Summary

Samenvatting hoorcolleges van vasculaire pathologie

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Course
Vasculaire Pathologie

Institution
Vrije Universiteit Brussel (VUB)

Deze samenvatting bevat 15 hoofdstukken/ onderdelen van de lessen van vasculaire pathologie. Dit is een samenvatting met de PTT's en eigen notities van de lessen.

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Uploaded on June 6, 2023
Number of pages 136
Written in 2022/2023
Type Summary

vasculaire pathologie hoc
hoorcolleges
samenvatting vasculaire pathologie

Institution
Vrije Universiteit Brussel (VUB)
Education
Revalidatiewetenschappen En Kinesitherapie
Course
Vasculaire Pathologie

KinesitherapieSamenvattingen

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VASCULAIRE PATHOLOGIE 2023
INHOUDSTAFEL
INLEIDING ................................................................................................................................................ 8
1) Wat is homeostase ? ................................................................................................................... 8
2) Twee systemen ........................................................................................................................... 8
1. Het arteriële systeem .............................................................................................................. 9
2. Het veneuze systeem .............................................................................................................. 9
HOOFDSTUK 1 : Arteriële vaatlijden ..................................................................................................... 10
1) Semiologie v/h arteriële stelsel ................................................................................................ 10
1. Anamnese ............................................................................................................................. 11
2. Klinisch onderzoek ................................................................................................................ 11
3. Pathofysiologie van artherosclerose..................................................................................... 12
4. Cardiovasculaire risicofactoren van atherosclerose ............................................................. 12
2) Stenoserend /occlusief arteriële ziekte .................................................................................... 12
1. Chronische arteriële insufficiëntie v/d OL ............................................................................ 12
2. Arteriële insufficiëntie v/d supra- aortische vaten ............................................................... 15
3. Arteriële insufficiëntie viscerale vaten ................................................................................. 17
4. Renale bloedvaten ................................................................................................................ 17
5. Acute ischemie van de onderste ledematen ........................................................................ 17
3) Dilaterende arteriële ziekte of aneurysmatisch lijden .............................................................. 20
1. Etiologie ................................................................................................................................ 20
2. Aneurysma aorta abdominalis (AAA) .................................................................................... 21
HOOFDSTUK 2 : symptomatisch perifeer arterieel vaatlijden (PAV) .................................................... 24
1) INLEIDING .................................................................................................................................. 24
2) GEZONDHEIDSPROBLEEM PAV ................................................................................................. 24
3) ANAMNESE................................................................................................................................ 26
4) Onderzoek ................................................................................................................................. 27
1. Functieonderzoek ................................................................................................................. 27
2. Differentiaaldiagnose ............................................................................................................ 30
3. Comorbiditeit ........................................................................................................................ 30
5) Behandeldoelen ........................................................................................................................ 30
6) Behandelplan ............................................................................................................................ 30
1. Voorlichting ........................................................................................................................... 31
2. Verminderen v/d objectieve en subjectieve afname v/h inspanningsvermogen ................. 32

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, 3. Verbeteren v/h looppatroon................................................................................................. 33
4. Optimaliseren van activiteiten en participatie ..................................................................... 33
5. Ondersteuning van cardiovasculair risicomanagement ....................................................... 33
6. Activeringsprogramma.......................................................................................................... 33
7. Eindevaluatie......................................................................................................................... 33
HOOFDSTUK 3 : ANATOMIE SCHEMA’S ................................................................................................ 34
1) Anatomie oppervlakkige lymfevaten bovenste lidmaat ........................................................... 34
2) Anatomie lymfeknopen v/d oksel & sleutelbeen ..................................................................... 34
3) Anatomie oppervlakkige lymfevaten borstklier........................................................................ 35
4) Drainage arm & romp ............................................................................................................... 35
5) Anatomie oppervlakkige lymfevaten v/d onderste ledematen ................................................ 35
HOOFDSTUK 4 : HET LYMFESTELSEL ..................................................................................................... 36
1) Inleiding..................................................................................................................................... 36
1. Het lymfestelsel .................................................................................................................... 36
2. Lymfatische capillairen = de kleinste lymfevaten ................................................................. 36
3. (Pre)collectoren .................................................................................................................... 37
4. Lymfatische trunken ............................................................................................................. 37
5. Lymfeklieren.......................................................................................................................... 38
6. Het lymfesysteem ................................................................................................................. 38
2) Het interstitium ......................................................................................................................... 39
1. Actieve weefselmassa(ATM)/ extracellulaire masse(ECM) .................................................. 39
2. Proteïnen en mineralen ........................................................................................................ 39
3. Interstitium bevat ................................................................................................................. 39
4. Structuur interstitium ........................................................................................................... 39
5. Fysiologie .............................................................................................................................. 42
3) Oedeem..................................................................................................................................... 44
1. Inleiding................................................................................................................................. 44
2. Intracellulaire oedemen door : ............................................................................................. 44
3. Extra cellulaire oedeem ........................................................................................................ 44
HOOFDSTUK 5 :Behandeling oedeem via complex physical therapy ................................................... 49
1) Inleiding..................................................................................................................................... 49
2) Huidverzorging is super belangrijk ............................................................................................ 49
3) Manuele lymfedrainage ............................................................................................................ 49
1. Vodder methode ................................................................................................................... 50
2. Casley-smith methode .......................................................................................................... 50
3. Földi methode ....................................................................................................................... 50

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, 4. Leduc methode (VUB-ULB) ................................................................................................... 50
5. Technieken ............................................................................................................................ 51
4) compressie therapie ................................................................................................................. 54
1. Intermitterende pneumatische compressie ......................................................................... 54
2. Compressie therapie (in)elastische meerlagige benadering ................................................ 54
5) Lymfetaping via kinesiotape ..................................................................................................... 55
6) Gezonde levenstijl ..................................................................................................................... 55
7) Oefeningen, beweging en elevatie ........................................................................................... 55
8) CONSENSUS : Behandeling........................................................................................................ 56
HOOFDSTUK 6 : Belgische wetgeving behandeling van (lymf)oedeem ................................................ 57
1) Nomenclatuur ........................................................................................................................... 57
HOOFDSTUK 7 : Zin & Onzin MLD : Evidence based practice ............................................................... 60
1) Diagnostiek................................................................................................................................ 60
2) Back to basics ............................................................................................................................ 60
1. Starling evenwicht : krachten – proteïnen............................................................................ 60
2. Vulling en lediging ................................................................................................................. 61
3. Samentrekkingen en stroming .............................................................................................. 61
4. Bijkomende routes ................................................................................................................ 61
5. Autonoom zenuwstelsel ....................................................................................................... 62
3) Beyond the basics ..................................................................................................................... 62
4) Nieuwe opportuniteiten ........................................................................................................... 62
1. Rol van de patiënt i/d lymfoedeemzorg ............................................................................... 62
2. Tonometrie ........................................................................................................................... 62
3. Internationaal : state of the art = consensusdocument ISL .................................................. 63
4. Microchirurgie verwijzing voor lymfeoedeem ...................................................................... 63
HOOFDSTUK 8 : ISL CONSENSUS DOCUMENT-diagnose & behandeling .............................................. 64
1) Algemene overwegingen .......................................................................................................... 64
1. Definitie & pathophysiologie ................................................................................................ 64
2. Differentiaaldiagnose/ complicaties ..................................................................................... 64
3. Preventie / vroege identificatie en behandeling .................................................................. 64
2) Classificatie van lymfeoedeem ................................................................................................. 65
3) Diagnose.................................................................................................................................... 65
4) Behandeling .............................................................................................................................. 66
1. Niet-operatief behandeling................................................................................................... 66
2. Operatieve behandeling ....................................................................................................... 67
3. Evaluatie behandeling & follow up ....................................................................................... 67

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, 4. Moleculaire therapie............................................................................................................. 67
5) Onderzoeksagenda voor verder onderzoek & conclusie ......................................................... 68
HOOFDSTUK 9 : LYMFECHIRURGIE ....................................................................................................... 69
1) Inleiding..................................................................................................................................... 69
2) Reductie chirurgie ..................................................................................................................... 69
1. Debulking .............................................................................................................................. 69
2. Lymfoliposuctie ..................................................................................................................... 70
3) Lymfevat reconstructie ............................................................................................................. 70
1. Indicaties ............................................................................................................................... 70
2. Autologe lymfevat transplantatie ......................................................................................... 71
3. Autologe lymfeklier transplantatie ....................................................................................... 71
4. Lymfeknoop veneuze anastomose ....................................................................................... 72
5. Lymfoveneuze anastomose .................................................................................................. 72
6. Percutane lymfografie en embolisatie .................................................................................. 73
4) Ductus thoracicus...................................................................................................................... 73
1. Beeldborming van de ductus thoracicus............................................................................... 73
2. Toegang tot de ductus thoracicus......................................................................................... 73
3. Thoracicus ductus interventies ............................................................................................. 74
4. pulmonary lympharic perfusion syndrome........................................................................... 74
5) WAT IS ER NIEUW ..................................................................................................................... 74
HOOFDSTUK 10: LIPOEDEEM ................................................................................................................ 75
1) Inleiding..................................................................................................................................... 75
2) Klinische revalidatie .................................................................................................................. 75
3) Klinische presentatie ................................................................................................................. 75
4) Verloop lipoedeem ................................................................................................................... 76
5) Epidemiologie ........................................................................................................................... 76
6) Pathofysiologie.......................................................................................................................... 76
1. Genetica ................................................................................................................................ 76
2. Hormonaal ............................................................................................................................ 76
3. Histologie .............................................................................................................................. 77
7) Lipolymfoedeem ....................................................................................................................... 77
8) Diagnose.................................................................................................................................... 77
1. Anamnese ............................................................................................................................. 77
2. Inspectie ................................................................................................................................ 77
3. Palpatie ................................................................................................................................. 78
4. Klinisch onderzoek ................................................................................................................ 78

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