Acute Injury Flashcards

1
Q

What is the difference between acute and chronic injury?

A

Acute is less than 6 weeks, chronic is more than 6 weeks

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2
Q

What are the 3 stages of tissue healing?

A

Stage 1: Inflammation
Stage 2: Organisation, granulation
Stage 3: Regeneration, fibrosis, remodelling

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3
Q

What is fibrosis?

A

Scarring

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4
Q

When does tissue repair occur?

A

When barriers are penetrated, e.g. puncture, crush, tear, sheering, bruise, burn

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5
Q

What are the two methods of tissue repair?

A
  • Regeneration: Same kind of tissues replace destroyed tissues, original function restored
  • Fibrosis: Connective tissue replaces destroyed tissue, original function lost
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6
Q

What occurs during the inflammation stage of tissue healing?

A
  • Release of inflammatory chemicals (kinins)
  • Dilation of blood vessels
  • Increase in vessel permeability
  • Clotting
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7
Q

During inflammation, why do the blood vessels become more permeable?

A

To allow white blood cells, fluid, clotting proteins and other plasma proteins to seep into the injured area

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8
Q

What are the functions of the inflammatory response?

A
  • Prevents spread of damaging agents
  • Disposes of cell debris and pathogens
  • Alerts adaptive immune system
  • Sets the stage for repair
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9
Q

How does inflammation begin?

A

Chemicals are released into ECF by injured tissues, immune cells & blood proteins

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10
Q

What cells bear toll-like receptors (TLRs)?

A

Macrophages & epithelial cells of boundary tissues

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11
Q

How many types of TLRs recognise specific classes of infecting microbes?

A

11

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12
Q

What do activated TLRs trigger release off?

A

Cytokines that promote inflammation

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13
Q

What are inflammatory mediators & what do they cause?

A

Kinins, prostaglandins & complement - dilate local arteriols, make capillaries leaky, attract leukocytes

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14
Q

What does swelling (oedema) cause?

A

Pushes on nerve endings causing pain, moves foreign materials into lymphatic vessels, delivers clotting proteins and complement

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15
Q

What do clotting factors form & what is its function?

A

Fibrin mesh - scaffold for repair, isolates injured area so invaders cannot spread

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16
Q

What are the cardinal signs of acute inflammation?

A

Redness, heat, swelling, pain & sometimes impairment of function

17
Q

What are the main components of organisation & granulation?

A

New nerve tissue, new capillary beds & fibroblasts/myofibroblasts

18
Q

What do myofibroblasts do?

A

Pull the edges of a wound together

19
Q

In stage 2 of tissue healing, what does organisation achieve & how?

A

Restores blood supply

  • Blood clot is replaced with granulation tissue
  • Epithelium regenerates
  • Fibroblasts produce collagen fibres to bridge the gap
  • Debris phagocytosed
  • New blood vessels & nerve endings grow together
20
Q

What occurs during stage 3 of tissue healing (regeneration & fibrosis)?

A
  • Scab detaches
  • Fibrous tissue matures
  • Results in fully regenerated epithelium with underlying scar tissue
21
Q

What tissues regenerate extremely well?

A

Epithelial, bone, areolar connective, dense irregular connective

22
Q

What tissues have moderate regenerating capacity?

A

Smooth muscle, dense regular connective

23
Q

What tissues have virtually no functional regenerative capacity?

A

Cardiac, nervous tissue of brain & spinal cord

24
Q

What are the healing response time frames?

A
  • Inflammation: 1 hour - 4 days
  • Organisation, granulation: 12 hours - 3 weeks
  • Regeneration, fibrosis, remodelling: 3 days - 18 months
25
Q

What are the benefits of RICE?

A
  • Prevents re-bleeding/further injury
  • Allows platelets, myofibroblastts to hold position
  • Relieves pain
  • Decreases circulation
  • Decreases bleeding
  • Decreases inflammation
  • Decreases swelling
26
Q

What are the risks of RICE?

A
  • Stiffness
  • Lack of circulation of blood and lymphatics
  • Ice burn
  • Slow healing if ice used for too long
  • Slow circulation/cut off circulation