tissue reponse to injury Flashcards

1
Q

signs of inflammation

A
redness
swelling
tenderness
increase temperature
loss of function
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2
Q

chemical mediators

A

histamine, leukotrienes and cytokines

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3
Q

inflammation response phases

A

inflammation: day 1-4
fibroblastic repair phase: day 4 to week 6
maturation-remodling phase: 4 weeks to 3 years

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4
Q

histamine

A

released from the injured mast cells, causes vasodilation and increased cell permeability, owing to a swelling to endothelial cells and then separation between the cells

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5
Q

margination

A

leukotrienes and prostaglandins are responsible for margination: leukocytes (neutrophils and macrophages) adhere along the cell walls this will increase cell permeability affecting the passage of fluid, proteins and neutrophils though cell walls

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6
Q

diapedisis

A

movement of white blood cells OUT of small arterial vessels

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7
Q

exudate

A

accumulation of fluid that penetrates through vessel walls into joining extravascular space

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8
Q

neutrophils

A

a type of white blood cell that engulf invading microbes and contributes to the nonspecific defences of the body against disease

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9
Q

phagocytes

A

a type of white blood cell that ingests invading microbes

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10
Q

vasoconstriction

A

narrowing of blood vessels

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11
Q

inflammation response sequence

A
  1. injury to cell
  2. chemical mediators liberated (histamine, leukotrienes and cytokines)
  3. vascular reaction (vasoconstriction, vasodilation and exudate creates stasis)
  4. plateelts and leukocytes adhere to vascular wall
    5 phagocytosis
  5. clot formation
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12
Q

blood clot coagulation

A
thromboplastin
prothrombin
thrombin
fibrinogen
insoluble fibrin clot
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13
Q

collagen

A

structural protein found in the skin and connective tissue

type 1: found in skin, fascia, tendon, bone, ligaments, cartilage, and interstitial tissues (*found most in fibroblastic repair phase)
type 2: found in hyaline cartilage and vertebral disks
type 3: found in skin, smooth muscle, nerves and blood vessels (less tensile strength)

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14
Q

granulation tissue

A

fibroblasts, collagen and capillaries

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15
Q

extracellular matrix

A

collagen, elastic, ground substance, proteoglycans, glycosaminoglycans

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16
Q

maturation - remodling phases

A

a realignment or remodeling of the collagen fibers that make up scar tissue according to the tensile forces to which that scar is subjected

17
Q

fibroblastic repair phase

A

along with increased oxygen delivery comes an increase in blood flow, which delivers nutrients essential for tissue regeneration in the area. The formation of a delicate connective tissue called granulation tissue occurs with the breakdown of the fibrin clot. granulation consists of fibroblasts, collagen and capillaries.

18
Q

factors that impede healing

A
extent of injury (micro/macro tears)
edema
hemorrhage
poor vascular supply
separation of tissue
muscle spasm
atrophy
corticosteriods
kelod/hypertrophic scars
infection
humidity/climate/oxygen tension
health/age/nutrition
19
Q

ligament healing

A
  • immediately after injury, ~72 hrs thee is a loss of blood from damaged vessels and attraction of inflammatory cells
  • next 6 weeks, vascular proliferation w/ new capillary growth begins to occur along with fibroblastic activity, forming a fibrin clot
  • gradually there is a decrease in fibroblastic activity, decrease in vascularity, and max increas in collagen density of a scar
  • maturation of a scar may require at least 12 mos
20
Q

myelinated axon

A

transmission of action potential travels- acts as a catalyst to make these signals travel quicker

21
Q

schwann cell

A

supporting cells of the peripheral nervous system responsible for the formation of myelin

22
Q

NSAIDS

A

nonsteroidal antiinflammatory drugs

23
Q

therapeutic modalities

A

machines, devices, or substances that are used to enhance recovery from an injury

*heat facilitates an acute inflammatory response and cold slows down the inflammatory response

24
Q

bone healing

A
  1. blood vessels are broken at the fracture line, the blood clots and forms hematoma
  2. blood vessels grow into the fracture and fibrocartilage soft callus forms
  3. fibrocartilage becomes ossified and forms a bony callus made up of spongy bone
  4. osteoclasts remove excess tissue from the bony callus and the bon eventually resembles its original appearance
25
acute pain
episode of pain that lasts from seconds to less than 6 months
26
chronic pain
episode of pain that lasts for 6 months or longer | may be intermittent or continuous
27
myofascial pain
small hyper-irritable areas within a muscle in which nerve impulse bombard the central nervous system and are expressed as a referral pain
28
gate control theory
sensory information coming FROM cutaneous receptors in the skin enteres the ascending AB afferents and is carried to the substantia gelatinosa in the dorsal horn of the spinal cord. likewise pain messages from the nociceptors are carried along the Ad and C afferent fibers and enter the dorsal horn. sensory information coming from AB fibers overrids or inhibits the "pain information" carried along Ad/C fibers thus inhibiting or effectively "closing the gate" to, the transmission of pain information to second order neurons. Pain information is not transmitted and never reaches sensory centers in the brain this theory occurs at the spinal cord level
29
neurotransmitters
serotonin, norepinephrine, substance P, enkephalins, beta-endorphins
30
first order neurons
first-order or primary afferents tranmist impulses from a nociceptor to the dorsal horn of the spinal cord. 4 types: 1. Aalpha * LARGE DIAMETER 2. Abeta *LARGE DIAMETER 3. Adelta *small 4. C *smal
31
efferent nerve fibers
nerve fiber, such as motor neurons, transmits impulses FROM the spinal cord TOWARDS the periphery
32
afferent nerve fibers
nerve fibers transmit impulses FROM the nociceptors TOWARD the spinal cord
33
A-Delta fibers
transmit sensation of pain and temperature small originate from nociceptors located in skin and transmit fast pain
34
C-fibers
small pain and temperature orginate from both superficial tissure (skin) and deeper tissue (ligaments and muscles) and transmit slow pain
35
neural transmission
``` first order (nociceptors to dorsal horn of spinal cord second order (afferent carries sensory message from dorsal horn to brain and are then categorized as nociceptor specific neuron synapse with third order which carry information via ascending spinal tracts to various brain centers, where the input is integrated, interpreted and acted upon ```
36
descending pathway pain control
previous experiences, emotional influences, sensory perception, and other factors could influence the transmission of pain messages and thus the perception of pain the information coming from higher centers in the brain along efferent descending pathways in the spinal cord causes a release of two neurotransmitter like substances, enkephalin and norepinephrine, into the dorsal horn, which together block or inhibit the synaptic transmission of impulses from the Adelta and C afferent to second-order afferent neurons
37
beta endorphin
pain (noxious) stimulation of nociceptors resultant in the transmission of the pain information along adelta and C afferents can stimulate the release of an opiate like chemical called beta endorphin from the hypothalamus and anterior pituitary. Beta-endorphin is endogenous to the central nervous system and is konwn to have strong analgesic effects. The exact mechanism by which beta-endorphin produces these potent analgesic effect are unclear. Acupuncture, acupressure, point stim using electrical currents are all techniques that may stimulate the release of beta endorphin.