Inflammation and Healing

Question 1

Erythrocytes

Answer 1

RBCs
do not migrate to injury
ROLE: O2 transport
Hemoglobin specifically transports the O2

Question 2

Leukocytes

Answer 2

WBCs migrate to the injury
clear debris - PHAGOCYTOSIS to prep for healing
each one is specialized for a task in early or later stages of inflammation

Question 3

Monocyte becomes Macrophage once out of capillary WBC

Answer 3

PHAGOCYTOSIS - eating dead stuff
prominent in CHRONIC inflammation
come and go quickly in acute inflammation
too many is BAD = chronic infla

Question 4

Lymphocyte WBC

Answer 4

bacteria killer - come and go within 1-2 days
if chronic it sticks around
too many is bad = chronic infla

Question 5

Eosinophil

Answer 5

if high count - scary
allergic reaction or parasite infection
too many is bad = chronic

Question 6

Neutrophil

Answer 6

bacteria killer - come and go in a couple of days

acute inflammation/ NL

Question 7

Basophil

Answer 7

acute inflammation/ NL
releases histamine (inc BF to area)

Question 8

Mast Cells

Answer 8

found in CT (not blood)
releases HISTAMINE/Heparin in response to tissue injury and infla
present in NL infla process

Question 9

Platelets

Answer 9

1st cells to injury site and promote blood clotting
even come to site when skin is intact
PDGF - platelet derived growth factor creates PRP (platelet rich plasma) which can be injected into injury to speed up healing process

Question 10

Chemotactic Signaling

Answer 10

platelets send out chemical messages than an injury is present
the signal is PDGF

Question 11

Fibroblasts **

Answer 11

Spew Collagen**
found in CT and forms collagen fibers
Good - but too much is not always good
EPA’s inc their activity: US/laser

Question 12

Inflammation

Answer 12

1-6 days
prepares the wound for healing to occur
some EPAs try to trigger/restart this process

Question 13

Inflammation Signs

Answer 13

heat, pain, swelling, redness, loss of function

Resolve QUICKLY! prevent chronic inflammation

Question 14

Vascular Inflammation Response

Answer 14

Brief VC (5-10min) to not lose blood
VD and inc permeability to clean up and bring troops
Extravasation, Histamine, Hageman Factor, Bradykinin, Prostaglandin

Question 15

Extravasation

Answer 15

the process of a leukocyte migrating form the vessel to the tissue

Question 16

Histamine = VD

Answer 16

VD**
released by Mast, plateets and basophils
VD to inc vascular permeability leading to edema

Question 17

Hageman Factor (clot factor XII)

Answer 17

enzyme found in blood that helps to stop local bleeding

Question 18

Bradykinin

Answer 18

mediated the inflammatory process
inc VD**
maybe some pain regulation

Question 19

Prostaglandin

Answer 19

attracts leukocytes
chemotactic signaling - attracts WBCs (troops)
pain - receptors sensitized

Question 20

Hemostatic Inflammation Response

Answer 20

limit local bleeding and fluid drainage
seal damaged vessels
platelets - 1st to promote clot and PDGF
collect fibrin and collagen to help clot

Question 21

Cellular Inflammation Response

Answer 21

Mast and platelets release chemotactic agents to attract leuk. Destroy neutrophils to break down fibers, mediate immune response, macrophage - phagocytose and attract fibroblasts

Question 22

PT goals with Inflammation

Answer 22

Protect area and Prevent Inflammation

Question 23

Proliferation

Answer 23

“Fibroblastic Phase”
rebuilds damaged tissue and strengthen the wound
4 steps: epithelialization, collagen production, wound contraction, neovascularization/angiogenesis

Question 24

Epithelialization

Answer 24

if open wound - reestablishment of epidermis, provides protection, healthy cells migrate to cover wound

Question 25

Collagen Production

Answer 25

fibro eat Ca and spew collagen which is thin, weak, unorganized (type III) which tolerates early and controlled movement.
Day 12 type III is replaced by type I which is more mature and stronger - still unorganized

Question 26

Wound Contraction

Answer 26

pulls edges of site together for smaller area of scar
myofibroblasts have contractile properties and pull good skin together
can have contracture

Question 27

Contractures

Answer 27

uncontrolled wound contraction

inc resistance to passive stretch

Question 28

Neovascularization/ Angiogenesis

Answer 28

Development of new bld vsls to area helps healing and supply of O2 and nutrients
Form a capillary loop which is weak and often immob helps protect these was they grow
pink/bright red

Question 29

Maturation/ Remodeling

Answer 29

modifies scar tissue into its mature form

Question 30

Maturation Response

Answer 30

collagen reabsorbed if off direction
longest phase up to 1 yr
changes in size, form, strength of scar (become white)
Type I coll replace type III need O2 - also need a balance between synthesis of new and lysis of III

Question 31

Induction Theory

Answer 31

scar mimics tissue its healing

Question 32

Tension Theory

Answer 32

internal and external stressed placed on area determine final structure
tension during healing can inc tensile strength
immobilization reduces tensile strength and collagen structure

Question 33

1st phase EPAs

Answer 33

cryo, compression, iontophoresis, laser, TENS, e-stim

Question 34

2nd phase EPAs

Answer 34

inc BF - heat, diathermy

inc cell metab - laser, estim, US*

Question 35

3rd phase EPAs

Answer 35

US*, laser, CPM, traction, NM e-stim

Question 36

Acute Infla

Answer 36

sequence of healing continuous and within expected time frame

Question 37

Chronic Inflammation

Answer 37

delay in processs because repeat trauma, poor perfusion/oxygenation, immune response to foreign material or RA

Question 38

local factors to wound healing

Answer 38

type/size/location
wound dimension
infection
vascular supply
external forces
movement

Question 39

Systemic factors of wound healing

Answer 39

age
disease
medications
nutrition - smoking