Samenvatting
Samenvatting Stationtoets 3A/3C
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Uitwerking van alle pathologieen van de stationtoets van MSA. Pathologieen beschreven met symptomen, het onderzoek en de behandeling ervan. Stationtoets jaar 3 in blok A of C.
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4 december 2017
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Stationstoets 3A
Inhoudsopgave
Schouder –........................................................................................................................................3
Anterieure laxiteit van het kapsel.......................................................................................................3
Posterieure laxiteit van het kapsel.....................................................................................................3
Rotatorcuff dysfunctie/ ruptuur.........................................................................................................3
AC-artropathie...................................................................................................................................4
TOS – Thorcic Outlet Syndrome..........................................................................................................5
SLAP laesie.........................................................................................................................................5
Scapulaire dyskinesie.........................................................................................................................6
Impingement......................................................................................................................................6
Elleboog –..........................................................................................................................................7
Ulnaire instabiliteit.............................................................................................................................7
Postero-laterale instabiliteit...............................................................................................................7
Epicondylitis lateralis – tenniselleboog..............................................................................................8
Epicondylitis medialis – golfelleboog..................................................................................................8
Plica impingement.............................................................................................................................9
Ruptuur distale biceps pees................................................................................................................9
Pols & hand –...................................................................................................................................10
Scapholunaire instabiliteit................................................................................................................10
Midcarpale instabiliteit....................................................................................................................10
Lunotriquetrale instabiliteit..............................................................................................................10
Radio-ulnaire instabiliteit.................................................................................................................11
Morbus Quervain.............................................................................................................................11
Occult ganglion................................................................................................................................12
Os scaphoid fractuur........................................................................................................................12
Carpaal tunnel syndroom.................................................................................................................13
Volair plaatletsel..............................................................................................................................13
Collateraal band letsel.....................................................................................................................14
Triggervinger....................................................................................................................................14
TFCC letsel........................................................................................................................................14
Skiduim............................................................................................................................................15
CMC gewricht...................................................................................................................................15
Perifeer entrapment n ulnaris..........................................................................................................16
Perifeer entrapment n medianus......................................................................................................16
Perifeer entrapement n radialis........................................................................................................17
Dupuytren........................................................................................................................................18
Heup –.............................................................................................................................................19
Heupartrose.....................................................................................................................................19
Labrum letsel...................................................................................................................................20
Heupdysplasie..................................................................................................................................20
Acetabulum- femorale anteroire inpingement (FAI).........................................................................21
Liesklachten/ adductor gerelateerde klachten.................................................................................21
Snapping Hip....................................................................................................................................22
Knie –..............................................................................................................................................22
Voorste kruisband letsel...................................................................................................................23
Achterste kruisband letsel................................................................................................................23
, Meniscus letsel.................................................................................................................................24
Mediale collateraal band letsel........................................................................................................24
Lateraal collateraal bandletsel.........................................................................................................25
Patellofemoraal pijn syndroom........................................................................................................25
Postomediaal Complex Letsel (PMC)................................................................................................26
Postolateraal complex letsel (PMC)..................................................................................................26
Kraakbeen letsel...............................................................................................................................26
Jumpers knee...................................................................................................................................27
Runners knee...................................................................................................................................27
Enkel/ voet –...................................................................................................................................27
Fractuur...........................................................................................................................................27
Ruptuur ligamentum Talo-fibulare anterior (TFA)............................................................................28
Syndesmose letsel............................................................................................................................28
Achillespeesruptuur.........................................................................................................................29
Enkel impingement..........................................................................................................................29
Spierruptuur.....................................................................................................................................29
Veneuze trombose............................................................................................................................30
Mediaal Tibiaal stress syndroom......................................................................................................30
Compartimentsyndroom..................................................................................................................31
Hielspoor/ fancitis plantaris.............................................................................................................31
CWK/ TWK –....................................................................................................................................32
Cervicale radiculopathie...................................................................................................................32
Cervicale Myelopathie......................................................................................................................33
Cervicale stenose..............................................................................................................................33
Morbus Bechterew...........................................................................................................................34
M scheuermann...............................................................................................................................34
Motor control CWK..........................................................................................................................35
Cervicale instabiliteit........................................................................................................................35
Cervicale artrose..............................................................................................................................36
LWK + bekken –...............................................................................................................................36
Reduced motor control.....................................................................................................................36
Excessive motor control....................................................................................................................37
SI-problematiek................................................................................................................................37
Bekken instabiliteit...........................................................................................................................38
Lumbale artrose...............................................................................................................................38
Spondylolisthesis..............................................................................................................................39
2
,Schouder –
Anterieure laxiteit van het kapsel
Symptomen Onderzoek
- Instabiel gevoel bij naar voren reiken - Problematische handeling
- Toegenomen PROM/AROM - Inspectie/palpatie
- Klik klachten - PROM/AROM
- Eindstandig pijnlijk - Horizontale retroflexie test
- Eindstandig instabiel gevoel - Apprehension – relocation – release
test
Behandeling
- Pijn + mogelijke ontsteking verminderen rust, ijs, NSAID
- Preventie van luxatie door middel van houdingstraining
- Mobilisatie richting adductie en endorotatie
- Neuromusculaire training van de schouder
- Spierversterkende oefeningen rotator cuff, deltoideus
Posterieure laxiteit van het kapsel.
Symptomen Onderzoek
- Licht prominerende proc - Problematische handeling
coracoideus - Inspectie/palpatie
- Beperkte elevatie, exorotatie - PROM/AROM
- Posterieure translatie vergroot - Posterior Jerk test
- Instabiel gevoel, klik klachten - Achterste stress test
- Pijn
- Uiting aan de laterale zijde.
Behandeling
- Pijn + mogelijke ontsteking verminderen rust, ijs, NSAID
- Preventie van luxatie door middel van houdingstraining
- Mobilisatie richting adductie en endorotatie
- Neuromusculaire training van de schouder
- Spierversterkende oefeningen rotator cuff
Rotatorcuff dysfunctie/ ruptuur
Symptomen Onderzoek
3
, - Acuut bij jongere, icm - PROM/AROM
bloeduitstorting, pijn en - Drop sign teres minor +
krachtsvermindering. infraspinatus
- Chronisch bij oudere, vaak een - External rotation lag sign
sluipend begin, slijmbeurs infraspinatus
ontsteking, verstoring van beweging - Full can / empty can infraspinatus,
en slaapproblemen. supraspinatus
- Pijn is savonds erger - Bear hug subscapularis
- Pijn vooral in de bovenarm - Lift off test subscapularis
- Liggen geeft pijn - Exorotatie tegen weerstand
Behandeling
- Pijn en mogelijke inflammatie verminderen
- Krachttraining UHV
o 10-20 hh
o 2-4 sets
o 20-50% van 1RM
- Bij een groot trauma eventueel opereren.
AC-artropathie
Symptomen Onderzoek
- Pijn tijdens bewegen - Palpatie AC
- Scherpe lokale pijn - PROM/AROM
- Provocatie bij anteflexie, rotatie en - AC resisted compression
horizontale adductie. - Paxinos sign
- Liggen op de aangedane zijde is - Pianotoetsfenomeen.
pijnlijk.
Behandeling:
- Eventueel een operatie bij ernstige scheur.
- Pijn verminderen door middel van ultra geluid, of warmte therapie.
- Isometrisch trainen
o 10 sec weerstand van de hand
- schouderspieren trainen + houding trainen.
Indeling AC-artopathie:
4