Tissue Damage + Nutrients

Question 1

what are the 4 phases of wound healing

Answer 1

Homeostatsis
inflammatory
proliferation
remodeling

Question 2

what happens during phase 1- homeostasis

Answer 2

• 5-10 min period of vasoconstriction followed by active vasodialation
• platlets within a fibrin clot secrete a variety of growth factors and cytokine
• Bradykins and prostaglandins lead to long term vasodilation

-fibrin plugs clot in the wound

Question 3

What occurs in phase 2- inflammatory

Answer 3

-increase in vascular perm (migration of neutrophils and monocytes into surrounding tissue)

Question 4

Order of WBC to reach wound in inflammatory phse

Answer 4

• polymorphonuclear leukocytes- first WBC to respond (begin phago)
• neutrophil migration ceases 1st few days post injury
• in late phase, monocytes convert to macrophages

Question 5

What occurs in stage 3- proliferative

Answer 5

formation of granulation tissue and epitheiazation

• capilary growth
• chemotatic growth factors released from platelets and macrophages stim migration and activation of wound fibroblasts
• Collagen synthesis

Question 6

What happens in phase 4= remodelling

Answer 6

• reorganization of collagen fibres

- contiues up to 2 years (achieving 40-70% strength @ 4 weeks)

Question 7

How does Vit A influence wound healing + dosage

Answer 7

• epthelialization
• bone development
• cellular differentiation
• immune system function

–10 000 IU
(tox > 50 000)

Question 8

what is zinc key for in wound healing

Answer 8

• important in action of collagenase*
• DNA synthesis
• Cell division
• Pro synthesis
• Processes for tissue regeneration + repair

Question 9

What to keep in mind w supplementing EPA/DHA(fish oils) in wound healing

Answer 9

EPA can be antinflamatory
(increasing omega 3 fatty acids at wrong time may change ability of the inflammatory stage)

-but may be benificial in stage 3/4 when inflammation is no longer needed

Question 10

how can vit c be good in wound healing

Answer 10

• only effective if pt has def*
• cofactor for synthesis of collagen
• procollagen translation increased

Question 11

Protein in wound healing and amounts needed

Answer 11

traumatically injured pts are usually catabolic

1.5/kg may be adequate
>2/kg may be better

Question 12

how many g of pro is MTOR pathway activated at

Answer 12

20-30g

Question 13

how does curcurmin help wound healing

Answer 13

curcurmin targets NF-kB

-IL-1b inflammation and apoptosis inhibited

Question 14

time response of the 3 nitric oxide syndthase isoforms and role in healing

Answer 14

Involved in tissue (tendon) healing
-increased thru L-arganine

inducible (INOS)- day 4
Endothelial (eNOS) - day 7
Neuronal (bNOS)- day 21

Question 15

What is enhanced recovery after surgery + why

Answer 15

carb loading pre surgical client

- shorten hospital stay by decreasing post operative endocrine catabolic response and improving insulin resistence

Question 16

What are the anesthesia concerns w enhanced recovery after sugery

Answer 16

• aspiration can result (if food is present in stomach during surgery
• done in= cholescystemctomy, colorectal surgery, hip replacement

Question 17

What do Natural health products include

Answer 17

vit/mins
herbal remedies
homeopathic med
traditional med
probiotics

Question 18

Natural health products must have what

Answer 18

• product licening
• site licensing
• GMP (good manufacturing process)
• Safety + efficacy
• Reviewal and approval process by HC

Question 19

When is vit A a drug

Answer 19

vit A dose containing more than 10 000 iu

Question 20

Vit K levels as a drig

Answer 20

sold for external use

or oral at .120mg or less

Question 21

Vit D levels as a drug

Answer 21

more than 62.5-2500iu

Question 22

l tryptophen levels for drug

Answer 22

more than 220mg per dosage

Question 23

folic acid level for drug

Answer 23

containing more than 1mg per dose

Question 24

nictotinic acid level for drug

Answer 24

provides 500mg or more per dosage unit