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Samenvatting physiotherapy in internal diseases
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Physiotherapy in internal diseasesMain topics:
- Oncological rehabilitation (Dra. T. Van Soom, dr. H. Verbelen & prof. E. Van Breda)
- The lymphatic system (prof. N. Gebruers):
o Anatomy of the vascular system, especially the lymphatic system
o Physiology of microcirculation, lymphatic transport; glycocalyx and Starling
Forces
o Pathology of the vascular system
o Basic assessment of patient with vascular pathology
o Relationschip between oncologic treatment and lymphatic problems (breast
cancer and pelvic surgery)
o Rehabilitation of oncological patients (broad and specific for breast cancer)
o Treatment of burns & scars (surgical scars)
o Clinical Cases
- Oedema treatment (dr. H. Verbelen & prof. N. Gebruers)
- Burns & scars treatment (dr. J. Meirte)
,Het lymfestelstel (N. Gebruers)
PHYSIOTHERAPHY IN INTERNAL DISEASES .............................................................................................. 1
Het lymfestelstel (N. Gebruers) ........................................................................................................... 2
Oppervlakkige aderen (= venen) van de bovenste en onderste extremiteit................................ 3
Veneus systeem: kenmerken ...................................................................................................... 3
Oppervlakkige aderen van de bovenste extremiteit ................................................................... 4
Oppervlakkige aderen van de onderste extremiteit ................................................................... 4
Anatomie van het lymfestelsel....................................................................................................... 6
Korte geschiedenis van de lymfevaten........................................................................................ 6
Embryologische ontwikkeling van het lymfestelsel .................................................................... 6
Verschillende lymfevaten (structuren) ........................................................................................ 8
Lymfecapillairen...................................................................................................................... 9
Lactealen ............................................................................................................................... 10
Lymfevaten: pre-collectoren en collectoren........................................................................ 11
Lymfeklier (= lymph node).................................................................................................... 11
Trunci lymphatica (lymph trunks) ........................................................................................ 12
Samenstelling van de lymfevloeistof ................................................................................... 12
Samenvloeiing van het lymfestelsel in de bloedsomloop ................................................... 13
Fysiologie van het lymfestelsel (van microcirculatie tot lymfatisch transport) ......................... 14
Basisprincipes en concepten ..................................................................................................... 14
Diffusie .................................................................................................................................. 14
Osmose.................................................................................................................................. 15
De interstitiële ruimte .......................................................................................................... 16
Basisinformatie: capillairen .................................................................................................. 17
Microcirculatie (vorming van interstitiële vloeistof) ................................................................. 18
Starling forces, die netofiltratie aandrijven............................................................................... 19
Van de evenwichtshypothese naar de herziene Starling-formule; belang van de Glycocalyx
geïncludeerd .............................................................................................................................. 19
Opname van interstitiële vloeistof door de initiële lymfevaten ............................................... 25
, Oppervlakkige aderen (= venen) van de bovenste en onderste extremiteit
Veneus systeem: kenmerken
- Functie, belang: bloed → hart
- Kleppen (waarom kleppen?, Overal?)
- 2 systemen:
→ Diep = onder fascia (generalis) = subfasciaal systeem (80%)
→ Oppervlakkig = boven fascia (generalis) = epifasciaal systeem (20%)
- Verschillende verbindingen tussen het diepe en oppervlakkige netwerk = perforerende
aders en / of communicerende aders
Slagaders (arteries): transport bloed
Veneus systeem: transport bloed terug naar het hart
- Groen= juist! = communicatie tussen 2 aders van hetzelfde systeem, bv 2 oppervlakkige
aders of 2 diepe aders.
- Geel= perforerende ader= tussen de diepe en de oppervlakkige ader
- Kleppen moeten bloed tegen de zwaartekracht in duwen
- Kleppen moeten bloed tegen de zwaartekracht in duwen
- We hebben beweging nodig, spiercontractie om bloed van distale delen van ons lichaam
naar het hart te verplaatsen
- Oppervlakkige aderen hebben een kleinere diameter dan de diepe aderen.
- De perforerende aderen zijn perfect om het bloed te omzeilen (bypassing), bloed uit de
oppervlakkige ader kan de diepe ader binnendringen. Andersom is niet mogelijk.
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