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Samenvatting functionele anatomie & fysiologie 2

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Deze samenvatting omvat de volledige cursus van 'functionele anatomie 2'. (TIP: bestudeer van tevoren de structuren op KENHUB en leg je SESAM atlas naast de samenvatting tijdens het studeren :) ). Achteraan in de samenvatting is ook het onderdeel 'fysiologie' samengevat. Dit geeft een duidelijk ov...

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  • August 1, 2023
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  • 2022/2023
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AP hogeschool



Samenvatting
Functionele anatomie &
fysiologie 2




Laura Schellekens
Schooljaar 2022-2023

,INHOUDSOPGAVE

FUNCTIONELE ANATOMIE

BOVENSTE LEDEMATEN
1. De beenderen ............................................................................................................................................... 7
1.1. Clavicula ....................................................................................................................................................... 7
1.1.1 Oriëntatie ............................................................................................................................................... 7
1.1.2 Beschrijving ............................................................................................................................................ 7
1.2 Scapula .......................................................................................................................................................... 7
1.2.1 Algemene vorm en oriëntatie ................................................................................................................ 7
1.2.2 Beschrijving ............................................................................................................................................ 8
1.3. Humerus ....................................................................................................................................................... 8
1.3.1 Oriëntatie ............................................................................................................................................... 8
1.3.2 Beschrijving ............................................................................................................................................ 8
1.4. Ulna .............................................................................................................................................................. 9
1.4.1 Oriëntatie ............................................................................................................................................... 9
1.4.2 Beschrijving ............................................................................................................................................ 9
1.5. Radius of het spaakbeen ............................................................................................................................ 10
1.5.1 Oriëntatie ............................................................................................................................................. 10
1.5.2 Beschrijving .......................................................................................................................................... 10
1.6. Skelet van de hand ..................................................................................................................................... 10
1.6.1 Algemene beschrijving ......................................................................................................................... 11
1.6.2 Gedetailleerde beschrijving: carpus ..................................................................................................... 11
1.6.3 Gedetailleerde beschrijving: metacarpus ............................................................................................ 12
1.6.4 Gedetailleerde beschrijving: phalangen ............................................................................................... 13
2. De gewrichten ............................................................................................................................................ 14
2.1. Gewrichten van de bovenste gordel en lidmaat ........................................................................................ 14
2.1.1 De articulatio sternoclavicularis ........................................................................................................... 14
2.1.2 De articulatio acromio-clavicularis ....................................................................................................... 14
2.2. Articulatio humeri ...................................................................................................................................... 15
2.3. De globale schouder ................................................................................................................................... 16
2.4. Elleboog gewricht of articulatio cubiti ....................................................................................................... 17
2.4.1 Gewrichten ........................................................................................................................................... 17
2.4.2 Ligamenten........................................................................................................................................... 17
2.4.3 Bewegingen .......................................................................................................................................... 18
2.5. Pols en handgewrichten ............................................................................................................................. 19
2.5.1 Eerste niveau: articulationes manus proximalis................................................................................... 19

1

, 2.5.2 Tweede niveau: articulationes carpometacarpeae en metacarpeae ................................................... 20
2.5.3 Derde niveau: articulationes metacarpophalangeae ........................................................................... 21
2.5.4 Vierde niveau: articulationes interphalangeae .................................................................................... 21
3. De spieren .................................................................................................................................................. 22
3.1 Dorsale en ventrale thoracale spieren ........................................................................................................ 22
3.2 Craniothoracale spieren .............................................................................................................................. 22
3.3 Tuberculum minus en majus spieren .......................................................................................................... 23
3.3.1 Tuberculum minus spieren ................................................................................................................... 24
3.3.2 Tuberculum majus spieren ................................................................................................................... 24
3.4 M. brachiales ventrales of pectorale spieren .............................................................................................. 26
3.5 Fascia pectoralis .......................................................................................................................................... 27
3.5.1 Oppervlakkig blad................................................................................................................................. 27
3.5.2 Diep blad .............................................................................................................................................. 27
3.6 Spieren van de bovenarm: ventrale en dorsale groep ................................................................................ 27
3.6.1 Ventrale groep ..................................................................................................................................... 27
3.6.2 Dorsale groep ....................................................................................................................................... 28
3.7 Fascia van de bovenarm: membrana interossea ........................................................................................ 28
3.8 Buigers van de voorarm: de 3 lagen ............................................................................................................ 29
3.8.1 Diepe laag ............................................................................................................................................. 29
3.8.2 Middenlaag .......................................................................................................................................... 30
3.8.3 Oppervlakkige laag ............................................................................................................................... 30
3.9 Strekkers van de voorarm: oppervlakkige spieren - diepe spieren (met dorsale en radiaire ondergroep) 31
3.9.1 Diepe groep .......................................................................................................................................... 32
3.9.2 Oppervlakkige groepen ........................................................................................................................ 33
3.10 Fascia van elleboog, voorarm en pols, anatomische snuifdoos ................................................................ 35
3.10.1 Fascia cubitalis.................................................................................................................................... 35
3.10.2 Fascia antebrachii ............................................................................................................................... 35
3.10.3 Fascia carpi ......................................................................................................................................... 35
3.10.4 Anatomische snuifdoos ...................................................................................................................... 36
3.11 Spieren van de hand: loge van de palm, duim & pinkmuis ....................................................................... 36
3.11.1 Handpalmspieren ............................................................................................................................... 36
3.11.2 Spieren van de duimmuis (thenar) ..................................................................................................... 37
3.11.3 Spieren van de pinkmuis .................................................................................................................... 38
3.12 Fascien van de hand .................................................................................................................................. 39
3.12.1 Fascia palmaris superficialis ............................................................................................................... 39
3.12.2 Fascia palmaris profunda ................................................................................................................... 40
3.12.3 Septa intermuscularia ........................................................................................................................ 40

2

, 3.13 Fascien en peesscheden van voorarm, hand en vingers ........................................................................... 40
3.13.1 Peesscheden van voorarm en hand ................................................................................................... 40
3.13.2 Fascien en peesscheden van vingers .................................................................................................. 41
3.14 Addendum: rotatiebewegingen van de arm ............................................................................................. 41
3.14.1 Schoudergewricht .............................................................................................................................. 41
3.14.2 Ellebooggewricht en voorarm ............................................................................................................ 41
3.14.3 Pols en hand ....................................................................................................................................... 41
ONDERSTE LEDEMATEN
4. De beenderen ............................................................................................................................................. 42
4.1. Bekkenbeenderen: os coxa, ilium, ischium en pubis.................................................................................. 42
4.1.1 Beschrijving van oppervlakkige zijde .................................................................................................... 42
4.1.2 Beschrijving van de diepe zijde ............................................................................................................ 42
4.1.3 Beschrijving van de rand ...................................................................................................................... 43
4.2. Femur of dijbeen ........................................................................................................................................ 43
4.2.1 Oriëntatie ............................................................................................................................................. 43
4.2.2 Beschrijving .......................................................................................................................................... 43
4.3. Patella of knieschijf .................................................................................................................................... 44
4.4. Tibia of scheenbeen ................................................................................................................................... 44
4.4.1 Oriëntatie ............................................................................................................................................. 44
4.4.2 Beschrijving .......................................................................................................................................... 44
4.5. Fibula of kuitbeen ...................................................................................................................................... 45
4.5.1 Oriëntatie ............................................................................................................................................. 45
4.5.2 Beschrijving .......................................................................................................................................... 45
4.6. Talus of sprongbeen ................................................................................................................................... 46
4.6.1 Oriëntatie ............................................................................................................................................. 46
4.6.2 Beschrijving .......................................................................................................................................... 46
4.7 Calcaneus of hielbeen ................................................................................................................................. 47
4.8. Overige beenderen van de voet ................................................................................................................. 47
4.8.1 Os naviculare (pedis) ............................................................................................................................ 47
4.8.2 Ossa cuneïforme .................................................................................................................................. 47
4.8.3 Os cuboideum ...................................................................................................................................... 47
4.8.4 Ossa metatarsi...................................................................................................................................... 47
4.8.5 Phalangen ............................................................................................................................................. 48
5. De gewrichten ............................................................................................................................................ 48
5.1. Articulatio coxae of heupgewricht ............................................................................................................. 48
5.1.1 Gewrichtsvlakken ................................................................................................................................. 48
5.1.2 Ligamenten en banden......................................................................................................................... 48

3

, 5.1.3 Werking van het gewricht .................................................................................................................... 49
5.2. Articulatio genu of kniegewricht ................................................................................................................ 50
5.2.1 Gewrichtsvlakken ................................................................................................................................. 50
5.2.2 Kruisbanden en menisci ....................................................................................................................... 50
5.2.3 Ligamenten........................................................................................................................................... 51
5.2.4 Werking totale kniegewricht ................................................................................................................ 52
5.3. Junctura tibiofubularis ............................................................................................................................... 52
5.3.1 De articulatio tibiofibularis ................................................................................................................... 52
5.3.2 Membrana interossea cruris ................................................................................................................ 52
5.3.3 Syndesmosis tibiofibularis .................................................................................................................... 53
5.4. Enkel- en voetgewricht............................................................................................................................... 53
5.4.1 Articulatio talocruralis .......................................................................................................................... 53
5.4.2 Articulatio talotarsalis (subtalaris) ....................................................................................................... 54
5.4.3 Metatarso phalangeaal- en interphalangeaalgewrichten .................................................................... 55
6. De spieren .................................................................................................................................................. 56
6.1 Trochanter minor groep .............................................................................................................................. 56
6.1.1 M. psoas major ..................................................................................................................................... 56
6.1.2 M. iliacus .............................................................................................................................................. 56
6.2 Trochanter major groep, met de ondergroepen ......................................................................................... 57
6.2.1 Algemene groep ................................................................................................................................... 57
6.2.2 Voorste ondergroep ............................................................................................................................. 58
6.2.6 Achterste ondergroep .......................................................................................................................... 60
6.3 Extensoren van de knie en oppervlakkige spieren ...................................................................................... 60
6.3.1 Extensoren van de knie ........................................................................................................................ 60
6.3.2 Oppervlakkige spieren.......................................................................................................................... 61
6.4 Flexoren van de knie ................................................................................................................................... 62
6.4.1 Spieren van de hamstrings ................................................................................................................... 62
6.5 Fascia van heup en dij & tractus iliotibialis ................................................................................................. 63
6.5.1 Fascia lata of fascia van het bovenbeen ............................................................................................... 63
6.5.2 Tractus iliotibialis ................................................................................................................................. 63
6.6 Loges van het onderbeen ............................................................................................................................ 63
6.7 Spieren van de voorste, laterale, oppervlakkige en diepe achterste loge .................................................. 64
6.7.1 Spieren van de voorste loge ................................................................................................................. 64
6.7.2 Spieren van de laterale loge ................................................................................................................. 65
6.7.3 Spieren van de diepe achterste loge (Tom, Dick & Harry) ................................................................... 66
6.7.4 Spieren van de oppervlakkige achterste loge ...................................................................................... 67
6.8 Ligamenten van de enkel ............................................................................................................................ 68

4

, 6.8.1 Fascia cruris .......................................................................................................................................... 68
6.8.2 Ligamenten van de enkel ..................................................................................................................... 68
6.9 Korte voetspieren, dorsaal en plantair ........................................................................................................ 69
6.9.1 Dorsale voetspieren ............................................................................................................................. 69
6.9.2 Plantaire voetspieren ........................................................................................................................... 70
6.9.3 Spieren voor de grote teen .................................................................................................................. 70
6.9.4 Spieren voor de kleine teen ................................................................................................................. 71
6.10 Peesscheden van enkel en voet ................................................................................................................ 72
6.10.1 Dorsaal ............................................................................................................................................... 72
6.10.2 Plantair ............................................................................................................................................... 72
6.10.3 Fibulair................................................................................................................................................ 72
6.10.4 Tibiaal ................................................................................................................................................. 72
6.11 Fascien van de voet ................................................................................................................................... 72
6.11.1 Fascia dorsalis pedis ........................................................................................................................... 72
6.11.2 Fascia plantaris ................................................................................................................................... 73
6.12 Het voetgewelf .......................................................................................................................................... 73

FYSIOLOGIE

5. Fysiologie van de voortbeweging ............................................................................................................... 74
5.1 Inleiding ....................................................................................................................................................... 74
5.2 Soorten bewegingen ................................................................................................................................... 74
5.3 Skeletspierweefsel ...................................................................................................................................... 74
5.3.1 Soorten spierweefsel............................................................................................................................ 74
5.3.2 Structuur van het skeletspierweefsel ................................................................................................... 75
5.3.3 Contractiemechanisme ........................................................................................................................ 76
5.3.4 Klinische voorbeelden .......................................................................................................................... 78
5.4 Hartspierweefsel ......................................................................................................................................... 79
5.4.1 Structuur .............................................................................................................................................. 79
5.4.2 Contractie ............................................................................................................................................. 79
5.4.3 Klinische voorbeelden .......................................................................................................................... 80
5.5 Glad spierweefsel ........................................................................................................................................ 81
5.5.1 Voorkomen & functie ........................................................................................................................... 81
5.5.2 Structuur .............................................................................................................................................. 81
5.5.3 Contractie ............................................................................................................................................. 81
6. Fysiologie van het bloed – de bloedsomloop .............................................................................................. 82
6.1 Algemene functies ....................................................................................................................................... 82
6.1.1 Transport .............................................................................................................................................. 82


5

, 6.1.2 Bescherming en afweer ........................................................................................................................ 82
6.2 Samenstelling van het bloed ....................................................................................................................... 82
6.2.1 Volume ................................................................................................................................................. 82
6.2.2 Vaste bloedbestanddelen .................................................................................................................... 82
6.2.3 Plasma .................................................................................................................................................. 82
6.3 Bloedcellen .................................................................................................................................................. 83
6.3.1 Rode bloedcellen .................................................................................................................................. 83
6.3.2 Witte bloedcellen ................................................................................................................................. 85
6.4 Bloedplaatjes ............................................................................................................................................... 87
6.5 Bloedsomloop ............................................................................................................................................. 87
6.5.1 Delen van de bloedsomloop ................................................................................................................ 87
6.5.2 Eigenschappen ..................................................................................................................................... 88
6.6 Bouw van het hart ....................................................................................................................................... 88
6.6.1 Hartafdelingen ..................................................................................................................................... 88
6.6.2 Bloedvaten ........................................................................................................................................... 88
6.6.3 Hartwand: 3 lagen ................................................................................................................................ 88
6.6.4 Hartkleppen.......................................................................................................................................... 89
6.6.5 Prikkelgeleiding .................................................................................................................................... 89
6.7 Hartcontractie ............................................................................................................................................. 89
6.7.1 Hartspierweefsel .................................................................................................................................. 89
6.7.2 Hartcyclus ............................................................................................................................................. 89
6.7.3 Verloop van de hartcyclus .................................................................................................................... 90
6.7.4 ECG: elektrocardiogram ....................................................................................................................... 91
6.8 Bloeddruk .................................................................................................................................................... 92
6.9 Weg die het bloed volgt .............................................................................................................................. 92




6

,FUNCTIONELE ANATOMIE 2
HET BEWEGINGSSTELSEL VAN BOVENSTE GORDEL EN LIDMAAT
1. DE BEENDEREN

1.1. CLAVICULA


1.1.1 ORIËNTATIE
• Oppervlakkige ligging:
o Mediale uiteinde: massief, mediaal gericht vlak
o Laterale uiteinde: afgeplat
o Bovenzijde: vlak
o Onderzijde: onregelmatigheden
o Voorrand: convex mediaal en concaaf lateraal
o Achterrand: concaaf mediaal en convex lateraal


1.1.2 BESCHRIJVING
• Extremitas sternalis vertoont facies articularis
o Meest massieve deel van het been
o Errond ruwheden voor ligamenten
• Extremitas acromialis (lateraal)
o Bovenvlak: plat
o Ondervlak: ruw
o Facies articularis acromialis tussen onderzijde en laterale rand
• Sulcus mi subclavii: in midden van onderzijde van het bot
o Lateraal ervan: tuberculum conoideum en linea trapezoidea
o Mediaal ervan: impressie voor ligamentum costo-clavicularis
• Bovenzijde
o Vlak en onder huid gelegen
o Sulcus mi subclavii aan onderzijde van middenstuk
• Voorrand
o Ruw door spierinserties
• Achterrand
o Ruw door insertie van m. trapezius

1.2 SCAPULA


1.2.1 ALGEMENE VORM EN ORIËNTATIE
• Driehoekig, plat been met 2 opvallende uitsteeksels
• Hoek met grote gewrichtsvlak ziet naar lateraal
• Grote kam met processus ligt dorsaal
• Processus bij articulaire hoek zit vast op bovenrand




7

,1.2.2 BESCHRIJVING
• 2 zijden, 3 hoeken en 3 randen
• Zijden
o Zijde 1: op facies dorsalis ligt spina scapulae
▪ Beenderige kam die doorloopt als het acromion
▪ Verdeeld de achterzijde van scapula in:
• Fossa supraspinata
• Fossa infraspinata
▪ Acromion:
• Brede, horizontale beenplaat: lateraal en naar voor
• Facies articularis acromii ligt mediaal en voor en tegen de clavicula
• Achterrand verbreed tot trigonum spinale scapulae
o Zijde 2: facies costalis
▪ Concaaf, naar voor, mediaal gerichte zijde
▪ Margo superior: bovenrand
▪ Incisura scapulae: ligt lateraal en wordt overbrugd door ligamentum transversum
scapulae
▪ Processus coracoideus = ravenbekuitsteeksel
• Lateraal en voor
• Palpabel
• Hoeken volgen grotendeels oriëntatie
o Angulus superior: gevormd door margo medialis en margo superior
o Angulus inferior: gevormd door margo lateralis en margo medialis
o Angulus lateralis: gevormd door margo superior en margo lateralis
• Randen volgen ook oriëntatie
o Margo medialis: verticaal opstaande rand
o Margo lateralis: lateraal en naar onder gericht, naar axilla
• Cavitas glenoidalis is ovaal en licht concaaf
o Onder: tubercula infraglenoidalis
o Boven: tubercula supraglenoidalis

1.3. HUMERUS

1.3.1 ORIËNTATIE
• Proximaal: bolvormige epifyse
• Mediaal: gewrichtsoppervlakte van epifyse
• Dorsaal: grote driehoekige put in distale epifyse


1.3.2 BESCHRIJVING
• Proximale epifyse = caput humeri: naar proximaal, mediaal en dorsaal gewend
o Collum anatomicum: rond articulaire deel: begrenst gewrichtsoppervlak
o Tuberculum maius: 3 facetten in verband met insertiepezen
▪ Naar proximaal, dorsaal en tussen beiden
o Tuberculum minus: ventraal met 1 facet
→ Beide naar onder verlengd door ruwe crista tuberculi
o Sulcus intertubercularis: gevormd door crista tuberculi minoris en maioris
o Collum chirurgicum: vernauwing van humerus distaal van tubercula
▪ Meeste fracturen treden hier op

8

, o Diafyse: corpus humeri is driehoekig waardoor 3 margines ontstaan (anterior, lateralis,
medialis)
▪ Begrenzen 3 facies:
• Facies antero-radialis: vertoont tuberositas deltoidea (ruwheid)
• Facies antero-ulnaris: vertoont tubersitas coracobrachialis (aanhechting)
• Facies posterior: vertoont sulcus nervi radialis waarin n. radialis loopt
• Distale epifyse = condylus humeri: 2 gewrichtsvlakken:
o Bevatten fossae en 2 epicondyli: mediaal en lateraal
o Zadelvormige trochlea en bolvormig caput humeri
▪ Trochlea humeri: onderdeel van schroef waarvan groeve loopt over de cirkel
▪ Capitulum humeri: radiaal en deel van sfeeroppervlak
o Door sulcus gescheiden
o Erboven: 2 ventrale fossae:
▪ Fossa coronoidea: boven trochlea humeri
▪ Fossa radialis: boven capitulum
o Erachter: dorsaal van trochlea
▪ Fossa olecrani
o 2 onderhuidse epicondyli:
▪ Mediale tegen trochlea
▪ Laterale reikt meer distaal dan de ulnaire
→ aanhechtingsplaatsen kunnen ontsteken: tenniselleboog (radiair) en golfelleboog (ulnair)

1.4. ULNA


1.4.1 ORIËNTATIE
• Dikste epifyse ligt proximaal en gewrichtsoppervlak is volair georiënteerd
• Margo interosseus ligt radiair


1.4.2 BESCHRIJVING
• 3 margines:
o Margo anterior: enkel distaal duidelijk
o Margo posterior: grens tussen subcutane deel van ulna en deel waar spieren op vasthechten
o Margo interosseus: duidelijk en scherp, proximaal ruwer
• 3 facies:
o Facies anterior: vlak en licht uitgehold, proximaal tuberositas ulnae
o Facies: posterior: minder glad, door oorsprong van spieren
o Facies medialis: rond, glad, subcutaan
▪ Proximaal bindt zich de crista supinatoria (aftakking van margo interosseus)
• Proximale epifyse:
o Bevat 2 processi
▪ Processus coronoideus: volair gericht
▪ Processus olecrani: proximaal gericht
• Past in fossa olecrani van humerus
• Punt is volair gericht
o Twee incisurae aan proximale einde:
▪ Incisura trochlearis: halfcirkelvormige articulaire oppervlakte gevormd door 2
vlakken en een kam die past in groeve in trochlea humeri
▪ Incisura radialis: concave gewrichtsoppervlakte langs radiale kant

9

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