Inflammatory Process Flashcards
Ultimate goal of treating injury?
- Promote a strong, mobile scar.
- As much as possible, full, pain free movement of affected structures and full strength
What happens with re-epithelialization?
- Regeneration is possible w/ epithelial cells, nerves and hepatic cells.
- no scar tissue, normal tissue structure results
- if exudate (fluid release) occurs, some fibrosis in tissue will result
What is Granulation Tissue?
- Part of any first or second intention healing (tissue repair)
- new blood vessels come support, called “neoangiogenesis”
- fibroblasts are important here, they make collagen fibres they form loose CT matrix (replaces blood clot for acute stage)
Healing of Scar Tissue?
- With increased loss of epidermal and dermal layers or damage to mm, tendon, ligaments
- Replaced with tissue different from original tissue
- mature collagen repair is often called scar tissue
Primary or First Intension Healing
- With some tissue loss, wound edges are approximated {may be done with tape, sutures, staples}
- healing = efficient, only small amounts of collage made to repair tissue
Secondary or Second Intention Healing
- when there’s extensive tissue loss/large surface area
- wound edges cannot be brought together easily
- healing takes longer through re-epithelialization and large amounts of granulation tissue
Factors that affect the healing process?
- severity of injury
- age
- infection
- presence of foreign material
- nutritional support
- Exciting conditions
- Adequate blood supply
- Wound separation
- effects of some drugs
- smoking
How long is the Acute Phase of tissue healing and inflammatory process?
From ment on injury up to 3-4 days post-injury
With acute stage of inflammatory process what is present?
- Redness, swelling, heat, pain, possible loss of function, mm spasm and guarding.
- Bruising will be blue, red or purple
What vascular changes happen in the acute stage?
Initial vasoconstriction followed by vasodilation
{This causes observable redness and heat due to dilation of blood vessels}
What happens at the end of the acute phase?
Inflammatory process begins to resolve
Tx considerations/goals in the acute stage?
Limit inflammatory process, reduce pain & swelling, reduce SNS firing & prevent re-injury, protective spasms are reduced but not removed, compensatory structures are treated
How long is the Subacute phase (as a whole) of the inflammatory process?
Within 2 days and continues for up to 3 weeks after injury, up to 6 weeks.
How long is early subacute stage?
2 days and may continue for up to 3 weeks
Signs of the early subacute stage?
Affected area shows diminished signs of inflammation, with pink, warm, slightly oedematous and less painful tissue, mm spasms diminish
{bruising is vertically unchanged from acute}
Treatment goals in the subacute stage of the inflammatory process?
Continue to ⬇️ effects of inflammation, pain, swelling & spasm, while ↔️ the available ROM and strength
What are the Hydrotherapy applications during early subacute stage of the inflammatory process?
Includes cool applications and the introduction of mild contrast applications
Treatment considerations/goals in the late subacute stage?
⬇️ remaining edema, reduce TP, pain & adhesions, improve ROM and mm strength
How long is the late subacute stage of the inflammatory process?
Begins 2-3 weeks of the subacute stage
What happens to blood vessels in the late subacute stage?
Neoangiogenesis retract during this stage
Symptom picture is the late subacute stage of the inflammatory process
- may or may not be a pocket of residual swelling
- bruising present, changed to yellow, brown or green, then disappears
- pain is experienced with over pressure to affected tissue
Tx considerations/goals in the chronic stage of the inflammatory process
⬇️ restrictive adhesions and TP, restore ROM and strength to affected areas
How long is the Chronic stage of the inflammatory process?
Overlaps with later part of the late subacute stage at about 2-3 weeks post injury and continues for up to 1-2 years
Symptom picture of the chronic stage of the inflammatory process?
-Inflammatory process = resolved, likely no edema but loss of full ROM with subsequent ⬇️ in function is possible, pain may occurs with over pressure
- chronic inflammation may be part of a self-perpetuating cycle if irritating agent like inflammatory arthritis, or inflammation may develop because of micro traumas like tendinitis
