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MPT 2 > Connective Tissue Healing > Flashcards

Connective Tissue Healing Flashcards

(79 cards)

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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
what is the goal during chronic phase?
return to function increase tensile quality of scar through exercise
26
if injured tissue is continually stressed beyond its ability to repair what can occue?
chronic inflammation
27
what happens after rest with chronic inflammation
stiffness and loss of ROM
28
definition of chronic pain
pain greater than 6 months (some literature says 3 months)
29
T or F: chronic pain can be linked to a current mechanical source
F
30
what could cause chronic pain after an injury
- return to function too quickly - scar tissue - repeated/vigorous activity - faulty movement patterns
31
treatment approach for chronic pain
address pain, correct faulty movement patterns, patient education (PNE)
32
three types of cells in bone
osteoblasts, osteocytes, osteoclasts
33
osteoblasts
make bone
34
osteoclasts
break down bone
35
osteocytes
mature bone cells, daily function
36
cortical bone
hard outer bone
37
cancellous/trabecular bone
soft spongey bone
38
epiphysis
growth plate
39
wolf's law
bone will adapt to stresses being placed upon it
40
bone is viscoelastic meaning...
response depends on rate and duration of loading
41
this is the best type of load for bone and results in bone formation
compression
42
bone has good strength with this type of load when loaded parallel to the bone. it results in bone reabsorption
tension
43
bone is weakest when loaded in this fashion and fractures easily
torsion/shear *small intermittent loads do increase bone strength
44
trabeculae are highest in areas where there has been _________
tosion/shear
45
key factors for bone healing
- adequate fixation - alignment - good nutrition - blood supply - oxygen - compression
46
3 phases of bone healing (and time frames)
soft callus: 0-3/4 weeks hard callus: 4-6weeks bony union: 3-4 mths
47
during what phase do you continue to immobilize most fractures
soft callus because it is a fragile union
48
can you do normal daily activity during hard callus phase
yes because fracture is stabilized
49
tendons and ligaments are made up of what kind of cells
fibrocytess
50
structure of tendons and ligaments
collagen - 30% elastin - 2% ground substance - 68%
51
what happens to the ground substance with loss of motion
loss of water
52
davis's law
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
T or F: fibrous connective tissue is viscoelastic
T
54
creep
the lengthening that occurs when a stretch force is applied ex. hamstring stretch
55
load relaxation
longer load is placed the less stress felt ex: cervical traction
56
are tendons or ligaments more elastic
ligaments *tendons fail at 10% length
57
ligaments/tendons respond best to this kind of load
tension *they don't handle compression very well
58
0 to 4-6 weeks fibrous connective tissue healing
- protected ROM - minimal strength training
59
4-6 weeks fibrous connective tissue healing
- structural union occurs - begin resuming normal ROM
60
6 weeks-3 months fibrous connective tissue healing
initial protected strength training
61
4-8 months fibrous connective tissue healing
improving strength of fibers, possible resumption athletic activity
62
8-12 months fibrous connective tissue healing
complete remodeling
63
what type of cells is articular cartilage made up of
chondrocytes
64
what does articular cartilage not heal well
chondrocytes are limited in number and unable to reproduce
65
articular cartilage is arranged in 4 ______
zones
66
collagen is for _______ and ground substance is for __________-
strength shock absorption
67
zone 1 of articular cartilage
large amount of collagen, parallel to surface allows for gliding and strength
68
zone 2 of articular cartilage
- less collagen than zone 1 - random fiber orientation - provides strength and shock attenuation
69
zone 3 of articular cartilage
- less collagen than zone 1 and 2 - perpendicular orientation - provides shock attenuation
70
zone 4 of articular cartilage
calcified and attached to bone
71
80% of articular cartilage weight is
water
72
T or F: articular cartilage is viscoelastic
T
73
T or F: articular cartilage is avascular and aneural
T: this is why it has poor healing
74
T or F: tendons are stronger than articular cartilage
F: articular cartilage is stronger than tendon and SC bone
75
articular cartilage is very strong with _______ and _______ but weak with ________
compression and tension shear
76
what is articular cartilage healing affected by
hemarthrosis effusion injection depth of lesion
77
T or F: a deeper lesion in articular cartilage may heal better
T: b/c more blood flow
78
what is the primary goal when it comes to articular cartilage healing
restore mobility
79
platelet rich plasma
platelets contain protein and cytokines to help regulate wound healing

MPT 2 (11 decks)

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