Tissue Response to Injury Flashcards

1
Q

What is a grade 1 tissue injury?

A

Ache after activity, mild local tenderness and local inflammatory changes

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2
Q

What is a grade 2 tissue injury?

A

Ache or pain at onset of activity/after activity, local tenderness, some ROM limitation, weakness

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3
Q

What is a grade 3 tissue injury?

A

Constant ache exaggerated by activity, local tenderness, loss of ROM, weakness, possible atrophy

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4
Q

What are the 3 phases of the healing process?

A

Inflammatory response, fibroblastic repair, maturation/remodelling

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5
Q

What is the treatment for the inflammatory response phase?

A

RICER and no HARM

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6
Q

What are the indicators for referral during the inflammatory response phase?

A
  • Unable to bear weight
  • Unable to move injury through 50% ROM
  • Joint swells majorly within 1-2 hours
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7
Q

What occurs during the fibroblastic repair phase?

A

Scar formation (fibroplasia)

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8
Q

What is cicatrisation?

A

Development of cicatrix scar tissue (avascular, contracted, firm) during the fibroblastic repair phase, characterised by discolouration

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9
Q

What is the treatment for the fibroblastic repair phase?

A

Anti-inflammatories, physiotherapy, stretching (passive then active)

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10
Q

What occurs during the maturation of cicatrisation?

A

Muscle wasting, weakness and loss of proprioception and skill

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11
Q

What occurs during the maturation/remodelling phase?

A

Realignment of collage and continued breakdown and synthesis of collagen (type 3 becomes type 1)

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12
Q

What are the aims of treatment for tissue injuries?

A

Assist healing, regain length and strength of tissues, regain function

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13
Q

During what phase of healing should activity be added?

A

Repair phase

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14
Q

What type of exercises should be incorporated into the maturation/remodelling phase?

A

Aggressive ROM and strength exercises

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15
Q

What are the four types of soft tissue?

A
  • Epithelial tissue (skin, vessel & organ linings)
  • Connective tissue (tendons, ligaments, cartilage, fat, blood, bone)
  • Muscle tissue (skeletal, smooth & cardiac)
  • Nerve tissue (brain, spinal cord & nerves)
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16
Q

What is metaplasia?

A

Transformation of tissue from one type to another, abnormal type

17
Q

What is dysplasia?

A

Abnormal development of tissue

18
Q

What is hyperplasia?

A

Excessive proliferation of normal cells

19
Q

What are the characteristics of cartilage healing?

A
  • Limited capacity to heal
  • Little or no direct blood supply
  • Chondrocyte and matrix disruption
20
Q

What are the characteristics of ligament healing?

A
  • Similar healing course as other vascular tissues

- Repair phase often involves random laying down of collagen

21
Q

What are the factors affecting ligament healing?

A
  • Surgically-repaired ligaments usually stronger
  • Intra-articular tears
  • Exercised ligaments are stronger
22
Q

What are the characteristics of skeletal muscle healing?

A
  • Initial bleeding
  • Proliferation of ground substance and fibroblasts
  • Formation of myoblastic cells
23
Q

What are the characteristics of tendon healing?

A
  • Requires dense fibrous union of separated ends
  • Abundance of collagen
  • Initially adheres to surrounding tissues, then separates
24
Q

What are the characteristics of nerve healing?

A
  • Regeneration can take place within a neuron (more difficult if near nerve cell)
  • Requires optimal environment
  • Injured CNS nerves fo not heal as well as PNS nerves
25
What are the healing times for muscles, tendons/ligaments, bones and joints?
- Muscles: 6-12 weeks - Tendons/ligaments: 12 weeks - Bones: 6-8 weeks - Joints: 6-12 weeks
26
What are the prescribed recommendations for NSAIDs?
- Prescribe as early as possible | - Full dosage = 3-5 days
27
What is meant by the 'ceiling effect' of NSAIDs?
Beyond a certain dosage they don't provide additional benefit
28
How are corticosteroids used?
Injected as local treatment of soft tissue inflammation, with 10 days rest between injections
29
What is a possible consequence of repetitive injection of corticosteroids into a joint?
Crystal aropathy, which has a catabolic effect on bone
30
What do analgesics do?
Inhibit perception of pain
31
What does aspirin do?
Masks pain, acts as an anti-inflammatory, reduces fever, promotes excretion of uric acid, reduces platelet stickiness and may produce ulcerations/gastric bleeding
32
What is paracetamol?
An aspirin alternative that is metabolised in the liver and kidney
33
What are the four types of imaging?
X-ray, CT scan, MRI scan and bone scan
34
When is an X-ray used and what is it based on?
Suspected hard tissue problems, based on ionising radiation
35
What does a CT scan do?
Uses computerised tomography to view soft tissue in cross-sectional slices, displaying precise detail
36
What does an MRI scan do?
Produces images of hard and soft tissue (nerve tissue)
37
What does a bone scan do?
Shows elevated levels of osteoblast activity as a darkened hot spot