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Kinesiology > Chapter 10: Exam 1 > Flashcards

Chapter 10: Exam 1 Flashcards

1
Q

Why is it important for an ATC to know healing process?

A

Because the ATC helps rehab the injury from diagnosis to healing (short and long term)

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2
Q

What must the ATC know about the healing process?

A
  • understand the phases

- know the time frames physiological changes associated with each phase

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3
Q

Signs of inflammation (5)

A
  • redness
  • swelling
  • tenderness
  • increased temperature
  • loss of function
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4
Q

3 phases of the inflammatory response

A
  • inflammatory response phase
  • Fibroblastic repair phase
  • maturation and remodeling phase
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5
Q

Phase 1: Inflammatory Response

A

Healing process begins immediately after the injury occurs

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6
Q

Goal of phase 1 (4)

A
  • protect
  • localize
  • decrease injurious agents
  • prepare for healing and repair
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7
Q

Phase 1 vascular response

A
  • vasoconstriction

- vasodilation

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8
Q

Vasoconstriction

A
  • first 5-10 minutes post injury
  • seal the blood vessels
  • damage control
  • everything constricts
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9
Q

Vasodilation

A
  • 5-10 post injury
  • initial effusion of blood and plasma (lasts 24-36 hours)
  • goal is to bring reinforcements
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10
Q

Histamine

A

Vasodilation

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11
Q

Cytokines

A

Attract phagocytes

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12
Q

Leukotrienes

A

Allow helper cells to adhere (margination)

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13
Q

Exudate

A

Protein layer at site of injury, doesn’t permeate so too much for too long is a problem

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14
Q

Vasoconstriction

A

Everything constricts for damage control

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15
Q

Clot formation

A

Contains damage

***do not disrupt the clot (heat and massage)

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16
Q

How long is damage control?

A

First 2-3 days

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17
Q

Phase 2: Fibroplastic repair

A

Rebuilding

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18
Q

Scar formation (phase 2)

A

Disorganized scar tissue

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19
Q

Phase 3: Maturation and remodeling

A

Reorganization of scar tissue

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20
Q

Wolff’s law

A

Collagen realigns along the stress lines so rehab in the range of motion you want back

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21
Q

Articular cartilage

A

Shiny white at the end of bones (protection)

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22
Q

Miniscis

A

Cushion between 2 bones

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23
Q

Cartilage characteristics

A

Little to no blood supply so it won’t heal itself

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24
Q

Meniscectomy

A

Tear on medial surface will continue to tear so surgically shave around the tear—> shorter recovery time

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25
Q

Meniscus repair

A

Red zone edge tear can heal itself with sutures (8 weeks no weight bearing)

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26
Q

Microfracture

A

Drill holes into the bone to generate tissue repair process

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27
Q

Isometric muscle contractions

A

Causing muscle contractions but not moving through range of motion

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28
Q

Nerve healing

A

Very slow and nerves cannot regenerate but axons can

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29
Q

Callus formation

A

Soft callus—> bony callus (able to see old fracture later in life)

30
Q

Avasular Necrosis

A

If bones aren’t aligned correctly, the bone will lose blood supply and begin to die

31
Q

Pain

A

Influenced by different factors (psychological)

32
Q

Clot formation

A
  • platelets adhere to collagen
  • blood coagulation—> clot formation
  • clots wall off damage
33
Q

How long does the inflammatory phase last?

A

2-4 days after the injury

34
Q

Chronic inflammation

A
  • insufficient inflammatory response results in tissue not being restored to normal physiologic state
  • granulation and fibrotic tissue develops (thick scar)
  • typically associated with overuse, overload, cumulative micro trauma
35
Q

Phase II

A

Fibroplastic repair

36
Q

Phase II: Fibroplastic repair

A
  • begins within first few days
  • lasts 4-6 weeks
  • formation of delicate connective tissue (granulation tissue)
37
Q

Which phase is a temporary scaffold?

A

Phase II

38
Q

Fibroplasia

A

Scar formation

39
Q

Scar formation

A
  • Gradual replacement of weak fibrin plug with stronger collagen
  • formation of disorganized scar tissue
40
Q

Phase III

A

maturation and remodeling

41
Q

Phase III: maturation and remodeling

A
  • realignment of collagen along stress lines
  • continued breakdown and synthesis of collagen–> increased strength
  • Tissue will gradually assume normal appearance
42
Q

Length of time of Phase III

A
  • long term process
  • may require several years to complete
  • lasts approximately 3 weeks for a strong scar
43
Q

Factors that impede healing

A
  • extent of injury
  • Edema
  • hemorrhage
  • poor vascular supply
  • muscle spasm
  • atrophy
  • keloids and hypertrophic scars
  • infection
  • humidity, climate, oxygen tension
  • health, age, nutrition
44
Q

Wolff’s Law (power point)

A

Bone and soft tissue will respond to the physical demands placed upon them

45
Q

Negative manifestation of Wolff’s Law

A

Osgood Schlatters and myositis ossification

46
Q

healing of articular cartilage

A

If it fails to clot or has no cell response heals very slowly

47
Q

Cartilage that involves subcontractors bone

A

(Enhanced blood supply) healing will proceed normally

48
Q

Cartilage healing

A

Usually requires surgical intervention

49
Q

Ligament repair phase

A

As scar forms collagen will mature and realign in reaction to joint stress and strain

50
Q

Ligament healing failure

A

Failure to produce enough scar and failure to reconnect end of ligaments to proper location on bones

51
Q

Healing length of ligaments

A

Full 12 months

52
Q

Non surgically repaired ligaments

A

Prone to joint instability

53
Q

Reason intra-articular ligaments fail to heal spontaneously

A

They can’t form a good clot within the synovial joint fluid (ACL)

54
Q

Ligament rehabilitation

A
  • balance between exercising and immobilization
  • surrounding muscles must be strengthened to reinforce joint
  • preventative
55
Q

Length of healing of skeletal muscles

A

6-8 weeks depending on injured muscle

56
Q

Skeltal muscles following inflammation phase

A

Myoblastic cells form—>regeneration of new muscle fibers

57
Q

Skeletal muscle re-injury risk

A

Prone to reinjury and chronic strain cycle (hamstring)

58
Q

Tendon healing

A

-abundance of collagen is required for good tensile strength, but too much can result in adhesion and thickening which will interfere with gliding tendon motion

59
Q

Tendon healing time

A

Tissue not strong enough until week 4-5 to withstand force of muscle contraction

60
Q

Nerve healing scar formation

A

-scar formation can block approximation

61
Q

CNS and peripheral nerves

A

Don’t regenerate

62
Q

Bone healing acute fractures 5 stages

A
  • hematoma formation
  • cellular proliferation
  • callus formation
  • ossification
  • remodeling
63
Q

Bone healing

A

-hard callus becomes more well-formed as osteoblasts lay down cancellous bone replacing cartilage

64
Q

Complete ossification time

A

Years

65
Q

Bone immobilization time

A

3-8 weeks depending on size and location of bone

66
Q

Less than ideal immobilization

A

Produces cartilaginous Union instead of bony callus

67
Q

Acute fracture management

A

-must be appropriately immobilized until x-Ray reveals the presence of a hard callus

68
Q

What areas must not interfere with bone healing

A
  • poor blood supply
  • poor immobilization
  • infection
69
Q

stress fracture cause

A

-constant stress can impact bone resorption, leading to micro fracture

70
Q

Stress fracture healing

A
  • early recognition to prevent complete fracture

- decreased activity and elimination of factors causing excess stress

71
Q

Osteoclastic activity>osteoblastic activity

A

Bone becomes more prone to fractures

72
Q

Pain

A
  • inhibit healing by limiting motivation and willingness

- goal of clinician is to manage patients perception of pain

Kinesiology (23 decks)

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