Inhoudsopgave
HC 2.02 Bindweefsel ................................................................................................................................... 4
Cellen -> weefsels ................................................................................................................................................. 4
Bindweefsel .......................................................................................................................................................... 5
Fibroblast ............................................................................................................................................................. 5
proteoglycaanaggregaat ..................................................................................................................................... 6
Bindweefsel algemeen ......................................................................................................................................... 6
Bouw van collageen ............................................................................................................................................. 6
Van molecuul (a) naar fibril (c) ............................................................................................................................ 7
Collageen: onbelast vs belast............................................................................................................................... 7
Elastine................................................................................................................................................................. 7
Pees, membrana fibrosa en ligament: fibreus of collageen bindweefsel ............................................................ 7
Pees en ligament .................................................................................................................................................. 7
Relatie ligament en gewricht ............................................................................................................................... 7
Articulatio synovialis ............................................................................................................................................ 7
HC 3.01 A ................................................................................................................................................... 8
Fasen weefselherstel ............................................................................................................................................ 8
Lagen in de afweer ............................................................................................................................................... 8
Fysieke barrière .................................................................................................................................................... 8
A-specifieke afweer .............................................................................................................................................. 8
Specifieke afweer ................................................................................................................................................. 9
Oorzaken van de ontstekingsreactie.................................................................................................................... 9
Micro-organismen................................................................................................................................................ 9
Weefselschade als gevolg van auto-immuunreactie ........................................................................................... 9
Ontsteking: fysiologische reactie op beschadigd weefsel.................................................................................... 9
Ontstekingsmediatoren: alarmstoffen en groeifactoren ..................................................................................... 9
Intermezzo: hoe ontstaat weefselvocht? ..................................................................................................... 10
Cellulaire reactie ........................................................................................................................................... 11
Lokale ontstekingsverschijnselen: ...................................................................................................................... 11
Andere plaats, ander effect ............................................................................................................................... 11
Hc 3.01 B .................................................................................................................................................. 12
Proliferatiefase................................................................................................................................................... 12
Cytokinen stimuleren fibroblasten tot beweging en deling. .............................................................................. 12
Wondcontractie ................................................................................................................................................. 12
Remodelleringsfase/ reorganisatiefase ............................................................................................................. 13
Conclusie ............................................................................................................................................................ 13
,Hc 3.02 A .................................................................................................................................................. 14
Diagnostisch proces ........................................................................................................................................... 14
Anamnese .......................................................................................................................................................... 14
Onderzoek .......................................................................................................................................................... 14
Diagnose en indicatiestelling ............................................................................................................................. 14
Onderzoek vs hulpvraag..................................................................................................................................... 15
Diagnoses ........................................................................................................................................................... 15
Medische diagnose ....................................................................................................................................... 15
Fysiotherapeutische diagnose 1......................................................................................................................... 15
Fysiotherapeutische diagnose 2......................................................................................................................... 15
Therapeutische fase ........................................................................................................................................... 15
Hc 3.02 B .................................................................................................................................................. 16
ICF nut en noodzaak........................................................................................................................................... 16
ICF....................................................................................................................................................................... 16
Stoornis in functies en anatomische eigenschappen ......................................................................................... 16
Beperking in activiteiten .................................................................................................................................... 16
Beperking in participatie .................................................................................................................................... 17
Externe factoren................................................................................................................................................. 17
Persoonlijke factoren: ........................................................................................................................................ 17
HC 3.02 C.................................................................................................................................................. 18
Methoden data verzameling.............................................................................................................................. 18
Verzamelmethode......................................................................................................................................... 18
Methodiek casuïstiek (hypothetico deductief) ............................................................................................. 18
Patroonherkenning ....................................................................................................................................... 18
Rehabiliation problem solving formulier (RPS) .................................................................................................. 18
HC 4.02 A ................................................................................................................................................. 19
Belangrijkste doel zenuwstelsel ......................................................................................................................... 19
Soorten cellen in het zenuwstelsel ..................................................................................................................... 19
Prikkelvorming en geleiding: de actiepotentiaal ............................................................................................... 19
Myeline (schedes) .............................................................................................................................................. 20
Prikkelgeleiding: de zenuw................................................................................................................................. 20
BELANGRIJK PLAATJE! ................................................................................................................................... 20
Prikkeloverdracht: neuromusculaire transmissie............................................................................................... 21
Prikkeloverdacht: neuron naar neuron (snaps) ................................................................................................. 21
Excitatie en inhibitie ........................................................................................................................................... 21
Prikkeltransport ................................................................................................................................................. 21
Centraal en perifeer zenuwstelsel ...................................................................................................................... 22
Somatisch en autonoom zenuwstelsel ............................................................................................................... 22
HC 4.02 B ................................................................................................................................................. 23
, Proprioceptie ...................................................................................................................................................... 23
Spierspoel ........................................................................................................................................................... 23
Pees- en gewrichtssensoren ............................................................................................................................... 24
Evenwichtsorgaan (vestibulair apparaat, propriosensoren) ............................................................................. 24
Exteroceptie ....................................................................................................................................................... 24
Somatosensoriek ................................................................................................................................................ 25
Sensomotorische integratie (ruggenmerg, hersenen) ....................................................................................... 25
HC 5.02 .................................................................................................................................................... 25
Therapeutisch proces ......................................................................................................................................... 25
Richtlijn fysiotherapeutische dossiervoering KNGF (2019) ................................................................................ 26
Behandelplan in de richtlijn ............................................................................................................................... 26
Hoofdoel en subdoelen ...................................................................................................................................... 26
Behandelbare grootheden ................................................................................................................................. 27
Spier ................................................................................................................................................................... 27
Gewricht ............................................................................................................................................................. 27
Perifeer zenuwstelsel ......................................................................................................................................... 27
Centraal zenuwstelsel ........................................................................................................................................ 27
Activiteiten (zonder duidelijke functiestoornis of bij systeemaandoening/NAH/etc.) ...................................... 28
Systeemfuncties ................................................................................................................................................. 28
Overig ................................................................................................................................................................. 29
HC 2.02 Bindweefsel ................................................................................................................................... 4
Cellen -> weefsels ................................................................................................................................................. 4
Bindweefsel .......................................................................................................................................................... 5
Fibroblast ............................................................................................................................................................. 5
proteoglycaanaggregaat ..................................................................................................................................... 6
Bindweefsel algemeen ......................................................................................................................................... 6
Bouw van collageen ............................................................................................................................................. 6
Van molecuul (a) naar fibril (c) ............................................................................................................................ 7
Collageen: onbelast vs belast............................................................................................................................... 7
Elastine................................................................................................................................................................. 7
Pees, membrana fibrosa en ligament: fibreus of collageen bindweefsel ............................................................ 7
Pees en ligament .................................................................................................................................................. 7
Relatie ligament en gewricht ............................................................................................................................... 7
Articulatio synovialis ............................................................................................................................................ 7
HC 3.01 A ................................................................................................................................................... 8
Fasen weefselherstel ............................................................................................................................................ 8
Lagen in de afweer ............................................................................................................................................... 8
Fysieke barrière .................................................................................................................................................... 8
A-specifieke afweer .............................................................................................................................................. 8
Specifieke afweer ................................................................................................................................................. 9
Oorzaken van de ontstekingsreactie.................................................................................................................... 9
Micro-organismen................................................................................................................................................ 9
Weefselschade als gevolg van auto-immuunreactie ........................................................................................... 9
Ontsteking: fysiologische reactie op beschadigd weefsel.................................................................................... 9
Ontstekingsmediatoren: alarmstoffen en groeifactoren ..................................................................................... 9
Intermezzo: hoe ontstaat weefselvocht? ..................................................................................................... 10
Cellulaire reactie ........................................................................................................................................... 11
Lokale ontstekingsverschijnselen: ...................................................................................................................... 11
Andere plaats, ander effect ............................................................................................................................... 11
Hc 3.01 B .................................................................................................................................................. 12
Proliferatiefase................................................................................................................................................... 12
Cytokinen stimuleren fibroblasten tot beweging en deling. .............................................................................. 12
Wondcontractie ................................................................................................................................................. 12
Remodelleringsfase/ reorganisatiefase ............................................................................................................. 13
Conclusie ............................................................................................................................................................ 13
,Hc 3.02 A .................................................................................................................................................. 14
Diagnostisch proces ........................................................................................................................................... 14
Anamnese .......................................................................................................................................................... 14
Onderzoek .......................................................................................................................................................... 14
Diagnose en indicatiestelling ............................................................................................................................. 14
Onderzoek vs hulpvraag..................................................................................................................................... 15
Diagnoses ........................................................................................................................................................... 15
Medische diagnose ....................................................................................................................................... 15
Fysiotherapeutische diagnose 1......................................................................................................................... 15
Fysiotherapeutische diagnose 2......................................................................................................................... 15
Therapeutische fase ........................................................................................................................................... 15
Hc 3.02 B .................................................................................................................................................. 16
ICF nut en noodzaak........................................................................................................................................... 16
ICF....................................................................................................................................................................... 16
Stoornis in functies en anatomische eigenschappen ......................................................................................... 16
Beperking in activiteiten .................................................................................................................................... 16
Beperking in participatie .................................................................................................................................... 17
Externe factoren................................................................................................................................................. 17
Persoonlijke factoren: ........................................................................................................................................ 17
HC 3.02 C.................................................................................................................................................. 18
Methoden data verzameling.............................................................................................................................. 18
Verzamelmethode......................................................................................................................................... 18
Methodiek casuïstiek (hypothetico deductief) ............................................................................................. 18
Patroonherkenning ....................................................................................................................................... 18
Rehabiliation problem solving formulier (RPS) .................................................................................................. 18
HC 4.02 A ................................................................................................................................................. 19
Belangrijkste doel zenuwstelsel ......................................................................................................................... 19
Soorten cellen in het zenuwstelsel ..................................................................................................................... 19
Prikkelvorming en geleiding: de actiepotentiaal ............................................................................................... 19
Myeline (schedes) .............................................................................................................................................. 20
Prikkelgeleiding: de zenuw................................................................................................................................. 20
BELANGRIJK PLAATJE! ................................................................................................................................... 20
Prikkeloverdracht: neuromusculaire transmissie............................................................................................... 21
Prikkeloverdacht: neuron naar neuron (snaps) ................................................................................................. 21
Excitatie en inhibitie ........................................................................................................................................... 21
Prikkeltransport ................................................................................................................................................. 21
Centraal en perifeer zenuwstelsel ...................................................................................................................... 22
Somatisch en autonoom zenuwstelsel ............................................................................................................... 22
HC 4.02 B ................................................................................................................................................. 23
, Proprioceptie ...................................................................................................................................................... 23
Spierspoel ........................................................................................................................................................... 23
Pees- en gewrichtssensoren ............................................................................................................................... 24
Evenwichtsorgaan (vestibulair apparaat, propriosensoren) ............................................................................. 24
Exteroceptie ....................................................................................................................................................... 24
Somatosensoriek ................................................................................................................................................ 25
Sensomotorische integratie (ruggenmerg, hersenen) ....................................................................................... 25
HC 5.02 .................................................................................................................................................... 25
Therapeutisch proces ......................................................................................................................................... 25
Richtlijn fysiotherapeutische dossiervoering KNGF (2019) ................................................................................ 26
Behandelplan in de richtlijn ............................................................................................................................... 26
Hoofdoel en subdoelen ...................................................................................................................................... 26
Behandelbare grootheden ................................................................................................................................. 27
Spier ................................................................................................................................................................... 27
Gewricht ............................................................................................................................................................. 27
Perifeer zenuwstelsel ......................................................................................................................................... 27
Centraal zenuwstelsel ........................................................................................................................................ 27
Activiteiten (zonder duidelijke functiestoornis of bij systeemaandoening/NAH/etc.) ...................................... 28
Systeemfuncties ................................................................................................................................................. 28
Overig ................................................................................................................................................................. 29