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Volledige samenvatting Blok Heelkunde Geneeskunde Master jaar 1 $19.45   Add to cart

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Volledige samenvatting Blok Heelkunde Geneeskunde Master jaar 1

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Dit is een volledige samenvatting van alle heelkundige onderdelen van de geneeskunde. Het is een document die alle leerstof bevat voor het blok Heelkunde van het eerste jaar master. De samenvatting is duidelijk, overzichtelijk, goed leesbaar en bevat illustraties. Een super handig document die ik...

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  • January 14, 2024
  • 133
  • 2022/2023
  • Summary

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By: carlotaeikelboom • 3 months ago

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Blok 3 – Heelkunde
Samenva'ng

Inhoudsopgave

Anatomie........................................................................................................................................................ 4
Hand ................................................................................................................................................................... 4
Pols ..................................................................................................................................................................... 5
Arm ..................................................................................................................................................................... 5
Voet..................................................................................................................................................................... 7
Enkel ................................................................................................................................................................... 7
Been .................................................................................................................................................................... 9
Buik ..................................................................................................................................................................... 9
Lies ...................................................................................................................................................................... 9
Hals ................................................................................................................................................................... 11
Oor .................................................................................................................................................................... 14
Mond ................................................................................................................................................................ 18
Neus .................................................................................................................................................................. 19

Trauma ......................................................................................................................................................... 20
Veelvoorkomende aandoeningen hand & pols ................................................................................................. 20
Morbus Dupuytren ...................................................................................................................................... 20
Carpaal tunnel syndroom............................................................................................................................. 20
Trigger finger (snapping finger) .................................................................................................................... 20
Artrose ......................................................................................................................................................... 20
Reumatoïde artri?s ...................................................................................................................................... 20
Letsels bovenste extremiteit ............................................................................................................................. 21
Hand & pols ................................................................................................................................................. 21
Arm & elleboog ............................................................................................................................................ 25
Letsels onderste extremiteit .............................................................................................................................. 28
Onderbeen ................................................................................................................................................... 28
Enkel............................................................................................................................................................. 31
PostoperaIeve pijn ........................................................................................................................................... 32
Polytrauma ....................................................................................................................................................... 33
Aantekeningen college ................................................................................................................................. 33
E-learning ABCDE-techniek .......................................................................................................................... 35
Traumaopvang en ATLS ................................................................................................................................ 37
Shock............................................................................................................................................................ 39
Damage control chirurgie ............................................................................................................................ 44
Thoraxtrauma .............................................................................................................................................. 45
Buiktrauma .................................................................................................................................................. 49
PerioperaIeve zorg ........................................................................................................................................... 50
Wondverzorging ............................................................................................................................................... 53

,Thorax .......................................................................................................................................................... 55
AortadissecIe – pijn op de borst....................................................................................................................... 55
Differen?aaldiagnose pijn op de borst ......................................................................................................... 56
Mesenteriaal trombose – acute buikpijn .......................................................................................................... 56
Differen?aaldiagnose acute buikpijn ........................................................................................................... 57
Knobbel in de borst ........................................................................................................................................... 58
Differen?aaldiagnose ................................................................................................................................... 58
Mammacarcinoom ....................................................................................................................................... 58
Fibrocysteuze mastopathie .......................................................................................................................... 60
Gynaecomas?e ............................................................................................................................................ 60
Slikklachten ....................................................................................................................................................... 61
Diver?kels .................................................................................................................................................... 61
Mo?liteitsstoornissen .................................................................................................................................. 62
Hernia diafragma?ca.................................................................................................................................... 63
Gastro-oesofageale refluxziekte (GERD) ...................................................................................................... 63
Oesofagustumoren ...................................................................................................................................... 64
Arterieel vaatlijden – pijn onderbeen ............................................................................................................... 65
Perifeer arterieel vaatlijden ......................................................................................................................... 65
Varices .......................................................................................................................................................... 68
Diep-veneuze trombose en longembolie ..................................................................................................... 69

Abdomen ..................................................................................................................................................... 71
Beeldvorming abdomen – CT ............................................................................................................................ 71
Galsteenlijden – koliekpijn ................................................................................................................................ 71
Differen?aaldiagnose pijnaanvallen in de buik ............................................................................................ 73
Rectaal bloedverlies .......................................................................................................................................... 73
Differen?aaldiagnose bloed bij de ontlas?ng .............................................................................................. 73
Colorectaal carcinoom ................................................................................................................................. 74
Acute buik- en rugpijn ....................................................................................................................................... 75
Differen?aaldiagnose acute buik- en rugpijn ............................................................................................... 75
Symptoma?sch aorta aneurysma ................................................................................................................ 75
Buikpijn ............................................................................................................................................................. 76
Differen?aaldiagnose ................................................................................................................................... 76
Acute buik .................................................................................................................................................... 78
Peritoni?s ..................................................................................................................................................... 81
Pijn rechtsonder in de buik................................................................................................................................ 82
Differen?aaldiagnose ................................................................................................................................... 82
Appendici?s ................................................................................................................................................. 83
Pijn linksonder in de buik .................................................................................................................................. 83
Differen?aaldiagnose ................................................................................................................................... 83
Diver?culi?s ................................................................................................................................................. 84
Zwelling in de lies .............................................................................................................................................. 86
Differen?aaldiagnose ................................................................................................................................... 86
Hernia inguinalis .......................................................................................................................................... 86
PostoperaIeve complicaIes ............................................................................................................................. 87
Aantekeningen college ................................................................................................................................. 87
Protocol PONV of postopera?eve misselijkheid en braken voor pa?ënten >16 jaar ................................... 88
Post-opera?eve pijn ..................................................................................................................................... 89
Infec?es, an?bio?ca en resisten?e .............................................................................................................. 92

,KNO .............................................................................................................................................................. 97
Duizeligheid ...................................................................................................................................................... 97
Evenwicht ..................................................................................................................................................... 97
Duizeligheid in je spreekkamer .................................................................................................................... 98
Differen?aaldiagnose duizeligheid ............................................................................................................. 101
Tinnitus ........................................................................................................................................................... 103
Oorsuizen (?nnitus) ................................................................................................................................... 103
Beleid bij ?nnitus ....................................................................................................................................... 105
Differen?aaldiagnose bij ?nnitus ............................................................................................................... 105
Oorpijn ............................................................................................................................................................ 107
Od?s media .............................................................................................................................................. 107
Od?s externa ............................................................................................................................................ 108
Differen?aaldiagnose oorpijn .................................................................................................................... 109
Keelpijn ........................................................................................................................................................... 109
Differen?aaldiagnose keelpijn ................................................................................................................... 109
(Faryngo)tonsilli?s ..................................................................................................................................... 110
Verstopte neus ................................................................................................................................................ 111
Differen?aaldiagnose verstopte neus ........................................................................................................ 111
Rini?s ......................................................................................................................................................... 111
Rhinosinusi?s ............................................................................................................................................. 112
Radiotherapie ................................................................................................................................................. 113

Samenva>ng van de samenva>ng ............................................................................................................. 116
Trauma ........................................................................................................................................................... 116
Thorax ............................................................................................................................................................. 119
Abdomen ........................................................................................................................................................ 120
KNO................................................................................................................................................................. 124
Anatomie ........................................................................................................................................................ 128

,Anatomie

Hand
è Zie prac)cumhandleiding

- Os metacarpale I vormt samen met het os trapezium een
zadelgewricht waarin veel bewegingen mogelijk zijn
o Hierdoor hee> de duim een essen)ële rol bij het
grijpen
- Andere metacarpalia zijn rigide met de handwortel
verbonden
- MCP-gewricht van de duim is rigide en laat weinig
bewegingen toe

Vingers:
- Flexie en extensie van de falangen worden mogelijk door 2
buigpezen en 1 strekpees
o Vingerflexoren: mm. Flexor digitorum profundus
en superficialis
o Vingerextensoren: mm. Interossei en mm.
Lumbricalis
- Volaire plaat: beschermt de vingers tegen hyperextensie
- Pulley’s: bindweefseltunnels; houden de flexorpezen
tegen het bot

,Pols
è Zie prac)cumhandleiding

- 2 gewrichten:
o Radiocarpale gewricht (os scaphoid en lunatum)
§ Bewegingen: flexie, extensie, abduc)e en adduc)e
o Radio-ulnaire gewricht (DRU)
§ Bewegingen: pro- en supina)e onderarm
§ Radius draait om de ulna
- Ulna: ar)culeert niet direct met de carpalia;
o Tussen de ulna en hamatum en triquetrum zit het TFCC
(triangulaire fibrocarDlagineuze complex) (een driehoekig
bindweefselstructuur)
- 3 kolommen:
o Radiare kolom: ossale afsteuning van het scaphoïd en de
aanhech)ng van intracapsulaire ligamenten (vooral rich)ng
processus styloïdeus radii)
o Middelste kolom: krachtoverdracht (os lunatum)
o Ulnaire kolom: rota)e en krachtoverdracht (via TFCC en
processus styloïdeus ulnae)
- Extrinsieke spieren: oorsprong buiten pols en hand
o Extensie van de pols
§ M. extensor carpi radialis longus
§ M. extensor carpi radialis brevis
§ M. extensor carpi ulnaris
o Flexie van de vingertoppen
§ Mm. Flexor digitorum profundus
o Flexie middenkootje
§ Mm. Flexor digitorum superficialis
o Flexie pols
§ M. flexor carpi radialis
§ M. flexor carpi ulnaris
§ M. palmaris longus (niet bij iedereen aanwezig)
- Intrinsieke spieren: in de hand
o Extensie vingers en flexie MCP’s
§ Mm. Lumbricalis
o Spreiden vingers
§ Mm. Interosseï dorsalis
o Sluiten vingers
§ Mm. Interosseï palmaris

Arm

Het ellebooggewricht: humerus, ulna en radius – 1 gewrichtsholte
- Bewegingen: in 2 rich)ngen mogelijk
o Flexie/extensie: hoofdzakelijk tussen de humerus en ulna + radius.
o Rota)e (pro- en supina)e): hoofdzakelijk tussen radius en ulna.

, - Gewrichten
o Het proximale radio-ulnaire gewricht: capitulum radii, die roteert ten
opzichte van de ulna.
o Het distale radio-ulnaire gewricht: t.h.v. de pols.
o Het humeroradiale gewricht en humero ulnaire gewricht werken samen als
een scharniergewricht.
- Ligamenten en spieren
o Mediale en laterale collaterale banden à stabiel gewricht
§ De radiuskop wordt op zijn plaats gehouden door het lig. annulare.
§ Extensie wordt hoofdzakelijk verzorgd door de m. triceps brachii.
§ Flexie wordt hoofdzakelijk verzorgd door de m. biceps brachii, de m.
brachialis en de m. brachioradialis.
§ PronaDe wordt verzorgd door de m. pronator teres
§ SupinaDe wordt verzorgd door de m. supinator en m. biceps brachii.

Vragen e-learning:
- Radiuskopluxa)e à valgusstand elleboog
- Pro- en supina)e: door het roteren van de radius om de
ulna.
o Hierbij wordt zowel het proximale- als het distale
radio-ulnaire gewricht gebruikt.
- Tijdens supina)e liggen de radius en ulna naast elkaar
- Fracturen/ luxa)e elleboog:
o Supracondylaire humerusfractuur à n. radialis at
risk (loopt op het distale 1/3e deel vand e
humerus naar anterieur)
o Luxa)efractuur met sulcus ulnaris aangedaan à
n. ulnaris at risk

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