Lecture 4 Flashcards
What are the three essential phases of healing?
Inflammatory, Proliferation(fibroblastic repair) and remodeling(maturation
How long is the inflammatory phase?
5 days
How long is the proliferation phase?
up to 21 days
How long is the remodeling phase?
up to one year
What should happen during the inflammatory phase?
stabalize and contain injured area
What should happen during the proliferation phase?
dispose of dead tissues and restores circulation
What should happen during the remodeling phase?
stabalize and reestablish the area
What is the immune response to an injury?
response to foreign body, release of antibodies and response is specific to antigen/invader
What is the inflammation response to an injury?
used to protect,used to localize, used to rid injurious agent and prepares for healing and repair
What is acute inflammation?
short onset and duration, change in hemodynamics, production of exudate and granular leukocytes
What is chronic inflammation?
long onset and duration, presence of non-granular leukocytes and extensive scar tissue
What are 5 signs of inflammation?
redness, swelling/edema, pain, heat and loss o function
What is the purpose of inflammation?
Protect, localize, decrease injurious agents and prepare for healing and repair
How can you control swelling?
R.I.C.E
What does R.I.C.E.S stand for?
Rest, ice, compression and Elevate and stabalization
Why do we use ice?
to reduce the risk the secondary hypoxic injury,
cold=less metabolism=less need for oxygen=less hypoxic damage
Why does cold decrease the need for oxygen and nutrients?
slower metabolism
what is margination?
neutrophils and macrophages line up against cell wall
What are phagocytes?
neutrophyls, macrocytes and leukocytes that ingest micro-organisms, damaged cells and/or foreign particals
What is Diapedesis?
movement of WBC out of small arterial vessels
What is Exudate?
accumulation of fluid that penetrates cell wall into extravascular space
What is Vasoconstriction?
decrease in diamete of blood vessels
What are the 8 phases of inflammation?
Injury Ultrastructural changes Metabolic (hypoxic) changes Activation of chemical mediators Hemodynamic changes Permeability changes Leukocyte migration Phagocytosis
In what hour of the Inflammatory response phase does the following happen: Vasoconstriction and coagulation occur to seal blood vessels and chemical mediators are released
Immediately followed by vasodilation of blood vessel
First hour
Decreased blood flow, increase in blood viscosity, edema and release of chemical mediators happens in what hour of what phase
second hour of inflammatory response phase
How do clots help the healing process?
obstruct lympathic system and localize injury
In what phase does Scar tissue form?
Fibroblastic(proliferation) phase
What happens during the Maturation phase?
realignment of collagen, increased strength, tissue will start to look normal
When does chronic inflammation occur
When acute inflammatory reponse does not eliminate injurious agent
Overuse, overload and cumulative micro trauma are associated with which type of Inflammation?
Chronic
What factors impede healing?
extent of injury, edema/swelling,hemorrhage, poor vascular suuply, muscle spasm, Atrophy, Smoking, infection, humidity/climate, health, age, smoking and nurition
What are four types of tissue?
Muscle, Connective, Epithelial and nerve tissue
What is Metaplasia?
transformation from one tissue to another that is not normal
What is dysplasia?
abnormal development of tissue
What is Hyperplasia?
excessive proliferation of normal tissue in normal cells
What is Atrophy?
decrease in size of tissue due to cell death and reabsorbtion or decreased cell proliferatione
What is Hypertrophy?
increased size of tissue without increase in the number of cells
What has more chronic injuries than acute?
Tendons
What is the rate of healing for a nerve?
3-4mm per day
What are four things that can modify healing?
Therapuetic exercise, electric modalities, drug utilization and thermal modalities
What does electric modalities treat?
Inflammation
What are some different types of modalities?
electrical stimulation, microwave, ultra sound
What are 5 stages of acute fracture healing?
hematoma formation, cellular proliferation, callus proliferation, ossification and remodeling
In what cavity does a hemotoma develop in the first 48 hours of bone healing?
Medullary
What is a soft callus?
random network of woven bone
What fills calluses to immobilize the site?
Osteoblasts
When does hard callus formation begin and for how long?
begins 3-4 weeks and last 3-4 months
When is ossification complete?
When the bone has been laid down and excess callus has been resbsorbed by osteoclasts.
What are 3 things that interfere with bone healing?
Poor blood supply, infection and poor immobilization
What are 3 sites for poor blood supply?
head of femur, navicular of wrist and talus
Stress fractures result from what?
cyclic forces, axial compression and tension from muscle pulling
What are 4 pain sources?
Cutaneous, deep somatic, visceral and psychogenic
What is cutaneous pain?
sharp, bright and burning with fast and slow onset
What is deep somatic pain?
originates in tendons, muscles, joints, periosteum and blood vessels
What is visceral pain?
begins in organs, may diffuse and then be localized
What is psychogenic pain?
emotional pain rather than physical pain
What is the difference in acute pain and Chronic pain?
Acute lasts less than six months, Chronic is longer
pain which occurs away from the site of injury is?
Referred pain
myofascial, sclelotomic and dermatomic are all what type of pain?
Referred Pain
What are two ways to control pain?
Modalities, pharamaceutical agents
