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Samenvatting colleges pathologie CNA leerjaar 2
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Bevat een samenvatting van de colleges pathologie CNA van leerjaar 2 van de opleiding fysiotherapie.
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Neurologie- CNA: pathologie:Kwartiel 2 leerjaar 2 fysiotherapie Saxion Enschede samenvatting kennistoets neurologie
CNA: pathologie.
Literatuur:
Van der Burgt, Fysiologie Leerboek voor paramedische opleidingen, 8edruk:
Pathophysiology for the Health Proffesions Gould e.a 6e druk
Inhoud
CVA deel 1- infarcten:.............................................................................................................................2
College:...............................................................................................................................................2
CVA 2 – intracraniële bloedingen:..........................................................................................................4
College:...............................................................................................................................................4
Abnormale tonus:...................................................................................................................................6
College:...............................................................................................................................................6
Parkinson:...............................................................................................................................................8
College:...............................................................................................................................................8
Dwarslaesie:...........................................................................................................................................9
College:...............................................................................................................................................9
Multiple sclerose:.................................................................................................................................11
College:.............................................................................................................................................11
Neurale plasticiteit hersteltheorieën:...................................................................................................12
College:.............................................................................................................................................12
DCD in de FT praktijk:...........................................................................................................................13
College:.............................................................................................................................................13
Pathologie CP:......................................................................................................................................17
College:.............................................................................................................................................17
, CVA deel 1- infarcten:
College:
Cerebro vasculair accident:
Hersencellen kunnen maar kortdurend overleven zonder zuurstof of glucose.
Acute vermindering van bloedtoevoer zorgt ervoor dat verzorgingsgebied van het
getroffen bloedvat zonder zuurstof komt te zitten. Deel cellen sterven af, en deel
cellen overleven het, raken beschadigd en schakelen functie (tijdelijk) uit.
(penumbra)
Hierdoor acuut neurologische uitval.
CVA= beroerte
o iCVA= bloedprop infarct
corticaal infarct
subcorticaal infarct
lacunair infarct
waterscheidingsinfarct
o hCVA= bloeding
lobaire bloeding
hemorragische transformatie van infarct
subarachnoïdale bloeding (sab)
Oorzaken + risicofactoren: infarct
o Artherosclerose:
Hypertensie
Roken
Diabetes mellitus
Overgewicht
Weinig lichaamsbeweging
o Caridaal:
Boezemfibrilleren
Recent myocardinfarct
Therapie op stroke-unit:
1. Trombolyse
o <4,5 uur
o Contra-indicaties
o 10-15%
2. Onderzoek causale factoren
3. Optimale omstandigheden
o Bloeddruk
o Glucose
o Vochthuishouding
o Temperatuur
Preventie complicaties:
o Verslikpneumonie
o Infectie
o Decubitus
o Gewichtsproblemen, contracturen
o Drukneuropathie
o DVT, longembolie
o Schouder-handsyndroom
Medische therapieën:
o Decompressie
o Carotisdesobstructie
o Medicatie gericht op recidief
, o Leefstijl adviezen
Beloop:
o Shockfase
o Meeste herstel 6 weken
o Eindtoestand 2 jaar
o EPOS studie, voorspellers MI, TCT, dorsaalflexie hand
o Achteruitgang in latere fase? Conditie, toename spasticiteit, recidief?
Latere complicaties:
o Epilepsie
o Contracturen
o Schouder-hand syndroom
Infarct ACM – algemeen:
Hemiparese (gelaat, arm > been)
Aanvankelijk hypotoon later hypertoon
Hemihypesthesie (gnostisch > vitaal)
Stereoagnosie gestoord
Hemianopsie
Dwangstand hoofd ogen
Dysarthrie (mondhoekparese)
o Infarct ACM – links vs. rechts:
Taaldominante hemisfeer:
o Fatische stoornissen
o Ideomotorische, ideatoire apraxie
Niet-taaldominante hemisfeer:
o Agnosie
o Neglect
o Kledingapraxie, constructieve apraxie
o Ruimtelijke stoornissen
Infarct ACA:
Parese been
Onhandigheid arm
Cognitieve (frontale) problemen
Infarct ACP:
Hemianopsie
o Problemen gezichtsherkenning
o Visuele hallucinaties
Geheugen- gedragsstoornissen
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