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Fundamentals of Disease > Injury, Inflammation, and Healing > Flashcards

Injury, Inflammation, and Healing Flashcards

1
Q

8 mechanisms of cellular injury:

A
  • ischemia
  • infectious
  • immune
  • genetics
  • nutritional
  • physical
  • chemical
  • psychosocial
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2
Q

the phases of normal healing for all tissue types

A
  • hemostasis and degeneration
  • inflammation
  • proliferation and migration
  • remodeling and maturation
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3
Q

stage:

  • immediately after injury body tries to stop bleeding via platelets, hematoma, necrosis of dead cells
  • abnormal: low platelets or blood thinner meds
  • cytokines are released
  • causes inflammation-growth factors and fibroblasts
A

1: hemostasis and degeneration

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4
Q

stage:

  • protective and curative
  • replaces injured tissue
  • begins with formation of blood clot (vasodilation)
  • leukocytes, macrophages and proteases
  • growth factors, chemokines and cytokines
  • about 5 days: fibroblasts
  • chronic disease
A

2: inflammation

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5
Q

cardinal signs of inflammation (5):

A
  • erythema (rubor)
  • heat
  • edema
  • pain
  • loss of function
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6
Q

type of inflammation:

  • protective
  • proteins and fluid build-up
  • slower in older adults
  • subsides in presence of small amount of necrosis
  • will heal on its own
A

acute (normal)

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7
Q

type of inflammation:

  • large/prolonged injury
  • delays healing
  • common in older adults
  • occurs with larger amount of necrosis or lack of intervention
  • requires skilled care
A

chronic (pathologic)

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8
Q

stage:

  • starts ~2 days after injury (overlaps w/ inflammation)
  • endothelial cells proliferate to establish vascular network for O2 and nutrients (angiogensis)
  • new vessels are “leaky” (edema)
  • fibroblasts synthesize collagen
  • lasts for several weeks
  • healing can also stall at this phase, again d/t poor control of co-morbid disease
A

3: proliferation and migration

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9
Q

stage:

  • scar tissue reduced and remodeled
  • reorientation of collagen and strength regained
  • mature scar 3-4 months
  • lasts for 1-2 yrs
A

4: remodeling and maturation

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10
Q

muscle injury etiology (4):

A
  • contusion (blunt force)
  • laceration (open wound)
  • strain
  • stiffness
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11
Q

an injury to muscle, typically occurring at the myotendinous junction. Over straining of the myofiber likely during eccentric contraction. May have significant bleeding

A

strains

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12
Q

Etiology: a tensile, mechanical stress/trauma

A

strains

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13
Q

there are # grades of strains

A

3

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14
Q

strain grade #:

  • minor discomfort and swelling
  • a few torn muscle fibers
  • minimal loss of strength and movement
A

1

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15
Q

strain grade #:

  • moderate to severe pain
  • pain with muscle contraction that limits activity
  • measurable loss of strength
A

2

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16
Q

strain grade #:

  • severe pain
  • complete rupture of muscle belly or muscle-tendon complex
  • severe loss of function
A

3

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17
Q

muscle regeneration reorganization of scar tissue takes up to ______.

A

1 year

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18
Q

4 causes of muscle stiffness:

A
  • microfibrous adhesions
  • increased collagen fibers
  • electrolyte changes
  • release of muscle enzymes
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19
Q

a injury to a ligament

A

sprain

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20
Q

etiology: the ligament is mechanically stressed

A

sprain

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21
Q

order of ankle sprain faiure (3):

A
  1. ATFL
  2. calcaneal fibular
  3. PTFL
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22
Q

there are # grades of sprains

A

3

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23
Q

sprain grade #:

  • minimal pain
  • no significant instability
A

1

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24
Q

sprain grade #:

  • severe pain
  • minimal to moderate joint instability but definite joint end feel
  • partial tear of ligaments
A

2

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25
Q

sprain grade #:

  • severe pain during injury, less pain after
  • very unstable joint, no joint end feel
  • ligament has been completely torn
A

3

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26
Q

healed ligament will be # to #% weaker in tensile strength than before injury

A

30-50%

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27
Q

treatments that stabilize joint (2):

A
  • put ligament in optimal length

- position can reduce scarring

28
Q

early controlled ______/_____ of ligament can promote healing and improve post-injury tensile strength

A

mobilization/loading

29
Q

In a ligament injury, ______ is slower than strength to return, which contributes to re-injury

A

proprioception

30
Q

4 types of cartilage:

A
  • articular
  • fibrocartilage
  • elastic
  • fibroelastic
31
Q

3 healing challenges of cartilage:

A
  • avascular
  • aneural
  • alymphatic
32
Q

bone fracture signs (4):

A
  • visual/palpable change in anatomy (deformity)
  • radiographic changes
  • inflammation
  • crepitus (noise)
33
Q

bone fracture symptoms (3):

A
  • severe, persistent pain
  • point tenderness
  • inability to bear weight
34
Q

type of fracture that results when the skin is broken and the bone is exposed. Very high risk for infection and total disruption of the bone.

A

open fracture

35
Q

type of fracture where the bone is broken, but the skin remains intact

A

closed fracture

36
Q

type of fracture where the bone fragments are separated completely. The bone is broken in 2 or more pieces.

A

complete fracture

37
Q

type of fracture where the bone is only partially broken. The bone fragments are still partially joined.

A

incomplete fracture

38
Q

type of fracture: a single break in the bone. Bone ends maintain their alignment and position

A

simple fracture

39
Q

type of fracture: multiple fracture lines and bone fragments

A

comminuted fracture

40
Q

type of fracture: common in vertebrae and osteoporosis. Occurs when a bone is crushed and results in significant pain and disability

A

compression fracture

41
Q

type of fracture: similar to a compression fracture. One end of the bone is forced into the adjacent bone. Common in car accidents and falls

A

impacted fracture

42
Q

type of fracture: results from weakness in bone structure due to conditions such as a tumor, hormonal imbalance or osteoporosis. The break occurs spontaneously or with very little stress on the bone.

A

pathological fracture

43
Q

type of fracture: results from repeated excessive stress. Common overuse injury, most often seen in athletes who run and jump on hard surfaces. Common in tibia, femur, and metatarsals.

A

stress fracture

44
Q

type of fracture: if the epiphyseal plate is separated from the epiphysis of diaphysis without proper treatment, growth will not be normal.

A

epiphyseal fracture

45
Q

type of fracture: a fragment of bone at the insertion of a muscle, tendon, or ligament becomes detached as the result of excessive tension. A piece of bone pulled free (usually occurs near the joint line)

A

avulsion fracture

46
Q

classification by direction of fracture line (4):

A
  • transverse fracture
  • linear fracture
  • oblique fracture
  • spiral fracture
47
Q

type of fracture: fracture is at right angle to the bone’s long axis

A

transverse

48
Q

type of fracture that is parallel to the bone’s long axis

A

linear

49
Q

type of fracture: the fracture is at an angle to the diaphysis of the bone. The fragments tend to override as a result of muscle contraction, unless stability is maintained by fixation.

A

oblique fracture

50
Q

type of fracture: a break that angles around the bone. usually due to a twisting injury and requires fixation

A

spiral fracture

51
Q

4 bone healing phases:

A
  • hematoma
  • inflammation
  • reparative phase
  • bone remodeling
52
Q

bone healing phase: fracture blood clot, fibrin and platelets

A

hematoma

53
Q

bone healing phase:

  • vasoactive (heat, redness, swelling, pain)
  • fibrin meshwork, fibroblasts
  • phagocyte cells to area of inflammation to remove hematoma
  • chondroblasts brought to the site of injury
A

inflammation

54
Q

bone healing phase:

  • soft callus formation ~2 weeks
  • soft callus replaced by hard callus usually 6-12 weeks
  • fracture is now stable at end of this phase
A

reparative phase

55
Q

bone healing phase:

  • bone restructures itself over a period of ~1 yr, medullary canal is restored
  • callus is reabsorbed and the anatomic contour of the bone is regained
  • Wolff’s Law
  • from disorganized to mature organized bone tissue
A

bone remodeling

56
Q

law that states that bone forms and remodels in the direction of forces (mechanical stresses) acting on it.

A

Wolff’s Law

57
Q

preservation and restoration of function in fracture management:

A
  • AROM exercises for the rest of the body

- strengthening exercises

58
Q

ORIF:

A

Open Reduction Internal Fixation

- use of pins, plates, and or rods to position bones in anatomical alignment

59
Q

OREF:

A

Open Reduction External Fixation

- cyborg/Frankenstein

60
Q

4 complications during fracture healing:

A
  1. infections
  2. ischemia
  3. nerve damage
  4. slowed healing
61
Q

3 types of abnormal fracture healing:

A
  • delayed union
  • non-union
  • mal-union
62
Q

factors that could cause a _____ ____ are poor health, poor circulation, and infection

A

delayed union

63
Q

a fracture that does not heal. Causes may include poor health, poor circulation, infection and fracture mismanagement

A

non-union

64
Q

the fracture heals in an unacceptable position and could cause a significant impairment

A

mal-union

65
Q

therapy considerations for preservation and restoration of function (4):

A
  • AROM exercises for rest of body
  • strengthening exercises
  • we do not treat fracture
  • immobilization is bad
66
Q

clinical presentation of a fracture SandS (5):

A
  • quick onset of pain: local tenderness
  • hot and limited ROM
  • bruising (if blood vessels damaged)
  • immediate swelling
  • altered joint end-feel (grades 2 and 3)

Fundamentals of Disease (10 decks)

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