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Modalities > Physiology of Healing > Flashcards

Physiology of Healing Flashcards

1
Q

3 phases of healing

A

inflammatory response
fibroblastic repair
maturation-remodeling

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2
Q

T or F: the body must go through the inflammatory response to heal

A

T

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3
Q

symptoms of inflammation

A

swelling, pain, warmth, redness, crepitus, loss of function

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4
Q

what happens during the inflammatory phase? how long is it?

A
  • the injured area is walled off and leukocytes phagocytize foreign debris
  • lasts 2-4 (up to 10) days after injury
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5
Q

physiological cause of edema

A

increased permeability of blood vessels

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6
Q

physiological cause of erythema and warmth

A

increased blood flow

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7
Q

what are some factors that influence inflammatory phase?

A
  • medical conditions
  • meds
  • immobilization
  • location of injury
  • age
  • nutrition
  • physical agents
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8
Q

acute inflammation

A

local tissue damage
pain all the time

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9
Q

sub-acute inflammation

A

pain is actively related
can last 4-6 weeks if not managed

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10
Q

chronic inflammation

A

the longer pain lasts, the high the chance of pain being referred away from original location
* sign of impaired healing

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11
Q

what happens in the fibroblastic repair (proliferative) phase? how long is it?

A
  • regeneration leads to scar formation and repair of injured tissue
  • lasts 4-6 weeks
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12
Q

fibroplasia

A

the formation of fibrous tissue beginning within the first few hours after injury

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13
Q

clinical signs of fibroplasia

A
  • inflammation signs subside
  • if open wound you will be able to see tissue formation
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14
Q

by 6-7 days after injury fibroblasts begin producing _________

A

collagen

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15
Q

T or F: A persistent inflammatory response can lead to abnormal proliferation

A

T: due to extended fibroplasia and fibrogenesis (hypertrophic and keloid scars may result)

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16
Q

what happens in maturation-remodeling phase? how long?

A
  • realignment of collagen fibers along lines of tensile force
  • ongoing breakdown/ synthesis of collagen
  • may require several years to complete
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17
Q

how is scar tissue different than normal tissue

A

lacks elastin and weaker

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18
Q

scar tissue is initially type ___ collagen in a random pattern and once it matures it is type _______ in an organized pattern

A

3,1
*no elastin like in normal skin

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19
Q

what are some local factors associated with delayed healing

A

moisture
pressure
friction
shear
continued injury
inappropriate management

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20
Q

what are some systemic factors associated with delayed healing?

A

circulation
sensation
inadequate nutrition
age
body habitus
co-morbidities
meds
behavioral risk taking

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21
Q

hydrostatic pressure

A

pressure exerted by a fluid on an immersed body

22
Q

osmotic pressure

A

pressure that causes diffusion between fluids with different concentrations

23
Q

dependent position

A

feet lower than the rest of the body

24
Q

subjective questions to ask related to edema

A
  • when did it start
  • injury/surgery?
  • what makes it better/worse?
  • is it always like this?
  • both legs or one leg?
  • pain?
  • are shoes and socks fitting?
  • heavy legs?
  • tightness in legs?
25
Q

objective measures related to edema

A

assess skin
decreased hair growth
decreased pulses
erythema/cellulitis
thickening of skin
ulceration

26
Q

Homan’s sign assesses for?

A

DVT

27
Q

gold standard for DVT assessment?

A

ultrasound

28
Q

2 indications to take a circumferential measurement

A

edema
atrophy/hypertrophy
*could also use volumetrics

29
Q

adverse consequences of edema

A
  • delayed healing
  • restricted ROM
  • function limitations
  • pain
  • increased infection risk
  • subcutaneous tissue fibrosis
  • ulceration
30
Q

when determining treatment for edema what should you determine first?

A

etiology

31
Q

PRICE treatment

A

Protect
Restricted activity
Ice
Compression
Elevation

32
Q

what does ice (cryotherapy) do?

A
  • decreased metabolism to control secondary hypoxic injury
  • analgesia
  • possibly cause vasoconstriction
33
Q

how long should you use ice

A

20 mins to 1 hour, depending on the agent

34
Q

effects of compression

A
  • controls peripheral edema
  • manages scar formation
  • prevents DVT
  • promotes lymphatic and venous return
  • shaping of residual limb
35
Q

contraindications for compression

A
  • circulatory obstruction
  • DVT
  • heart failure
  • infection of treated area
  • malignancy of treated area
  • unstable or acute fracture
  • pulmonary edema
36
Q

compression options

A
  • elastic wraps (short or long stretch)
  • compression garments
  • intermittent pneumatic compression
  • cryocuff
  • deep water submersion
37
Q

indications for intermittent compression

A

edema, venous insufficiency, prevention of DVT, lymphedema

38
Q

the pressure for intermittent pneumatic compression should be greater than _______. why?

A

30mmHg
this is arterial capillary pressure

39
Q

total treatment time for intermittent pneumatic compression

A

at home: >1 hour, 2-3 times a day

40
Q

long stretch elastic wraps have a ________ working load and ______ resting load

A

low
high

41
Q

long stretch elastic wraps should be applied in what pattern

A

figure 8
*from metatarsal heads to tibial plateau

42
Q

should you wear long-stretch elastic wraps at night

A

no

43
Q

should stretch bandages have a ________- working load and a _______- resting load

A

high
low

44
Q

short stretch bandages are applied how

A

circumferentially with padding

45
Q

primary use of short stretch bandages

A

lympedema

46
Q

how long should you elevate legs

A

30mins to 1 hour at a time
*try to get them above your heart

47
Q

kinesiotaping works on what system

A

lymphatic

48
Q

how do you start the anchor in KT taping for edema?

A

in direction you want the lymphatics to flow

49
Q

contraindications for kinesiotaping for edema

A
  • fragile or healing skin
  • over malignant areas
  • areas cellulitis/infection
  • allergies to tape
50
Q

is ice and rest appropriate if a patient’s edema is due to a medical condition

A

no

51
Q

treatment options for edema due to a medical condition

A
  • calf muscle pump
  • elevation
  • compression

Modalities (9 decks)

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