Lecture 5 - Phases of healing Flashcards
What is a strain
Strain: Term used to describe physical damage to “active” soft tissues (muscle, tendon, myofascia).
What’s a sprain?
Sprain: Term used to describe physical damage to “passive” soft tissues (esp. ligament and joint capsule).
T/F The description of a 1st, 2nd and 3rd degree of a sprain differ slightly from a strain because of the difference in tissue damage.
If T: describe what are those differences?
F: it’s the exact same thing
For ligaments that are closely anatomically related to surrounding structure (s/a joint capsule), the completeness of the rupture may be less simple to determine.
How do we grade in those cases?
For ligaments that are closely anatomically related to surrounding structure (s/a joint capsule), the completeness of the rupture may be less simple to determine (e.g. the MCL of the knee).
For the latter, the grade of 3 may be assigned based on the severity of the damage, rather than a clear anatomical distinction.
What are the 3 phases of soft tissue healing?
When do they occur?
Lasts until when?
- Inflammatory – first 48-72 hours (up to 10 days)
- Proliferative – from ~day 3 (lasts 3 - 6 wks)
- Remodeling – from ~day 9 (lasts 6 wks to 12 mths)
What are the 5 cardinal signs of inflammation?
Redness, heat, edema, pain, decreased function
What are the 4 different responses in the inflammatory phase?
–Hemostatic response
–Vascular response
–Cellular response
–Immune response
How is the inflammatory phase begin and end
It begins with disruption of normal tissue physiology
–Caused by injury, disease, etc. (duh)
It ends with complete removal of the wound debris
During inflammatory phase, is there a vasoconstriction or a vasodilation?
BOTH
Initial Vasoconstriction – with the role of limiting blood loss
Followed by vasodilation
What are the treatment in the inflammatory phase of healing?
POLICE
T/F
In the “protection” of the POLICE acronym: short period of unloading are not recommended in the first 24h but may be necessary after 24-36h
F
Short periods of unloading may be necessary
(I made up the rest)
T/F
The proliferative phase may be named “chronic phase” in clinical terminology
F
Proliferative : subacute phase
Remodeling phase: chronic phase
What are the different names for proliferative phase?
Physiological: Proliferative, granulation, fibroblastic or repair phase
Clinical: Subacute phase
Management: Controlled motion phase
What are the different names for remodeling phase?
Physiological: Remodeling phase
Clinical: Chronic phase
Management: Return-to-Function phase
When does the proliferative phase ends?
•It ends when
–Fibroblasts activity / collagen production returns to baseline levels
–Fibroblast-rich granulation tissue is replaced by scar tissue
