Inflammation and tissue repair

Question 1

What are the three phases of tissue healing?

Answer 1

hemostasis/inflammation
proliferation
maturation

Question 2

What phase of healing minimizes localized tissue damage

Answer 2

inflammation

Question 3

What phase of healing begins the process of returning strength?

Answer 3

Proliferation

Question 4

What phase of healing begins to tolerate prior level of function?

Answer 4

maturation

Question 5

How long does the hemostasis/inflammation phase last?

Answer 5

1-6 days

Question 6

How long does the proliferation phase last?

Answer 6

3-20 days

Question 7

How long does the maturation phase last?

Answer 7

from 9 days on. sometimes takes years

Question 8

What are the cardinal signs of inflammation?

Answer 8

redness, heat, swelling, pain

Question 9

What causes the redness, heat and swelling associated with inflammation?

Answer 9

Increased blood flow to the area

Question 10

In the first 5-10 minutes of inflammation, what is caused by norepinephrine and seratonin?

Answer 10

vasconstriction

Question 11

uninjured local vasodilation and increased capillary permeability results in…

Answer 11

edema (lasts about an hour)

Question 12

What substances cause local vasodilation?

Answer 12

histamine, bradykinin, prostaglandins

Question 13

What activates coagulation and initiates vasoconstriction?

Answer 13

Hageman factor (clotting factor XII)

Question 14

What clears the injured site in anticipation of tissue repair?

Answer 14

leukocytes

Question 15

What phase rebuilds damaged structures and strengthens the wound?

Answer 15

proliferation phase

Question 16

reestablishment of the epidermis to decrease risk of infection

Answer 16

epithelialization

Question 17

development of new blood supply

Answer 17

neovascularization

Question 18

granulation tissue- newly formed capillaries, fobroblasts, and myofibroblasts- is created

Answer 18

collagen production

Question 19

What type of collagen is produced in the proliferation phase?

Answer 19

Type III (weak and without organization)

Question 20

What phase do the tissues have the most collagen?

Answer 20

Collagen production portion of the proliferation phase

strength of type III only 15% of normal tissues

Question 21

edges of wound are pulled together

Answer 21

wound contraction

Question 22

What 4 processes occur in the proliferation phase?

Answer 22

epithelialization
neovascularization
collagen production
wound contraction

Question 23

In what phase does restoration of prior function of injured tissue occur?

Answer 23

maturation phase

Question 24

Collagen will develop to be similar to tissue that is healing

Answer 24

Induction theory

Question 25

internal and external stresses that are placed on healing tissue will determine overall strength of those tissues

Answer 25

tension theory

Question 26

What occurs during the maturation phase?

Answer 26

- reduction of vascular tissues in injured area - synthesis and lysis of collagen occur in balanced fashion - collagen formation Type I

Question 27

In the maturation phase, what type of collagen is synthesized and what is lysed?

Answer 27

Type I, Type III

Question 28

synthesis and lysis occur in a balanced fashion. Which depends on oxygen?

Answer 28

synthesis

Question 29

synthesis and lysis occur in a balanced fashion. if balance doesn't occur what develops?

Answer 29

keloid or hypertrophic scars

Question 30

Which is stronger? type I or type III collagen?

Answer 30

type I

Question 31

Persistent state of inflammation that leads to prolonged irritation and potential tissue destruction

Answer 31

chronic inflammation -Result of continued aggravation of injured tissues or as an immune response most commonly due to foreign materials or autoimmune conditions

Question 32

What are the primary cells that are present in chronic inflammation?

Answer 32

lymphocytes, macrophages, and monocytes

Question 33

Is tendinosis a form of chronic inflammation?

Answer 33

NO

Question 34

What is tendinosis?

Answer 34

more of a degenerative state that does not include active inflammation

Question 35

8 Local factors that affect the healing process

Answer 35

1. type, size, and location of injury 2. infection 3. vascular supply 4. Movement/excessive pressure 5. temperature deviation 6. topical medications 7. electromagnetic energy 8. retained foreign body

Question 36

8 systemic factors that affect the healing process

Answer 36

1. age 2. infection or disease 3. metabolic status 4. nutrition 5. hormones 6. medication 7. fever 8. oxygen

Question 37

What are some important determinants of healing?

Answer 37

regenerative capacity of tissues, vascular supply extent of damage

Question 38

4 tissues with different capacities for healing

Answer 38

- cartilage - tendons and ligaments - skeletal muscle - bone

Question 39

limited ability to heal lacks lymphatics, blood vessels, and nerves

Answer 39

cartilage

Question 40

T/F Cartilaginous injuries that involve subchondral bone don't allow proper repair of injured cartilage

Answer 40

F- Cartilaginous injuries that also involve subchondral bone allow inflammatory cells from bone to gain access to repair the injured cartilage

Question 41

T/F Repair of tendons and ligaments is dependent on the extent of the damage, type, vascular supply, and control of movement

Answer 41

T

Question 42

T/F If healing occurs, tendons possess a unique scar maturation phase that can achieve an advanced state of repair

Answer 42

T

Question 43

Ligaments heal better with _________

Answer 43

controlled passive mobilization

Question 44

T/F In skeletal muscles healing may occur through stem cells that can proliferate and differentiate

Answer 44

T

Question 45

What may occur if there is a severe contusion?

Answer 45

calcified hematoma (myositis ossificans)

Question 46

What are the four stages of healing for bone?

Answer 46

inflammation soft callus hard callus bone remodeling

Question 47

During inflammation in bone healing what happens?

Answer 47

a hematoma is created, disrupts blood supply, lowers ph

Question 48

What does the formation of a soft callus do?

Answer 48

stabilizes fracture, decreases pain, and reduces chance of fat embolism

Question 49

What phase of bone healing corresponds to clinical healing period?

Answer 49

hard callus (3 weeks to 4 months)

Question 50

What is bone remodeling?

Answer 50

healed fibrous bone is converted to lamellar bone, and medullary canal becomes patent again