Exam 1: Rehabilitation/physiological response to injury

Question 1

ATC needs to know

Answer 1

• how body heals itself
• how rehab may be accelerated
• how rehab may be delayed
• anatomy
• physiology

Question 2

What is pathology

Answer 2

Study of nature and cause of disease and injury

Question 3

Pathophysiology

Answer 3

Study of how normal physiological processes are altered by disease or injury

Question 4

Vascular physiology

Answer 4

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

Question 5

What are the two opposing forces that move fluid, nutrients, etc through the capillary wall?

Answer 5

1) hydrostatic pressure

2) water concentration difference

Question 6

Is pressure higher or lower inside the capillary compared to the surrounding tissue?

Answer 6

higher in the capillary

Question 7

what are three forces that direct lymphatic drainage?

Answer 7

1) muscle pump
2) gravity through elevation
3) massage

Question 8

What is the primary goal of rehabilitation?

Answer 8

To facilitate the positive parts of the healing process

Question 9

What are the three injury repair phases?

Answer 9

• Inflammation
• Repair & regeneration
• Remodeling

Question 10

What are the 4 signs of inflammation?

Answer 10

1. heat
2. redness
3. swelling
4. pain

Question 11

What are the causes of inflammation?

Answer 11

1. trauma
2. chemical agents
3. thermal extremes
4. pathogenic organisms

Question 12

What is the purpose of inflammation?

Answer 12

1. put the fire out
2. prevent extensive spread of injury causing agents
3. set stage for repair & regeneration phase

Question 13

Inflammation Phase

Answer 13

1. injury
2. injured blood vessels begin to hemorrhage
3. injured cells release chemical messages which signal injury
4. brief period of capillary vasoconstriction at injury site
5. body initiates clotting process
6. chemical messengers/enzymes are released
7. chemical messengers cause:
   
   • capillary vasodilation
   • capillary hyperpermeability

Question 14

What 4 chemical messengers/enzymes are released during inflammation?

Answer 14

• Prostaglandin
• histamine
• serotonin
• bradykinin

Question 15

What is prostaglandin?

Answer 15

a protein responsible for increased vasodilation & capillary permeability during the inflammation response stage

Question 16

What is thromboxane

Answer 16

Protein responsible for clotting - makes surfaces of WBC’s sticky

Question 17

What is phagocytosis?

Answer 17

Removal of pathogens or cell debris

Question 18

What are the physiological effects of vasodilation?

Answer 18

1. slows rate of blood flow through the capillary
2. marginasation - permits leukocytes to move from central flow to periphery
3. Thrombocytes - cause leukocytes to adhere to the blood vessel wall

Question 19

Physiological effects of hyperpermiability

Answer 19

Diapedesis

1. endothelial cells contract
2. this increases space between cells
3. facilitates movement of leukocytes & other large cells through capillary wall

Question 20

What are the secondary problems that arise from the inflammation phase?

Answer 20

1. pain
2. muscle spasm
3. impaired circulation
4. blood stasis
5. secondary hypoxic injury

Question 21

What is secondary hypoxic injury?

Answer 21

disruption of blood flow to the injury site and surrounding uninjured tissue. Hypoxia can cause further tissue damage.

Question 22

What are 3 important factors that influence the body’s ability to regenerate itself?

Answer 22

1. elimination of dead tissue
2. restoration of circulation
3. formation of scar tissue

Question 23

What 3 types of cells are capable of regeneration?

Answer 23

1. endothelial cells - circulatory
2. epithelial cells - skin+
3. fibroblasts - connective tissue

Question 24

Define phagocytosis

Answer 24

the process of engulfing microorganisms such as bacteria, dead cells, foreign particles, etc

Question 25

What are fibroblasts?

Answer 25

Connective tissue cells that produce collagen, which is used in muscles, tendons, ligaments, and scar tissue

Question 26

Descrbe mature scar tissue

Answer 26

It’s firm, fibrous, inelastic, non-vascular…excessive scar tissue has a negative effect on the healing process

Question 27

What happens in the Remodeling phase?

Answer 27

1. newly formed collagen begins to be organized and integrated into the injury site.
2. collagen increases in tensile strength
3. controversy begins
   Must be a balance between activity and rest

Question 28

P.R.I.C.E.

Answer 28

Protection
Rest
Ice 
Compression
Elevation

Question 29

What is the function of compression?

Answer 29

1. Aids in clotting process - compression of blood vessels
2. inhibits extravasation of plasma into interstitial space
3. maintains soft tissue structures in a more normal configuration
4. prevents separation of tissues
5. facilitates lymphatic drainage

Question 30

What are the primary physiological effects of cold?

Answer 30

decreased metabolism

• vasoconstriction - aids in clotting
• decreased blood flow
• reduces swelling
• decreased edema
• decreased pain
• decrease muscle spasm
• decreased inflammatory response