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EPHE 344 > #10. Stages of Tissue Healing > Flashcards

#10. Stages of Tissue Healing Flashcards

1
Q

Primary Injury: blood and damaged tissue, pain and disability, and the body’s initial reaction is inflammation. What is this?

A

Acute Macrotrauma

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2
Q

When the body induces inflammation, what is it trying to do?

A

create its own internal cast

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3
Q

Three major stages of healing?

A
  1. Inflammatory Phase
  2. Fibroblastic-Repair Phase (proliferation)
  3. Maturation-Remodeling Phase
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4
Q

How long does the inflammatory phase last for?

A

72 hours to 4 days

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5
Q

How long does the Fibroblastic phase last for? When does this phase usually start?

A

3-4 weeks - starts around day 3 or 4 after injury

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6
Q

How long can the maturation phase last for and when does it usually begin?

A

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

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7
Q

During the inflammatory phase, when does healing begin?

A

immediately

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8
Q

Injury results in an altered _____ and liberation of various materials. What does this cause?

A

metabolism; when the metabolism is altered it makes the area very warm

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9
Q

The initial reaction to an injury is by the ____ and ____ cells.

A

leukocytes and phagocytic cells

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10
Q

The goal of the reaction by leukocytes and phagocytic cells is…?

A
  • protect
  • localize
  • decrease injurious agents
  • prepare for healing and repair
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11
Q

The inflammatory phase introduces ___, ____, and _____ responses that are all interwoven.

A

chemical, vascular, and cellular

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12
Q

What is the SHARP acronym? What is it used for?

A 
S - swelling
H - heat
A - ache / ability to move?
R - redness
P - pain
Used for checking inflammatory response.
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13
Q

What does the RTCDF acronym stand for and what is it used for?

A 
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.
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14
Q

When a cell is injured, the chemical mediators are liberated, what are they? (3)

A

histamine, leukocytes, cytokines

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15
Q

When is the best time to see what is going on before swelling occurs?

A

The period of vasoconstriction that occurs before the vascular reaction of vasodilation.

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16
Q

After the vascular reaction occurs, ____ and ____ adhere to the vascular wall and _____ occurs which causes ____ formation.

A

Platelets and Leukocytes
Phagocytosis
Clot formation

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17
Q

____ _____ are derived from invading organisms, damaged tissue, plasma enzyme systems and WBCs

A

chemical mediators

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18
Q

Histamine is from what type of cell?

A

mast cells

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19
Q

___ is the first to arrive in an inflammatory response; it causes ____ and changes cell permeability owing to swelling

A

histamine ; vasodilation

20
Q

What is margination and what chemical mediators impact it?

A

Adherence along cell walls - leukotrienes, bradykinin and prostaglandins

21
Q

“increase permeability locally for fluid and protein passage”

A

diapedesis - done by leukotrienes, bradykinin and prostaglandins

22
Q

Leukotrienes, bradykinin and prostaglandins facilitate exudate formation and ______ entrance to injured site.

A

neutrophil

23
Q

____ regulate leukocyte and phagocytic activity

A

cytokines

24
Q

7 Steps to Inflammatory Process?

A
  1. Bacteria enters
  2. Platelets release blood-clotting proteins @ wound site
  3. Mast cells mediate vasodilation and vascular constriction
  4. Neutrophils secrete factors that kill pathogens
  5. Neutrophils/macrophages remove pathogens via phagocytosis
  6. Macrophages secrete cytokines that attract immune cells
  7. Response continues until all foreign bodies are gone
25
Q

What is the vascular response?

A
  • vasoconstriction and coagulation
  • chemical mediators released
  • vasodilation occurs 5-10 minutes later
26
Q

When vasodilation occurs, initial increases in what are seen?

A

blood flow - transitory

27
Q

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?

A

Pitting edema

28
Q

Clot formation - platelets adhere to exposed ____ leading to formation of a “plug”

A

collagen

29
Q

Clots obstruct ______ drainage and aid in localizing injury

A

lymphatic - blocked drainage causes “swamp”

30
Q

Clot formation requires the conversion of ____ to ____

A

fibrinogen to fibrin

31
Q

The ___ clot seals the wound until the vessel wall heals.

A

fibrin

32
Q

What is the final stage of the inflammatory phase?

A

when leukocytes phagocytize the remaining debris

33
Q

What is it called when the acute inflammatory response is unable to eliminate the injuring agent?

A

Chronic Inflammation

34
Q

____ inflammation is typically associated with overuse, overload, and cumulative microtrauma

A

chronic

35
Q

What phase includes healing and regeneration?

A

II: fibroblastic repair

36
Q

In what phase will athletes complain initially of pain with movement and point tenderness?

A

fibroblastic repair

37
Q

During what phase do signs and symptoms of inflammation subside?

A

fibroblastic repair

38
Q

During fibroblastic repair, capillary buds begin to _____

A

proliferate

39
Q

what does it mean when capillaries proliferate?

A

they are reacting to hypoxia (lack of oxygen) by creating revascularization

40
Q

Capillaries and fibroblasts unite and create a matrix that contains ____ and ____. This is the scar.

A

collagen and elastin

41
Q

Tensile strength of the scar increase in proportion to _____ _____

A

collagen proliferation

42
Q

What phase is characterized by a remodeling of the scar tissue according to tensile forces?

A

III: maturation and remodeling

43
Q

____ Law - when you need to actually have pressure on it to have it heal

A

Wolfe’s

44
Q

___ has a limited capacity to heal due to the fact that it has little or no direct blood supply

A

Cartilage

45
Q

If the injury is an an area of a synovial joint, why is it hard to heal?

A

The synovial fluid bathes all of the clotting away.

46
Q

Full healing for a ligamentous injury may take up to how long?

A

12 months

EPHE 344 (10 decks)

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