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aet: injury prevention > Tissue Response to Injury > Flashcards

Tissue Response to Injury Flashcards

1
Q

What are the four types of pain sources?

A
  1. Cutaneous
  2. Deep Somatic
  3. Visceral
  4. Psychogenic
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2
Q

What is sclerotomic pain?

A

Deep pain with slow or fast characteristics

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3
Q

What is Dermatomic pain?

A

Sharp, well-localized pain

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4
Q

What kinds of pain do we experience?

A

fast and slow, acute and chronic, local and referred.

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5
Q

What kind of pain is perceived at the source but also extends to nearby tissues?

A

Radiating

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6
Q

What is referred pain?

A

When it is felt in a part of the body that is removed from the tissues causing the pain. eg. heart attack is felt in arm/neck as well as chest.

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7
Q

What is myofascial pain?

A

Trigger points and referred to a reference zone.

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8
Q

What kind of receptors are nociceptors?

A

pain receptors that are located in the skin, periosteum. Surround bones, teeth, some organs.

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9
Q

What nerve fibers transmit the impulses toward the spinal cord?

A

Afferent nerve fibers.

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10
Q

What types of assessment techniques can be used for pain?

A

Visual analog scale( no pain to severe)
Pain charts
McGill pain questionnare
Numeric rating scale

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11
Q

What are the three phases of healing?

A
  1. Inflammatory response phase
  2. fibroblastic repair phase
  3. maturation and remodeling phase
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12
Q

What are the goals of phase 1 of inflammation?

A

Protect, localize, decrease injurious agents, prepare for repair and remodeling

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13
Q

When does the inflammatory response phase occur?

A

right from injury until 3-4 days post injury.

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14
Q

What are the cardinal signs of inflammation and what is it’s acronym?

A 
SHARP:
Swelling
Heat
Altered function
Redness
Pain
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15
Q

What cells are involved in the initial reaction from injury?

A

Leukocytes and phagocytic cells

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16
Q

What are the 3 mechanisms that act to stop blood loss form a wound?

A
  1. Local vasoconstriction,
  2. platelet reaction
  3. coagulation cascade
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17
Q

What occurs during the platelet reaction (also known as clotting)?

A

Fibrin forms blood clot/scab, platelets produce chemical mediators.

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18
Q

What cells rid the injury site of debris and what is it called?

A

Neutrophils and macrophages; phagocytosis

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19
Q

What cells release histamine?

A

Mast and basophils

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20
Q

What peptide promotes inflammation by vasodilation and therefore increasing permeability of blood vessel walls?

A

Bradykinin

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21
Q

What contains clotting proteins & antibodies and brings in oxygen and nutrients?

A

Exudate (pus)

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22
Q

How does clot formation occur?

A

Platelets adhere to collagen creating a plug (clot).

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23
Q

What aids in localizing an injury?

A

Clots

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24
Q

What is chronic inflammation?

A

when the bodies ability to heal fails.

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25
Q

What can occur if inflammation continues?

A

Necrosis and fibrosis prolong healing process.

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26
Q

When is chronic inflammation common?

A

Overuse, overload, and cumulative microtrauma.

27
Q

What occurs during the scar formation?

A

-capillary buds form, granulation tissue develops, collagen is laid down, scar tensile strength increases.

28
Q

What is the time frame of fibroblastic repair phase?

A

2 days to 6 weeks.

29
Q

What occurs during fibroblastic phase?

A

Hematomas decrease in size, strength increases, vascularization decreases(becomes whiter) scar tissue is fibrous, inelastic & and not at pre-injury strength.

30
Q

What is 1st intention healing?

A

when wound edges are closely approximated and minimal scarring occurs.

31
Q

What is 2nd intention healing?

A

when wound edges are gapping and scar tissue is abundant to close gaps. Common in musculoskeletal type injuries.

32
Q

What is the maturation and remodeling phase?

A
  • long term process
  • realignment of collagen
  • increased strength
  • tissue gradually assumes normal appearance
  • may require several years to complete.
33
Q

When does maturation and remodeling occur?

A

aprox. 3 weeks post injury and overlaps with repair/regeneration phase. Stress without distress should occur.

34
Q

What is wolff’s law?

A

bones will adapt based on stress or demands placed on them. Progressively load tissues throughout rehabilitation process.

35
Q

How does progressive mobility play a role in healing?

A

repair phase allows some stress to occur so that injured tissues can strengthen. Activities should be controlled and incorporated slowly.

36
Q

What might impede healing?

A

extent of injury, edema, hemorrhage, poor vascular supply, separation of tissue, muscle spasm, atrophy, foreign bodies, corticosteroids, keloid/hypertrophic scars, infection, climate, health/age/nutrition, inappropriate care.

37
Q

What are the 4 types of tissue in the body?

A

Epithelial, Connective, Muscle, nerve.

38
Q

Where is epithelial tissue found?

A

skin, vessels, organ linings

39
Q

Where is connective tissue found?

A

tendons, ligaments, cartilage, fat, blood, and bone

40
Q

Where types of muscle tissue are there?

A

Skeletal, smooth and cardiac

41
Q

What is nerve tissue?

A

Brain, spinal cord, and nerves

42
Q

What has little capacity to heal and little/no direct blood supply?

A

Cartilage

43
Q

What is an example of cartilage that can be damaged?

A

Meniscus

44
Q

How does ligament repair itself?

A

proper care allows collagen to lay forming scars then realigns by reacting to joint stresses/strain. Takes up to 12 months to heal completely.

45
Q

Why are surgically repaired ligaments stronger?

A

Decreased scar formation from surgery.

46
Q

How can you strengthen ligaments?

A

exercise strengthens muscles thus reinforcing joint. More tension of muscle will develop better joint stability.

47
Q

How does skeletal muscle heal?

A

bleeding followed by proliferation of ground substance/fibroblast. Myoblastic cells form leading to regeneration of myofibrils. Collagen matures and orients along lines of tension.

48
Q

What is myositis ossifcans?

A

Bone tissue forms within muscle stemming from an injury.

49
Q

How long does healing take for skeletal muscle?

A

6-8 weeks.

50
Q

What occurs during tendon healing?

A

Dense fibrous union of separated ends. requires collagen to have tensile strength though too much can lead to fibrosis which will interfere with gliding.

51
Q

After how many weeks is tissue in tendons sufficiently strong to support tension?

A

4-5 weeks.

52
Q

Nerve healing process:

A

regeneration can take place within nerve fiber;
proximity of injury to nerve cell makes regeneration more difficult;
slow process, 3-4mm per day;
injured CNS nerves do not heal much compared to PN.

53
Q

What are some considerations for soft-tissue healing?

A 
blood supply and nutrients necessary and play huge role in healing capacity;
healing in older patients/those with poor diets make take longer;
some disorders(blood conditions) may slow/inhibit healing process.
54
Q

What 3 phases do bone healing go through?

A
  1. inflammatory response
  2. fibroblastic repair
  3. maturation and remodeling
55
Q

What are the stages of an acute fracture?

A
  1. hematoma formation
  2. cellular proliferation
  3. callus formation
  4. ossification
  5. remodeling
56
Q

What occurs during the hematoma stage and how long does it last?

A

First 48 hrs hematoma within medullary cavity and surrounding tissue develops. Blood supply is disrupted by clotting vessels and cellular debris.

57
Q

What occurs during the soft callus stage of bone healing?

A

It is a random network of woven bone, formed by bone fragments that bridge fracture gaps. Internal callus creates rigid immobilization early.

58
Q

What occurs during the hard callus stage of bone healing?

A

Osteoblasts lay down cancellous bone replacing cartilage. Crystallization of callus leads to remodeling.
Less than ideal immobilization produces cartilaginous union instead of bony union.

59
Q

What occurs during the ossification stage?

A

Complete when bone has been laid down & excess callus is reabsorbed by osteoclasts.
Bone continually adapts to applied stress (wolff’s law).
Time required depends on severity/site of fracture/age/extent of trauma.

60
Q

How long does the ossification stage last?

A

~3-8 weeks.

61
Q

What does PIER stand for?

A

Pressure- limit swelling
Ice- pain relief: analgesia, decrease blood flow and metabolic needs
Elevation- Limits swelling (improves lymphatic drainage), decreases blood flow (gravity);
Rest/ Restricted function (defined)- limits swelling, protects against re-injury

62
Q

What does RICE stand for

A

Rest
Ice
Compression
Elevation

63
Q

What are some management concepts for inflammation?

A

analgesic & NSAIDs
heat/cold, electrotherapy, therapeutic ultrasound
exercise: increase ROM, strength, endurance, prevent atrophy.

aet: injury prevention (11 decks)

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