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Samenvatting propedeutica
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Complete samenvatting propedeutica gebaseerd op uitgetypte lessen.
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Samenvatting propedeuticaInhoudsopgave
Algemene inleiding .......................................................................................................................................... 6
Methoden en instrumenten................................................................................................................................. 6
Methoden ....................................................................................................................................................... 6
Instrumenten .................................................................................................................................................. 6
Klinisch onderzoek ............................................................................................................................................... 7
Het bloed ......................................................................................................................................................... 8
Bloedstaalname .................................................................................................................................................. 8
Indicatie, voorbereiding en dierfixatie ............................................................................................................ 8
Bloednametechniek ........................................................................................................................................ 8
Recipiënten ..................................................................................................................................................... 8
Bewaring ......................................................................................................................................................... 8
Pre-analytische fouten!! ................................................................................................................................. 9
Macroscopische beoordeling............................................................................................................................... 9
Analyse van het staal .......................................................................................................................................... 9
Bewaring en transport .................................................................................................................................... 9
Wie doet de analyse ........................................................................................................................................ 9
Wat is normaal? Wat is afwijkend? ................................................................................................................. 9
Analytische fouten .......................................................................................................................................... 9
Hematologie ........................................................................................................................................................ 9
Rode bloedcellen ........................................................................................................................................... 10
Witte bloedcellen .......................................................................................................................................... 11
Bloedplaatjes, thrombocyten ........................................................................................................................ 12
Biochemie .......................................................................................................................................................... 13
Totaal serumeiwit ............................................................................................................................................. 13
Albumine ....................................................................................................................................................... 13
Alfa globulines ............................................................................................................................................... 13
Beta globulines .............................................................................................................................................. 13
Gamma globulines ........................................................................................................................................ 13
Bilirubine (lever) ............................................................................................................................................ 14
Galzuren ........................................................................................................................................................ 14
Ammoniak (lever) .......................................................................................................................................... 14
Ureum en creatinine (nier) ............................................................................................................................ 14
Glucose (energiemerker)............................................................................................................................... 14
NEFA, vrije vetzuren ...................................................................................................................................... 14
Ketonen ......................................................................................................................................................... 14
Lactaat ........................................................................................................................................................... 15
Enzymes ........................................................................................................................................................ 15
Ionen ............................................................................................................................................................. 15
Sporenelementen.......................................................................................................................................... 16
Bloedgasanalyse................................................................................................................................................ 16
Bijkomend onderzoek ........................................................................................................................................ 16
Postanalytische fouten ...................................................................................................................................... 16
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,Het circulatiestelsel ........................................................................................................................................ 17
Anamnese en algemene indruk ......................................................................................................................... 17
Hartinsufficiëntie ............................................................................................................................................... 17
Dyspnee en (snelle) vermoeidheid................................................................................................................ 17
Hoesten ......................................................................................................................................................... 17
Oedeem ......................................................................................................................................................... 17
(Pre)syncope ................................................................................................................................................. 17
Specifiek klinisch onderzoek .............................................................................................................................. 17
Het arterieel systeem: de pols ...................................................................................................................... 17
Het capillair systeem: de slijmvliezen (mucosae) .......................................................................................... 19
Het veneuze systeem .................................................................................................................................... 19
Het hart ......................................................................................................................................................... 19
Bijkomend onderzoek ........................................................................................................................................ 23
Medische beeldvorming ................................................................................................................................ 23
Bloedonderzoek ............................................................................................................................................ 23
ECG ................................................................................................................................................................ 23
De nier ........................................................................................................................................................... 25
Herhaling van de fysiologie van de nier en de urinelozing ................................................................................ 25
Werking van de nier ...................................................................................................................................... 25
Urineopslag en losing (mictio) ...................................................................................................................... 25
Signalement van een nierpatiënt ...................................................................................................................... 26
Anamnese en algemene indruk ......................................................................................................................... 26
Waar ligt het probleem: pre-renaal, renaal of postrenaal? .......................................................................... 26
Wat heeft de eigenaar gezien? ..................................................................................................................... 26
Is het een primair probleem of is het secundair aan een andere aandoening ............................................. 27
Klinisch onderzoek ............................................................................................................................................. 27
Algemene symptomen die wijzen op een nierprobleem .............................................................................. 27
Onderzoek van de nieren .............................................................................................................................. 27
Onderzoek van de ureters ............................................................................................................................. 27
Onderzoek van de blaas en de urethra ......................................................................................................... 28
Onderzoek van de penis en vulva ................................................................................................................. 28
Verzamelen van urine ................................................................................................................................... 28
Het specifieke onderzoek................................................................................................................................... 29
Aanwijzingen uit het bloedonderzoek .......................................................................................................... 29
Urine onderzoek ............................................................................................................................................ 30
Testen om de nierfunctie in te schatten. ........................................................................................................... 32
Beeldvorming en endoscopie ........................................................................................................................ 32
Het spijsverteringsstelsel ............................................................................................................................... 33
Signalement ...................................................................................................................................................... 33
Anamnese en algemene indruk ......................................................................................................................... 33
Wat heeft de eigenaar gezien? ..................................................................................................................... 33
Bijkomende vragen ....................................................................................................................................... 34
Klinisch onderzoek ............................................................................................................................................. 34
Uitwendig onderzoek van de kop ................................................................................................................. 34
Mondholte .................................................................................................................................................... 34
Slokdarm ....................................................................................................................................................... 35
Abdomen: Maagdarmstelsel ......................................................................................................................... 35
Lever .............................................................................................................................................................. 38
Milt ................................................................................................................................................................ 38
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, Rectum, anus en omgeving ........................................................................................................................... 39
Specifiek onderzoek ........................................................................................................................................... 39
Buikpunctie ................................................................................................................................................... 39
Pensvocht ...................................................................................................................................................... 39
Echografie ..................................................................................................................................................... 40
Biopsie lever ...................................................................................................................................................... 40
Stomatologie .................................................................................................................................................. 41
Onderzoek van de mondholte bij hond en kat................................................................................................... 41
De tand .......................................................................................................................................................... 41
Het gebit van de hond ................................................................................................................................... 41
Het gebit van de kat ...................................................................................................................................... 42
Anamnese ..................................................................................................................................................... 42
Wakker onderzoek ........................................................................................................................................ 43
Verder onderzoek? ........................................................................................................................................ 44
Onderzoek van het paardengebit ...................................................................................................................... 45
Hypsodont gebit ............................................................................................................................................ 45
Diphydont gebit............................................................................................................................................. 45
Leeftijd schatten............................................................................................................................................ 45
Anisognathie ................................................................................................................................................. 45
De bouwstenen van een paardentand .......................................................................................................... 45
Het mondonderzoek ..................................................................................................................................... 46
Het ademhalingsstelsel .................................................................................................................................. 47
Anamnese en algemene indruk ......................................................................................................................... 47
Neusvloei....................................................................................................................................................... 47
Stridor ........................................................................................................................................................... 47
Niezen en ‘reverse Sneezing’ ........................................................................................................................ 47
Hoesten ......................................................................................................................................................... 48
Dyspnee......................................................................................................................................................... 48
Abnormale stem en kreunen ........................................................................................................................ 48
Hik ................................................................................................................................................................. 48
Andere cruciale informatie ........................................................................................................................... 48
Lichamelijk onderzoek ....................................................................................................................................... 48
Specifiek klinisch onderzoek .............................................................................................................................. 48
Ademhalingsbewegingen .............................................................................................................................. 48
Ademhalingspatroon ..................................................................................................................................... 50
Neus .............................................................................................................................................................. 50
Sinussen ........................................................................................................................................................ 51
Mond en keelstreek ...................................................................................................................................... 51
Trachea .......................................................................................................................................................... 51
Thorax ........................................................................................................................................................... 51
Bijkomende onderzoeken van long en luchtwegen ...................................................................................... 53
Orthopedie..................................................................................................................................................... 54
Anamnese en algemene indruk ......................................................................................................................... 54
Het iatrope probleem.................................................................................................................................... 54
Signalement .................................................................................................................................................. 54
Kat ................................................................................................................................................................. 55
Hond .............................................................................................................................................................. 55
Paard ............................................................................................................................................................. 55
Anamnese ..................................................................................................................................................... 55
Oorzaken erg manken/geen steunname ...................................................................................................... 56
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, Lichamelijk onderzoek ....................................................................................................................................... 56
Inspectie ........................................................................................................................................................ 56
Palpatie ......................................................................................................................................................... 58
Buigproeven .................................................................................................................................................. 60
Bijkomend onderzoek ........................................................................................................................................ 60
Thermografie................................................................................................................................................. 60
Medische beeldvorming ................................................................................................................................ 60
Anesthesie ..................................................................................................................................................... 60
Gewrichtspunctie .......................................................................................................................................... 61
Arthroscopie/tomie ....................................................................................................................................... 61
Gedrag ........................................................................................................................................................... 62
Specifiek gedrag ................................................................................................................................................ 62
Anamnese.......................................................................................................................................................... 62
Valkuilen anamnese ...................................................................................................................................... 62
Andere meetinstrumenten ter aanvulling van de anamnese ....................................................................... 63
Observatie van het gedrag en interpretatie van de klacht ................................................................................ 63
Meest voorkomende klachten ...................................................................................................................... 63
Klinische aanpak van gedragsklachten .......................................................................................................... 63
Welke contexten bevragen ........................................................................................................................... 64
Onderzoek uitlokkende factoren ....................................................................................................................... 65
Stress ............................................................................................................................................................. 65
Interne stressfactoren ................................................................................................................................... 65
Externe stressfactoren .................................................................................................................................. 66
Klinisch belang................................................................................................................................................... 67
Standard operating procedure .......................................................................................................................... 67
Verloskunde, voortplanting ............................................................................................................................ 68
Oestrale cyclussen ............................................................................................................................................. 68
Koe ................................................................................................................................................................ 68
Teef ............................................................................................................................................................... 69
Onderzoek van het geslachtsapparaat ............................................................................................................. 71
Teef en kattin ................................................................................................................................................ 71
Reu en kater .................................................................................................................................................. 74
Dermatologie/cytologie ................................................................................................................................. 78
Inleiding ............................................................................................................................................................. 78
Signalement ...................................................................................................................................................... 78
Anamnese en algemene indruk ......................................................................................................................... 78
Het iatrope probleem.................................................................................................................................... 78
Het algemeen functioneren .......................................................................................................................... 78
Leefomstandigheden .................................................................................................................................... 78
Voorgeschiedenis .......................................................................................................................................... 79
Algemeen lichamelijk onderzoek ....................................................................................................................... 79
Dermatologisch onderzoek................................................................................................................................ 79
Lichaamsverdeling ......................................................................................................................................... 79
Morfologie..................................................................................................................................................... 79
Configuratie van de letsels ............................................................................................................................ 83
Specifieke huiddelen ..................................................................................................................................... 83
Bijkomend onderzoek ........................................................................................................................................ 84
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