Op aanraden van mijn medestudenten verkoop ik nu mijn samenvattingen! In deze samenvatting maak ik veel gebruik van afbeeldingen, tabellen en opsommingen. Hierdoor hoef je geen lange lappen saaie en ingewikkelde tekst te lezen. In deze samenvatting staat alle stof van de boeken, colleges en leerdoe...
,Inhoud
Week 5: Pain...........................................................................................................................................6
Taxonomy of pain...................................................................................................................................6
A painful history.................................................................................................................................7
The (over)demanding and (over)sensitive patient..........................................................................7
Modern western medicine.............................................................................................................8
Somatic sensations: I. General organisation, the tactile and position senses...................................10
Detection and transmission of tactile sensations.........................................................................10
The dorsal column-medial lemniscal system (DC-ML system)......................................................10
Anterolateral pathway..................................................................................................................12
Somatic sensations: II. Pain, Headache and Thermal sensations......................................................14
Pain suppression: “analgesia”.......................................................................................................14
Clinical abnormalities of pain and other somatic sensations........................................................14
Headache......................................................................................................................................15
Thermal sensation........................................................................................................................15
Opioid analgesics and the management of pain...............................................................................16
Opioid analgesics..........................................................................................................................19
Pain management.........................................................................................................................21
Nonsteroidal anti-inflammatory drugs.............................................................................................23
Nonsteroidal anti-inflammatory drugs.........................................................................................24
Nonselective NSAIDs.....................................................................................................................24
Selective COX-2 inhibitors.............................................................................................................25
Paracetamol..................................................................................................................................26
Indications for using NSAIDs.........................................................................................................26
Multidisciplinary assessment of patients with chronic pain.............................................................27
Pain in the palliative phase...............................................................................................................28
Placebo and nocebo.........................................................................................................................29
Pain and occupation.........................................................................................................................30
Week 6: Headache................................................................................................................................33
Headache and facial pain......................................................................................................................33
Migraine.......................................................................................................................................33
Facial pain.....................................................................................................................................35
Cluster headache..........................................................................................................................36
Temporal arteritis.........................................................................................................................37
Tension-type headache................................................................................................................37
2
, Acute headache............................................................................................................................38
Red flags in cases of headache.....................................................................................................38
Infections of the central nervous system and meninges..................................................................40
Meningitis.....................................................................................................................................40
Brain abscess................................................................................................................................43
Viral encephalitis..........................................................................................................................44
Neurological complications of HIV infections...............................................................................46
Tuberculosis of the central nervous system.................................................................................47
Tetanus.........................................................................................................................................48
Syphilis..........................................................................................................................................48
Neuroborreliosis...........................................................................................................................49
Headache and fever..........................................................................................................................51
Pharmacotherapy in migraines.........................................................................................................52
Pathogenesis of migraine.............................................................................................................52
Drugs for migraines......................................................................................................................53
Management of migraine and other headaches...........................................................................54
Week 7.................................................................................................................................................55
Neuroanatomy: Diencephalon.............................................................................................................55
Neuroanatomy: Cerebral hemispheres/telencephalon....................................................................56
Anatomy of the cerebral hemispheres.........................................................................................56
Basal ganglia.................................................................................................................................59
Internal capsule............................................................................................................................61
Neuroanatomy: Ventricles and coverings of the brain.....................................................................63
The ventricular system.................................................................................................................63
Meninges and submeningeal spaces............................................................................................64
Skull..............................................................................................................................................66
Neuroanatomy: Vascular supply.......................................................................................................68
Arterial supply of the brain...........................................................................................................68
Venous drainage...........................................................................................................................71
Strength and sensation.....................................................................................................................74
The spinal reflex............................................................................................................................74
Sensory feeling.............................................................................................................................76
Central sensory pathways.............................................................................................................76
Segmentation of the spinal cord...................................................................................................77
Clinically relevant reflexes............................................................................................................78
Examination of the motor and sensory system............................................................................78
3
, Non-organic disorders..................................................................................................................81
Motor control...................................................................................................................................82
Central motor control...................................................................................................................82
The basal ganglia..........................................................................................................................82
The cerebellum.............................................................................................................................85
The higher cerebral functions...........................................................................................................87
Functions of the cerebral cortex...................................................................................................87
Aphasia.........................................................................................................................................87
Apraxia..........................................................................................................................................88
Agnosia.........................................................................................................................................88
Aprosody......................................................................................................................................89
Spatial disorders...........................................................................................................................89
Cognitive disorders.......................................................................................................................89
The visual system..............................................................................................................................91
Central visual information processing..........................................................................................91
Visual field defects........................................................................................................................92
Higher visual disorders.................................................................................................................93
Positive visual phenomena...........................................................................................................93
Diseases of the spinal cord...............................................................................................................94
Loss of function due to spinal injury.............................................................................................95
Traumatic spinal cord injuries.......................................................................................................96
Spinal cord compression due to non-traumatic causes................................................................97
Myelopathy without spinal cord compression..............................................................................98
The cerebrovascular system.............................................................................................................99
Arterial blood supply to the brain.................................................................................................99
Venous drainage.........................................................................................................................101
The blood-brain barrier..............................................................................................................101
The cerebral blood flow..............................................................................................................102
Pathological vascular changes....................................................................................................103
Cerebrovascular diagnostics.......................................................................................................105
Cerebral infarction and cerebral haemorrhage..............................................................................107
Terminology................................................................................................................................107
Causes and effects......................................................................................................................107
Clinical aspects of cerebral vascular occlusions..........................................................................108
Treatment for cerebral infarctions.............................................................................................109
Intracranial haemorrhages.........................................................................................................110
4
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