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VOLLEDIGE samenvatting THEORIE Onderste Lidmaat 3e bach $5.35
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VOLLEDIGE samenvatting THEORIE Onderste Lidmaat 3e bach

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Dit document is een volledige samenvatting van alle theorie van het vak revalidatie en kinesitherapie van het onderste lidmaat uit het 3e bach. Het geeft een gedetailleerd overzicht van de 2 boeken die over de theorie gaan (deel pathologie en deel kinesitherapie) alsook het extra deel van prof J. ...

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  • December 23, 2024
  • 40
  • 2023/2024
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SAMENVATTING ONDERSTE
LIDMAAT
Inhoud
Pathologie:................................................................................................................................................................3
Hoofdstuk 1: Pathologie thv de heup en dij.........................................................................................................3
Femoroacetabulair Impingement FAI (leidt tot coxarthrose)..........................................................................3
Adductorenstrain..............................................................................................................................................3
Snapping of clicking hip (=coxa saltans)...........................................................................................................3
Bursitis in de heupregio....................................................................................................................................4
Osteitis pubis....................................................................................................................................................4
Gerefereerde pijnen in de heupregio...............................................................................................................4
Avulsiefracturen in de sport.............................................................................................................................4
Wekedelenletsels thv de dij.............................................................................................................................4
Hoofdstuk 2: pathologie van de knie...................................................................................................................5
Biomechanica...................................................................................................................................................5
Factoren voor malalignement..........................................................................................................................6
Patella-instabiliteit met (sub)luxatie................................................................................................................6
Chondromalacie (patellaire KB-aantasting).....................................................................................................6
Tendinopathiën................................................................................................................................................7
Hoofdstuk 3: pathologie van het onderbeen, enkel en voet...............................................................................8
Shin splits (periostitis tibialis, stressfract. tibia/fibula en chronisch comp-syndroom)...................................8
Chronisch compartimentsyndroom.................................................................................................................8
Achillespeesletsels............................................................................................................................................9
Tendionopathiën van de enkelregio..............................................................................................................10
Problemen in de hielregio onderaan..............................................................................................................10
Hoofdstuk 4: zenuwletsels algemeen................................................................................................................11
Classificatie volgens Seddon...........................................................................................................................11
Classificatie volgens Sunderland....................................................................................................................11
Hoofdstuk 5: zenuwletsels  onderste lidmaat....................................................................................................12
Plexus lumbosacralis......................................................................................................................................12
N. cutaneus fem lateralis (L2-L3)....................................................................................................................12
N. femoralis (L2-L4)........................................................................................................................................12
N. saphenus....................................................................................................................................................12
N. Obturatorius L2-L4.....................................................................................................................................12

, N. Ischiadicus (L4-S3)......................................................................................................................................12
N. Suralis.........................................................................................................................................................12
N. Tibialis........................................................................................................................................................12
N. Fibularis communis....................................................................................................................................13
N. fibularis superficialis..................................................................................................................................13
Kinesitherapie.........................................................................................................................................................14
Deel 1: klinisch denkkader..................................................................................................................................14
Hoofdstuk 1: inleiding....................................................................................................................................14
Hoofdstuk 2: algemene revalidatieaanpak bij letsels (GW, spier, ligamentair en peesaandoeningen)........14
Hoofdstuk 3: biomechanica vh stap- en looppatroon....................................................................................14
Deel 2: regiospecifiek: heup...............................................................................................................................19
Hoofdstuk 1: kinesiologie in relatie tot de revalidatie...................................................................................19
Hoofdstuk 2: mehanica en pathomechanica vd spieractiviteit......................................................................19
Hoofdstuk 3: algemene postoperatieve aanpak bij heupletsels....................................................................19
Hoofdstuk 4: revalidatie bij veelvoorkokmende heupaandoeningen............................................................20
Deel 3: regiospecifiek: knie................................................................................................................................23
Hoofdstuk 1: Algemene revalidatieaanpak bij knieletsels.............................................................................23
Hoofdstuk 2: revalidatieaanpak bij patellofemorale aandoeningen (PFP)....................................................23
Hoofdstuk 3: reavlidatieaanpak bij VKB letsels (ong 6-9md).........................................................................25
Hoofdstuk 4: revalidatieaanpak bij meniscusletsels......................................................................................26
Deel 4: regiospecifiek voet/enkel.......................................................................................................................27
Hoofdstuk 1: algemene biomechanische begrippen vh voet/enkelcomplex................................................27
Hoofdstuk 2: revalidatie bij veelvoorkomende voet/enkel aandoeningen...................................................29
Deel J. Victor...........................................................................................................................................................32
Fracturen............................................................................................................................................................32
Weke delen.........................................................................................................................................................33
Pathologie enkel.............................................................................................................................................33
Pathologie van de voet...................................................................................................................................35
Heup...............................................................................................................................................................35
Knie.................................................................................................................................................................37

,PATHOLOGIE :

HOOFDSTUK 1: PATHOLOGIE THV DE HEUP EN DIJ


FEMOROACETABULAIR IMPINGEMENT FAI (LEIDT TOT COXARTHROSE)
 Cam impingement (= pistol grip deformity; = gedaalde femorale anteversie)
 Osseuze bump
 Alfa-hoek > 50°
 Kop-hals-offset < 7,2 +/- 0,7 mm
 Pincer impingement (= acetabulaire retroversie)
 Willberghoek > 40°
 C-sign
 FADDIR
 Behandeling:
o tracties en stabilisatieoefeningen (ook van lage rug), pelvic drop opsoren en glut med optrainen)


ADDUCTORENSTRAIN
 Myofasciale junctie
 Meestal adductor longus
 Behandeling:
o POLICE, stretchen en oefentherapie


SNAPPING OF CLICKING HIP (=COXA SALTANS)
 Internal (anterieur/mediaal)
 Suction phenomenon bij flexiebeweging vd dij
 Gewrichtsmuis  Rx/Ct
 Subluxatie  Rx/Ct
 Lig iliofemorale over femurkop
 Psoaspees over troch minor
 Psoas over SIAI
 Vaak met psoasbursitis
 External (lateraal)
 Glut max/ TFL (ITB) over troch major
 Meestal onderliggende tekorte ITB
 KLINISCH:
 Negatief functieonderzoek
 Bij ACTIEVE flexie vanuit heupextensie  klikken hoor-/voelbaar lateraal
 Vaak bijkomende bursitis
 Behandeling:
o Uitlokkende factoren zoeken/aanpakken
o Spierverkortingen, spieronevenwicht, slechte trainingstechnieken, verstoorde biomechanische
alignatie

, BURSITIS IN DE HEUPREGIO
 Psoasbursitis
 Trochanterica bursitis (= skirunners hip)
o Door herhaalde flexie/extensie
o Overbelasting
o Functioneel beenlengteverschil
o Pijn bij elongatie ITB
o Pijn uitstralend naar lateraal
o Vaak + snapping hip
o Behandeling:
o Rust
o NSAIDs
o Onderliggende biomech factoren
o Stretch verkorte hamstrings
 Os ischiadicum bursitis


OSTEITIS PUBIS
(inflammatie botstructuren rondom symphyis)

 Rectus abdoministendinopathie (bovenaan op symfyse)
 Gracilissyndroom (onderaan; gevolg van adductor- of gracilispeesprobleem)


GEREFEREERDE PIJNEN IN DE HEUPREGIO
 Piriformissyndroom


AVULSIEFRACTUREN IN DE SPORT
(zelden tgv direct trauma, meestal tgv excentrische overbelasting)

 Crista iliaca
 SIAS
 SIAI
 Tuber ischiadicum
 Troch major
 Klinisch:
 Lokale zwelling evenredig met ernst
 Plotse acute lokale pijn die uitstraalt id spieren


WEKEDELENLETSELS THV DE DIJ
 Hamstringstrain
o Eerstegraads- of mildegraads strain
o Tweedegraads- of moderate strain
o Derdergraads- of severe strain ( gap)
o HS/QD= 60/100 (bij 90°/sec)
o Li-re verschil van meer dan 10% is predisponerend
o Behandeling:
 POLICE
 Stretch tot normale lengte

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