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Sports Medicine 2 > Test 1 - Modalities and Healing > Flashcards

Test 1 - Modalities and Healing Flashcards

1
Q

inflammatory response phase

A
  • injury to day 4
  • symptoms: swelling, pain, warmth, crepitus
  • direct destruction of soft tissue cells
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2
Q

vascular reaction for inflammatory response

A
  1. vasocontstriction of vascular walls
  2. vasodilation with hyperemia (excess of blood)
  3. stagnation and stasis (blood doesn’t move properly)
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3
Q

immediate vascular reaction of injury

A
  1. vessels endothelium disrupted
  2. platelets adhere to exposed collagen
    sticky matrix for platelets and leukocytes
  3. formation of plug
  4. obstructs local lymphatic drainage
  5. localizes injury response
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4
Q

cellular reaction for inflammatory response phase

A

chemical mediators released for cell (histamine, leucotaxin, necrosin)

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5
Q

histamine

A

vasodilation and increases cell permeability

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6
Q

leucotaxin

A

margination (movement of particles towards the wall of channel) and increases inflammation
forms exudate

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7
Q

necrosin

A

turns on phagocytes

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8
Q

fibroblastic repair phase

A

prolifertaive, regenerative activity which leads ot a period of scar formation and repair of injured tissue

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9
Q

maturation and remodeling phase

A

increase in tensile strnegth and decrease in fibroblasts is a sign for maturation and remodeling phase
- realignment of collage fibers along lines of tensile force
- ongoing breakdown/syntehsis of collagen
- increase in tensile strength of scar matrix
- at 3-weeks a contracted non vascular scar exists
- may require several years to complete

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10
Q

chronic inflammation

A
  • occurs when acute responses does not elimante injuring agent
  • leukocytes replace macrophages, lymphocytes, and plasma
  • specific mehcniasim which causes conversion is unknown
  • overuse or overload with cumulative repetitive microtrauma
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11
Q

fibroplasia

A

process of forming fibrous tissue
- begins within the first few hours following the injury
- signs of inflammation subside
- pain and tenderness to touch
- may last 4-6 weeks

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12
Q

eschar

A

scab development over a burn

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13
Q

vascular reaction for fibroblastic repair phase

A
  1. growth of endothelial cpaillary bouds into the area
  2. increased blood flow
  3. increased delivery of essential nutrients for tissue regneneration
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14
Q

cellular reaction for fibroblastic repair phase

A
  1. breakdown of fibrin clot
  2. formation of granulation tissue (fibroblasts, collagen, capillaries)
  3. fibroblasts accumalate along capillary beds
  4. synthesizes extracellular matrix
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15
Q

wolffs law

A

bone and soft tissue will respond to the physical demands placed on tehm causing them to remodel along lines of tensile force

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16
Q

abnormal response to healing

A

persistent inflamatory response can cause extended fibroplasia (building of fibers) and fibrogenesis

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17
Q

factors that impede healing

A
  • extent of injury
  • edema
  • hemorrhage
  • poor vascular supply
  • separation of tissue
  • muscle spasm
  • atrophy (degeneration of cells)
  • corticosteriods
  • keloids and hypertrophic scars
  • infection
  • humidity/climate
  • age, health, nutrition
18
Q

What is better controlled mobilizatoin or immobilization?

A

controlled mobilization
- decreases scar formation
- increases revascularization
- facilitates muscle regeneration
- reorientation of muscle and ligament fibers

19
Q

P.R.I.C.E.

A

protection
- protect from additional injury using splints

rest
- allow the inflammatory phase to do what is suppode to do

ice
- decreases metabolism to control secondary hypoxic injury
- analgesia
- vasocontrition
- ice bags, cryocuff

compression
- reduces space for swelling
- elastic wrap and compression dressing
- intermittent compression, cryocuff, elastic wraps

elevation
- reduces pooling of blood in the extremities
- facilitates venous and lymphatic drainage

20
Q

modulating pain

A
  • low-power laser
  • cold
  • e-stem
21
Q

facilitating healing

A
  • low intensity ultrasound (can be used immediately following injury)
22
Q

modalities for inflammatory response phase

A
  • cryotherapy shoudl still be used to reduce likelihood of swelling
  • intermittent compression can decrease swelling (encourages resorption of by products by lymphatic system)
  • estem currents and low power laser can be used to help reduce pain
  • incorapate active and passive ROM exercise
23
Q

modalities for fibroblastic repair phase

A
  • may change from cold to heat
  • thermotherapy (encourages circulation to the injured area)
  • heat can produce some analgesia
  • intermittent compression can facilitate removal of injury by products
  • estem currents assist process by eliciting a muscle construction
  • continue to stress importance of ROM and strenghtening exercises and progress them appropriately
24
Q

modalties for maturation-remodeling phase

A
  • heat modalties
  • deep heating modalties (ultrasound, shortave, and microwave diathermy)
  • superificial heating are less effective
  • estem can be sued to stimulate muscle contractions for increasing ROM
  • low power laser used to modulate pain
  • role of controlled mobility
25
Q

the 3 categories of heat

A
  • chemical action associated with metabolism
  • electrical or magnetic currents as those found in diathermy
  • mechanical action as found with ultrasound
26
Q

thermotherapy

A

the application of heat modalties

27
Q

superficial heating agents

A

increasing skin tempt with a range of 104 - 113
- transfers through conduction, but superficial heating is limited to depth of less htan 2 cm

28
Q

what will applying heat do in the active inflammatory cycle?

A

increase cell metabolism and accelerate amount of hypoxic injury

29
Q

local effects of heat application

A
  • vasodilation
  • increase cell metabolism
  • increase capillary permeability
  • increase delivery of leukocytes
  • edema formation
  • removal of metabolic waste
  • increase elasticity of ligaments, capsules, and muscle
  • analgesia and sedation of nerves
  • increase nerve conduction
  • decrease muscle tone
  • sweat
30
Q

systemic effects of heat exposure

A

increase body temp
increase pulse rate
increase respiratory rate
decrease blood pressure

31
Q

indications for heat

A
  • subacute or chronic inflammatory conditions
  • reduction of subacute or chronic pain
  • subacute or chronic muscle spasm
  • decreased rom
  • hematoma resolution
  • reduction of joint contractures
32
Q

contraindications for heat

A
  • acute injuries
  • impaired circulation
  • poor thermal regulation
  • anesthetic areas
  • neoplasms (abnormal tissues like tumors)
33
Q

cellular response to heat

A
  • for each increase of 18 degrees farenheit in skin, cells metabolic rate increases by a factor of 2 or 3
  • as the cells metabolic rate increases, so does it demand for oxygen and nutrients
  • waste also increases
  • increased metabolic rate = increased tissue temp
34
Q

paraffin bath

A
  • 7 parts wax to 1 part oil
  • kept at constant temp of 118-126
  • temps for lower extremity is decreased (113-121)
  • glove method
  • 15 to 20 minutes
35
Q

shortwave diathermy

A
  • a deep heating modality
  • uses energy similar to broadcrast radio waves
  • high frequency alternating current
  • frequencies of 13.56, 27.12, and 40.61 are for medical use
  • 2 units commonly used : condenser and conduction
    prep
  • no metal
  • cover area with terry cloth to avoid perspiration
36
Q

indications for shortwave diathermy

A
  • joint inflammation
  • large areas that can’t be effectively heated using other methods
  • fibrositis
  • myositis
  • subacute and chronic inflammatory conditions
  • osteoarthritis
37
Q

contraindications for shortwave diathermy

A
  • ischemic areas
  • peripheral vascular disease
  • metal implants
  • perspiration and moist dressings
  • tendency to hemorrhage
  • cancer
  • fever
  • sensory loss
  • cardiac pace makers
  • ares of particular sensitivity
38
Q

rebound vasocontriction

A
  • occurs 20 minutes into treatments
  • temp gradient starts eveing out and the body counteracts energy and starts vasoconstricting
39
Q

effects of heat on muscle spasm and elasticity

A
  • decreases muscle spasm
  • increase blood flow and rom is improved
40
Q

heats effect on pain

A

leads to a state of analgesia because nerve fibers are stimulated
- analgesia (the inablity to feel pain)

Sports Medicine 2 (1 decks)

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