Summary
Module LWK/TWK samenvatting theorietoets
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Uitgebreide maar overzichtelijke samenvatting van alle theorie die je moet weten voor toets van module LWK/TWK.
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Toetsmatrijs,Inhoudsopgave
Inhoudsopgave
Toetsmatrijs ..................................................................................................................................................... 1
Inhoudsopgave................................................................................................................................................. 2
DAG 1 ............................................................................................................................................................... 6
Hoorcollege Wat is Rugpijn? ............................................................................................................................ 7
Epidemiologie en achtergrond ........................................................................................................................... 7
Validiteit diagnostiek manueel therapeut .......................................................................................................... 7
Lage rugpijn definitie en indeling ....................................................................................................................... 8
Risicofactoren voor lage rugpijn ......................................................................................................................... 9
Aspecifieke lage rugpijn.................................................................................................................................... 11
Specifieke lage rugpijn...................................................................................................................................... 11
Rode vlaggen .................................................................................................................................................... 12
Screening en Diagnostiek: EBP Stap 1 en 2 ..................................................................................................... 13
Palpatie regio TWK, LWK en bekken ............................................................................................................... 16
Doelstellingen en toepassing manuele palpaties ............................................................................................. 16
Betrouwbaarheid .............................................................................................................................................. 17
Validiteit ........................................................................................................................................................... 17
Palpatietechnieken LWK ................................................................................................................................... 17
LWK en TWK diagnostiek: (geleid)actief bewegingsonderzoek ....................................................................... 19
DAG 2 ............................................................................................................................................................. 20
Accuratesse van diagnostische tests............................................................................................................... 21
Bepalen van diagnostische accuratesse ........................................................................................................... 21
2x2 tabel en beoordeling validiteit ................................................................................................................... 24
Likelihood Ratio’s.............................................................................................................................................. 26
Vooraf kans en achterafkans ............................................................................................................................ 27
Bias ................................................................................................................................................................... 28
Betrouwbaarheidsinterval ................................................................................................................................ 29
Screening: bevragen, beslissen en screeningtests .......................................................................................... 30
Klinisch redeneren binnen het Concept Klinisch Redeneren ad modum SOMT (screening) .............................. 30
Klinisch redeneren binnen het Concept Klinisch Redeneren ad modum SOMT (diagnostiek) .......................... 37
DAG 3 ............................................................................................................................................................. 38
,Pijn ................................................................................................................................................................. 39
Definitie IASP: ................................................................................................................................................... 39
Belangrijke termen ........................................................................................................................................... 39
Evolutionaire betekenis pijn ............................................................................................................................. 40
Chronische pijn ................................................................................................................................................. 42
Dimensies van pijn ............................................................................................................................................ 42
Soorten pijn ...................................................................................................................................................... 43
Indeling naar oorzaak van pijn: waar zit de bron van de pijn? ......................................................................... 45
Neuro-anatomie en neurofysiologie van nociceptie ......................................................................................... 46
Neuro immunologie .......................................................................................................................................... 49
Functionele anatomie en osteo- en arthrokinematica van de TWK en LWK ................................................... 54
Functionele anatomie LWK............................................................................................................................... 54
Artrokinematica................................................................................................................................................ 61
Bindweefsel ...................................................................................................................................................... 65
Kinematica LWK ............................................................................................................................................... 70
Functionele anatomie TWK .............................................................................................................................. 72
Osteokinematica TWK ...................................................................................................................................... 73
Artrokinematica TWK ....................................................................................................................................... 73
DAG 4 ............................................................................................................................................................. 75
Kennisclips Lage rug-beenpijn ........................................................................................................................ 76
Referred pain .................................................................................................................................................... 79
Nociceptieve pijn .............................................................................................................................................. 80
Facetgewricht pijn ............................................................................................................................................ 81
SI-gewricht pijn ................................................................................................................................................. 82
Dicus pijn .......................................................................................................................................................... 82
Zenuwen van de lumbale wervelkolom ............................................................................................................ 84
Veranderingen LWK door veroudering ............................................................................................................. 90
Degeneratieve gewrichtaandoeningen ............................................................................................................ 91
Discus herniatie ................................................................................................................................................ 92
Verhoogde neurale mechanosensitiviteit ......................................................................................................... 93
Werkgroep Diagnostiek specifieke lage rugklachten ...................................................................................... 94
Lumbosacraal radiculair syndroom .................................................................................................................. 95
Lumbale spinale stenose .................................................................................................................................. 98
Spondylolyse ..................................................................................................................................................... 99
Spondylolisthesis .............................................................................................................................................. 99
Spondyloarthritis ............................................................................................................................................ 100
De ziekte van Bechterew ................................................................................................................................ 100
, Practicum Diagnostische vaardigheden specifieke lage rugklachten ............................................................ 102
Lasegue testen................................................................................................................................................ 103
Onderzoek geleidingsstoornissen ................................................................................................................... 104
Sensibiliteit ..................................................................................................................................................... 104
Spierkracht: myotomen/Kenspieren ............................................................................................................... 106
Diagnostiek spinale stenose ........................................................................................................................... 108
Onderzoek neurale mechanosensitiviteit ....................................................................................................... 109
DAG 5 ........................................................................................................................................................... 111
Klinisch redeneren screening en diagnostiek: subclassificatiesystemen ........................................................ 112
Klinisch redeneren screening en diagnostiek: thoracale pijn ........................................................................ 115
Categoriseren rode vlaggen ........................................................................................................................... 115
Borstwandpijn ................................................................................................................................................ 117
Cervicothorecale angina ................................................................................................................................. 119
Diagnostische vaardigheden: Provocatietests .............................................................................................. 120
Screenende tests regio bekken/lwk ................................................................................................................ 120
Betrouwbaarheid van palpatie bij nek- en rugpijn ......................................................................................... 121
DAG 6 ........................................................................................................................................................... 122
Online hoorcollege en werkgroep ‘Betrouwbaarheid’ .................................................................................. 123
Begrippen ....................................................................................................................................................... 123
COSMIN-richtlijnen ......................................................................................................................................... 124
Betrouwbaarheid ............................................................................................................................................ 124
Validiteit ......................................................................................................................................................... 129
Klinisch redeneren screening en diagnostiek: SI-pijn .................................................................................... 130
Van der Wurf et al. (2006) .............................................................................................................................. 132
Laslett et al. (2005) ......................................................................................................................................... 134
Active straight leg raise .................................................................................................................................. 138
DAG 7 ........................................................................................................................................................... 139
Functionele anatomie SIG en Pelvic Girlde Pain ........................................................................................... 140
Functie SIG ...................................................................................................................................................... 140
Anatomie ........................................................................................................................................................ 140
Bewegingen SIG .............................................................................................................................................. 145
Klinische manifestatie SIG-pijn ....................................................................................................................... 146
Bekkenbodem ................................................................................................................................................. 147
Vormsluiting en krachtsluiting ....................................................................................................................... 148
Krachtenoverdracht ........................................................................................................................................ 148
Thorecolumbale fascii..................................................................................................................................... 149
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