CASUÏSTIEK
Blok 2.4 – Integratie/IP8
,INHOUDSOPGAVE
Standaardprocedure .............................................................................................................................. 5
Anamnese ............................................................................................................................................. 5
Inspectie ................................................................................................................................................ 5
Bewegingsonderzoek ........................................................................................................................... 6
Klachten aan de bovenste extremiteit.................................................................................................. 7
Casus 1 (Schouderklachten links) ........................................................................................................ 7
Pathofysiologie .................................................................................................................................. 7
Onderzoek ......................................................................................................................................... 8
Behandeling .................................................................................................................................... 11
Casus 2 (Subcapitale humerusfractuur) ............................................................................................. 15
Pathofysiologie ................................................................................................................................ 15
Onderzoek ....................................................................................................................................... 15
Behandeling .................................................................................................................................... 16
Casus 3 (Pijn linker elleboog) ............................................................................................................. 18
Pathofysiologie ................................................................................................................................ 18
Onderzoek ....................................................................................................................................... 19
Behandeling .................................................................................................................................... 20
Casus 4 (Osteoporotische polsfractuur) ............................................................................................. 23
Pathofysiologie ................................................................................................................................ 23
Onderzoek ....................................................................................................................................... 23
Behandeling .................................................................................................................................... 24
Casus 5 (Reumatoïde artritis pols) ..................................................................................................... 26
Pathofysiologie ................................................................................................................................ 26
Onderzoek ....................................................................................................................................... 27
Behandeling .................................................................................................................................... 30
Rug- en nekklachten ............................................................................................................................ 34
Casus 6 (Nekklachten met hoofdpijn)................................................................................................. 34
Pathofysiologie ................................................................................................................................ 34
Onderzoek ....................................................................................................................................... 34
Behandeling .................................................................................................................................... 36
Casus 7 (Nek- en schouderklachten) ................................................................................................. 39
Pathofysiologie ................................................................................................................................ 39
Onderzoek ....................................................................................................................................... 39
Behandeling .................................................................................................................................... 42
Casus 8 (Nek- en armklachten) .......................................................................................................... 46
Pathofysiologie ................................................................................................................................ 46
Onderzoek ....................................................................................................................................... 46
Behandeling .................................................................................................................................... 47
Casus 9 (Aspecifieke lage rugpijn) ..................................................................................................... 49
Pathofysiologie ................................................................................................................................ 49
Onderzoek ....................................................................................................................................... 49
Behandeling .................................................................................................................................... 50
1
, Casus 10 (Lage rugklachten met uitstraling in de bil) ........................................................................ 57
Pathofysiologie ................................................................................................................................ 57
Onderzoek ....................................................................................................................................... 57
Behandeling .................................................................................................................................... 58
Casus 11 (Aspecfieke lage rugklachten met uitstraling in het been) ................................................. 63
Pathofysiologie ................................................................................................................................ 63
Onderzoek ....................................................................................................................................... 64
Behandeling .................................................................................................................................... 65
Casus 12 (Lage rugklachten met uitstraling been) ............................................................................. 71
Pathofysiologie ................................................................................................................................ 71
Onderzoek ....................................................................................................................................... 72
Behandeling .................................................................................................................................... 73
Klachten aan de onderste extremiteit ................................................................................................ 75
Casus 13 (Klachten heup/lies regio)................................................................................................... 75
Pathofysiologie ................................................................................................................................ 75
Onderzoek ....................................................................................................................................... 76
Behandeling .................................................................................................................................... 77
Casus 14 (Total hip/knee)................................................................................................................... 80
Pathofysiologie – total hip ............................................................................................................... 80
Onderzoek ....................................................................................................................................... 81
Behandeling .................................................................................................................................... 83
Pathofysiologie – total knee ............................................................................................................ 87
Onderzoek ....................................................................................................................................... 88
Behandeling .................................................................................................................................... 88
Casus 15 (Knieklachten rechts na sportbeoefening).......................................................................... 91
Pathofysiologie ................................................................................................................................ 91
Onderzoek ....................................................................................................................................... 91
Behandeling .................................................................................................................................... 92
Casus 16 (Meniscectomie) ................................................................................................................. 93
Pathofysiologie ................................................................................................................................ 93
Onderzoek ....................................................................................................................................... 94
Behandeling .................................................................................................................................... 96
Casus 17 (Kuitklachten links) ............................................................................................................. 98
Pathofysiologie ................................................................................................................................ 98
Onderzoek ....................................................................................................................................... 98
Behandeling .................................................................................................................................... 99
Casus 18 (Enkelklachten links) ........................................................................................................ 103
Pathofysiologie .............................................................................................................................. 103
Onderzoek ..................................................................................................................................... 104
Behandeling .................................................................................................................................. 105
Centraal neurologische aandoeningen ............................................................................................ 108
Casus 19 (CVA rechts – A. cerebri media) ...................................................................................... 108
Pathofysiologie .............................................................................................................................. 108
Onderzoek ..................................................................................................................................... 109
Behandeling .................................................................................................................................. 109
Casus 20 (Multiple Sclerose) ............................................................................................................ 111
2
, Pathofysiologie .............................................................................................................................. 111
Onderzoek ..................................................................................................................................... 112
Behandeling .................................................................................................................................. 112
Casus 21 (Ziekte van Parkinson) ..................................................................................................... 114
Pathofysiologie .............................................................................................................................. 114
Onderzoek ..................................................................................................................................... 114
Behandeling .................................................................................................................................. 115
Casus 22 (Dwarslaesie C6) .............................................................................................................. 117
Pathofysiologie .............................................................................................................................. 117
Onderzoek ..................................................................................................................................... 118
Behandeling .................................................................................................................................. 119
Perifeer neurologische aandoeningen ............................................................................................. 121
Casus 23 (Polyneuropathie) ............................................................................................................. 121
Pathofysiologie .............................................................................................................................. 121
Onderzoek ..................................................................................................................................... 122
Behandeling .................................................................................................................................. 123
Casus 24 (Plexuslaesie) ................................................................................................................... 125
Pathofysiologie .............................................................................................................................. 125
Onderzoek ..................................................................................................................................... 126
Behandeling .................................................................................................................................. 127
Casus 25 (N. Radialislaesie) ............................................................................................................ 129
Pathofysiologie .............................................................................................................................. 129
Onderzoek ..................................................................................................................................... 129
Behandeling .................................................................................................................................. 130
Casus 26 (N. Ulnarislaesie) .............................................................................................................. 131
Pathofysiologie .............................................................................................................................. 131
Onderzoek ..................................................................................................................................... 131
Behandeling .................................................................................................................................. 132
Casus 27 (N. Femoralislaesie) ......................................................................................................... 134
Pathofysiologie .............................................................................................................................. 134
Onderzoek ..................................................................................................................................... 134
Behandeling .................................................................................................................................. 135
Casus 28 (N. Peroneuslaesie) .......................................................................................................... 137
Pathofysiologie .............................................................................................................................. 137
Onderzoek ..................................................................................................................................... 137
Behandeling .................................................................................................................................. 138
Hart- en longaandoeningen ............................................................................................................... 139
Casus 29 (Myocardinfarct)................................................................................................................ 139
Pathofysiologie .............................................................................................................................. 139
Onderzoek ..................................................................................................................................... 140
Behandeling .................................................................................................................................. 140
Casus 30 (Chronisch hartfalen) ........................................................................................................ 143
Pathofysiologie .............................................................................................................................. 143
Onderzoek ..................................................................................................................................... 144
Behandeling .................................................................................................................................. 144
Casus 31 (Pneumonie) ..................................................................................................................... 146
3
Blok 2.4 – Integratie/IP8
,INHOUDSOPGAVE
Standaardprocedure .............................................................................................................................. 5
Anamnese ............................................................................................................................................. 5
Inspectie ................................................................................................................................................ 5
Bewegingsonderzoek ........................................................................................................................... 6
Klachten aan de bovenste extremiteit.................................................................................................. 7
Casus 1 (Schouderklachten links) ........................................................................................................ 7
Pathofysiologie .................................................................................................................................. 7
Onderzoek ......................................................................................................................................... 8
Behandeling .................................................................................................................................... 11
Casus 2 (Subcapitale humerusfractuur) ............................................................................................. 15
Pathofysiologie ................................................................................................................................ 15
Onderzoek ....................................................................................................................................... 15
Behandeling .................................................................................................................................... 16
Casus 3 (Pijn linker elleboog) ............................................................................................................. 18
Pathofysiologie ................................................................................................................................ 18
Onderzoek ....................................................................................................................................... 19
Behandeling .................................................................................................................................... 20
Casus 4 (Osteoporotische polsfractuur) ............................................................................................. 23
Pathofysiologie ................................................................................................................................ 23
Onderzoek ....................................................................................................................................... 23
Behandeling .................................................................................................................................... 24
Casus 5 (Reumatoïde artritis pols) ..................................................................................................... 26
Pathofysiologie ................................................................................................................................ 26
Onderzoek ....................................................................................................................................... 27
Behandeling .................................................................................................................................... 30
Rug- en nekklachten ............................................................................................................................ 34
Casus 6 (Nekklachten met hoofdpijn)................................................................................................. 34
Pathofysiologie ................................................................................................................................ 34
Onderzoek ....................................................................................................................................... 34
Behandeling .................................................................................................................................... 36
Casus 7 (Nek- en schouderklachten) ................................................................................................. 39
Pathofysiologie ................................................................................................................................ 39
Onderzoek ....................................................................................................................................... 39
Behandeling .................................................................................................................................... 42
Casus 8 (Nek- en armklachten) .......................................................................................................... 46
Pathofysiologie ................................................................................................................................ 46
Onderzoek ....................................................................................................................................... 46
Behandeling .................................................................................................................................... 47
Casus 9 (Aspecifieke lage rugpijn) ..................................................................................................... 49
Pathofysiologie ................................................................................................................................ 49
Onderzoek ....................................................................................................................................... 49
Behandeling .................................................................................................................................... 50
1
, Casus 10 (Lage rugklachten met uitstraling in de bil) ........................................................................ 57
Pathofysiologie ................................................................................................................................ 57
Onderzoek ....................................................................................................................................... 57
Behandeling .................................................................................................................................... 58
Casus 11 (Aspecfieke lage rugklachten met uitstraling in het been) ................................................. 63
Pathofysiologie ................................................................................................................................ 63
Onderzoek ....................................................................................................................................... 64
Behandeling .................................................................................................................................... 65
Casus 12 (Lage rugklachten met uitstraling been) ............................................................................. 71
Pathofysiologie ................................................................................................................................ 71
Onderzoek ....................................................................................................................................... 72
Behandeling .................................................................................................................................... 73
Klachten aan de onderste extremiteit ................................................................................................ 75
Casus 13 (Klachten heup/lies regio)................................................................................................... 75
Pathofysiologie ................................................................................................................................ 75
Onderzoek ....................................................................................................................................... 76
Behandeling .................................................................................................................................... 77
Casus 14 (Total hip/knee)................................................................................................................... 80
Pathofysiologie – total hip ............................................................................................................... 80
Onderzoek ....................................................................................................................................... 81
Behandeling .................................................................................................................................... 83
Pathofysiologie – total knee ............................................................................................................ 87
Onderzoek ....................................................................................................................................... 88
Behandeling .................................................................................................................................... 88
Casus 15 (Knieklachten rechts na sportbeoefening).......................................................................... 91
Pathofysiologie ................................................................................................................................ 91
Onderzoek ....................................................................................................................................... 91
Behandeling .................................................................................................................................... 92
Casus 16 (Meniscectomie) ................................................................................................................. 93
Pathofysiologie ................................................................................................................................ 93
Onderzoek ....................................................................................................................................... 94
Behandeling .................................................................................................................................... 96
Casus 17 (Kuitklachten links) ............................................................................................................. 98
Pathofysiologie ................................................................................................................................ 98
Onderzoek ....................................................................................................................................... 98
Behandeling .................................................................................................................................... 99
Casus 18 (Enkelklachten links) ........................................................................................................ 103
Pathofysiologie .............................................................................................................................. 103
Onderzoek ..................................................................................................................................... 104
Behandeling .................................................................................................................................. 105
Centraal neurologische aandoeningen ............................................................................................ 108
Casus 19 (CVA rechts – A. cerebri media) ...................................................................................... 108
Pathofysiologie .............................................................................................................................. 108
Onderzoek ..................................................................................................................................... 109
Behandeling .................................................................................................................................. 109
Casus 20 (Multiple Sclerose) ............................................................................................................ 111
2
, Pathofysiologie .............................................................................................................................. 111
Onderzoek ..................................................................................................................................... 112
Behandeling .................................................................................................................................. 112
Casus 21 (Ziekte van Parkinson) ..................................................................................................... 114
Pathofysiologie .............................................................................................................................. 114
Onderzoek ..................................................................................................................................... 114
Behandeling .................................................................................................................................. 115
Casus 22 (Dwarslaesie C6) .............................................................................................................. 117
Pathofysiologie .............................................................................................................................. 117
Onderzoek ..................................................................................................................................... 118
Behandeling .................................................................................................................................. 119
Perifeer neurologische aandoeningen ............................................................................................. 121
Casus 23 (Polyneuropathie) ............................................................................................................. 121
Pathofysiologie .............................................................................................................................. 121
Onderzoek ..................................................................................................................................... 122
Behandeling .................................................................................................................................. 123
Casus 24 (Plexuslaesie) ................................................................................................................... 125
Pathofysiologie .............................................................................................................................. 125
Onderzoek ..................................................................................................................................... 126
Behandeling .................................................................................................................................. 127
Casus 25 (N. Radialislaesie) ............................................................................................................ 129
Pathofysiologie .............................................................................................................................. 129
Onderzoek ..................................................................................................................................... 129
Behandeling .................................................................................................................................. 130
Casus 26 (N. Ulnarislaesie) .............................................................................................................. 131
Pathofysiologie .............................................................................................................................. 131
Onderzoek ..................................................................................................................................... 131
Behandeling .................................................................................................................................. 132
Casus 27 (N. Femoralislaesie) ......................................................................................................... 134
Pathofysiologie .............................................................................................................................. 134
Onderzoek ..................................................................................................................................... 134
Behandeling .................................................................................................................................. 135
Casus 28 (N. Peroneuslaesie) .......................................................................................................... 137
Pathofysiologie .............................................................................................................................. 137
Onderzoek ..................................................................................................................................... 137
Behandeling .................................................................................................................................. 138
Hart- en longaandoeningen ............................................................................................................... 139
Casus 29 (Myocardinfarct)................................................................................................................ 139
Pathofysiologie .............................................................................................................................. 139
Onderzoek ..................................................................................................................................... 140
Behandeling .................................................................................................................................. 140
Casus 30 (Chronisch hartfalen) ........................................................................................................ 143
Pathofysiologie .............................................................................................................................. 143
Onderzoek ..................................................................................................................................... 144
Behandeling .................................................................................................................................. 144
Casus 31 (Pneumonie) ..................................................................................................................... 146
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