,Inhoudsopgave
W1 – Obstructief en Restrictief ...................................................................................................... 9
Long volume en capaciteit .......................................................................................................... 9
Betekenis obstructief en restrictief ............................................................................................... 9
Emfyseem ................................................................................................................................10
Centriacinaire en Panacinaire Emfyseem.....................................................................................11
FC Anatomie Longen ....................................................................................................................13
FC Fysiologie longen ....................................................................................................................16
Hoofdfuncties ..........................................................................................................................16
Ventilatie .................................................................................................................................17
Ademhalingsmechanica ............................................................................................................17
Weerstand bij ademhaling .........................................................................................................17
Gasuitwisseling ........................................................................................................................17
Gastransport ............................................................................................................................18
Zuur-base balans ......................................................................................................................18
Ademhalingsregulatie ................................................................................................................18
FC Lichamelijk onderzoek longen .................................................................................................18
Inspectie (observatie van de patiënt) ...........................................................................................18
Auscultatie (met stethoscoop) ....................................................................................................19
Palpatie ...................................................................................................................................19
Percussie .................................................................................................................................19
FC Longfunctie ............................................................................................................................19
Indeling longfunctiestoornissen ..................................................................................................19
Spirometrie ..............................................................................................................................20
Andere longfunctietests .............................................................................................................20
FC Onderzoek longen ...................................................................................................................20
Diagnostische beeldvorming ......................................................................................................20
X-thorax ...................................................................................................................................21
Overige onderzoeken.................................................................................................................21
FC Dyspneu .................................................................................................................................21
Definitie (volgens ATS) ...............................................................................................................21
Mechanisme van dyspneu..........................................................................................................21
Beschrijvingen van dyspneu (vraag aan patiënt) ............................................................................22
Intensiteit van dyspneu meten ....................................................................................................22
Diagnostiek bij dyspneu .............................................................................................................22
Behandeling van dyspneu ..........................................................................................................22
1
,W2 – FT Trainingsfysiologie...........................................................................................................22
Oorzaken van inspanningsbeperking (COPD & andere) ..................................................................22
Krachtdefinities (bij training) .......................................................................................................23
Beweegnormen ........................................................................................................................23
KNGF Richtlijn COPD (2023) .........................................................................................................23
Definitie COPD .........................................................................................................................23
Diagnostiek ..............................................................................................................................24
Fysiotherapie bij COPD ..............................................................................................................24
Trainingsvormen .......................................................................................................................24
Zorg bij progressieve COPD ........................................................................................................25
FC COPD .....................................................................................................................................25
Pink Puffer (typisch bij emfyseem)...............................................................................................26
Blue Bloater (typisch bij chronische bronchitis) ............................................................................26
FC Hyperinflation ........................................................................................................................27
FC Bloed gas analyse ...................................................................................................................28
FC Long falen ..............................................................................................................................30
Type 1 Respiratoir Falen .............................................................................................................30
Type 2 Respiratoir Falen .............................................................................................................31
Behandeling .............................................................................................................................32
Take Home Messages ................................................................................................................32
FC Astma ....................................................................................................................................33
FC Pneumonie .............................................................................................................................34
FC Pneumothorax ........................................................................................................................36
FC CF (Cystic Fibrosis) .................................................................................................................38
FC Bronchiectasis .......................................................................................................................39
FC Anatomie hart.........................................................................................................................41
Hartlagen .................................................................................................................................41
Hartkamers ..............................................................................................................................42
Hartkleppen .............................................................................................................................42
1. Tricuspidalisklep ....................................................................................................................... 44
2. Pulmonalisklep ......................................................................................................................... 44
3. Mitralisklep (bicuspidalisklep) ................................................................................................. 45
4. Aortaklep ................................................................................................................................... 45
Kan het bloed dan nog wel stromen? ........................................................................................... 45
Geleidingssysteem....................................................................................................................46
Coronaire circulatie ..................................................................................................................48
2
, Systemische circulatie ..............................................................................................................48
FC Fysiologie hart ........................................................................................................................49
Hartcyclus ...............................................................................................................................49
Regulatie van hartritme ..............................................................................................................49
Slagvolume (SV) – beïnvloed door: ..............................................................................................49
Hartminuutvolume (CO) ............................................................................................................49
Bloeddistributie tijdens inspanning .............................................................................................50
Veneuze terugstroom ................................................................................................................51
Verouderingseffecten ................................................................................................................51
FC Lichamelijk onderzoek hart .....................................................................................................52
Inspectie & Palpatie ..................................................................................................................52
Auscultatie (hartgeluiden) ..........................................................................................................52
Activiteitsbeoordeling ................................................................................................................52
FC Onderzoek hart .......................................................................................................................53
Indicaties voor hartonderzoek ....................................................................................................53
Niet-invasieve onderzoeken .......................................................................................................53
Inspanningstesten ....................................................................................................................53
Farmacologische stresstesten ...................................................................................................53
Beeldvorming van coronaire vaten ..............................................................................................53
Invasieve onderzoeken ..............................................................................................................54
FC Cardiovasculair risicomanagement .........................................................................................54
Coronary Arterial Disease (CAD)...................................................................................................56
Introductie & Epidemiologie .......................................................................................................56
Anatomie van de kransslagaders ................................................................................................56
Atherosclerose & Myocardiale Perfusie .......................................................................................56
Risicofactoren voor CAD ............................................................................................................57
Klinisch Verloop van CAD ...........................................................................................................57
Complicaties van Myocardinfarct ...............................................................................................57
Prognose .................................................................................................................................57
Niet-chirurgische behandeling van CAD .......................................................................................57
Primaire Preventie .....................................................................................................................57
Farmacologische Behandeling ...................................................................................................58
Verhoging zuurstoftoevoer: ........................................................................................................58
Percutane Coronaire Interventie (PCI) .........................................................................................58
Cardiale Revalidatie ..................................................................................................................58
Richtlijn hart revalidatie ...............................................................................................................59
3
W1 – Obstructief en Restrictief ...................................................................................................... 9
Long volume en capaciteit .......................................................................................................... 9
Betekenis obstructief en restrictief ............................................................................................... 9
Emfyseem ................................................................................................................................10
Centriacinaire en Panacinaire Emfyseem.....................................................................................11
FC Anatomie Longen ....................................................................................................................13
FC Fysiologie longen ....................................................................................................................16
Hoofdfuncties ..........................................................................................................................16
Ventilatie .................................................................................................................................17
Ademhalingsmechanica ............................................................................................................17
Weerstand bij ademhaling .........................................................................................................17
Gasuitwisseling ........................................................................................................................17
Gastransport ............................................................................................................................18
Zuur-base balans ......................................................................................................................18
Ademhalingsregulatie ................................................................................................................18
FC Lichamelijk onderzoek longen .................................................................................................18
Inspectie (observatie van de patiënt) ...........................................................................................18
Auscultatie (met stethoscoop) ....................................................................................................19
Palpatie ...................................................................................................................................19
Percussie .................................................................................................................................19
FC Longfunctie ............................................................................................................................19
Indeling longfunctiestoornissen ..................................................................................................19
Spirometrie ..............................................................................................................................20
Andere longfunctietests .............................................................................................................20
FC Onderzoek longen ...................................................................................................................20
Diagnostische beeldvorming ......................................................................................................20
X-thorax ...................................................................................................................................21
Overige onderzoeken.................................................................................................................21
FC Dyspneu .................................................................................................................................21
Definitie (volgens ATS) ...............................................................................................................21
Mechanisme van dyspneu..........................................................................................................21
Beschrijvingen van dyspneu (vraag aan patiënt) ............................................................................22
Intensiteit van dyspneu meten ....................................................................................................22
Diagnostiek bij dyspneu .............................................................................................................22
Behandeling van dyspneu ..........................................................................................................22
1
,W2 – FT Trainingsfysiologie...........................................................................................................22
Oorzaken van inspanningsbeperking (COPD & andere) ..................................................................22
Krachtdefinities (bij training) .......................................................................................................23
Beweegnormen ........................................................................................................................23
KNGF Richtlijn COPD (2023) .........................................................................................................23
Definitie COPD .........................................................................................................................23
Diagnostiek ..............................................................................................................................24
Fysiotherapie bij COPD ..............................................................................................................24
Trainingsvormen .......................................................................................................................24
Zorg bij progressieve COPD ........................................................................................................25
FC COPD .....................................................................................................................................25
Pink Puffer (typisch bij emfyseem)...............................................................................................26
Blue Bloater (typisch bij chronische bronchitis) ............................................................................26
FC Hyperinflation ........................................................................................................................27
FC Bloed gas analyse ...................................................................................................................28
FC Long falen ..............................................................................................................................30
Type 1 Respiratoir Falen .............................................................................................................30
Type 2 Respiratoir Falen .............................................................................................................31
Behandeling .............................................................................................................................32
Take Home Messages ................................................................................................................32
FC Astma ....................................................................................................................................33
FC Pneumonie .............................................................................................................................34
FC Pneumothorax ........................................................................................................................36
FC CF (Cystic Fibrosis) .................................................................................................................38
FC Bronchiectasis .......................................................................................................................39
FC Anatomie hart.........................................................................................................................41
Hartlagen .................................................................................................................................41
Hartkamers ..............................................................................................................................42
Hartkleppen .............................................................................................................................42
1. Tricuspidalisklep ....................................................................................................................... 44
2. Pulmonalisklep ......................................................................................................................... 44
3. Mitralisklep (bicuspidalisklep) ................................................................................................. 45
4. Aortaklep ................................................................................................................................... 45
Kan het bloed dan nog wel stromen? ........................................................................................... 45
Geleidingssysteem....................................................................................................................46
Coronaire circulatie ..................................................................................................................48
2
, Systemische circulatie ..............................................................................................................48
FC Fysiologie hart ........................................................................................................................49
Hartcyclus ...............................................................................................................................49
Regulatie van hartritme ..............................................................................................................49
Slagvolume (SV) – beïnvloed door: ..............................................................................................49
Hartminuutvolume (CO) ............................................................................................................49
Bloeddistributie tijdens inspanning .............................................................................................50
Veneuze terugstroom ................................................................................................................51
Verouderingseffecten ................................................................................................................51
FC Lichamelijk onderzoek hart .....................................................................................................52
Inspectie & Palpatie ..................................................................................................................52
Auscultatie (hartgeluiden) ..........................................................................................................52
Activiteitsbeoordeling ................................................................................................................52
FC Onderzoek hart .......................................................................................................................53
Indicaties voor hartonderzoek ....................................................................................................53
Niet-invasieve onderzoeken .......................................................................................................53
Inspanningstesten ....................................................................................................................53
Farmacologische stresstesten ...................................................................................................53
Beeldvorming van coronaire vaten ..............................................................................................53
Invasieve onderzoeken ..............................................................................................................54
FC Cardiovasculair risicomanagement .........................................................................................54
Coronary Arterial Disease (CAD)...................................................................................................56
Introductie & Epidemiologie .......................................................................................................56
Anatomie van de kransslagaders ................................................................................................56
Atherosclerose & Myocardiale Perfusie .......................................................................................56
Risicofactoren voor CAD ............................................................................................................57
Klinisch Verloop van CAD ...........................................................................................................57
Complicaties van Myocardinfarct ...............................................................................................57
Prognose .................................................................................................................................57
Niet-chirurgische behandeling van CAD .......................................................................................57
Primaire Preventie .....................................................................................................................57
Farmacologische Behandeling ...................................................................................................58
Verhoging zuurstoftoevoer: ........................................................................................................58
Percutane Coronaire Interventie (PCI) .........................................................................................58
Cardiale Revalidatie ..................................................................................................................58
Richtlijn hart revalidatie ...............................................................................................................59
3
