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Fundamentals of MSK > Healing Phases > Flashcards

Healing Phases Flashcards

1
Q

What are the characteristics of direct trauma?

A

Obvious trauma, rapid onset of symptoms

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2
Q

What are the characteristics of overuse syndrome?

A

No trauma, sudden changes in parameters of activity, subsequent onset of symptoms

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3
Q

What are the characteristics of repetitive strain syndrome?

A

No trauma, gradual onset without change in parameters of activity, typically a local biomechanical limitations or a degenerative disease such as OA

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4
Q

What are the characteristics of regional interdependance?

A

Gradual onset without change in activity parameters, symptoms usually distant from a “silent and real culprit”; often abnormal spinal motion/stability due to past and subtle trauma and/or persistent poor posturing; Possible increased pain response

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5
Q

What are the 4 general phases of tissue healing?

A
  1. hemostasis
  2. inflammation
  3. proliferation or repair
  4. remodeling
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6
Q

Are the phases of tissue healing mutually exclusive?

A

not mutually exclusive; overlap chronologically

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7
Q

Can healing occur without inflammation?

A

No

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8
Q

Can inflammation occur without healing?

A

yes

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9
Q

What is acute inflammation like?

A

sharp and severe

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10
Q

How long does acute inflammation last?

A

24 hours to 2 weeks

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11
Q

What are cardinal S&S of acute inflammation?

A

Red
swollen
hot
pain

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12
Q

What are the purposes of acute inflammation?

A

Protection and preparation for next phases

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13
Q

What are the vascular reactions to hemostasis?

A
  • systemic vasoconstriction
  • local vasodilation and vascular permeability
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14
Q

What are the cellular reactions to hemostasis?

A
  • Serotonin released
  • platelets aggregate, release growth factors for inflammation and repair
  • histamines/prostaglandins/proteins/NO released for local dilation
  • WBCs
    -RBCs, cellular debris and fibronectin (glue)
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15
Q

What is local stasis? What does it do?

A

Edema
- increased viscosity
- increased chemicals and acidity

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16
Q

What does local stasis lead to?

A

Protection / tenderness and muscle guarding

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17
Q

What does local vasodilation and vascular permeability do?

A
  • brings cells to kill and clean
  • brings cells to form a fragile clot/matrix to support the area
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18
Q

What does systemic vaso-constriction do?

A
  • shunt blood to injured site, stars clotting, and slows bleeding
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19
Q

What is the P in POLICED?

A

Protection with possible…
- activity modification
- immobilization
- assistive device

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20
Q

What is the OL in POLICED?

A

Optimal Loading through activity and MET for pain and inflammation

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21
Q

What does optimal loading promote?

A
  • Tissue repair and remodeling to prevent random fiber alignment
  • muscle activation to combat inhibition
  • confidence for motion
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22
Q

What is the ICED in POLICED?

A

Ice
Compression
Elevation
Drugs

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23
Q

What do we use modalities/MT to control?

A

pain
inflammation
muscle guarding

24
Q

When does the repair/proliferation phase?

A

begins within 24 hours to ~10 weeks

25
Q

What are the purposes of the repair phase?

A

Collagen production by respective tissue cells & angiogenesis

26
Q

What is angiogenesis?

A

formation of new blood vessels

27
Q

What is the repair phase general rx?

A
  • Greater address of ROM restrictions and involved tissues with manual therapy and MET
  • progress MET for optimal stresses with dose response
28
Q

What does dose response with MET help with?

A

Protecting forming collagen and achieve neuromuscular benefits

29
Q

FORM FOLLOWS …

A

Function

30
Q

What does the patient need to know about the repair phase?

A

Their body can adapt heal and needs optimal stresses

31
Q

Little to no stress is almost as bad as …

A

too much

32
Q

When does collagen repair and remodel best?

A

With early and optimal healthy stress

33
Q

What do we need to modify in the line of stress regarding articular cartilage/ inner annulus of vertebral discs/ and nucleus of disc and menisci?

A

Compression/ decompression/ glidingW

34
Q

What do we need to modify about bone in the line of stress?

A

Compression/ decompression

35
Q

What do we need to modify for muscles/tendons/ligaments/capsules/etc. in the line of stress?

A

Tension

36
Q

When is the remodeling phase?

A

Highest rate from 2 weeks out to 1 year but may continue up to 3 years

37
Q

What is the purpose of the remodeling phase?

A

Collagen conversion and organization

38
Q

What happens to the collagen in the remodeling phase?

A

Initial and different type of immature collagen changes to its mature original type and alignment

39
Q

How long for full cellular turnover?

A

Well over a year

40
Q

What is the remodeling phase rx?

A
  • address symptoms prn
  • restore full ROM with MT/MET
  • progress to higher MET purposes
41
Q

What is sub-acute inflammation?

A

mild prolonging of inflammatory response

42
Q

What does chronic or persistent inflammation NOT have?

A

redness or head

43
Q

What does chronic inflammation have?

A

pitting edema and hardness with resistant absorption

44
Q

What happens with more prostaglandins?

A

More pain and may lead to nociplastic pain

45
Q

What happens with homunculus reorganization with more prostaglandins?

A

Increased nociceptive response

46
Q

What does having more prostaglandins prolong?

A

Local vasodilation and permeability

47
Q

What is persistent inflammation releasing more of?

A

Inflammatory products such as prostaglandins

48
Q

What happens with excess oxygen from increased cellular metabolism?

A

Damages cell structure

49
Q

What happens when we have more macrophages?

A

they release fibronectin and lead to extra matrices to accept more collagen

50
Q

Is scar tissue a natural part of the healing process?

A

yes

51
Q

What is remodeled tissue?

A

Combination of original and secondary types of collagen (aka scar tissue)

52
Q

When is scar tissue a problem?

A

If excessive and disorganized = abnormal

53
Q

What does abnormal scar tissue doi?

A

-limits tissue extensibility and elasticity
- crimps off veins so limits circulation
- impairs healing
- C-fibers tolerate pressure and are left behind

54
Q

What do C-fibers do?

A

tolerate compression and generate pain under tension

55
Q

What do we have to manage while promoting optimal loading?

A

Pain and inflammation

Fundamentals of MSK (2 decks)

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