boys healing response Flashcards
three types of inflammation
- loss of structure (injury)
- loss of function
- loss of regulation
2 primary injury
macrotrauma and microtrauma
macrotramua
occurs when there is a MOI
microtrauma
chronic injuries result from overuse as repetitive dynamics of running, throwing, jumping (tendinitis, bursitis, tenosynovitis)
what is a secondary injury
an injury occurs after the primary injury (prolong swelling)
- an example would be stroke (part of the tissue is not getting oxygen)
- an ankle sprain (amount of swell that could causes an injury to the nerves)
phases of the healing process
- inflammatory response
- proliferative
-maturation
inflammatory phase
- 0 to 6 days
- redness, swelling, tenderness, increased temperature, loss of function
proliferative phase ( fibroblastic repair)
- 2 days to 6wks
- diminishing pain and tenderness, gradual return to function
maturation remodeling phase
- 8 wks to 2 years
- strong, contracted scar develops, increasing strength and full return to function
signs of inflammation
- pain
- redness
- swelling
- increased temp
- loss of function
dolor
pain
rubor
redness
tumor
swelling
calor
increased temperature
functio laesa
loss of function
vascular response (inflammatory phase)
- stops bleeding and form a clot
-1) transient vasoconstriction (5-10min) - 2) vasodilation (24-36hrs)
- 3) hemostatic response/clotting
immune response (inflammatory phase)
- fight possible infection and initiate tissue repair
- chemical mediators
- recruit leukocytes
clotting process?
Thromboplastin causes Prothrombin → Thrombin, which causes Fibrinogen → Fibrin (sticky clot)
chemical mediators (immune)
- histamine
- leukotrienes and prostaglandins
- cytokines
histamine
increase vasodilation and cell permeability
leukotrienes and prostaglandins
marination (leukocytes adhere along cell walls) and diapedesis
cytokines
regulate leukocyte traffic and attract leukocytes to injury site
neutrophils
first to respond to bacteria or a virus
eosinophil
known for their role in allergy symptoms
basophils
known for their role in asthma
lymphocytes
fight infections by producing antibodies
monocytes
clean up dead cells
proliferative phase (fibroblastic repair) consist of
- fibroplasia
- angiogenesis
- ganulation tissue
fibroplasia
fibroblasts produce collagen fibers for scar formation
angiogenesis
new capillaries are formed in fibrin clot/scar
granulation tissue
fibrin clot is replaced
roles of fibroplasia
- increased fibroplastic activity, laying down lots of collagen in very random fashion
- starts day 6-7 after an injury up to 4-6 weeks
- many inflammatory signs/symptoms subside
roles of angiogenesis
-artery, capillary sprouting, will migrate towards tissue that is hypoxic
- forms a capillary network (new blood flow)
roles of granulation tissue
- fibrin clot is replaced with granulation tissue
- fibroblasts, colagen, and capillaries
- extracellular matrix
- ground substance
importance of fibroblasts, collagen, and capillaries
make the wound bed more strong
what is the importance of tensile strength during proliferation phase of the granulation tissue?
tensile strength of the wound increases and signals for the number of fibroblasts to decrease/reduce fibroblastic activity and move to maturation phase
issue with signaling end of proliferative phase
- keloid scarring
-fibrosis
keloid scarring
persistent inflammatory response and continued release of inflammatory products extend fibroplasia and excessive fibrogenesis. this leads to irreversible tissue damage, resulting in necrosis and fibrosis prolonging the healing process
fibrosis
occurs in synovial structures (adhesive capsulitis) and in extra-articular tissues like tendon, ligament, bursae, muscle
keloids scarring and fibrosis symptoms
- decrease range of motion
- decreased in coordination
- decreased in strength
- decreased balance
- pain not so much
roles of maturation phase
- realignment or remodeling of collagen fibers that make up scar tissue, based on tensile stresses
- going breakdown and synthesis of collagen
- based upon stresses induced
- lasts up to 2 years
factors affecting healing
- extent/severity of injury
-poor vascular supply
-atrophy - infection
-health, age, and nutrition
general adaptation syndrome
- Hans selye
- how the body responds to stress physiologically
- stress can make or break a biological tissue or system
wolff’s law
bones in a healthy person will adapt to loads under which it is placed
davis’s law
soft tissue will heal according to the manner in which they are mechanically stressed
