Exam 1: Rehabilitation/physiological response to injury Flashcards
ATC needs to know
- how body heals itself
- how rehab may be accelerated
- how rehab may be delayed
- anatomy
- physiology
What is pathology
Study of nature and cause of disease and injury
Pathophysiology
Study of how normal physiological processes are altered by disease or injury
Vascular physiology
1) under normal circumstances 2 opposing forces act to move fluid, nutrients, cells, and wast products through capillary wall
2) when injury occurs:
- larger cells in capillary taking up space & more H2O outside capillary
- lymphatic system removes large particles from tissue that can’t cross capillary wall into blood
What are the two opposing forces that move fluid, nutrients, etc through the capillary wall?
1) hydrostatic pressure
2) water concentration difference
Is pressure higher or lower inside the capillary compared to the surrounding tissue?
higher in the capillary
what are three forces that direct lymphatic drainage?
1) muscle pump
2) gravity through elevation
3) massage
What is the primary goal of rehabilitation?
To facilitate the positive parts of the healing process
What are the three injury repair phases?
- Inflammation
- Repair & regeneration
- Remodeling
What are the 4 signs of inflammation?
- heat
- redness
- swelling
- pain
What are the causes of inflammation?
- trauma
- chemical agents
- thermal extremes
- pathogenic organisms
What is the purpose of inflammation?
- put the fire out
- prevent extensive spread of injury causing agents
- set stage for repair & regeneration phase
Inflammation Phase
- injury
- injured blood vessels begin to hemorrhage
- injured cells release chemical messages which signal injury
- brief period of capillary vasoconstriction at injury site
- body initiates clotting process
- chemical messengers/enzymes are released
- chemical messengers cause:
- capillary vasodilation
- capillary hyperpermeability
What 4 chemical messengers/enzymes are released during inflammation?
- Prostaglandin
- histamine
- serotonin
- bradykinin
What is prostaglandin?
a protein responsible for increased vasodilation & capillary permeability during the inflammation response stage
What is thromboxane
Protein responsible for clotting - makes surfaces of WBC’s sticky
What is phagocytosis?
Removal of pathogens or cell debris
What are the physiological effects of vasodilation?
- slows rate of blood flow through the capillary
- marginasation - permits leukocytes to move from central flow to periphery
- Thrombocytes - cause leukocytes to adhere to the blood vessel wall
Physiological effects of hyperpermiability
Diapedesis
- endothelial cells contract
- this increases space between cells
- facilitates movement of leukocytes & other large cells through capillary wall
What are the secondary problems that arise from the inflammation phase?
- pain
- muscle spasm
- impaired circulation
- blood stasis
- secondary hypoxic injury
What is secondary hypoxic injury?
disruption of blood flow to the injury site and surrounding uninjured tissue. Hypoxia can cause further tissue damage.
What are 3 important factors that influence the body’s ability to regenerate itself?
- elimination of dead tissue
- restoration of circulation
- formation of scar tissue
What 3 types of cells are capable of regeneration?
- endothelial cells - circulatory
- epithelial cells - skin+
- fibroblasts - connective tissue
Define phagocytosis
the process of engulfing microorganisms such as bacteria, dead cells, foreign particles, etc
What are fibroblasts?
Connective tissue cells that produce collagen, which is used in muscles, tendons, ligaments, and scar tissue
Descrbe mature scar tissue
It’s firm, fibrous, inelastic, non-vascular…excessive scar tissue has a negative effect on the healing process
What happens in the Remodeling phase?
- newly formed collagen begins to be organized and integrated into the injury site.
- collagen increases in tensile strength
- controversy begins
Must be a balance between activity and rest
P.R.I.C.E.
Protection Rest Ice Compression Elevation
What is the function of compression?
- Aids in clotting process - compression of blood vessels
- inhibits extravasation of plasma into interstitial space
- maintains soft tissue structures in a more normal configuration
- prevents separation of tissues
- facilitates lymphatic drainage
What are the primary physiological effects of cold?
decreased metabolism
- vasoconstriction - aids in clotting
- decreased blood flow
- reduces swelling
- decreased edema
- decreased pain
- decrease muscle spasm
- decreased inflammatory response
