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Uitgebreide samenvatting 9789036827867 Fysische Diagnostiek
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Uitgebreide samenvatting 9789036827867 Fysische Diagnostiek
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FYSIEKE DIAGNOSTIEKVERLEEGKUNDIGE IN OPLEIDING TOT SPECIALIST
,1. Verleden, Heden en toekomst van het lichamelijk onderzoek...............................................5
1.1 Geschiedenis van het lichamelijk onderzoek....................................................................5
1.2 Het lichamelijk onderzoek in deze tijd..............................................................................5
1.2.1 Het belang van het lichamelijk onderzoek.....................................................................5
1.2.2. De plaats van het lichamelijk onderzoek in het diagnostisch proces........................5
1.3 De toekomst......................................................................................................................6
1.3.1 Nieuwe technieken.....................................................................................................6
1.4 Ten slotte, waarom nog lichamelijk onderzoek?..............................................................6
1. Hygiëne en infectiepreventie tijdens het lichamelijk onderzoek...........................................8
2. Basistechnieken van het lichamelijk onderzoek.....................................................................8
3.1 Inleiding.............................................................................................................................8
3.1 Inspectie............................................................................................................................8
3.2 Percussie............................................................................................................................8
3.3 Auscultatie.........................................................................................................................8
3.4 Palpatie..............................................................................................................................8
3.6 Hulpmiddelen....................................................................................................................8
3.6.1. De stethoscoop..........................................................................................................9
3. Omgang met de patiënt en communicatie tijdens het lichamelijk onderzoek.......................9
4. Verslaglegging en EPD.............................................................................................................9
5. De waarde van diagnostische bevindingen............................................................................9
6. De algemene indruk................................................................................................................9
7.1 Inleiding.............................................................................................................................9
7.2 Bewustzijn en oriëntatie....................................................................................................9
7.2.1. Klinische betekenis van gestoord bewustzijn............................................................9
7.2.2. Specifieke testen voor bewustzijn...........................................................................10
7.3 Eerste indrukken van de patiënt.....................................................................................10
7.3.1 Zieke/niet-zieke indruk.............................................................................................10
7.3.2 Biologische leeftijd versus kalenderleeftijd..............................................................10
7.3.3 Pijn............................................................................................................................10
7.3.4 Lichaamsgeur............................................................................................................10
7.3.5 Verzorging.................................................................................................................11
7.3.6 Contact, affect...........................................................................................................11
7.3.7 Overige observaties..................................................................................................11
7.4 Lichaamsbouw.................................................................................................................11
7.4.1. Beoordeling lichaamsbouw.....................................................................................11
, 7.4.2 Klinische betekenis van de lichaamsbouw...............................................................12
7.4.3 Oorzaken van afwijkende lichaamsbouw.................................................................12
7.5 Vitale functies..................................................................................................................13
7.5.1 Polspalpatie..............................................................................................................13
7.5.2. Bloeddruk.................................................................................................................13
7.5.3. Ademhaling..............................................................................................................14
7.5.4 Zuurstofsaturatie......................................................................................................14
7.5.5 Lichaamstemperatuur..............................................................................................15
11. De Oren...............................................................................................................................17
11.3 onderzoek van het oor..................................................................................................17
11.4.1 Gehoortesten..........................................................................................................17
11.4.2 Evenwichtstesten....................................................................................................17
11.5 Klinische betekenis van de bevindingen bij het onderzoek van het oor......................18
11.5.1 Fluisterspraaktest...................................................................................................18
11.5.2 Stemvorkproeven...................................................................................................18
11.5.3 Audiometrie............................................................................................................18
11.5.4 Evenwichtstesten....................................................................................................18
12 De neus en neusbijholten....................................................................................................18
12.2 Anatomie en fysiologie van de neus en neusbijholten.................................................18
12.3 Oriënterend onderzoek van de neus.............................................................................19
12.4 Onderzoek op indicatie van de neus.............................................................................19
12.5 Klinische betekenis van de bevindingen bij het onderzoek van de neus......................19
12.5.1 Uitwendig................................................................................................................19
12.5.2 Inwendig.................................................................................................................20
13 De mond(holte)....................................................................................................................20
13.1 inleiding.........................................................................................................................20
13.2 Anatomie en fysiologie van de mond............................................................................20
13.3 onderzoek van de mond(holte).....................................................................................20
13.4 Onderzoek van de mond(holte) op indicatie................................................................21
13.4.1 Afvoergangen van de speekselklieren....................................................................21
13.4.2 Palpatie van de mond.............................................................................................21
13.5 klinische betekenis van de bevindingen bij het onderzoek van de mond....................21
14 De hals..................................................................................................................................22
14.2 Anatomie van de hals....................................................................................................22
14.2.1 De indeling van de hals lymfeklieren......................................................................22
, 14.3 Oriënterend onderzoek van de hals..............................................................................22
14.4 Onderzoek op indicatie van de hals..............................................................................22
14.4.1 Aanvullend onderzoek van lymfeklieren, speekselklieren en schildklier...............22
14.5 Klinische betekenis van de bevindingen bij het onderzoek van de hals.......................23
14.5.1 Stand van de trachea..............................................................................................23
14.5.2 Lymfeklieren...........................................................................................................23
14.5.3 Speekselklieren.......................................................................................................23
14.5.4 Schildklier................................................................................................................23
15 De anatomie van de thorax..................................................................................................25
15.1 inleiding.........................................................................................................................25
15.2 Anatomie van de thoraxholte.......................................................................................25
15.3 Anatomie van de benige thorax....................................................................................25
15.3.1 Oriëntatiepunten en denkbeeldige lijnen..............................................................25
15.3.2 thoraxvormen.........................................................................................................26
16 Het hart................................................................................................................................26
16.1 inleiding.........................................................................................................................26
16.2 Anatomie en fysiologie van het hart.............................................................................26
16.2.1 Anatomie................................................................................................................26
16.2.2.................................................................................................................................27
16.3 Onderzoek van het hart.................................................................................................28
16.3.1 Inspectie..................................................................................................................28
16.3.2 Palpatie van het hart..............................................................................................28
16.3.3 Auscultatie van het hart.........................................................................................28
16.4 Onderzoek op indicatie.................................................................................................29
16.4.1 Aanvullende palpatie..............................................................................................29
16.4.2 Aanvullende percussie............................................................................................29
16.4.3 Aanvullende auscultatie.........................................................................................29
16.5.6 Cardiale ziektebeelden met afwijkende bevindingen bij lichamelijk onderzoek...29
7 De longen en luchtwegen......................................................................................................30
17.1 inleiding.........................................................................................................................30
17.2.2 De luchtwegen........................................................................................................31
17.2.3 De pleura.................................................................................................................31
17.2.4 De ademhaling........................................................................................................31
17.3 Het onderzoek van de longen.......................................................................................31
17.3.1 Inspectie..................................................................................................................31
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