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Samenvatting vasculaire pathologie
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Dit is een samenvatting van de volledige module vasculaire pathologie verwerkt samen met notities van de lessen.
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By: driesvanlangendonck • 4 year ago
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VASCULAIRE PATHOLOGIEINHOUDSTAFEL
Inleiding................................................................................................................................................................... 5
Het (cardio)vasculair systeem ............................................................................................................................. 5
Het arteriële systeem .......................................................................................................................................... 5
Het veneuze systeem .......................................................................................................................................... 7
Het lymfestelsel................................................................................................................................................... 8
Lymfatische capillairen .................................................................................................................................... 9
(Pre) Collectoren ........................................................................................................................................... 10
Lymfatische trunken...................................................................................................................................... 11
Lymfeklieren .................................................................................................................................................. 12
Samenvatting ................................................................................................................................................ 13
Anatomie van het lymfestelsel.............................................................................................................................. 14
Bovenste extremiteit ......................................................................................................................................... 14
Venen ............................................................................................................................................................ 14
Lymfevaten .................................................................................................................................................... 15
Contralateral lymphatic pathways .................................................................................................................... 20
Onderste extremiteit......................................................................................................................................... 21
Venen ............................................................................................................................................................ 21
Lymfevaten .................................................................................................................................................... 22
Belang anatomie van de lymfebanen ............................................................................................................ 25
Het interstitium ..................................................................................................................................................... 26
Definitie ............................................................................................................................................................. 26
Actief weefsel massa/extracellulaire massa ................................................................................................. 26
Proteïnen en mineralen ................................................................................................................................ 26
Structuur ........................................................................................................................................................... 27
Het interstitium is opgebouwd uit volgende zaken: ..................................................................................... 27
Total body water ........................................................................................................................................... 29
Extracellulair vocht ........................................................................................................................................ 29
Intracellulair vocht ........................................................................................................................................ 29
Extracellulaire/intracellulaire verdeling ........................................................................................................ 29
Fysiologie........................................................................................................................................................... 30
Homeostatisch evenwicht (Starling) ............................................................................................................. 30
Uitwisseling: capillairen en interstitium ........................................................................................................ 31
Fysiologie: homeostase ..................................................................................................................................... 32
Starling principe: modificaties ....................................................................................................................... 32
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,Oedeem ................................................................................................................................................................. 32
Behandeling van Lymfoedeem .............................................................................................................................. 38
Consensus ......................................................................................................................................................... 38
Risicofactoren.................................................................................................................................................... 39
Complex physical therapy ................................................................................................................................. 41
Indicaties en contraindicaties van physical therapy treatment .................................................................... 46
Physical therapy treatment ................................................................................................................................... 47
lymftaping ......................................................................................................................................................... 47
Gezonde levensstijl ........................................................................................................................................... 47
Complex physica therapie ................................................................................................................................. 48
Medicamenteuze behandeling.......................................................................................................................... 49
Diagnostiek........................................................................................................................................................ 49
Niet-invasief .................................................................................................................................................. 49
Invasief .......................................................................................................................................................... 52
Hart- en vaatziekten .............................................................................................................................................. 53
Atherosclerose .................................................................................................................................................. 53
Cardiovasculaire risicofactoren ..................................................................................................................... 54
Semeiologie van het arteriële stelsel ............................................................................................................ 54
Chronische arteriële insufficiëntie van de onderste ledematen ................................................................... 55
Niet-invasieve technische vaatonderzoeken ................................................................................................ 56
Beeldvormingstechnieken ............................................................................................................................. 56
Occlusief arterieel lijden ............................................................................................................................... 57
Chronische arteriële insufficiëntie van de onderste ledematen ................................................................... 57
Arteriële insufficiëntie van de supra-aortische vaten ................................................................................... 58
Aneurysmatische lijden ..................................................................................................................................... 59
Etiologie ........................................................................................................................................................ 59
Aneurysma aorta abdominalis AAA .............................................................................................................. 60
Behandeling .................................................................................................................................................. 61
Oppervlakkige veneuze insufficiëntie – Varices ............................................................................................ 61
Veneuze return ............................................................................................................................................. 62
Etiologie ........................................................................................................................................................ 62
CEAP – classificatie ........................................................................................................................................ 63
Kliniek en diagnose ....................................................................................................................................... 63
Behandeling .................................................................................................................................................. 64
Veneuze trombose ............................................................................................................................................ 64
Oppervlakkige tromboflebitis ....................................................................................................................... 64
Diepe veneuze trombose .............................................................................................................................. 65
2
, Thoracic outlet syndroom ................................................................................................................................. 68
Oorzaken van TOS ......................................................................................................................................... 68
Fysiopathologische gevolgen ........................................................................................................................ 69
Klinische aspecten ......................................................................................................................................... 69
Conservatieve behandeling ........................................................................................................................... 71
Symptomatisch perifeer arterieel vaatlijden – KNGF richtlijn .............................................................................. 72
Gezondheidsprobleem .................................................................................................................................. 72
Anamnese ..................................................................................................................................................... 74
Onderzoek ..................................................................................................................................................... 75
Analyse .......................................................................................................................................................... 79
Behandeldoelen ............................................................................................................................................ 80
Behandelplan ................................................................................................................................................ 80
(Eind) evaluatie ............................................................................................................................................. 83
Borstkanker ........................................................................................................................................................... 84
Inleiding ............................................................................................................................................................. 84
Anatomie van de axilla ...................................................................................................................................... 84
Histologie van de borst ..................................................................................................................................... 85
Symptomen ....................................................................................................................................................... 85
Goedaardige borstaandoeningen ..................................................................................................................... 85
Borstkanker ....................................................................................................................................................... 86
Risicofactoren................................................................................................................................................ 86
Lichamelijk onderzoek ................................................................................................................................... 87
Evolutie ......................................................................................................................................................... 89
Tumorbiologie ............................................................................................................................................... 89
Moleculaire typering ..................................................................................................................................... 90
Mammaprint ................................................................................................................................................. 91
Oppuntstelling............................................................................................................................................... 91
Heelkundige behandeling ............................................................................................................................. 91
Borstkankerheelkunde .................................................................................................................................. 92
Borstsparende heelkunde ............................................................................................................................. 92
Oncoplastische heelkunde ............................................................................................................................ 93
Axillaire uitruiming ........................................................................................................................................ 94
Sentinelklierprocedure .................................................................................................................................. 94
Wat na een positieve sentinelklier? .............................................................................................................. 95
Beslissing tot chemotherapie ........................................................................................................................ 96
Neoadjuvante chemotherapie (NAC) ............................................................................................................ 96
Nabehandeling .............................................................................................................................................. 97
3
, Chemotherapie ............................................................................................................................................. 99
Herceptin ....................................................................................................................................................... 99
Lymfoedeem: van diagnose tot behandeling ...................................................................................................... 100
Inleiding ........................................................................................................................................................... 100
Frequentie ....................................................................................................................................................... 100
Etiologie .......................................................................................................................................................... 100
Pathofysiologie ................................................................................................................................................ 101
Classificatie (WHO) .......................................................................................................................................... 101
Medische beeldvorming .................................................................................................................................. 102
Evaluatie .......................................................................................................................................................... 102
Behandeling .................................................................................................................................................... 103
Chirurgische behandeling ............................................................................................................................ 103
Borstreconstructie .............................................................................................................................................. 106
Introductie....................................................................................................................................................... 106
Flappen ........................................................................................................................................................ 106
Oncoplastische chirurgie ............................................................................................................................. 106
Indicaties en contra-indicaties ........................................................................................................................ 107
Anatomie ......................................................................................................................................................... 107
Plannen van de operatie ................................................................................................................................. 107
Interventie ....................................................................................................................................................... 108
Post-operatieve zorg ....................................................................................................................................... 108
Conclusie ......................................................................................................................................................... 109
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