#10. Stages of Tissue Healing Flashcards
Primary Injury: blood and damaged tissue, pain and disability, and the body’s initial reaction is inflammation. What is this?
Acute Macrotrauma
When the body induces inflammation, what is it trying to do?
create its own internal cast
Three major stages of healing?
- Inflammatory Phase
- Fibroblastic-Repair Phase (proliferation)
- Maturation-Remodeling Phase
How long does the inflammatory phase last for?
72 hours to 4 days
How long does the Fibroblastic phase last for? When does this phase usually start?
3-4 weeks - starts around day 3 or 4 after injury
How long can the maturation phase last for and when does it usually begin?
up to a couple years; just because you cant see anything on the outside, doesnt mean it isnt trauma on the inside - starts around week 5ish after injury
During the inflammatory phase, when does healing begin?
immediately
Injury results in an altered _____ and liberation of various materials. What does this cause?
metabolism; when the metabolism is altered it makes the area very warm
The initial reaction to an injury is by the ____ and ____ cells.
leukocytes and phagocytic cells
The goal of the reaction by leukocytes and phagocytic cells is…?
- protect
- localize
- decrease injurious agents
- prepare for healing and repair
The inflammatory phase introduces ___, ____, and _____ responses that are all interwoven.
chemical, vascular, and cellular
What is the SHARP acronym? What is it used for?
S - swelling H - heat A - ache / ability to move? R - redness P - pain Used for checking inflammatory response.
What does the RTCDF acronym stand for and what is it used for?
R - rubor (redness) T - tumor (swelling) C - color (heat) D - dolor (pain) F - functio laesa (loss of function) Shitty acronym (doesn't form a word :/ ) used to check inflammatory response.
When a cell is injured, the chemical mediators are liberated, what are they? (3)
histamine, leukocytes, cytokines
When is the best time to see what is going on before swelling occurs?
The period of vasoconstriction that occurs before the vascular reaction of vasodilation.
After the vascular reaction occurs, ____ and ____ adhere to the vascular wall and _____ occurs which causes ____ formation.
Platelets and Leukocytes
Phagocytosis
Clot formation
____ _____ are derived from invading organisms, damaged tissue, plasma enzyme systems and WBCs
chemical mediators
Histamine is from what type of cell?
mast cells
___ is the first to arrive in an inflammatory response; it causes ____ and changes cell permeability owing to swelling
histamine ; vasodilation
What is margination and what chemical mediators impact it?
Adherence along cell walls - leukotrienes, bradykinin and prostaglandins
“increase permeability locally for fluid and protein passage”
diapedesis - done by leukotrienes, bradykinin and prostaglandins
Leukotrienes, bradykinin and prostaglandins facilitate exudate formation and ______ entrance to injured site.
neutrophil
____ regulate leukocyte and phagocytic activity
cytokines
7 Steps to Inflammatory Process?
- Bacteria enters
- Platelets release blood-clotting proteins @ wound site
- Mast cells mediate vasodilation and vascular constriction
- Neutrophils secrete factors that kill pathogens
- Neutrophils/macrophages remove pathogens via phagocytosis
- Macrophages secrete cytokines that attract immune cells
- Response continues until all foreign bodies are gone
What is the vascular response?
- vasoconstriction and coagulation
- chemical mediators released
- vasodilation occurs 5-10 minutes later
When vasodilation occurs, initial increases in what are seen?
blood flow - transitory
When you have poor vascular flow, wear clothing that is too tight, or are on an airplane and get swollen feet what are you possibly experiencing?
Pitting edema
Clot formation - platelets adhere to exposed ____ leading to formation of a “plug”
collagen
Clots obstruct ______ drainage and aid in localizing injury
lymphatic - blocked drainage causes “swamp”
Clot formation requires the conversion of ____ to ____
fibrinogen to fibrin
The ___ clot seals the wound until the vessel wall heals.
fibrin
What is the final stage of the inflammatory phase?
when leukocytes phagocytize the remaining debris
What is it called when the acute inflammatory response is unable to eliminate the injuring agent?
Chronic Inflammation
____ inflammation is typically associated with overuse, overload, and cumulative microtrauma
chronic
What phase includes healing and regeneration?
II: fibroblastic repair
In what phase will athletes complain initially of pain with movement and point tenderness?
fibroblastic repair
During what phase do signs and symptoms of inflammation subside?
fibroblastic repair
During fibroblastic repair, capillary buds begin to _____
proliferate
what does it mean when capillaries proliferate?
they are reacting to hypoxia (lack of oxygen) by creating revascularization
Capillaries and fibroblasts unite and create a matrix that contains ____ and ____. This is the scar.
collagen and elastin
Tensile strength of the scar increase in proportion to _____ _____
collagen proliferation
What phase is characterized by a remodeling of the scar tissue according to tensile forces?
III: maturation and remodeling
____ Law - when you need to actually have pressure on it to have it heal
Wolfe’s
___ has a limited capacity to heal due to the fact that it has little or no direct blood supply
Cartilage
If the injury is an an area of a synovial joint, why is it hard to heal?
The synovial fluid bathes all of the clotting away.
Full healing for a ligamentous injury may take up to how long?
12 months
