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The Inflammatory Response & Healing Flashcards

1
Q

Introduction

What is inflammation?

Definition

A

The local tissue response of the body to any irritant

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2
Q

Introduction

Designed to?

A

It is the fundamental action designed to protect, localize and rid the body of injured tissue in preparation for healing to occur

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3
Q

Introduction

Inflammatory response can be?

A

The inflammatory response can be acute or chronic

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4
Q

Introduction

What is the acute phase?

A
  • The initial reaction of the body’s tissues to any irritant
  • Usually has a short onset and short duration
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5
Q

Introduction

Why is inflammation necessary?

A

Inflammation is necessary for laying the ground work for healing and repair

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6
Q

Introduction

Overlapping of which events?

A

There is an overlapping of chemical, vascular and cellular events

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7
Q

Introduction

Inflammatory response is characterized by pneumonic?

A

The inflammatory response is characterized by the pneumonic SHARP

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8
Q

Introduction

Varying degrees of trauma cause?

A

Varying degrees of trauma will cause varying degrees of the inflammatory response

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9
Q

Inflammatory Response

S

A

S - Swelling
May be immediate or may develop over a period of time (usually within 24 hours)

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10
Q

Inflammatory Response

H

A

H - Heat
or increased local temperature (due to an increase in local metabolism)

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11
Q

Inflammatory Response

A

A

A - altered function
such as restricted movement or a limp

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12
Q

Inflammatory Response

R

A

R - redness
occurs due to an increase in blood flow (vasodilation)

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13
Q

Inflammatory Response

P

A

P - pain
may be chemical in nature or due to swelling putting pressure on free nerve endings

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14
Q

Inflammatory Exudate

Inflammation is caused by?

A

Inflammation is caused by the inflammatory exudate

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15
Q

Inflammatory Exudate

What is the inflammatory exudate?

A

The inflammatory exudate is cellular debris accumulating in the area of injury

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16
Q

Inflammatory Exudate

Inflammatory exudate is defined as:

A

“Fluid with a high protein content caused by the accumulation of cellular debris in or around the area of injury”

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17
Q

Inflammatory Exudate

What does the inflammatory exudate include?

A
  • Red blood cells
  • White blood cells
  • Water
  • Platelets
  • Chemicals
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18
Q

Types of Trauma Causing Inflammation

What are types of trauma causing inflammation?

A
  • Allergic - hypersensitivity to a foreign protein
  • Chemical - adhesive, latex
  • Thermal - sunburn, hot pack
  • Psychological - a stress reation, psychosomatic
  • Physical - soft tissue or bony
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19
Q

Inflammatory Response & Muscle Spasm

What is the body’s first reaction whenever you feel pain of any kind, and when pain reaches a certain threshold?

A

Whenever you feel pain of any kind, and when that pain reaches a certain threshold, the body’s first reaction is muscle guarding

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20
Q

Inflammatory Response & Muscle Spasm

What do the muscles do to protect?

A

The muscles “splint” or immobolize the area where you feel the pain to protect it

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21
Q

Inflammatory Response & Muscle Spasm

What is spasm (and is not)?

A

Spasm is a symptom and not a cause

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22
Q

Inflammatory Response & Muscle Spasm

Effects of spasm?

A

Muscle spasm can have good as well as bad effects

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23
Q

Inflammatory Response & Muscle Spasm

What does prolonged muscle guarding produce?

A

Prolonged muscle guarding produces muscle spasm and inflammation

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24
Q

Inflammatory Response & Muscle Spasm

Muscle spasm can be? (sign)

A

Muscle spasm may be very painful but it is not necessarily a sign of a serious problem

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25
# Inflammatory Response & Muscle Spasm What does muscle spasm present with?
Muscle spasm presents with tender, painful muscles, slowed circulation and low-grade inflammation which continues this cycle CYCLE Pain -> muscle guarding -> circulatory statsis -> retention of metabolities and restricted movement -> myositis and muscle spasm
26
# Inflammatory Response & Muscle Spasm What does the pain/spasm cycle need to be interrupted with?
The pain/spasm cycle needs to be interrupted with: * Medication * Treatments: cold compression, rest, restricted movement (in the acute phase), heat, massage, electrical stimulation, and other therapeutic modalities
27
# Inflammatory Response & Muscle Spasm Treatment regiment? Problems with it?
This treatment regiment is important and necessary, but it is doing very little to address the real cause of the problem, only treating the symptoms
28
# Inflammatory Response & Muscle Spasm What to do after the inflammatory response and associated spasm settle down?
This is why once the inflammatory response and any associated spasm has settled down, a re-evaluation of the nature and extent of the injury must be established
29
# Inflammation & The Phases of Healing What categories does soft tissue injury fall in?
Soft tissue injury falls into three phases or categories
30
# Inflammation & The Phases of Healing Timelines?
Each of these phases has specific timelines based on what is happening physiologically at the tissue level
31
# Inflammation & The Phases of Healing Three phases are known as:
* Inflammatory or Acute Phase * Regenerative or Fibroblastic Phase * Remodeling or Maturation Phase
32
# The Inflammatory Phase Natural response to trauma
Inflammation and the inflammatory phase is the body's natural response to trauma
33
# The Inflammatory Phase What is the shortest/most painful phase?
The inflammatory phase is the shortest phase and is the most painful
34
# The Inflammatory Phase How long does the inflammatory phase last?
It usually lasts between 48-72 hours unless it is interrupted
35
# The Inflammatory Phase What is it characterized by?
It is characterized by the simultaneously overlapping of vascular, cellular and chemical events with the result being inflammation (evident through SHARP)
36
# The Inflammatory Phase How does the inflammatory phase lay groundwork?
Through the inflammatory exudate, the inflammatory phase lays the groundwork for healing to commence
37
# Regenerative or Fibroblastic Phase What does it extend from?
The regenerative or fibroblastic phase extends from the end of inflammation
38
# Regenerative or Fibroblastic Phase How long does it last?
It lasts for appoximately 6 weeks
39
# Regenerative or Fibroblastic Phase What does it do?
It lays the groundwork for healing by scar tissue (fibroplasia)
40
# Remodeling or Maturation Phase What is the final phase?
The final phase is the remodeling or maturation phase
41
# Remodeling or Maturation Phase What is the longest phase? How long can it last?
Remodeling or maturation is the longest phase and can last up to or beyond a year
42
# Remodeling or Maturation Phase What is it characterized by?
This phase is characterized by the ongoing synthesis (building up) and lysis (breaking down) of scar tissue
43
# The Inflammatory Phase (Vascular Events) Events during this phase?
There is an overlapping of various events during this phase which results in inflammation in and around an area of injury
44
# The Inflammatory Phase (Vascular Events) Signs and symptoms duration?
The signs and symptoms of SHARP will be evident for up to 72 hours, signaling ongoing inflammation
45
# The Inflammatory Phase (Vascular Events) What do the vascular events include?
Vascular events include: * an initial vasoconstriction (Golden Period of Evaluation), allowing for coagulation to occur * followed by vasodilation, bringing blood flow, chemicals and cells to the tissue for clean up and repair to commence
46
# The Inflammatory Phase (Cellular Events) The second event?
The second event which occurs as vasodilation and vasoconstriction occur in the vascular system is **cellular events**
47
# The Inflammatory Phase (Cellular Events) "Pavementing"
With injury, white blood cells move toward the periphery of local capillaries in a process called "pavementing"
48
# The Inflammatory Phase (Cellular Events) "Margination"
Line up and stick to the vessels close to the injury, and eventually migrate out into the surrounding tissue
49
# The Inflammatory Phase (Cellular Events) Diapedesis
Cells pass through the vessel wall
50
# The Inflammatory Phase (Cellular Events) Chemotaxis
Guided to the injury site
51
# The Inflammatory Phase (Cellular Events) Phagocytosis
Engulf cellular debris
52
# Phagocytosis What is it?
There are a variety of white blood cells which engulf cellular debris (phagocytosis) and perform other similar functions
53
# Phagocytosis Examples of common white blood cells
Neutrophils and macrophages are examples of two of the most common white blood cells
54
# Phagocytosis What leaves the vessel first?
Neutrophils are smaller so they leave the vessel first but soon die and add to the cellular debris, cleaned by the macrophages
55
# The Inflammatory Phase (Chemical Events) What is released during the inflammatory process from injured cells?
There are numerous chemicals released during the inflammatory process from injured cells
56
# The Inflammatory Phase (Chemical Events) Chemical mediators act as?
These chemical mediators act as traffic cops and play numerous roles as well as activating numerous processes
57
# The Inflammatory Phase (Chemical Events) Numerous processes activated?
Vasodilation, pain, increasing cell permeability, initiating other sequences to occur (clotting) and attracting different cells to the area of injury
58
# The Inflammatory Phase (Chemical Events) Some examples of these chemicals and their roles
Histamine, Bradykinin, Leukotrienes
59
# Tissue Repair What is it?
Tissue repair is the process of replacing dead or damaged cells with healthy ones
60
# Tissue Repair Three types of repair
* Complete/Regenerative * Tissue incapable of restoration * Substitution/replacement
61
# Regenerative or Fibroblastic Phase When does this phase begin?
This phase begins when the inflammatory response has ceased
62
# Regenerative or Fibroblastic Phase How long can this phase last?
Can last up to six weeks
63
# Regenerative or Fibroblastic Phase When does repair commence?
Repair commences when the injured area has been cleared of cellular debris
64
# Regenerative or Fibroblastic Phase Why is it also called the fibroblastic phase?
This is also called the fibroblastic phase because it is characterized by fibroplasia, that is, the laying down of fibroblasts or scar tissue which become active from the inflammatory exudate (granulation tissue)
65
# Regenerative or Fibroblastic Phase What do fibroblasts secrete?
Fibroblasts secrete soluble collagen
66
# Regenerative or Fibroblastic Phase Why do fibroblasts become active?
Fibroblasts (type 3 initially) become active to "fill in the gap" caused by the initial injury
67
# Regenerative or Fibroblastic Phase What do fibroblasts (type 3) get replaced with?
They are eventually replaced by type 1 fibers
68
# Regenerative or Fibroblastic Phase What is granulation tissue formed from?
Formed from exudate
69
# Regenerative or Fibroblastic Phase Granulation tissue - what is it?
Vascular mass with growth factor which stimulates fibroblasts to become active
70
# Regenerative or Fibroblastic Phase Fibroblast formation
* Time lines * Develop contractile properties
71
# Remodeling Phase What is the final phase?
The final phase is the remodeling phase
72
# Remodeling Phase How long does the remodeling phase last?
Lasts from three months up to one year
73
# Remodeling Phase Characterized by?
This phase is characterized by the maturity, strength and amount of fibroblasts (scar tissue) being laid down
74
# Remodeling Phase What happens throughout this phase?
Throughout this phase, there is an ongoing synthesis and lysis of scar tissue to ultimately build up as much strength as possible as well as having the fibroblasts line up along the "lines of stress"
75
# Remodeling Phase What is important during this phase?
Imposed forces during this phase are important
76
# Remodeling Phase What can delay healing?
Excessive forces or inadequate force can delay healing
77
# Healing How many types of healing can occur following injury?
There are two "types" of healing that can occur following injury
78
# Healing Two types of healing
These include: healing by primary or healing by secondary intent
79
# Healing What plays a role and may differentiate between these two types of healing?
The degree of approximation and amount of scar tissue
80
# Healing What does the efficiency of regeneration and healing depend on?
Depends on a number of factors including: * proper elimination of cellular debris * avoiding re-aggravation * proper vascularization * proper collagen production
81
# The SAID Principle What does SAID stand for?
SAID stands for Specific Adaption to Imposed Demands
82
# The SAID Principle What does SAID state?
"When the body is subjected to stresses and overloads of varying intensities, it will adapt over time to overcome the demands placed on it"
83
# The SAID Principle Movement?
General movement/exercise - sport specific movement/exercise
84
# The SAID Principle What does this principle play an important role in?
This principle plays an important role in the last two phases/stages of healing

KINE 3575 (7 decks)

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