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Passive Care Exam One > Stages of Healing > Flashcards

Stages of Healing Flashcards

1
Q

Electric stimulation, heat and cold therapy, mechanical energy, and light are all example of what kind of treatment category?

A

Electrophysical agents

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2
Q

Are electrophysical agents primarily used as a primary treatment or a complementary treatment?

A

Complementary

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3
Q

What is the difference between active and passive care?

A 
Active = patient has to perform activity/exercise to achieve effect 
Passive = doctor applies intervention
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4
Q

What are the 4 stages of healing (Belanger)?

A

1 hemostasis
2 inflammatory
3 proliferation
4 remodeling/maturation

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5
Q

What is the duration for each stage of healing?

A 
Hemostasis = seconds/minutes
Inflammatory = hours/days/weeks
Proliferation = weeks/months
Remodeling/maturation = months/year
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6
Q

What are the 3 stages of healing (other model)?

A

1 inflammation
2 repair
3 remodeling

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7
Q

What is another name for the inflammatory phase?

A

Acute phase

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8
Q

What is the purpose of the inflammatory/acute phase?

A

1 defend against foreign intruders (infection)
2 remove damaged tissue and debris
3 immobilize area

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9
Q

What types of tissue don’t heal well?

A

Avascular or poorly vascularized tissue

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10
Q

What are the cardinal signs of inflammation derived from Celsus in A.D. 25?

A

Heat (calor)
Redness (rubor)
Swelling (tumor)
Pain (dolor)

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11
Q

Which cardinal sign of inflammation was derived from Virchow in 1902?

A

Loss of function (functio laesa)

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12
Q

What is the 6th sign of inflammation added by Belanger?

A

Muscle spasm

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13
Q

What vascular changes are present in the inflammatory phase of healing?

A

1 vasodilation

2 increased capillary permeability

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14
Q

What cells are responsible for the phagocytosis seen in the inflammation stage of healing?

A

Neutrophils and macrophages

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15
Q

The inflammation stage of healing is controlled and initiated by approximately how many chemicals?

A

Over 180

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16
Q

Bradykinin, prostaglandins, and serotonin are examples of chemicals that initiate what kind of sensation during the inflammatory phase of healing?

A

Nociception (pain)

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17
Q

What type of injury can occur following too much inflammation during the healing process?

A

Secondary enzymatic injury or secondary hypoxic injury

18
Q

What occurs with secondary enzymatic injuries?

A

Lysosomal enzymes are released an attack healthy tissue

19
Q

What occurs with secondary hypoxic injuries?

A

Decreased O2 and nutrients leading to damage of surrounded uninjured tissue

20
Q

Hemorrhage, clotting, edema, spasm, and hematomas are all examples of what kind of injury following excessive inflammation?

A

Secondary hypoxic injury

21
Q

What are the ultimate goals of the inflammatory phase?

A

Limit extent of inflammation (only small amount needed)

Preserve range of motion (ROM)

22
Q

What is the acronym used for the inflammatory phase of healing?

A

PRICE:

Protect, rest, ice, compress, elevate

23
Q

What are the lengths of the acute phase of healing for ankle sprains for each grade type?

A

Grade 1 = 1-3 days
Grade 2 = 2-4 days
Grade 3 = 3-7 days

24
Q

What are the top areas of focus during the acute phase of an ankle sprain?

A

1 decrease swelling and pain
2 maintain motion and appropriate weight bearing
3 protect from re-injury

25
Q

What is another name for the proliferative phase?

A

Repair phase

26
Q

What is the term for the production of new capillaries during the proliferative phase of healing?

A

Angiogenesis

27
Q

What types of cells are primarily at work during the proliferative phase?

A

Fibroblasts, chondroblasts, osteoblasts

28
Q

What type of fibers and cells are found in the ECM during the proliferative phase?

A

Type III collagen & proteoglycans

29
Q

Why are Type III collagen fibers not ideal?

A

Weak, disorganized

30
Q

What term is the unconscious perception of movement and spatial orientation arising from stimuli within the body itself?

A

Proprioception

31
Q

How long does the proliferation phase last for each grade type of an ankle sprain?

A

Grade 1 = 2-4 days
Grade 2 = 3-5 days
Grade 3 = 4-8 days

32
Q

What are the goals of the proliferative phase of healing for an ankle sprain?

A 
1 decrease swelling and pain
2 increase pain ROM
3 begin non-weight bearing proprioceptive training
4 encourage and increase proliferation
5 provide protective support as needed
33
Q

What are examples of active care that can help in the proliferative stage of healing of an ankle sprain?

A 
1 proprioceptive training
2 range of motion
3 strengthening (carefully)
34
Q

What is another name for the remodeling phase?

A

Maturation phase

35
Q

What physiologic changes are seen during the remodeling phase?

A

1 scar contraction
2 decrease of blood vessels
3 type III collagen switching to type I

36
Q

What is the danger of scar contraction during the remodeling phase?

A

Can lead to joint adhesion and loss of motion

37
Q

What are the benefits on collagen of increasing tension on the connective tissue during the remodeling phase?

A

1 increased collagen fibril diameter
2 increased cross-linking
3 increased number of collagen fibrils
4 increased collagen fibril packing density
5 collagen is organized and aligned in parallel fashion
6 optimal strength

38
Q

How long is the remodeling phase of each grade type of an ankle sprain?

A

Grade 1 = one week
Grade 2 = two weeks
Grade 3 = three weeks

39
Q

What are the goals of the remodeling phase in reference to an ankle sprain?

A 
1 increase pain-free ROM
2 progress proprioceptive training
3 regain full strength
4 normal biomechanics
5 protect and strengthen any residual joint instability
40
Q

Which ligament is most commonly involved in an ankle sprain?

A

Anterior talofibular ligament (could also be posterior talofibular and calcaneofibular ligaments)

41
Q

Which muscles can be stretched following an ankle sprain to help with loss of dorsiflexion?

A

Gastrocnemius and soleus

42
Q

What are good exercises of active care for an individual with an ankle sprain to increase strength?

A

Heel/toe raises, stair steps, quarter squats, eccentric/concentric with cuff weights/theraband

Passive Care Exam One (4 decks)

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