ST And Bone Healing Flashcards
What are the 4 stages of healing?
1) Hemostasis & degradation
2) inflammation
3) Proliferation
4) Maturation
What is hemostatic response?
Sealing off of blood vessels causing clot to form.
What do growth factors do (GF)?
Summon inflammatory cells to tissue
Severely damaged cells
Necrosis
Coordinated reaction of body tissue to cell injury
Inflammation phase (days 1-6)
Inflammation phase includes
- vascular response
- humoral response
- neuro response
- cellular response
What happens in vascular response
1) vasodilation from chemical mediators (histamine)
2) fluid migration -> edema
3) Hemoconcentration
4) WBC accumulation
^ viscosity slows blood flow
Hemoconcentration
Complement system activated via antibody-antigen association
Humoral response
What happens in complement system
1) ^ vascular permeability
2) Stimulate phagocytosis
3) Act as chemostatic stimuli
Kills and removes injurious agent
Cellular response
Activate inflammatory mediators
T lymphocytes
Plasma cells that produce antibodies to bacteria to prepare for phagocytosis
B cells
Engulf dead cells
Macrophages
Phase of healing days 3-20
Proliferation
4 processes in proliferation phase
1) neovascularization
2) epithelialization
3) collagen production
4) Wound contraction
Presence of macrophages stimulate release of GF
Neovascularization
Secrete proteins to reconstitute ecm and provide framework
Fibroblast
Covers wound surface
Epithelialization
Epitheliazation provide protective barrier to
- prevent fluid/electrolyte loss
- decrease risk of infection
Creat collagen
Fibroblast
Collagen Timeline
Day 7- amt of collagen significant
Day 12- types 3-type 1
Day 21- Max collagen produced
6 weeks- 80% strength
Maturation phase (day9-) includes
Collagen synthesis
Collagen orientation
And healing injury
If lung basement membrane not intact, results in ____
Fibrosis
Gut cells reproduce _____ to _____
Proximal to distal
Rewiring of healthy functional neurons
Neuroplasticity
Peripheral nerve wallerian degeneration occurs
Distal to injury
In muscle if endomysium is not intact -»
Necrosis
Gradual re-mobilization after pain and swelling subside:
Rehab for muscle strains
What does rehab for muscle strains do.
- increase fiber regeneration
- improve fiber orientation
- decrease scarring
When does gentle gradual loading occur for tendons
Week 2-16 (wtf)
Occurs when synovium is injured
Tendon adhesion
Caused by repetitive trauma/excessive loading
Tendinopathy
Protected rest for sutured tendons is
3-5 days
Gentle PROM for sutured tendons is______
For what
5-28 days
To prevent contracture/reduce adhesion
AAROM for sutured tendon
Week 4-8
Tearing of synovium in ligaments limits
Hematoma formation and localization of GF
In ligaments if _____ is released it limits healing
Matrix metalloproteinase
Types of cartilage
Articular
Fibrocartilage
Fibroblast-elastic
Meniscus healing occurs via
Chondrocyte migration
Cycle of chronic injury and healing with immobilization leads to ____ b/w synovium and articular cartilage
Adhesions
Types of fractures
- Complete vs incomplete (green stick)
- Transverse
- oblique/spiral
- comminuted (>2 fragments)
- segmental
fracture healing: inflammation with pain swelling and heat
Phase 1
Fracture healing: repair phase, soft>hard callus, 6-12 weeks
Phase 2
Fracture healing: remodeling phase,
Phase 3
Stages of fracture healing and meaning
1: impact
2) inflammation
3) Soft callus
4) hard callus
5) Remodeling
Clear necrotic bone
Osteoclasts
Fraction healing occurring in expected time frame with unsatisfactory alignment
Mall ion
Fracture healed beyond expected time fram
Delayed union
Failure of fracture healing
Nonunion
Glucocorticoids regulate
T cell
B cell
NK cell
And Macrophage Fx.
Mediates vascular response via Sympathetic nervous system
Hypothalamus
Which cranial nerves can regenerate
3,4,5,7
Surgical IV of fracture
Bone graft
Internal and external fixation
Traction
Reduction
