Samenvatting Medische Diagnostiek
Inhoud
Hoofdstuk 1: Medische Beeldvorming...............................................................................................................3
1.1 Overzicht soorten van binnen uit.............................................................................................................3
1.1.1.Van binnen uit:..................................................................................................................................3
1.1.2. Radiofarmacon.................................................................................................................................4
1.1.3. Toepassingen - en +-stralers.......................................................................................................4
1.2. Overzicht soorten van buiten uit.............................................................................................................6
1.2.1. X-camera:..........................................................................................................................................6
1.2.2. CT......................................................................................................................................................7
1.2.3. MRI:..................................................................................................................................................8
1.2.4. Echografie:........................................................................................................................................8
Hoofdstuk 2: Radiotherapie...............................................................................................................................9
Overzicht Radiotherapie behandelingen:.......................................................................................................9
2.2. Conformele radiotherapie:....................................................................................................................10
Hoofdstuk 3: Vaatonderzoek............................................................................................................................11
3.1. Claudicatio intermittens:.......................................................................................................................11
3.2. Oscillografie in rust en na spanning:.....................................................................................................11
3.3. Arteriële Doppler:..................................................................................................................................11
3.3.1. Formule..........................................................................................................................................12
3.3.2. Belangrijke ultrageluideigenschappen...........................................................................................12
3.3.3. Doppler signaal...............................................................................................................................12
3.3.4. Morfologie van de normale doppler ultrageluid curve..................................................................12
3.4. Echografie en duplex:............................................................................................................................12
3.5. Plethysmografie:....................................................................................................................................13
3.6. Capillaroscopie:.....................................................................................................................................13
Hoofdstuk 4: Longfunctieonderzoek................................................................................................................14
4.1. Inleiding.................................................................................................................................................14
4.1.1. Functies van long............................................................................................................................14
4.1.2. Nut en betekenis longfunctieonderzoek........................................................................................14
4.1.3. Stoornissen in longfunctie..............................................................................................................14
4.2. Onderzoek van ventilatie:......................................................................................................................14
4.2.1. Spirometrie.....................................................................................................................................14
4.2.2. Pneumotachometrie......................................................................................................................17
4.2.3. Luchtwegenweerstand: RAW.........................................................................................................17
Hoofdstuk 5: Elektro-Encefalogram (EEG) Hersenfunctieonderzoek...............................................................18
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, 5.1. Nut en betekenis...................................................................................................................................18
5.2. Provocatiemethoden.............................................................................................................................18
5.2.1. Versterkte ademhaling (hyperventilatie).......................................................................................18
5.2.2. Lichtflitsprikkeling...........................................................................................................................19
5.2.3. Slaapopname..................................................................................................................................19
5.3. Kenmerken van EEG..............................................................................................................................19
5.3.1. -ritme..........................................................................................................................................19
5.3.2. -ritme...........................................................................................................................................21
5.3.3. -ritme..........................................................................................................................................21
5.3.4. -ritme..........................................................................................................................................21
5.3.5. Verschillende slaapstadia en bijhorende golven............................................................................21
5.4. EEG bij kinderen....................................................................................................................................21
5.5. Abnormale EEG’s...................................................................................................................................22
5.5.1. Epilepsie.........................................................................................................................................22
5.5.2. Stoornissen in bloedvoorziening....................................................................................................22
5.5.3. Hersengezwellen............................................................................................................................22
Hoofdstuk 6: Electrocardiogram.......................................................................................................................23
6.1. Indicaties...............................................................................................................................................23
6.2. Anatomische basis.................................................................................................................................23
6.3. Elektrofysiologische basis......................................................................................................................23
6.4. Routine-afleidingen van het ECG...........................................................................................................24
6.5. Deflecties en intervallen........................................................................................................................24
Hoofdstuk 7: Bloeddrukmeting........................................................................................................................25
Hoofdstuk 8: Ademtesten in de gastro-enterologie.........................................................................................26
8.1. Soorten ademtests................................................................................................................................26
8.2. H2-ademtesten.......................................................................................................................................26
8.2.1. Soorten H2-ademtesten..................................................................................................................26
8.2.2. Foutenbronnen H2-ademtesten.....................................................................................................27
8.3. 13CO2-ademtesten..................................................................................................................................27
8.3.1. soorten 13CO2-ademtesten..............................................................................................................27
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, Hoofdstuk 1: Medische Beeldvorming
= een onderzoek , waardoor een beeld (plaatje) van het inwendige lichaam gemaakt wordt.
= een belangrijk hulpmiddel bij stellen van diagnose & ook voor wetenschappelijk onderzoek.
1.1 Overzicht soorten van binnen uit
1.1.1.Van binnen uit:
1. Radionuclide (radiofarmacon) toedienen aan patiënt
2. Verdeling gemeten met extern detectiesysteem
1.1.1.1. Soorten apparatuur
Gamma-camera: verzameling van scintillatietelles met vaste detectoren.
- Teltechnieken NaI-kristal + elektronenvermenigvuldigers
Centrum van lichtdistributie bepalen
Plaats binnendringen -straal in kristal opp.
- Projectie van activiteitsverdeling in het lichaam op vlak van camera
d.m.v. multihole collimator tussen patiënt en kristal
NADELEN: Boven elkaar liggende organen worden op elkaar geprojecteerd
Attenuatie van straling in het lichaam: Bot absorbeert meer dan longweefsel
- Onderdelen:
o Detector
NaI-kristal (dikte = 0,5-2 cm; grootte =
50-60 cm)
Functie: gammastraling omzetten naar
lichtflits
o Collimator Pb (hoge Z-waarde)
groot aantal gaten 5000-4000 loodrecht
op detector
=> alleen gamma’s die loodrecht
staan op, vallen in op detector
o PMT buizen
X-Y positie bepaling
Z= pulshoogte van signaal
o Elektronische circuits
detector wordt ingedeeld in matrix
een kleurschaal wordt toegekend in functie van hoeveelheid straling die ingevallen is –
semikwantitatief werk
- Soorten opnames:
o Statisch
o Total body
o Dynamisch
SPECT = Single Photon Emission Computed Tomography
- Tomografische doorsneden geen superpositie
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