Healing Stages

Question 1

What are the three main stages of healing

Answer 1

inflammation, repair (proliferative), Remodeling (maturation)

Question 2

inflammation

Answer 2

generic response to tissue treat

Question 3

Biochemical mediators in acute inflammation

Answer 3

Histamine, prostaglandin, bradykinin

Question 4

How long does acute inflammation typically last

Answer 4

72hrs- typically exaggerated at first- calms down fairly quickly once threat is removed

Question 5

From where are biochemical mediators released

Answer 5

mast cells and from local blood vessels

Question 6

What changes occur at the level of the blood vessels during the inflamation stage

Answer 6

-vasodilation
-increased permeability of vessels-leak more into tissues

Question 7

What changes occur at the level of the nerves during the inflamation stage

Answer 7

-nerves in area more sensitive to threatening stimuli-acute hyperalgesia

Question 8

How does the inflammation stage present clinically

Answer 8

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)

Question 9

What is the difference between inflammation and swelling

Answer 9

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

Question 10

edema

Answer 10

fluid leaking into tissue

Question 11

hematoma

Answer 11

collection of blood that has escaped vessels

Question 12

hemarthrosis

Answer 12

bleeding into joint cavity

Question 13

joint effusion

Answer 13

synovial membrane creates excessive amount of synovial fluid

Question 14

Repair or proliferative stage

Answer 14

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.

Question 15

Repair or proliferative stage- macrophages

Answer 15

“big” “eater”- clean up

Question 16

Repair or proliferative stage- fibroblasts

Answer 16

creates new collagen- weaker and less organized- some structural integrity but not much. Along with new but fragile blood vessels–> granulation tissue

Question 17

Repair or proliferative stage- clinical presentation

Answer 17

fell better than during inflammation stage. SHARP symptoms decrease significantly- done mostly by end of stage. Improve lots but underlying structures still weak.

Question 18

Remodeling or maturation stage

Answer 18

starts about 3 weeks post injury, can last up to 2 years post injury. Progressively challenge structures so build and become shape needed.

Question 19

Remodeling or maturation stage- physiology

Answer 19

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.

Question 20

Remodeling or maturation stage- Now what clinically

Answer 20

can introduce more challenging and sport specific skills- required musculature as becoming more well developed and gain endurance.

Question 21

Remodeling or maturation stage- timeline for return

Answer 21

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