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Samenvatting Intramurale zorg (IZ) hele blok - Hogeschool Utrecht - Leerjaar 2
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Samenvattingen hele blok Intramurale zorg (IZ)
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,InhoudsopgaveWeek 1 – CABG (en THP): ................................................................................................................................................... 4
Hoorcollege 1: Hartactiviteit ................................................................................................................................................. 4
Hoorcollege 2: Pathofysiologie hart ...................................................................................................................................... 9
Case based learning 1: Geplande operatieve zorg CABG ..................................................................................................... 17
Case based learning 2: Geplande operatieve zorg: CABG & THP ......................................................................................... 18
Werkcollege 1: medische diagnostiek.................................................................................................................................. 20
Werkcollege 2: BIBO & Risicostratificatie PPC ..................................................................................................................... 21
Werkcollege 3: Klinisch redeneren CABG ............................................................................................................................. 23
Vaardigheidstraining 1: 2elijns FT bij CABG ......................................................................................................................... 24
Vaardigheidstraining 2: Zorgmanagement aan bed ............................................................................................................ 25
Klinische casuïstiek 1: Gastcollege ziekenhuisfysiotherapie ................................................................................................ 26
Week 2 – CVA stroke-unit: ............................................................................................................................................... 28
Hoorcollege 3: Fysiotherapie na CVA vroege revalidatie ..................................................................................................... 28
Hoorcollege 4: Cortex .......................................................................................................................................................... 33
Hoorcollege 5: Samenstelling en dynamiek van bloed......................................................................................................... 40
Hoorcollege 6: Longpatiënt in beeld .................................................................................................................................... 44
Case based learning 3: Stroke-unit bedmobiliteit en transfers I .......................................................................................... 48
Werkcollege 4: Hygiëne & infectie gevaar ........................................................................................................................... 51
Werkcollege 5: EBP stroke-unit............................................................................................................................................ 53
Vaardigheidstraining 3: Bedmobiliteit ................................................................................................................................. 54
Week 3 – COPD longaanval: ............................................................................................................................................. 56
Hoorcollege 7: fysiotherapie na CVA – late revalidatie........................................................................................................ 56
Hoorcollege 8: Ernstige dyspnoe ......................................................................................................................................... 61
Hoorcollege 9: Dyspnoe en sputumretentie......................................................................................................................... 65
Hoorcollege 10: Klinische inspanningsfysiologie: Inspanningslimitaties & CPET ................................................................. 74
Case based learning 5: COPD longaanval ............................................................................................................................ 79
Case based learning 6: Revalidatie (trap)lopen en arm/handvaardigheid I ........................................................................ 80
Werkcollege 6: Herstelfasen na CVA ................................................................................................................................... 80
Vaardigheidstraining 5: Lopen en traplopen & Vaardigheidstraining 6: Arm/handvaardigheden en ADL .......................... 81
Vaardigheidstraining 7: Respiratoir – ademhaling/ dyspnoe/ sputumretentie ................................................................... 82
,Week 4 – CVA revalidatie: ................................................................................................................................................ 83
Hoorcollege 11: Cognitieve functies .................................................................................................................................... 83
Hoorcollege 12: Hartfalen & klepafwijkingen ...................................................................................................................... 90
Case based learning 8: Revalidatie (trap)lopen en arm/handvaardigheid II ....................................................................... 97
Werkcollege 8: De rapportage ............................................................................................................................................. 98
Werkcollege 9: Cognitieve stoornissen ................................................................................................................................ 99
Vaardigheidstraining 8: CVA groepstraining – conditie en kracht ..................................................................................... 106
Vaardigheidstraining 9: ‘Weer naar huis’ .......................................................................................................................... 109
Week 5: Oncologie in ziektegerichte zorg ....................................................................................................................... 110
Hoorcollege 13: Poliklinische hartrevalidatie..................................................................................................................... 110
Hoorcollege 14: Technologie in de revalidatie ................................................................................................................... 115
Case based learning 9: Fysiotherapie bij de oncologische patiënt tijdens en na medische behandeling ........................... 117
Case based learning 10: Oncologische revalidatie ............................................................................................................. 119
Werkcollege 10: Gevolgen medische behandelingen van oncologie ................................................................................. 120
Werkcollege 11: Ondervoeding, cachexie, sarcopenie en frailty ....................................................................................... 124
Vaardigheidstraining 10: Hartrevalidatie – Diagnostisch proces ...................................................................................... 128
Vaardigheidstraining 11: Hartrevalidatie – Behandeling .................................................................................................. 129
Vaardigheidstraining 12: Training van een oncologische patiënt tijdens en na medische behandelingen ........................ 131
Week 7: Dementie ......................................................................................................................................................... 133
Hoorcollege 15: Fysiotherapie bij mensen met dementie .................................................................................................. 133
Case based learning 11: Dementie I .................................................................................................................................. 141
Case based learning 12: Dementie II ................................................................................................................................. 142
Vaardigheidstraining 14: Beweegzorg dementie middenfase ........................................................................................... 142
Vaardigheidstraining 15: Dementie eindfase .................................................................................................................... 143
3
, Week 1 – CABG (en THP):
Hoorcollege 1: Hartactiviteit
Leerdoelen
• Je kunt het proces van prikkelvorming en -geleiding in het hart beschrijven en kan
verklaren hoe ectopische prikkels kunnen leiden tot problemen in het functioneren van het
hart.
• Je kunt beschrijven hoe een elektrocardiogram (ECG) tot stand komt, en het patroon van
het standaard-ECG verklaren.
• Je kunt de fasen van de hartcyclus beschrijven en het drukverloop in de verschillende
compartimenten van hart en uitstroomvaten tijdens de hartcyclus verklaren.
• 4 Je kunt beschrijven hoe de hartactie wordt geregeld.
• Je kunt het functioneren van de coronaire circulatie uitleggen
Bloedsomloop
• Uit welk compartiment van het hart komt de a. pulmonalis?
- Uit het rechterventrikel
• Vervoert deze O2 arm of O2 rijk bloed?
- O2 arm bloed
Fasen hartcyclus – hartkleppen
• Welke kleppen zijn open tijdens de ejectiefase?
- De halvemaanvormige kleppen (semulinaire kleppen) van de a. pulmonalis en de aorta.
Diastole en systole
Diastole:
Ventrikels ontspannen,
bloed stroomt naar binnen.
Systole:
Ventrikels trekken samen,
bloed wordt weggepompt.
Coronaire circulatie
Vanuit aorta:
• Linker coronairarterie
• Rechter coronairarterie
Via sinus coronarius, terug naar het rechter atrium.
Hartactiviteit
• HMV = slagvolume x hartfrequentie
- HMV in rust is 5 liter per minuut
- Bij dynamische inspanning toename tot 25 liter per minuut of meer.
(Onder invloed van sympathisch zenuwstelsel)
• Slagvolume in rust bijvoorbeeld 80 ml
Einddiastolisch volume 120 ml
80 :8. 120 = 67%
4
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