................................35
Strottenhoofdkanker.................................................................................................................................................36
Huidkanker................................................................................................................................................................ 37
Neus(bij)holte en bovenkaakkanker..........................................................................................................................37
Kennisclip afasie............................................................................................................................................................37
Kennisclip Dysartrie.......................................................................................................................................................38
Kennisclip Dysfagie........................................................................................................................................................39
Kennisclip DIAS: diagnostisch instrument apraxie en spraak.........................................................................................40
Ziektebeelden................................................................................................................................................................40
, 1. Niet aangeboren hersenletsel
NAH = niet aangeboren hersenletsel
Pathologie van het zenuwstelsel
Pathologie = ziekteleer
Pathologie Centraal zenuwstelsel
Pathologie Perifere zenuwstelsel
CVA (en TIA)
o TIA is na 24 uur helemaal weg
Trauma
Infecties en ontstekingen
Tumor
Coma
Amnesie
Gevolgen van NAH
Zichtbare gevolgen (vaak lichamelijk)
o Bijv. parese, lopen, aangezicht is verslapt
Onzichtbare gevolgen (vaak mentaal)
o Voor deze mensen is het soms best confronterend hoe anderen hen benaderen. Ze zien
namelijk een 'gezond' mens voor ze.
Heeft veel invloed op persoon, eigen handelen en omgang met omgeving
Gevolgen dagelijks leven en naasten
Gevolgen participatie in maatschappij
Acceptatie van verlies (rouwverwerking)
NAH = complexe casuïstiek
Aandoening op meerdere niveaus ICF aanwezig (stoornis, participatie, activiteit etc.)
Meerdere stoornissen tegelijk
Meerdere disciplines betrokken
o Je doet het allemaal echt met elkaar, multidisciplinair team. Iets word wekelijks met elkaar
besproken en je sluit op elkaar aan.
Beginsituatie cliënt
Medische en logopedische (differentiaal) diagnose duidelijk hebben.
o Differentiaal diagnose: onderscheid maken in wat is wat.
Context/setting
Fase van revalidatie
Acute fase: overleven
Revalidatie fase: herstel
Chronische fase: blijvende beperkingen, met de stoornis kunnen omgaan
ICF-niveaus
Functieniveau; gericht op het herstel van de functie
Activiteitniveau: gericht op iemands handelen
Participatieniveau: gericht op iemands participatie in het dagelijks leven/interactie met de omgeving
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