Uitgebreide samenvatting van de theorie cursus en de ppt van de lessen.
Er werden ook duidelijke afbeeldingen toegevoegd als opfrissing voor de anatomie
,INHOUDSOPGAVE
HEUP ................................................................................................................................................................... 3
INLEIDING ................................................................................................................................................................... 3
AANDOENINGEN VAN DE HEUP .......................................................................................................................................... 5
gewrichtsaandoeningen.........................................................................................................................................5
coxartrose ........................................................................................................................................................................... 5
traumatische artritis ........................................................................................................................................................... 7
niet-traumatische artritis .................................................................................................................................................... 7
ischemische femurkopnecrose bij volwassenen ................................................................................................................ 9
transiënte osteoporose ....................................................................................................................................................... 9
corpus liberum .................................................................................................................................................................. 10
femoroacetabulair impingement FAI ................................................................................................................................. 10
heupdysplasie ................................................................................................................................................................... 11
labrumletsels/kraakbeenletsels ....................................................................................................................................... 11
gewrichtsaandoeningen bij kinderen .................................................................................................................... 12
morbus Perthes ................................................................................................................................................................. 12
transiënte synovitis ........................................................................................................................................................... 13
epifysiolysis capitis femoris .............................................................................................................................................. 13
aandoeningen van de bursae ............................................................................................................................... 15
bursITIS iliopectinae (psoas-bursitis) ................................................................................................................................ 15
greater trochanter pain SYNDROME (bursitis subtrochanterica) ......................................................................................... 16
bursitis ischiadica ............................................................................................................................................................. 17
aandoeningen van het spierpeesapparaat ............................................................................................................ 18
M. gluteus medius en minimus .......................................................................................................................................... 18
M. quadriceps femoris....................................................................................................................................................... 19
Mm. hamstrings................................................................................................................................................................. 21
pubalgie ............................................................................................................................................................................ 23
M. sartorius ....................................................................................................................................................................... 24
M.iliopsoas ........................................................................................................................................................................ 25
M.tensor fascia latae ......................................................................................................................................................... 26
coxa saltans (snapping hip) ................................................................................................................................................ 27
andere aandoeningen heup ................................................................................................................................. 28
sign of buttock ................................................................................................................................................................... 28
meralgia paresthetica ....................................................................................................................................................... 28
KNIE .................................................................................................................................................................. 29
INLEIDING .................................................................................................................................................................
29
evalueren oorsprong en oorzaak .......................................................................................................................... 29
tibiofemoraal gewricht ......................................................................................................................................... 31
de menisci ......................................................................................................................................................................... 31
Stabilisatoren: passief (KBA) en actief (musculatuur) ....................................................................................................... 33
patellofemoraal gewricht ..................................................................................................................................... 34
AANDOENINGEN VAN DE KNIE .........................................................................................................................................36
gewrichtsaandoeningen....................................................................................................................................... 36
traumatische artrtis .......................................................................................................................................................... 36
niet-traumatische artritis .................................................................................................................................................. 37
gonartrose ......................................................................................................................................................................... 37
corpora libera .................................................................................................................................................................... 39
meniscusletsels ................................................................................................................................................................ 40
plica-syndromen ............................................................................................................................................................... 44
intra-articulaire adhesies .................................................................................................................................................. 45
syndroom van Stieda en Pellegrini .................................................................................................................................... 46
aandoeningen van het kapselband apparaat ......................................................................................................... 47
verrekking lig. collaterale mediale MCL ............................................................................................................................ 48
verrekking lig. collaterale laterale LCL .............................................................................................................................. 49
verrekking van het lig. meniscotibiale mediale (=coronary ligament) ................................................................................ 49
verrekking van ligamentum meniscotibiale laterale ......................................................................................................... 50
ligamentaire aandoeningen MET instabiliteit .................................................................................................................... 51
aandoeningen van het patellofemoraal gewricht ................................................................................................... 55
subluxatie van de patella .................................................................................................................................................. 55
luxatie van de patella ........................................................................................................................................................ 57
patellofemoraal dysfunctiesyndroom PFDS ...................................................................................................................... 58
aandoeningen van de bursae ............................................................................................................................... 60
bursitis infrapatellaris superfiscialis en profunda............................................................................................................. 60
bursitis prepatellaris ......................................................................................................................................................... 61
bursitis pes anserinus superficialis................................................................................................................................... 61
1
, bursitis ligaemntum collaterale mediale........................................................................................................................... 61
tractus iliotibiaal frictiesyndroom ..................................................................................................................................... 62
Baker-cyste ....................................................................................................................................................................... 63
aandoeningen van het spierpeesapparaat ............................................................................................................ 64
ruptuur van quadricepspees of ligamentum patellae ........................................................................................................ 64
ruptuur hamstrings............................................................................................................................................................ 65
insertietendopathie van het strekapparaat ....................................................................................................................... 66
insertietendopathie van pes anserinus superfiscialis ....................................................................................................... 67
insertietendopathie M. semimembranosus ...................................................................................................................... 68
insertietendopathie M. biceps femoris .............................................................................................................................. 68
overige aandoeningen.......................................................................................................................................... 70
morbus osgood-schlatter .................................................................................................................................................. 70
syndroom van sinding, larsen en johansson ...................................................................................................................... 70
ENKEL ............................................................................................................................................................... 73
INLEIDING .................................................................................................................................................................
73
anatomie ............................................................................................................................................................ 73
Verschillende gewrichten.................................................................................................................................................. 73
Ligamenten ....................................................................................................................................................................... 74
Spieren .............................................................................................................................................................................. 75
functie ................................................................................................................................................................ 75
AANDOENINGEN ENKEL................................................................................................................................................. 76
statiekproblemen ................................................................................................................................................ 76
platvoet ............................................................................................................................................................................. 76
holvoet .............................................................................................................................................................................. 76
gewrichtsaandoeningen bovenste spronggewricht ................................................................................................ 77
artritis................................................................................................................................................................................ 77
artrose ............................................................................................................................................................................... 78
corpora libera .................................................................................................................................................................... 78
osteochondrosis dissectans talus .................................................................................................................................... 79
anterieur tibiotaliar compressiesyndroom ........................................................................................................................ 79
Posterieur tibiotalair compressiesyndroom ...................................................................................................................... 80
gewrichtsaandoeningen onderste spronggewricht ................................................................................................ 81
traumatische artritis ......................................................................................................................................................... 81
niet- traumatische artritis ................................................................................................................................................. 81
artrose ............................................................................................................................................................................... 81
bewegingsbeperking na immobilisatie .............................................................................................................................. 82
corpus liberum .................................................................................................................................................................. 82
gewrichtsaandoeningen midtarsaal ...................................................................................................................... 82
traumatische artritis ......................................................................................................................................................... 82
niet traumatische artritis................................................................................................................................................... 83
aandoeningen kapselband-apparaat .................................................................................................................... 83
inversietrauma .................................................................................................................................................................. 83
eversietrauma ................................................................................................................................................................... 86
aandoeningen spierpeesapparaat ........................................................................................................................ 86
achillodynie (achillespees tendinopathie) ........................................................................................................................ 86
ruptuur van de achillespees .............................................................................................................................................. 88
partiële ruptuur van de achillespees ................................................................................................................................. 88
partiële ruptuur van de M. gastrocnemicus ....................................................................................................................... 89
aandoeningen tibialis posterior ......................................................................................................................................... 89
aandoeningen M. tibialis anterior ...................................................................................................................................... 91
aandoeningen van de mm. peronei.................................................................................................................................... 92
fasciitis plantaris............................................................................................................................................................... 93
compartimentsyndroom ...................................................................................................................................... 94
2
, HEUP
INLEIDING
Articulatio coxae
- Overbrengen van krachten
- Plaatsen van de voet in de ruimte
Opgebouwd uit
- Fossa acetabuli (lateraal, ventraal, caudaal)
- Caput femoris
Mobiliteit
à Art. Spheroidea (kogelgewricht)
3 bewegingsvlakken – 3 assen
De heup heeft een gewichtsdragende functie waardoor er in tegenstelling tot de schouder meer stabiliteit is.
Een deel van het verlies van de mobiliteit wordt gecompenseerd door bewegingen in de lumbale wervelkolom
Stabiliteit
Passieve stabiliserende elementen
- Configuratie van femur en acetabulum
o Collumdiafyse hoek: hoek tussen diafyse en collum norm tussen 120°-135°
§ coxa vara: <120°
§ Coxa valga >135° à heel onstabiele positie voor luxaties
o Anteversiehoek: hoek tussen condyli femoris en collum femoris norm tussen 12°-14°
§ Retroversiehoek vanaf 5°
§ Toegenomen vanaf 14° à onstabiele positie, hierdoor zien we “toeing-in” voor stabiliteit
à W-zit: kinderen starten met een extreem grote anteversiehoek van 135°
o Hoek van Wiberg: maat voor benige overkapping
Collumdiafysehoek Anteversiehoek Hoek van Wiberg
- Zwaartekracht (hoek van Wiberg is hiervoor belangrijk)
- Negatieve intra-articulaire druk + zuigkracht labrum (vacuüm) (bekkenfractuur kan dit verstoren)
3
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