Summary
Samenvatting Pathologie interne/neuro leerjaar 2 Fysiotherapie
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Dit document bevat een volledige samenvatting van de colleges en literatuur van de toets Pathologie.
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Samenvatting pathologie neuro/interneInhoud
Coronaire hartziekten en ritmestoornissen ............................................................................................ 4
Angina pectoris .................................................................................................................................... 4
Symptomen ......................................................................................................................................... 5
Fysiologisch.......................................................................................................................................... 5
Myocardinfarct .................................................................................................................................... 5
Risicofactoren atherosclerose ............................................................................................................. 5
Myocardinfarct pathofysiologie .......................................................................................................... 6
Hartfalen ................................................................................................................................................ 10
Fysiologie Hart ................................................................................................................................... 10
Pathofysiologie .................................................................................................................................. 11
Etiologie (=oorzaken) ......................................................................................................................... 13
Symptomen ....................................................................................................................................... 13
Diagnostiek, aanvullend onderzoek .................................................................................................. 16
Therapie............................................................................................................................................. 16
Leefregels .......................................................................................................................................... 17
Vaatziekten ........................................................................................................................................... 18
Cardiovasculaire aandoeningen ........................................................................................................ 18
COPD en astma .................................................................................................................................. 27
Astma................................................................................................................................................. 32
Longpathologieën deel 1 + 2 ................................................................................................................. 34
Pneumonie ........................................................................................................................................ 35
Aspiratie............................................................................................................................................. 36
Longkanker ........................................................................................................................................ 37
Longembolie ...................................................................................................................................... 39
Pneumothorax ................................................................................................................................... 39
Atelectase .......................................................................................................................................... 40
Diabetes mellitus ................................................................................................................................... 43
Complicaties bij diabetes mellitus ......................................................................................................... 48
Endocrinologie....................................................................................................................................... 52
Endocriene organen .......................................................................................................................... 52
1
, Homeostase ....................................................................................................................................... 52
Hormoonklier en doelcellen .............................................................................................................. 52
Endocriene systeem .......................................................................................................................... 54
Endocriene organen .......................................................................................................................... 54
Stimuli voor endocriene organen ...................................................................................................... 54
Stoornissen in het endocriene systeem ............................................................................................ 55
Hypofyse ............................................................................................................................................ 55
ADH (vasopressine) tekort ................................................................................................................. 56
Schildklier .......................................................................................................................................... 57
Bijschildklier....................................................................................................................................... 58
Bijnieren ............................................................................................................................................ 59
syndroom van cushing ....................................................................................................................... 60
College CVA............................................................................................................................................ 61
CVA deel 2.............................................................................................................................................. 64
Literatuur: .............................................................................................................................................. 67
H4.2.1 onderzoek van spierfunctie.................................................................................................... 67
H4.3 het centrale hemibeeld ............................................................................................................. 67
H8 de hogere cerebrale functies ....................................................................................................... 67
H8.1 afasie ......................................................................................................................................... 68
H9.2.2. uit het oog verloren .............................................................................................................. 69
H11.2.2 Het herseninfarct ................................................................................................................. 69
H11.2.3 relatief zuurstoftekort .......................................................................................................... 70
H11.3 Pathologische vaatveranderingen ........................................................................................... 70
H17.2 oorzaken en gevolgen ............................................................................................................. 71
H17.3 diagnostiek .............................................................................................................................. 71
H17.4.1 TIA’s ...................................................................................................................................... 71
H17.5 therapie bij herseninfarct........................................................................................................ 73
H17.7 subarachnoïdale bloeding ....................................................................................................... 73
Abnormale tonus ................................................................................................................................... 75
College ............................................................................................................................................... 75
Literatuur ........................................................................................................................................... 77
H4.2.2 onderzoek van reflexen .......................................................................................................... 77
Interpretatie .................................................................................................................................. 77
Symptomen bij uitval in de basale kernen .................................................................................... 78
H27.3 hyper kinetische bewegingsstoornissen ................................................................................. 78
Parkinson ............................................................................................................................................... 82
2
, College ............................................................................................................................................... 82
Literatuur ........................................................................................................................................... 84
H27 bewegingsstoornissen................................................................................................................ 84
H27.2 Atypische vormen van parkinsonisme .................................................................................... 87
Dwarslaesie........................................................................................................................................ 89
College ............................................................................................................................................... 89
Literatuur ........................................................................................................................................... 89
H15.1.1. ligging van het ruggenmerg ................................................................................................ 92
Traumatische letsel van het ruggenmerg .......................................................................................... 93
Contusio cervicalis posterior ......................................................................................................... 94
Spinale epidurale bloeding ............................................................................................................ 94
Letsel van conus en cauda ............................................................................................................. 94
H15.5 ruggenmergbeknelling door niet-traumatische oorzaken ...................................................... 95
Multiple sclerose ............................................................................................................................... 96
College ............................................................................................................................................... 96
Literatuur ........................................................................................................................................... 99
H25 pathofysiologie van MS .............................................................................................................. 99
3
, Pathologie Interne
Coronaire hartziekten en ritmestoornissen
• Angina pectoris = tijdelijke ischemie (tijdelijk zuurstoftekort van spiercellen) hartspier
- Angina pectoris staat voor pijn op de borst, komt uit de hartspier zelf.
- Omdat het tijdelijk is, treed er nog geen schade op en alleen pijn.
• Myocard infarct = schade aan de hartspier
Angina pectoris
Is een wurgende pijn op de borst
t.g.v. te kort aan zuurstof van de
hartspier.
Pijn op de borst (hoeft niet per se
vanuit het hart te komen):
- Longembolie
- Brandend maagzuur
- Maagzweer
- Gewrichtpijn
- Hartspier → angina
pectoris/myocardinfarct
Zuurstof tekort van de hartspier
• Verminderde bloedtoevoer (aanvoerend).
• Abnormaal toegenomen inspanning / verbruik van hartspier.
• Combinatie van bovenstaande is ook mogelijk.
Oorzaken angina pectoris
• Atherosclerose (aderverkalking, plaques)
• Arteriosclerose (verharden van slagaderwanden)
• Vaatspasme (verkramping)
• Ernstige anemie (bloedarmoede, weinig HB) → hart moet harder werken voor voldoende
zuurstof.
• Ernstige longaandoening
• Tachycardie
• Hypertrofie bij hartfalen (vergroting van het hart zonder dat de vaten goed mee groeien) → hart
moet harder gaan werken.
• Hypertensie
Al deze dingen kunnen angina pectoris geven. Dus de oorzaak hoeft niet per se in de hartspier zelf
te liggen.
4
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