Inflammation and repair Flashcards
Define Thermal Agent
Define Mechanical Agent
Define Electromagnetic Agent
Thermal–Transfer energy to pt. to produce an increase or decrease in tissue temp. (hot pack, thermal ultrasound, cryotherapy)
Mechanical–Application of mechanical force to increase to decrease pressure in or on the body. (traction, compression, non-ultrasound)
Electromagnetic–electronmagnetic radiation or electric current (infrared radiation, e-stim, diathermy)
What is Inflammation?
What causes it?
How does it do its function?
Vascularized tissue’s response to trauma or disease (circulatory system–blood system responds to trauma)
injury or destruction of localized tissue, which serves to destroy, dilute or wall off (sequester) both the injurious agent and the injured tissue. (Inflammation is good…out of control inflammation is bad)
What are the 3 phases of Inflammation and Repair?
Inflammation Phase–prepares wound for healing.
Proliferative Phase– rebuilds the damaged structures and strengthens the wound (healing process)
Maturation Phase–modifies the scar tissue into its mature form (permanent tissue)
How should Inflammation and repair influence rehab protocols?
How does the PT know what phase of inflammation in injury is in?
In addition to inflammation, what else must be included in choosing modalities?
Rehab protocols and progression should be based primarily upon the physiologic response of tissue to injury.
the time table of inflammation and healing. (never use a modality that interferes with the time table.)
Signs and symptoms mus be included in the intervention time table.
What is the intervention equation?
(Time table of inflammation and repair) + (pt’s sign’s and Sx’s) = safe and appropriate use of modalities
Body’s purpose for inflammation and repair.
What is the purpose for inflammation phase?
What is the purpose for the Proliferation Phase?
What is the purpose for the Maturation phase?
Eliminates pathological or physical insult.Inflammation cleans up the debris in the area to provide a way for new tissue to come in.
Replace damaged or destroyed tissue
Promote regeneration of normal scar tissue in order to restore function.
What are the 8 causes of inflammation?
Soft tissue trauma Fractures Foreign bodies Autoimmune disease Microbial agents Chemical agents Thermal agents Irradiation
What is the time table of the normal inflammatory and healing process?
Inflammatory response 1-6 days
Proliferation 3-20 days
Maturation day 9 and on.
What are the 5 Cardinal signs of inflammation?
Calor–increased localized temperature due to hyperemia. (heat)
Rubor–increased redness due to hyperemia (increased blood)
Tumor–swelling due to eduma
Dolor–Pain due to irritation of nociceptors.
Functio laesa–loss of function due to pain and swelling.
When does Vasoconstriction happen? What controls it?
Vasodilation–How long does it last? What controls it?
Increased capillary permeability–how long does it last?
1st 5-10 minutes; controlled by norepinephrine and serotonin.
Lasts up to an hour; controlled by histamine, bradykinin, prostaglandin, and complement fractions.
permeability normally lasts about a week.
(vasoconstriction is immediate. Cells ooze out of the vessel. They head to inflammatory site. Fluid (plasma) also oozes out. These occur in the first few days. NO HEAT APPLIED!!! During the acute inflammatory phase. Heat exacerbates this process. Ice helps control inflammation.)
Polymorhonucleocytes are a type of what?
Where are they?
What do they do?
PMS are leucocytes.
In the blood stream.
Adhere to endothelium (margination and adhesion) and stack up (pavementing)
Squeeze through the vessel wall (diapedesis
Migrate to source of injury (emigration) [out of the bloodstream to the tissue as if they know where to know.] {extravasation}
What are the 3 fluids of edema?
Transudate–first fluid to escape into these spaces; thinner and clearer.
Exudate–later fluid to escape; more viscous and cloudy.
Pus–also called supporative exudate, is thick fluid containng PMNs, debris and bacteria. Suppurative exodate may form an abscess in more confined spaces. (full of old, white blood cells. The bacteria may be winning.)
Hemostatic Response (clotting response) What is the Platelet response?3
(Requires multiple events to occur in a sequence…40 to 100. Each depends on the previous event to occur. If that event doesn’t occur, a clot may not form.)
- Platelets do not normally adhere to the vascular walls.
- However, injury disrupts the endothelium and exposes the collagen causing the release of fibrin.
- Fibrin cross-links w/ collagen forming a sticky matrix which platelets stick to and eventually form a plug.
How is fibrin made?
Fibrinogen (an ever-presente blood protein) is converted to fibrin by a very complex cascade of chemical events.
What is extravasation?
How does this cellular reaction get rid of injury by-products?
Leukocytes and other phagocytic cells are delivered to the injury site through margination, diapedisis, and emigration.
Phagocytosis
