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Samenvatting colleges Medisch Handelen Leerjaar 1 Periode 2

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MED OP1.2
Inhoudsopgave
MED1 Inleiding in de pathologie..............................................................................3
Leerdoelen.......................................................................................................................................................... 3
Bronnen................................................................................................................................................................ 3
Inleiding in de pathologie............................................................................................................................. 3
Waarom pathologie?........................................................................................................................................ 3
International classification of diseases.................................................................................................... 4
Pathologie: verloop van ziektes.................................................................................................................. 4
Pathologie: prognose van ziektes.............................................................................................................. 4
Pathologie: invloeden van ziektes............................................................................................................. 4
‘nut’ van kennis van pathologie voor ons.............................................................................................. 4
MED2 Inleiding orthopedie.....................................................................................5
Leerdoelen.......................................................................................................................................................... 5
Bronnen................................................................................................................................................................ 5
Andere bronnen................................................................................................................................................... 5
Overzicht.............................................................................................................................................................. 5
Geschiedenis....................................................................................................................................................... 5
Wat is Orthopedie?.......................................................................................................................................... 6
Diagnostiek......................................................................................................................................................... 6
Therapie............................................................................................................................................................... 6
Conservatief.......................................................................................................................................................... 6
Chirurgisch (operatief).................................................................................................................................... 6
Prognose & Follow Up.................................................................................................................................... 6
‘Nut’ van kennis van Orthopedie?.............................................................................................................. 6
Cliënt met Tibia Fractuur.............................................................................................................................. 7
Cliënt met verstuikte enkel.......................................................................................................................... 7
MED3 Inleiding in acute klachten............................................................................8
Bronnen................................................................................................................................................................ 8
Overzicht.............................................................................................................................................................. 8
Acute klachten................................................................................................................................................... 9
Analyse van acute status  Trauma.............................................................................................................. 9
Ontstekingsproces........................................................................................................................................... 9
Ontsteking effecten............................................................................................................................................ 9
Ontsteking potentiële complicaties........................................................................................................... 9
Acute klachten- eerste hulp & diagnostiek.......................................................................................... 10
Casuïstiek.......................................................................................................................................................... 10
HA Perspectief................................................................................................................................................. 10
Huisarts vraagt naar...................................................................................................................................... 10
Lichamelijk onderzoek................................................................................................................................... 10
Specieel onderzoek.......................................................................................................................................... 11
Evaluatie.............................................................................................................................................................. 11
Educatie............................................................................................................................................................... 11
Controle en verwijzing................................................................................................................................... 12
MED4 Farmacotherapie en Fysiotherapie bij acute klachten..................................13
Leerdoelen........................................................................................................................................................ 13
Bronnen............................................................................................................................................................. 13
Introductie........................................................................................................................................................ 13

,Wat is pijn?....................................................................................................................................................... 13
Definities van pijn.......................................................................................................................................... 13
NHG Standaard (M106, 2015).................................................................................................................. 14
Medicamenteuze behandeling van pijn................................................................................................ 14
Aspecten van farmacologie (= de leer van de…)............................................................................... 14
Farmacotherapeutisch kompas................................................................................................................ 14
Werkingsmechanisme algemeen............................................................................................................. 14
Verloop Plasmaconcentratie -1................................................................................................................. 15
Verloop Plasmaconcentratie -2................................................................................................................. 16
Paracetamol..................................................................................................................................................... 16
NSAID’s (Non-steroidal anti-inflammatory drugs)..........................................................................17
ZST Bijwerkingen Ibuyprofen................................................................................................................... 17
NSAID’s.............................................................................................................................................................. 17
Tramadol........................................................................................................................................................... 17
Morfine............................................................................................................................................................... 18
Voorlichting/ advies bij acute pijn.......................................................................................................... 18
Belang van fysiotherapeut/ rol fysiotherapeut................................................................................. 19
MED5 verwijzingen en indicatiestellingen fysiotherapie bij acute klachten............20
Leerdoelen........................................................................................................................................................ 20
Bronnen............................................................................................................................................................. 20
Inhoud................................................................................................................................................................ 20
Huisarts- Perspectief.................................................................................................................................... 20
Rode vlaggen...................................................................................................................................................... 20
Anamnese............................................................................................................................................................ 21
Lichamelijk onderzoek................................................................................................................................... 21
Aanvullend.......................................................................................................................................................... 21
Behandeling 0-6 weken................................................................................................................................. 21
Controles 0-6 weken....................................................................................................................................... 22
Orthopedisch perspectief........................................................................................................................... 22
Oorzaken.............................................................................................................................................................. 22
Symptomen......................................................................................................................................................... 22
Testen en diagnose.......................................................................................................................................... 23
Behandeling....................................................................................................................................................... 23

, MED1 Inleiding in de pathologie
Leerdoelen
- De leerstof van de pathologische principes op het gebied van de acute
klachten te kunnen onderscheiden in hoofd- en bijzaken;
- Een collega fysiotherapeut i.o. te ondersteunen bij een leervraag over de
te bestuderen pathologie op het gebied van acute klachten;
- De leerstof te kunnen toepassen in een eenvoudige casuïstiek op aspecten
van de acute klachten, daar waar pathologische relevantie van toepassing
is;
- Een cliënt uitleg te kunnen geven over de pathologische processen rond
acute klachten met betrekking tot zijn klacht(en) en therapie;
- Een discussie te voeren met een collega fysiotherapeut i.o. over de
pathologische processen op het gebied van acute klachten bij een
eenvoudige cliënt-casus met betrekking tot de klachten en therapie.

Bronnen
- VanMeter, K & Hubert, R. (2014). Gould’s Pathophysiology for the Health
Professions (5th ed.). United States of America: Elsevier Saunders.
o Hoofdstuk 1 Introduction to Pathophysiology
o What is Pathophysiology and Why Study It?
o Introduction to Cellular Changes
o Chapter Summary
o Study Questions
- Wikipedia.org (2015). Pathology. Retrieved from the internet
https://en.wikipedia.org/wiki/Pathology.
o General medical pathology
o Overlap with other diagnostic medicine

Inleiding in de pathologie
Pathologie= ‘de leer van de ziekte’
Pathologie houdt zich bezig met het ontstaan, de aard en het verloop van ziektes.
Beschrijving van ziekte (of ziekte-beeld), de belangrijkste onderdelen:
- Oorzaak (etiologie)
- Verloop van de prognose
- Klachten tekens & symptomen (objectief vs. Subjectief)
- Diagnostiek; hoeveel kennis is er van de achtergrond van de ziekte
- Therapie; verschillende therapieën voor verschillende ziekten.

Waarom pathologie?
- Er is meer dan alleen spieren, pezen en botten
- Je gaat er rode en gele vlaggen door herkennen
- Klachten kunnen verschillende oorzaken hebben
- Co-morbiditeit kan de therapie beïnvloeden (combinatie van
aandoeningen)
- Bewust zijn van diagnostiek en interventies vanuit het medisch domein.
- Betekenis en consequenties voor het fysiotherapeutisch handelen.
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