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MPT 2 > Connective Tissue Healing > Flashcards

Connective Tissue Healing Flashcards

1
Q

how many grades of soft tissue lesions are there?

A

3

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2
Q

grade 1 soft tissue lesion

A

mild pain and swelling from tissue stress

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3
Q

grade 2 soft tissue lesion

A

moderate pain, some tearing of fibers, some increase in joint mobility

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4
Q

grade 3 soft tissue lesion

A

severe pain, near complete or complete tear or avulsion, joint instability

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5
Q

injury phase is from time of onset and up to ______ minutes after

A

15

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6
Q

how do patients present in injury phase?

A

may have low pain, minimal swelling, muscle guarding

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7
Q

what is the goal during the injury phase

A

stabilize patient

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8
Q

T or F: inflammation occurs after an injury

A

T

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9
Q

three stages of healing

A

acute, subacute, chronic

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10
Q

acute stage of healing

A

inflammatory reaction

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11
Q

subacute stage of healing

A

proliferation, repair, and healing

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12
Q

chronic stage of healing

A

maturation and remodeling

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13
Q

how long is the inflammatory phase?

A

4-6 days

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14
Q

how will a pt in inflammatory phase present

A

swelling, redness, warmth, pain before onset of resistance

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15
Q

what is happening at the tissue level during inflammatory phase?

A
  • vascular changes
  • exudation of cells and chemicals
  • clot formation
  • phagocytosis
  • early fibroblasic activity
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16
Q

what is the goal during inflammatory reaction phase

A

control inflammation, control effects of rest, patient ed

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17
Q

subacute is also called the…

A

fibroblastic phase

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18
Q

how long does subacute phase last

A

10-17 days but can be up to 6 weeks

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19
Q

how does a pt in the subacute phase present

A
  • decreasing inflammation
  • scar formation
  • onset of pain with resistance
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20
Q

what is happening at the tissue level during subacute phase

A
  • removal of noxious stimuli
  • growth of capillary beds into area
  • collagen formation
  • granulation tissue
  • very fragile, easily injured tissue
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21
Q

what is the goal during subacute phase?

A
  • controlled motion
  • promote mobility through controlled ROM, stretching, mobs
  • promote healing through stabilization and endurance exercises (be careful with intensity!)
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22
Q

the chronic stage lasts at least ___ weeks and up to ______ months

A

3, 18

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23
Q

how will patients in chronic stage present

A

no inflammation, pain after resistance

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24
Q

what is happening at the tissue level during chronic phase?

A
  • decreased fibroblasts and vascularity
  • 85% of original collagen replaced by 5 months
  • maturation of connective tissue
  • remodeling of scar tissue
  • collagen aligns to stress
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25
Q

what is the goal during chronic phase?

A

return to function
increase tensile quality of scar through exercise

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26
Q

if injured tissue is continually stressed beyond its ability to repair what can occue?

A

chronic inflammation

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27
Q

what happens after rest with chronic inflammation

A

stiffness and loss of ROM

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28
Q

definition of chronic pain

A

pain greater than 6 months (some literature says 3 months)

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29
Q

T or F: chronic pain can be linked to a current mechanical source

A

F

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30
Q

what could cause chronic pain after an injury

A
  • return to function too quickly
  • scar tissue
  • repeated/vigorous activity
  • faulty movement patterns
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31
Q

treatment approach for chronic pain

A

address pain, correct faulty movement patterns, patient education (PNE)

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32
Q

three types of cells in bone

A

osteoblasts, osteocytes, osteoclasts

33
Q

osteoblasts

34
Q

osteoclasts

A

break down bone

35
Q

osteocytes

A

mature bone cells, daily function

36
Q

cortical bone

A

hard outer bone

37
Q

cancellous/trabecular bone

A

soft spongey bone

38
Q

epiphysis

A

growth plate

39
Q

wolf’s law

A

bone will adapt to stresses being placed upon it

40
Q

bone is viscoelastic meaning…

A

response depends on rate and duration of loading

41
Q

this is the best type of load for bone and results in bone formation

A

compression

42
Q

bone has good strength with this type of load when loaded parallel to the bone. it results in bone reabsorption

43
Q

bone is weakest when loaded in this fashion and fractures easily

A

torsion/shear
*small intermittent loads do increase bone strength

44
Q

trabeculae are highest in areas where there has been _________

A

tosion/shear

45
Q

key factors for bone healing

A
  • adequate fixation
  • alignment
  • good nutrition
  • blood supply
  • oxygen
  • compression
46
Q

3 phases of bone healing (and time frames)

A

soft callus: 0-3/4 weeks
hard callus: 4-6weeks
bony union: 3-4 mths

47
Q

during what phase do you continue to immobilize most fractures

A

soft callus because it is a fragile union

48
Q

can you do normal daily activity during hard callus phase

A

yes because fracture is stabilized

49
Q

tendons and ligaments are made up of what kind of cells

A

fibrocytess

50
Q

structure of tendons and ligaments

A

collagen - 30%
elastin - 2%
ground substance - 68%

51
Q

what happens to the ground substance with loss of motion

A

loss of water

52
Q

davis’s law

A

soft tissue structures will adapt according to the stresses placed upon them
AKA: hypertrophy/atrophy are dependent upon the amount and type of activity

53
Q

T or F: fibrous connective tissue is viscoelastic

54
Q

creep

A

the lengthening that occurs when a stretch force is applied
ex. hamstring stretch

55
Q

load relaxation

A

longer load is placed the less stress felt
ex: cervical traction

56
Q

are tendons or ligaments more elastic

A

ligaments
*tendons fail at 10% length

57
Q

ligaments/tendons respond best to this kind of load

A

tension
*they don’t handle compression very well

58
Q

0 to 4-6 weeks fibrous connective tissue healing

A
  • protected ROM
  • minimal strength training
59
Q

4-6 weeks fibrous connective tissue healing

A
  • structural union occurs
  • begin resuming normal ROM
60
Q

6 weeks-3 months fibrous connective tissue healing

A

initial protected strength training

61
Q

4-8 months fibrous connective tissue healing

A

improving strength of fibers, possible resumption athletic activity

62
Q

8-12 months fibrous connective tissue healing

A

complete remodeling

63
Q

what type of cells is articular cartilage made up of

A

chondrocytes

64
Q

what does articular cartilage not heal well

A

chondrocytes are limited in number and unable to reproduce

65
Q

articular cartilage is arranged in 4 ______

66
Q

collagen is for _______ and ground substance is for __________-

A

strength
shock absorption

67
Q

zone 1 of articular cartilage

A

large amount of collagen, parallel to surface
allows for gliding and strength

68
Q

zone 2 of articular cartilage

A
  • less collagen than zone 1
  • random fiber orientation
  • provides strength and shock attenuation
69
Q

zone 3 of articular cartilage

A
  • less collagen than zone 1 and 2
  • perpendicular orientation
  • provides shock attenuation
70
Q

zone 4 of articular cartilage

A

calcified and attached to bone

71
Q

80% of articular cartilage weight is

72
Q

T or F: articular cartilage is viscoelastic

73
Q

T or F: articular cartilage is avascular and aneural

A

T: this is why it has poor healing

74
Q

T or F: tendons are stronger than articular cartilage

A

F: articular cartilage is stronger than tendon and SC bone

75
Q

articular cartilage is very strong with _______ and _______ but weak with ________

A

compression and tension

shear

76
Q

what is articular cartilage healing affected by

A

hemarthrosis
effusion
injection
depth of lesion

77
Q

T or F: a deeper lesion in articular cartilage may heal better

A

T: b/c more blood flow

78
Q

what is the primary goal when it comes to articular cartilage healing

A

restore mobility

79
Q

platelet rich plasma

A

platelets contain protein and cytokines to help regulate wound healing

MPT 2 (11 decks)

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