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Samenvatting Physiotherapy in Internal Diseases
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Uitgebreide samenvatting van alle hoorcolleges van het vak Physiotherapy in Internal Diseases (van Breda, Verbelen, Gebruers, Meirte, Van Soom)
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By: saratenbroek • 2 year ago
By: basvandijck12 • 1 year ago
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Universiteit AntwerpenAcademiejaar 2020 - 2021
Faculteit Geneeskunde en Gezondheidswetenschappen
Master Revalidatiewetenschappen en Kinesitherapie
Physiotherapy in Internal
Diseases
1
,THEORIE
2
,INHOUD
1. Het lymfatisch systeem ....................................................................................................................................... 6
1.1. Anatomie van het vasculair systeem, meer bepaald het lymfatisch systeem ............................................. 6
1.1.1. Oppervlakkige venen van de (bovenste en) onderste extremiteit........................................................ 6
1.1.2. Het lymfatisch systeem ....................................................................................................................... 10
1.2. Fysiologie van de microcirculatie, lymfatisch transport, glycocaly, Starling forces ................................... 20
1.2.1. Basisprincipes en concepten ............................................................................................................... 20
1.2.2. Microcirculatie, vorming van interstitieel vocht ................................................................................. 26
1.2.3. Starling forces, aansturing nettofiltratie ............................................................................................. 26
1.2.4. Opname van interstitieel vocht door de initiële lymfevaten .............................................................. 33
1.2.5. Transport van lymfevocht ................................................................................................................... 35
1.3. Pathologie van het vasculair systeem ........................................................................................................ 36
1.3.1. Introductie........................................................................................................................................... 36
1.3.2. Arteriële aandoeningen ...................................................................................................................... 37
1.3.3. Veneuze aandoeningen ....................................................................................................................... 42
1.3.4. Lymfatische aandoeningen ................................................................................................................. 48
1.3.5. Neurologische aandoeningen ............................................................................................................. 59
1.4. Evaluatie van patiënten met een vasculaire pathologie ............................................................................ 63
1.5. Klinische casussen ...................................................................................................................................... 63
2. Oncologische revalidatie (deel 1) ...................................................................................................................... 64
2.1. Introductie.................................................................................................................................................. 64
2.2. Morbiditeiten bij kanker ............................................................................................................................ 65
2.2.1. Psychologisch en psycho-sociaal gerelateerde comorbiditeiten ........................................................ 66
2.2.2. Fysiologisch gerelateerde comorbiditeiten ......................................................................................... 71
2.3. Metabolisme bij kanker.............................................................................................................................. 77
2.3.1. Moleculair metabolisme ..................................................................................................................... 77
2.3.2. Energieverbruik (EE) ............................................................................................................................ 80
2.3.3. Effecten van kanker en chemotherapie op energiebalans in termen van energieverbruik ................ 81
2.4. Revalidatie bij kanker ................................................................................................................................. 82
3. Oncologische revalidatie (deel 2) ...................................................................................................................... 83
3.1. Geschiedenis van kanker ............................................................................................................................ 83
3.2. Cijfers rond kanker ..................................................................................................................................... 83
3.3. Fysiotherapie na kanker ............................................................................................................................. 84
3.3.1. Waarom is revalidatie bij kanker nodig? ............................................................................................. 84
3.3.2. Definitie kanker revalidatie? ............................................................................................................... 84
3.3.3. Quality of Life (QoL) ............................................................................................................................ 84
3
, 3.3.4. Behandeldoelen .................................................................................................................................. 85
3.3.5. Mogelijke problemen tijdens de behandeling .................................................................................... 86
3.3.6. Maar waar ligt nu eigenlijk het probleem? ......................................................................................... 89
3.3.7. Korte en lange termijn effecten van kankerbehandelingen .............................................................. 101
4. Bortskanker en lymfeoedeem ......................................................................................................................... 103
4.1. Borstkanker .............................................................................................................................................. 103
4.1.1. Introductie......................................................................................................................................... 103
4.1.2. Wat is borstkanker? .......................................................................................................................... 105
4.1.3. Typen borstkanker ............................................................................................................................ 105
4.1.4. Metastasen........................................................................................................................................ 106
4.1.5. Risicofactoren .................................................................................................................................... 106
4.1.6. Diagnose ............................................................................................................................................ 108
4.1.7. Behandeling....................................................................................................................................... 111
4.1.8. Overleving ......................................................................................................................................... 116
4.2. Lymfeoedeem (na borstkanker) ............................................................................................................... 117
4.2.1. Definitie ............................................................................................................................................. 117
4.2.2. Incidentie........................................................................................................................................... 118
4.2.3. Risicofactoren .................................................................................................................................... 119
4.2.4. Complicaties ...................................................................................................................................... 119
4.2.5. Evaluatie ............................................................................................................................................ 120
4.2.6. Preventie ........................................................................................................................................... 126
4.2.7. Behandeling....................................................................................................................................... 132
4.3. Schouder- en armmorbiditeit na borstkanker ......................................................................................... 137
4.3.1. Verlies aan mobiliteit ........................................................................................................................ 137
4.3.2. Pijn..................................................................................................................................................... 139
4.3.3. Triggerpoints ..................................................................................................................................... 140
4.3.4. Krachtverlies ...................................................................................................................................... 141
4.3.5. Verkorting M. Pectoralis Maior en Minor ......................................................................................... 142
4.3.6. Paresthesie ........................................................................................................................................ 143
4.3.7. Axillary Web Syndrome ..................................................................................................................... 144
4.3.8. Scapula alata ..................................................................................................................................... 145
4.3.9. Seroma .............................................................................................................................................. 146
4.3.10. Borstoedeem ................................................................................................................................... 146
4.4. Postoperatieve behandeling en preventie ............................................................................................... 150
4.4.1. Informatie ......................................................................................................................................... 150
4.4.2. Mobilisaties ....................................................................................................................................... 150
4.4.3. Stretchen ........................................................................................................................................... 150
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