9.21 Injury, Inflammation, Healing 10

Question 1

keloid

Answer 1

beyond boundaries of injury

Question 2

tx for keloids

Answer 2

• surgical

- poor outcomes

Question 3

hypertrophic scars

Answer 3

• synthesis greater than lysis

- commonly seen with burn patients

Question 4

tx for hypertrophic scars

Answer 4

• pressure garments

- Do a great job of flattening the skin and normalizing as much as possible

Question 5

If joints are involved, contractures are called

Answer 5

arthrofibrosis

Question 6

contractures

Answer 6

• can be muscle, tendon, skin, etc
• joint capsule and capsular ligaments
• arthrofibrosis

Question 7

specific tissue healing:

lungs: regeneration vs. repair

Answer 7

• regeneration can occur if basement membrane is intact

- repair if damage is extensive

Question 8

specific tissue healing: cartilate (both types)

Answer 8

• poor blood supply

- poor healing

Question 9

specific tissue healing:

bone

Answer 9

• inflammation
• soft callus
• hard callus
• regeneration and remodeling

Question 10

bone healing: hard callus formation occurs when?

Answer 10

3 weeks - 4 months

Question 11

bone healing: regeneration and remodeling time frame

Answer 11

months to years

Question 12

specific tissue healing:

skeletal muscle

Answer 12

• regeneration can occur
• scarring is likely
• no proliferation
• myositis ossificans

Question 13

specific tissue healing:

tendons and ligaments (process)

Answer 13

• 72 hour inflammation
• collagen synthesis (2 weeks)
• tendons no AROM x 3 weeks
• tendons no max force x 8 weeks
• PROM indicated for both tissues within limits

Question 14

specific tissue healing:

others

Answer 14

• digestive tract
• nerves
• synovial membranes
• discs

etc.

Question 15

inflammatory and immune systems of neonates

Answer 15

transiently depressed inflammatory and immune systems

• takes time for everything to kick into gear after birth

Question 16

How long do neonates need to develop immune/inflammatory systems?

Answer 16

1 month to 6 weeks

Question 17

neonates: neutrophils

Answer 17

neutrophils not capable of efficient chemotaxis

**first line of defense down

Question 18

In addition to inflammatory/immune system and neutrophils, what else are neonates deficient in?

Answer 18

• complement system
• oxidative and bacterial responses

can develop overwhelming sepsis!!!

Question 19

How might capillary fragility occur?

Answer 19

• repeated sun exposure

- age over 60

Question 20

problems with older adults

Answer 20

• impaired fx of innate immune cells (phagocytes)
• impaired inflammation
• chronic medication intake
• diminished healing response
• infections and chronic inflammation

Question 21

older adults: impaired inflammation is likely a result of

Answer 21

chronic illness (diabetes, cardiovascular disease, etc.)

Question 22

older adults: chronic medication intake does this to the inflammatory response

Answer 22

decreases

Question 23

older adults: Why is healing response diminished?

Answer 23

skin’s loss of regenerative ability

Question 24

These are more common in older adults

Answer 24

• infection

- chronic inflammation

Question 25

Two examples of crappy healing

Answer 25

• heterotopic ossification

- myositis ossificans

Question 26

group that commonly gets heterotopic ossification and myositis ossificans

Answer 26

SCI pts

Question 27

Dealing with myositis ossificans

Answer 27

• gradual stiffening
• swelling, warmth, redness
• progressive loss of motion
• generally involves surgical removal