Inhoud
Embryologie zenuwstelsel en sensorische systeem (5) .......................................................................... 7
Embryologie sensorisch systeem ........................................................................................................ 7
Ontwikkeling oog............................................................................................................................. 7
Ontwikkeling oor ............................................................................................................................. 8
Embryologie zenuwstelsel ................................................................................................................... 9
Neurulatie ........................................................................................................................................ 9
Ontwikkeling ruggenmerg ............................................................................................................. 10
Ontwikkeling PNS .......................................................................................................................... 10
Ontwikkeling hersenen.................................................................................................................. 11
Anatomie + fysiologie zenuwstelsel en sensorische systeem (11) ........................................................ 13
Sensorisch systeem ........................................................................................................................... 13
Sensorische receptoren ................................................................................................................. 13
Oog ................................................................................................................................................ 15
Oor ................................................................................................................................................. 17
Smaak ............................................................................................................................................ 18
Ruiken ............................................................................................................................................ 19
Huid ................................................................................................................................................... 19
Zenuwstelsel ...................................................................................................................................... 20
Centrale zenuwstelsel ................................................................................................................... 21
Perifere zenuwstelsel .................................................................................................................... 27
Zenuwweefsel................................................................................................................................ 28
Elektrische signalen ....................................................................................................................... 31
Synaptische transmissie ................................................................................................................ 32
Pijn en pijnbehandelingsmogelijkheden (6) .......................................................................................... 38
Fysiologie van pijn ............................................................................................................................. 38
Pijnprikkel ...................................................................................................................................... 39
Pijnperceptie ................................................................................................................................. 39
Neurofysiologie acute pijn ................................................................................................................ 40
Baringspijn ......................................................................................................................................... 41
Mechanisme van pijn tijdens de baring ........................................................................................ 41
Pijn en emotie................................................................................................................................ 42
Ei van Loeser ...................................................................................................................................... 42
Nociceptie...................................................................................................................................... 43
Pijngewaarwording ........................................................................................................................ 43
1
, Pijnbeleving ................................................................................................................................... 43
Pijngedrag ...................................................................................................................................... 43
VAS score ........................................................................................................................................... 44
Pijnbehandeling durante partu ......................................................................................................... 44
Indicaties voor pijnbehandeling .................................................................................................... 44
Niet-medicamenteuze pijnstilling ................................................................................................. 45
Medicamenteuze pijnstilling ......................................................................................................... 47
Voorlichting ................................................................................................................................... 51
Farmacologie (6) .................................................................................................................................... 53
Anti-epileptica ................................................................................................................................... 53
Carbamazepine .............................................................................................................................. 54
Valproaat/valproïnezuur ............................................................................................................... 54
Fenobarbital .................................................................................................................................. 55
Fenytoïne ....................................................................................................................................... 55
Lamotrigine.................................................................................................................................... 56
Levetiracetam ................................................................................................................................ 56
Paracetamol ...................................................................................................................................... 56
Zwangerschap................................................................................................................................ 56
Kraamperiode ................................................................................................................................ 57
Neonaat ......................................................................................................................................... 57
NSAID ................................................................................................................................................. 57
Zwangerschap & baring ................................................................................................................. 57
Kraamperiode ................................................................................................................................ 58
Neonaat ......................................................................................................................................... 58
Antidepressiva ................................................................................................................................... 58
Bijwerkingen .................................................................................................................................. 58
Zwangerschap................................................................................................................................ 59
Kraamperiode ................................................................................................................................ 59
Neonaat ......................................................................................................................................... 59
Antipsychotica ................................................................................................................................... 59
Bijwerkingen .................................................................................................................................. 60
Zwangerschap................................................................................................................................ 60
Kraamperiode ................................................................................................................................ 60
Aandoeningen zenuwstelsel (6) ............................................................................................................ 61
Epilepsie Verschillende degraties ...................................................................................................... 61
Ontstaan epileptische aanval ........................................................................................................ 61
2
, Prevalentie..................................................................................................................................... 62
Etiologie ......................................................................................................................................... 62
Pathofysiologie .............................................................................................................................. 62
Symptomen ................................................................................................................................... 62
Zwangerschap................................................................................................................................ 63
Neonaat ......................................................................................................................................... 63
Beleid ............................................................................................................................................. 63
Pre-eclampsie/eclampsie .................................................................................................................. 64
Prevalentie..................................................................................................................................... 64
Etiologie ......................................................................................................................................... 64
Pathofysiologie .............................................................................................................................. 65
Symptomen ................................................................................................................................... 65
Complicaties .................................................................................................................................. 65
Beleid ............................................................................................................................................. 65
Hersenbloeding ................................................................................................................................. 66
Prevalentie..................................................................................................................................... 66
Etiologie ......................................................................................................................................... 66
Pathofysiologie .............................................................................................................................. 66
Symptomen ................................................................................................................................... 66
Complicaties .................................................................................................................................. 66
Beleid ............................................................................................................................................. 67
Sinustrombose................................................................................................................................... 67
Prevalentie..................................................................................................................................... 67
Etiologie ......................................................................................................................................... 67
Pathofysiologie .............................................................................................................................. 67
Symptomen ................................................................................................................................... 67
Baring............................................................................................................................................. 67
Beleid ............................................................................................................................................. 67
Multipele sclerose (MS)..................................................................................................................... 68
Vormen van MS ............................................................................................................................. 68
Prevalentie..................................................................................................................................... 68
Etiologie ......................................................................................................................................... 68
Pathofysiologie .............................................................................................................................. 68
Symptomen ................................................................................................................................... 69
Classificatie .................................................................................................................................... 69
Beleid ............................................................................................................................................. 69
3
, Zwangerschap................................................................................................................................ 69
Baring............................................................................................................................................. 69
Kraamperiode ................................................................................................................................ 70
Pijn/gevoelsstoornis in arm/hand ..................................................................................................... 70
Carpaletunnelsyndroom .................................................................................................................... 70
Pathologie...................................................................................................................................... 70
Symptomen ................................................................................................................................... 70
Zwangerschap................................................................................................................................ 70
Beleid ............................................................................................................................................. 70
Postpartum .................................................................................................................................... 71
Duizeligheid ....................................................................................................................................... 71
Alarmsymptomen .......................................................................................................................... 72
Visusstoornissen ................................................................................................................................ 72
Dubbelzien ..................................................................................................................................... 73
Alarmsymptomen .......................................................................................................................... 73
Hoofdpijn ........................................................................................................................................... 73
Alarmsymptomen .......................................................................................................................... 74
Beleid ............................................................................................................................................. 74
Wegraking ......................................................................................................................................... 75
Alarmsymptomen .......................................................................................................................... 75
Aandoeningen centrale zenuwstelsel neonaat (6) ................................................................................ 76
Afwijkingen centraal zenuwstelsel .................................................................................................... 76
Periventriculaire hemorragie ........................................................................................................ 76
Perinatale asfyxie .......................................................................................................................... 77
Hypoxische-ischemische encefalopathie (HIE) .............................................................................. 77
Convulsies ...................................................................................................................................... 79
Meningitis ...................................................................................................................................... 81
Neonataal abstinentiesyndroom (NAS) ......................................................................................... 82
Congenitale afwijkingen CZS ............................................................................................................. 84
Spina Bifida .................................................................................................................................... 84
Anencefalie .................................................................................................................................... 85
Hydrocephalus ............................................................................................................................... 85
Microcefalie ................................................................................................................................... 86
Stoornissen (neuro-)motorische ontwikkeling (6) ................................................................................ 88
Motorisch zenuwstelsel..................................................................................................................... 88
Hersenen ....................................................................................................................................... 89
4
Embryologie zenuwstelsel en sensorische systeem (5) .......................................................................... 7
Embryologie sensorisch systeem ........................................................................................................ 7
Ontwikkeling oog............................................................................................................................. 7
Ontwikkeling oor ............................................................................................................................. 8
Embryologie zenuwstelsel ................................................................................................................... 9
Neurulatie ........................................................................................................................................ 9
Ontwikkeling ruggenmerg ............................................................................................................. 10
Ontwikkeling PNS .......................................................................................................................... 10
Ontwikkeling hersenen.................................................................................................................. 11
Anatomie + fysiologie zenuwstelsel en sensorische systeem (11) ........................................................ 13
Sensorisch systeem ........................................................................................................................... 13
Sensorische receptoren ................................................................................................................. 13
Oog ................................................................................................................................................ 15
Oor ................................................................................................................................................. 17
Smaak ............................................................................................................................................ 18
Ruiken ............................................................................................................................................ 19
Huid ................................................................................................................................................... 19
Zenuwstelsel ...................................................................................................................................... 20
Centrale zenuwstelsel ................................................................................................................... 21
Perifere zenuwstelsel .................................................................................................................... 27
Zenuwweefsel................................................................................................................................ 28
Elektrische signalen ....................................................................................................................... 31
Synaptische transmissie ................................................................................................................ 32
Pijn en pijnbehandelingsmogelijkheden (6) .......................................................................................... 38
Fysiologie van pijn ............................................................................................................................. 38
Pijnprikkel ...................................................................................................................................... 39
Pijnperceptie ................................................................................................................................. 39
Neurofysiologie acute pijn ................................................................................................................ 40
Baringspijn ......................................................................................................................................... 41
Mechanisme van pijn tijdens de baring ........................................................................................ 41
Pijn en emotie................................................................................................................................ 42
Ei van Loeser ...................................................................................................................................... 42
Nociceptie...................................................................................................................................... 43
Pijngewaarwording ........................................................................................................................ 43
1
, Pijnbeleving ................................................................................................................................... 43
Pijngedrag ...................................................................................................................................... 43
VAS score ........................................................................................................................................... 44
Pijnbehandeling durante partu ......................................................................................................... 44
Indicaties voor pijnbehandeling .................................................................................................... 44
Niet-medicamenteuze pijnstilling ................................................................................................. 45
Medicamenteuze pijnstilling ......................................................................................................... 47
Voorlichting ................................................................................................................................... 51
Farmacologie (6) .................................................................................................................................... 53
Anti-epileptica ................................................................................................................................... 53
Carbamazepine .............................................................................................................................. 54
Valproaat/valproïnezuur ............................................................................................................... 54
Fenobarbital .................................................................................................................................. 55
Fenytoïne ....................................................................................................................................... 55
Lamotrigine.................................................................................................................................... 56
Levetiracetam ................................................................................................................................ 56
Paracetamol ...................................................................................................................................... 56
Zwangerschap................................................................................................................................ 56
Kraamperiode ................................................................................................................................ 57
Neonaat ......................................................................................................................................... 57
NSAID ................................................................................................................................................. 57
Zwangerschap & baring ................................................................................................................. 57
Kraamperiode ................................................................................................................................ 58
Neonaat ......................................................................................................................................... 58
Antidepressiva ................................................................................................................................... 58
Bijwerkingen .................................................................................................................................. 58
Zwangerschap................................................................................................................................ 59
Kraamperiode ................................................................................................................................ 59
Neonaat ......................................................................................................................................... 59
Antipsychotica ................................................................................................................................... 59
Bijwerkingen .................................................................................................................................. 60
Zwangerschap................................................................................................................................ 60
Kraamperiode ................................................................................................................................ 60
Aandoeningen zenuwstelsel (6) ............................................................................................................ 61
Epilepsie Verschillende degraties ...................................................................................................... 61
Ontstaan epileptische aanval ........................................................................................................ 61
2
, Prevalentie..................................................................................................................................... 62
Etiologie ......................................................................................................................................... 62
Pathofysiologie .............................................................................................................................. 62
Symptomen ................................................................................................................................... 62
Zwangerschap................................................................................................................................ 63
Neonaat ......................................................................................................................................... 63
Beleid ............................................................................................................................................. 63
Pre-eclampsie/eclampsie .................................................................................................................. 64
Prevalentie..................................................................................................................................... 64
Etiologie ......................................................................................................................................... 64
Pathofysiologie .............................................................................................................................. 65
Symptomen ................................................................................................................................... 65
Complicaties .................................................................................................................................. 65
Beleid ............................................................................................................................................. 65
Hersenbloeding ................................................................................................................................. 66
Prevalentie..................................................................................................................................... 66
Etiologie ......................................................................................................................................... 66
Pathofysiologie .............................................................................................................................. 66
Symptomen ................................................................................................................................... 66
Complicaties .................................................................................................................................. 66
Beleid ............................................................................................................................................. 67
Sinustrombose................................................................................................................................... 67
Prevalentie..................................................................................................................................... 67
Etiologie ......................................................................................................................................... 67
Pathofysiologie .............................................................................................................................. 67
Symptomen ................................................................................................................................... 67
Baring............................................................................................................................................. 67
Beleid ............................................................................................................................................. 67
Multipele sclerose (MS)..................................................................................................................... 68
Vormen van MS ............................................................................................................................. 68
Prevalentie..................................................................................................................................... 68
Etiologie ......................................................................................................................................... 68
Pathofysiologie .............................................................................................................................. 68
Symptomen ................................................................................................................................... 69
Classificatie .................................................................................................................................... 69
Beleid ............................................................................................................................................. 69
3
, Zwangerschap................................................................................................................................ 69
Baring............................................................................................................................................. 69
Kraamperiode ................................................................................................................................ 70
Pijn/gevoelsstoornis in arm/hand ..................................................................................................... 70
Carpaletunnelsyndroom .................................................................................................................... 70
Pathologie...................................................................................................................................... 70
Symptomen ................................................................................................................................... 70
Zwangerschap................................................................................................................................ 70
Beleid ............................................................................................................................................. 70
Postpartum .................................................................................................................................... 71
Duizeligheid ....................................................................................................................................... 71
Alarmsymptomen .......................................................................................................................... 72
Visusstoornissen ................................................................................................................................ 72
Dubbelzien ..................................................................................................................................... 73
Alarmsymptomen .......................................................................................................................... 73
Hoofdpijn ........................................................................................................................................... 73
Alarmsymptomen .......................................................................................................................... 74
Beleid ............................................................................................................................................. 74
Wegraking ......................................................................................................................................... 75
Alarmsymptomen .......................................................................................................................... 75
Aandoeningen centrale zenuwstelsel neonaat (6) ................................................................................ 76
Afwijkingen centraal zenuwstelsel .................................................................................................... 76
Periventriculaire hemorragie ........................................................................................................ 76
Perinatale asfyxie .......................................................................................................................... 77
Hypoxische-ischemische encefalopathie (HIE) .............................................................................. 77
Convulsies ...................................................................................................................................... 79
Meningitis ...................................................................................................................................... 81
Neonataal abstinentiesyndroom (NAS) ......................................................................................... 82
Congenitale afwijkingen CZS ............................................................................................................. 84
Spina Bifida .................................................................................................................................... 84
Anencefalie .................................................................................................................................... 85
Hydrocephalus ............................................................................................................................... 85
Microcefalie ................................................................................................................................... 86
Stoornissen (neuro-)motorische ontwikkeling (6) ................................................................................ 88
Motorisch zenuwstelsel..................................................................................................................... 88
Hersenen ....................................................................................................................................... 89
4
