Healing Stages Flashcards
What are the three main stages of healing
inflammation, repair (proliferative), Remodeling (maturation)
inflammation
generic response to tissue treat
Biochemical mediators in acute inflammation
Histamine, prostaglandin, bradykinin
How long does acute inflammation typically last
72hrs- typically exaggerated at first- calms down fairly quickly once threat is removed
From where are biochemical mediators released
mast cells and from local blood vessels
What changes occur at the level of the blood vessels during the inflamation stage
-vasodilation
-increased permeability of vessels-leak more into tissues
What changes occur at the level of the nerves during the inflamation stage
-nerves in area more sensitive to threatening stimuli-acute hyperalgesia
How does the inflammation stage present clinically
SHARP- may not experience all to same degree
S=swelling (fluid from increased permeability or bleeding or effusion)
H=heat (depends on depth of injury)
A=altered function (pain, lack of stability, WB, NWB)
R=redness (depends on depth of injury)
P=pain (chemicals stimulate nociceptors and make them more sensitive)
What is the difference between inflammation and swelling
swelling= collection of fluid- can be due to different things. Swelling can still be present after inflammation process is done particularly is immobile or if limb below trunk for extended period.
inflammation= process
edema
fluid leaking into tissue
hematoma
collection of blood that has escaped vessels
hemarthrosis
bleeding into joint cavity
joint effusion
synovial membrane creates excessive amount of synovial fluid
Repair or proliferative stage
clean up debris and build foundation to bridge the gap. Can last up to 3 weeks- begins about 2 days post injury once inflammation has decreased.
Repair or proliferative stage- macrophages
“big” “eater”- clean up
Repair or proliferative stage- fibroblasts
creates new collagen- weaker and less organized- some structural integrity but not much. Along with new but fragile blood vessels–> granulation tissue
Repair or proliferative stage- clinical presentation
fell better than during inflammation stage. SHARP symptoms decrease significantly- done mostly by end of stage. Improve lots but underlying structures still weak.
Remodeling or maturation stage
starts about 3 weeks post injury, can last up to 2 years post injury. Progressively challenge structures so build and become shape needed.
Remodeling or maturation stage- physiology
eventually reach point where no net gain in collagen content–> find balance in synthesis of new high quality well organized collagen and breakdown of old collagen (original). Blood vessels become more stable and new growth stops.
Remodeling or maturation stage- Now what clinically
can introduce more challenging and sport specific skills- required musculature as becoming more well developed and gain endurance.
Remodeling or maturation stage- timeline for return
Timeline for return depends on how much tissue needed to be repaired, how did the repair go, what type of tissue was injured (bone vs ligament), functional and psychological readiness
