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Physical Agents > Lecture #2 (Healing Process) > Flashcards

Lecture #2 (Healing Process) Flashcards

1
Q

What is primary healing?

A

Healing that occurs by the process of primary intention: it includes the bridge of cells that bind together the nearby edges of wounds. It results in faster healing and less scar tissue (i.e. stitches)

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2
Q

What is secondary healing?

A

Healing that occurs by the process of secondary intention: it includes the process in which a larger wound gap is filled in from the bottom up and sides to bridge the wound. It takes longer to heal and occurs with more scar tissue.

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3
Q

What are the three phases of tissue healing:

A 
Inflammation phase (inflammatory response phase)
Proliferation phase (fibroblastic repair phase)
Remodeling phase (maturation phase)
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4
Q

What phase of healing takes up to five days and includes protecting the area by stabilizing and containing it:

A

Inflammation

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5
Q

What phase takes up to 23 days and includes the disposalof dead tissue and restoration of tissue?

A

Proliferation

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6
Q

What phase takes up to 1 year and includes the stablization and reestablishment of the injured area:

A

Remodeling

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7
Q

During what phase of healing is a player normally returned to play?

A

Proliferation

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8
Q

What is the typical sequence of events of inflamation?

A

Injury-> blood vessel disruption-> vasoconstriction-> vasodialation -> influx of blood, serum proteins, clotting factors, and platelets

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9
Q

What is PRP therapy?

A

Removing a patient’s platelets from drawn blood and putting them back into the injured area to promote healing.

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10
Q

What stimulate fibroblasts to repair tissue?

A

Growth factors (stimulated for release by the platelets)

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11
Q

During the first few hours of an injury, what eliminate debris from the injury?

A

White blood cells–PMNs (polymorphonuclear leukocytes) and neutrophils

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12
Q

What replaces the neutrophils to help get rid of debris from in injury?

A

Macrophages and monocytes (mononuclear phagocytes)

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13
Q

Macrophages also remove what during the inflammatory phase (in addition to debris)

A

Exudate

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14
Q

What is the act of cells and chemicals stimulating each other?

A

Chemotaxis

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15
Q

What affects the vascular permeability during inflammation? What else does it stimulate to enter the cells?

A

Histamine; leukocytes, kinins, and serotonin.

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16
Q

After histamine, what controls the permeability of vessels?

A

Prostaglandulins

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17
Q

Prostaglandulins appear to help the healing process transition from:

A

The inflammation phase to the proliferation phase.

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18
Q

What causes nerves to be hypersensitive and irritable (ultimately causing pain)?

A

Histamine (also bradykinin and prostaglandulins)

19
Q

What are the signs of inflammation?

A

Pain, redness, swelling, heat, & decrease in function

20
Q

What is edema during an injury caused by?

A

The increased substances in the area and the blockage of lymph vessels.

21
Q

What is the difference between the inflammation and proliferation phases?

A

Proliferation has a transition to stronger collagen.

22
Q

What marks the start of proliferation?

A

The growth of new blood vessels and granulation tissue (angiogenesis) by fibroblasts.

23
Q

What is granulation tissue composed of?

A

Capillary beds and the extracellular matrix (collagen, proteoglycans, and elastin.

24
Q

What is the extracellular matrix?

A

It s jelly-like substance that has all the good healing factors in it to fill in the area.

25
Q

What is the first type of collagen laid down? It is thin and lacks tensile strength, and also doesn’t have a good organization.

A

Type III collagen.

26
Q

What type of collagen replaces type III and is more organized, durable, and stronger? How soon is it laid down?

A

Type I collagen; 12 days post injury

27
Q

What is drawing fluid into the area during the transition from type III to type I collagen (the extra water provides space for the proliferating fibroblasts)

A

Hyaluronic acid

28
Q

What are adheasions?

A

Myofibroblasts (that are converted from fibroblasts). They contract the wound to lessen the size and scarring.

29
Q

What determines the stage of healing and how is it deterimined?

A

Collagen transition:

50% is type I = remodeling

30
Q

What are some signs that a patient is transition from proliferation to remodeling?

A

They are no longer tender, they are no longer red, and there is no more swelling.

31
Q

How are growth factors named?

A

Named after the target cell they affect (i.e. EGF= epithelial growth factors that affect epithelial tissue)

32
Q

What is absolutely critical for healing?

A

Vascularization

33
Q

What is the main reason for the last two phases of healing to vary in length between different tissues?

A

The way in which they are organized.

34
Q

What is the maximum amount of stress or force that a structure can withstand before failure?

A

Tensile strength.

35
Q

True or False:

Injured tissue rarely returns to full tensile strength.

A

True

36
Q

Surgical repair is an example of what type of healing?

A

Primary because it approximates the tissue.

37
Q

This such as age, diabetes, HIV, arthritis, osteoporosis, carcinoma, renal disease, hepatic disease, cardiovascular disease, and autoimmune diseases all do what to healing tissue?

A

Affect it negatively.

38
Q

How does an infection affect healing?

A

More scar tissue, limits blood flow to healing tissues, and unable to mobilize the affected area.

39
Q

Diets lacking in what will slow healing?

A

Proteins, vitamins A and C, and minerals (calcium, zinc, and copper).

40
Q

What modalities can be used during the inflammation phase of healing?

A

Cryotherapy, e-stim (ONLY SENSORY, NO MOTOR), and ultrasound.

41
Q

What modalities can be used during the proliferation phase?

A

Cryotherapy, thermotherapy, compression therapy, and e-stim.

42
Q

What is the best way to increase blood flow?

A

Exercise.

43
Q

What modalities can be used during the remodeling phase?

A

Deep heat agents and e-stim (muscle reeducation)

**Pain control shouldn’t be used because pain shouldn’t be an issue by this point.

Physical Agents (13 decks)

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