Skip to main content
Top

2022 | OriginalPaper | Hoofdstuk

7. De algemene indruk

Auteurs : Dr. J. A. H. Eekhof, Drs. R. J. M. Claessen

Gepubliceerd in: Fysische diagnostiek

Uitgeverij: Bohn Stafleu van Loghum

share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

De arts observeert de patiënt voortdurend tijdens het consult, neemt gedrag van de patiënt waar en vormt zich hiermee een algemene indruk van de patiënt. Dit gebeurt deels bewust en deels onbewust. In dit hoofdstuk worden de aspecten die de arts kan waarnemen besproken. Deze waarnemingen komen tot stand door objectieve gegevens (bloeddruk, saturatie, buikomvang, enz.) en meer subjectieve gegevens (gedrag, geur, affect, enz.). De waarnemingen die de arts doet, leiden tot een algemene indruk die van belang kan zijn bij het stellen van de diagnose, bij de behandeling en ook voor het contact met de patiënt.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Literatuur
1.
go back to reference Rutten GEHM, Damoiseaux RAMJ, Olde Hartman TC, redactie. Het geneeskundig proces. 7e druk. Houten: Bohn Stafleu van Loghum; 2019. Rutten GEHM, Damoiseaux RAMJ, Olde Hartman TC, redactie. Het geneeskundig proces. 7e druk. Houten: Bohn Stafleu van Loghum; 2019.
2.
go back to reference Kuks JBM, Snoek JW, redactie. Leerboek klinische neurologie. 18e druk. Houten: Bohn Stafleu van Loghum; 2016. Kuks JBM, Snoek JW, redactie. Leerboek klinische neurologie. 18e druk. Houten: Bohn Stafleu van Loghum; 2016.
3.
go back to reference Van Deth R. Psychiatrie. Van diagnose tot behandeling. 6e druk. Houten: Bohn Stafleu van Loghum; 2019. Van Deth R. Psychiatrie. Van diagnose tot behandeling. 6e druk. Houten: Bohn Stafleu van Loghum; 2019.
4.
go back to reference Hengeveld MWJ. Het psychiatrisch onderzoek. 2e druk. Leusden: De Tijdstroom; 2009. Hengeveld MWJ. Het psychiatrisch onderzoek. 2e druk. Leusden: De Tijdstroom; 2009.
5.
go back to reference Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. II. Inter-observer variation and frequency of clinical findings. J Intern Med. 1990;228:147–50. Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. II. Inter-observer variation and frequency of clinical findings. J Intern Med. 1990;228:147–50.
6.
go back to reference Jones AE, Aborn LS, Kline JA. Severity of emergency department hypotension predicts adverse hospital outcome. Shock. 2004;22:410–4.CrossRef Jones AE, Aborn LS, Kline JA. Severity of emergency department hypotension predicts adverse hospital outcome. Shock. 2004;22:410–4.CrossRef
7.
go back to reference Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. I: The influence of physical findings on the global assessment. J Intern Med. 1989;226:123–5. Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. I: The influence of physical findings on the global assessment. J Intern Med. 1989;226:123–5.
8.
go back to reference Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17–24.CrossRef Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17–24.CrossRef
9.
go back to reference McInerny TK, Adam HM, Campbell DE, et al. American academy of pediatrics textbook of pediatric care (chapter 180: Odor (unusual urine and body)). 2e druk. Pediatric Care Inlone. McInerny TK, Adam HM, Campbell DE, et al. American academy of pediatrics textbook of pediatric care (chapter 180: Odor (unusual urine and body)). 2e druk. Pediatric Care Inlone.
10.
go back to reference Campisi G, Musciotto A, Di Fede O, et al. Halitosis, could it be more than bad breath? Intern Emerg Med. 2011;6:315–9.CrossRef Campisi G, Musciotto A, Di Fede O, et al. Halitosis, could it be more than bad breath? Intern Emerg Med. 2011;6:315–9.CrossRef
11.
go back to reference Shirasu M, Touhara K. The scent of disease: volatile organic compounds of the human body related to disease and disorder. J Biochem. 2011;150:257–66.CrossRef Shirasu M, Touhara K. The scent of disease: volatile organic compounds of the human body related to disease and disorder. J Biochem. 2011;150:257–66.CrossRef
13.
go back to reference Hughes FJ, McNab R. Oral malodour – a review. Arch Oral Biol. 2008;53(Suppl 1):S1-7.CrossRef Hughes FJ, McNab R. Oral malodour – a review. Arch Oral Biol. 2008;53(Suppl 1):S1-7.CrossRef
14.
go back to reference Ruzsányi V, Péter Kalapos M. Breath acetone as a potential marker in clinical practice. J Breath Res. 2017;11(2):024002. Ruzsányi V, Péter Kalapos M. Breath acetone as a potential marker in clinical practice. J Breath Res. 2017;11(2):024002.
16.
go back to reference Mitchell S, Ayesh R, Barrett T, Smith R. Trimethylamine and foetor hepaticus. Scand J Gastroenterol. 1999;34:524–8.CrossRef Mitchell S, Ayesh R, Barrett T, Smith R. Trimethylamine and foetor hepaticus. Scand J Gastroenterol. 1999;34:524–8.CrossRef
18.
go back to reference De Vries H, Bastiaans JF, Van Itterrsun FJ. Gewichtsverlies. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten. 5e druk. Houten: Bohn Stafleu van Loghum; 2021. De Vries H, Bastiaans JF, Van Itterrsun FJ. Gewichtsverlies. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten. 5e druk. Houten: Bohn Stafleu van Loghum; 2021.
19.
go back to reference Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993;1:646–9. Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993;1:646–9.
20.
go back to reference Aylsworth AS. Clinical aspects of defects in the determination of laterality. Am J Med Genet. 2001;101:345–55.CrossRef Aylsworth AS. Clinical aspects of defects in the determination of laterality. Am J Med Genet. 2001;101:345–55.CrossRef
21.
go back to reference Boron FBE. Medical physiology. Philadelphia, PA: Elsevier Saunders; 2005. Boron FBE. Medical physiology. Philadelphia, PA: Elsevier Saunders; 2005.
22.
go back to reference Santosa S, Jensen MD. Why are we shaped differently, and why does it matter? Am J Physiol. 2008;295:E531–5. Santosa S, Jensen MD. Why are we shaped differently, and why does it matter? Am J Physiol. 2008;295:E531–5.
24.
go back to reference Van Wayenburg C, Binsbergen J. Ondervoeding. Huisarts Wet. 2011;54:133–7.CrossRef Van Wayenburg C, Binsbergen J. Ondervoeding. Huisarts Wet. 2011;54:133–7.CrossRef
25.
go back to reference Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. New Engl J Med. 2008;359:2105–20.CrossRef Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. New Engl J Med. 2008;359:2105–20.CrossRef
26.
go back to reference Ostrowska B, Rozek-Mroz K, Giemza C. Body posture in elderly, physically active males. Aging Male. 2003;6:222–9.CrossRef Ostrowska B, Rozek-Mroz K, Giemza C. Body posture in elderly, physically active males. Aging Male. 2003;6:222–9.CrossRef
27.
go back to reference Van Aken MO, Feelders RA, De Jong FH, Pereira AM, Lamberts SWJ, De Herder WW. Syndroom van Cushing. I. Nieuwe ontwikkelingen in de diagnostiek. Ned Tijdschr Geneeskd. 2006;150:2359–64. Van Aken MO, Feelders RA, De Jong FH, Pereira AM, Lamberts SWJ, De Herder WW. Syndroom van Cushing. I. Nieuwe ontwikkelingen in de diagnostiek. Ned Tijdschr Geneeskd. 2006;150:2359–64.
28.
go back to reference Hamer JPM, Pieper PG, Van den Brink RBA. Anamnese en lichamelijk onderzoek van hart en arteriën. Houten: Bohn Stafleu van Loghum; 2014.CrossRef Hamer JPM, Pieper PG, Van den Brink RBA. Anamnese en lichamelijk onderzoek van hart en arteriën. Houten: Bohn Stafleu van Loghum; 2014.CrossRef
29.
go back to reference Klungel OH, De Boer A, Paes AH, et al. Estimating the prevalence of hypertension corrected for the effect of within-person variability in blood pressure. J Clin Epidemiol. 2000;53:1158–63.CrossRef Klungel OH, De Boer A, Paes AH, et al. Estimating the prevalence of hypertension corrected for the effect of within-person variability in blood pressure. J Clin Epidemiol. 2000;53:1158–63.CrossRef
30.
go back to reference Netea RT, Thien T. Blood pressure measurement: we should all do it better! Neth J Med. 2004;62:297–303.PubMed Netea RT, Thien T. Blood pressure measurement: we should all do it better! Neth J Med. 2004;62:297–303.PubMed
31.
go back to reference The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;2018(39):3021–104. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;2018(39):3021–104.
32.
go back to reference Kleefstra N, Houweling ST, Meyboom-de Jong B, Bilo HJ. Weinig nut van bloeddrukmeting aan beide armen; longitudinale studie naar interarmbloeddrukverschillen en de reproduceerbaarheid daarvan bij patiënten met diabetes mellitus type 2. Ned Tijdschr Geneeskd. 2007;151:1509–14.PubMed Kleefstra N, Houweling ST, Meyboom-de Jong B, Bilo HJ. Weinig nut van bloeddrukmeting aan beide armen; longitudinale studie naar interarmbloeddrukverschillen en de reproduceerbaarheid daarvan bij patiënten met diabetes mellitus type 2. Ned Tijdschr Geneeskd. 2007;151:1509–14.PubMed
33.
go back to reference Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet. 2012;379:905–14.CrossRef Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet. 2012;379:905–14.CrossRef
34.
go back to reference Pickering TG, Miller NH, Ogedegbe G, et al. American Heart Association; American Society of Hypertension; Preventive Cardiovascular Nurses Association. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1–9. Pickering TG, Miller NH, Ogedegbe G, et al. American Heart Association; American Society of Hypertension; Preventive Cardiovascular Nurses Association. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1–9.
36.
go back to reference Edmonds ZV, Mower WR, Lovato LM, Lomeli R. The reliability of vital sign measurements. Ann Emerg Med. 2002;39:233–7.CrossRef Edmonds ZV, Mower WR, Lovato LM, Lomeli R. The reliability of vital sign measurements. Ann Emerg Med. 2002;39:233–7.CrossRef
37.
go back to reference Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ (Clinical research ed). 2000;321(7262):673–4.CrossRef Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ (Clinical research ed). 2000;321(7262):673–4.CrossRef
39.
go back to reference Beijaart R. Percutane zuurstofsaturatiemeting. Huisarts Wet. 2019;9:50–5.CrossRef Beijaart R. Percutane zuurstofsaturatiemeting. Huisarts Wet. 2019;9:50–5.CrossRef
40.
go back to reference Sjoding MW, Dickson RP, Iwashyna TJ, Gay SE, Valley TS. Racial bias in pulse oximetry measurement. N Engl J Med. 2020;383(25):2477–8.CrossRef Sjoding MW, Dickson RP, Iwashyna TJ, Gay SE, Valley TS. Racial bias in pulse oximetry measurement. N Engl J Med. 2020;383(25):2477–8.CrossRef
41.
go back to reference Torp KD, Modi P, Simon LV. Pulse Oximetry. 2020, Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. Torp KD, Modi P, Simon LV. Pulse Oximetry. 2020, Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
42.
go back to reference Kelly AM, McAlpine R, Kyle E. How accurate are pulse oximeters in patients with acute exacerbations of chronic obstructive airways disease? Respir Med. 2001;95(5):336–40.CrossRef Kelly AM, McAlpine R, Kyle E. How accurate are pulse oximeters in patients with acute exacerbations of chronic obstructive airways disease? Respir Med. 2001;95(5):336–40.CrossRef
43.
go back to reference De Vries H, Van Agtmael MA, Bastiaans JF. Koorts bij volwassenen. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten. 5e druk. Houten: Bohn Stafleu van Loghum; 2021. De Vries H, Van Agtmael MA, Bastiaans JF. Koorts bij volwassenen. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten. 5e druk. Houten: Bohn Stafleu van Loghum; 2021.
44.
go back to reference Singh M, Pai M, Kalantri SP. Accuracy of perception and touch for detecting fever in adults: a hospital-based study from a rural, tertiary hospital in Central India. Trop Med Int Health. 2003;8:408–14.CrossRef Singh M, Pai M, Kalantri SP. Accuracy of perception and touch for detecting fever in adults: a hospital-based study from a rural, tertiary hospital in Central India. Trop Med Int Health. 2003;8:408–14.CrossRef
45.
go back to reference Teng CL, Ng CJ, Nik-Sherina H, et al. The accuracy of mother’s touch to detect fever in children: a systematic review. J Trop Pediatr. 2008;54:70–3.CrossRef Teng CL, Ng CJ, Nik-Sherina H, et al. The accuracy of mother’s touch to detect fever in children: a systematic review. J Trop Pediatr. 2008;54:70–3.CrossRef
46.
go back to reference Dodd SR, Lancaster GA, Craig JV, et al. In a systematic review, infrared ear thermometry for fever diagnosis in children finds poor sensitivity. J Clin Epidemiol. 2006;59:354–7.CrossRef Dodd SR, Lancaster GA, Craig JV, et al. In a systematic review, infrared ear thermometry for fever diagnosis in children finds poor sensitivity. J Clin Epidemiol. 2006;59:354–7.CrossRef
47.
go back to reference Van Staaij BK, Rovers MM, Schilder AG, Hoes AW. Accuracy and feasibility of daily infrared tympanic membrane temperature measurements in the identification of fever in children. Int J Pediatr Otorhinolaryngol. 2003;67:1091–7.CrossRef Van Staaij BK, Rovers MM, Schilder AG, Hoes AW. Accuracy and feasibility of daily infrared tympanic membrane temperature measurements in the identification of fever in children. Int J Pediatr Otorhinolaryngol. 2003;67:1091–7.CrossRef
–.
go back to reference De Jongh TOH, De Vries H, Knottnerus, et al. Diagnostiek van alledaagse klachten. 5e druk. Houten: Bohn Stafleu van Loghum; 2021. De Jongh TOH, De Vries H, Knottnerus, et al. Diagnostiek van alledaagse klachten. 5e druk. Houten: Bohn Stafleu van Loghum; 2021.
–.
go back to reference Van der Meer JWM, Postma CT, Blockmans DE, De Rooij SEJA. Anamnese en lichamelijk onderzoek. 9e druk. Houten: Bohn Stafleu van Loghum; 2019. Van der Meer JWM, Postma CT, Blockmans DE, De Rooij SEJA. Anamnese en lichamelijk onderzoek. 9e druk. Houten: Bohn Stafleu van Loghum; 2019.
Metagegevens
Titel
De algemene indruk
Auteurs
Dr. J. A. H. Eekhof
Drs. R. J. M. Claessen
Copyright
2022
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2787-4_7