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Z -AET 272 Midterm 1 > Tissue Response to Pain > Flashcards

Tissue Response to Pain Flashcards

1
Q

pain sources:
cutaneous

A

thru skin

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2
Q

pain sources:
deep somatic

A

thru bony structures

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3
Q

pain sources:
visceral

A

pain in diff area than injury

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4
Q

pain sources:
psychogenic

A

in situation resemble previous pain

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5
Q

sclerotomic pain

A

Deep, aching, and poorly localized; slow and fast characteristics

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6
Q

dermatomic pain

A

sharp and well localized

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7
Q

fast v slow pain

A

fast: pain accelerates when doing more in that area
slow: always hurts (throbbing)

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8
Q

local v referred pain

A

local: pain right where the injury occurred
referred: pain diff area than injury

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9
Q

myofascial pain

A

Trigger points: hyper contracted knot or a hyper irritable spot in the facia surrounding the muscle (feels like a P)
Referred to a reference zone
Causes shooting pain

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10
Q

nociceptors

A

receptors in body to recognize pain
- periosteum, skin, teeth, organs
- afferent nerve fibers: transmit pulses towards spinal cord

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11
Q

healing process phases

A
  • inflammatory response
  • fibroblastic repair
  • maturation and remodeling
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12
Q

Goals of inflammation

A
  • protect the area
  • localize the injury
  • decrease injurious agents
  • prepare for repair and remodel
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13
Q

inflammatory phase

A
  • 1st phase of healing process
  • body’s defense mechanism (need for heal)
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14
Q

healing (inflammatory response)

A
  • begins immediately
  • injury results in altered metabolism
  • initial reaction by leukocytes and phagocytic cells
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15
Q

inflammatory response timeline

A
  • Local vasoconstriction reduces blood loss at injury site
  • Platelet reaction (clotting)
  • Coagulation cascade
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16
Q

chronic inflammation

A

= failure to heal!
- as inflammation persists necrosis and fibrosis prolong the process
- granulation and fibrotic tissue develop in highly vascular and loose CT

  • due to overuse, tissue not restored to physiological state, and cause shift from acute to chronic
17
Q

Fibroblastic Repair Phase

A

Second phase of the healing process, leading to scar formation and repair of the injured tissue

18
Q

Scar Formation

A

○ Capillary buds form
○ Granulation tissue develops
○ Collagen is laid down
○ Scar tensile strength increases
○ Normal sequence = minimal scarring
○ Persistent inflammation = extended fibroplasia

19
Q

Fibroblastic Repair Phase timeline

A
  • 2 days - 6 weeks
  • hematoma (bad bruise) decrease in size
  • strength increase = vascularization decrease (whiter)
  • scar tissue is fibrous, inelastic, not pre-injury strength
20
Q

1st Intention Healing:

A
  • Happens when wound edges are closely approximated
  • Minimal scarring
21
Q

2nd Intention Healing

A

§ Wound edge gapping
§ Scar tissue abundant & used to bridge the gaps
§ Common in musculoskeletal type injuries

22
Q

Maturation & Remodeling Phase

A

-Long term process (start 3 weeks after injury)
-Realigned collagen
-Increased strength
-Tissue gradually assume normal appearance
-May require several years
- overlap repair
-Bone can heal best when under stress/demand

23
Q

Wolff’s Law

A
  • Progressively load tissues through the rehabilitation process
  • Pain indicates the rate of progression
24
Q

progressive mobility

A

as healing moves into repair phase, add controlled activity.
- during remodeling aggressive ROM and strength training should be added

25
Q

Cartilage Healing

A
  • limited capacity to heal, little or no direct blood supply
    -Healing depends on the blood supply to the cartilage*
26
Q

Ligament Healing

A
  • similar to repair phase (lay down collagen, scar forms, realign in reaction to joint stresses)
  • surgically repaired stronger due to lack of scaring
  • up to 12 months
  • muscles strengthen joint (exercise v immobilization)
27
Q

skeletal muscle healing

A
  • Initial bleeding followed by proliferation of ground substance and fibroblast
  • Myoblastic cells form = regeneration of new myofibrils
  • Collagen will mature and orient along lines of tension
  • Healing could last 6-8 weeks depending on muscle injured
28
Q

Tendon Healing

A
  • Abundance of collagen is required for good tensile strength.
  • Tissue not sufficiently strong for tension until weeks 4-5
29
Q

Nerve Healing

A
  • regeneration w/in nerve fiber
  • proximity of injury to nerve cells make regeneration difficult
  • 3-4mm per day
  • PNS heal better than CNS
30
Q

Acute bone healing

A
  1. hematoma formation
  2. Cellular proliferation
    3a. Soft callus formation
    3b. Hard callus formation
  3. Ossification
  4. Remodeling
31
Q

hematoma formation

A
  • in first 48hrs hematoma w/in medullary cavity and surrounding tissue develops
  • blood supply disrupted by cell debris and clotting vessels
32
Q

soft callus formation

A
  • random network of woven bone
  • formed by bone fragments that bridge fracture gap
  • internal callus creates rigid immobilization
33
Q

hard callus

A
  • osteoblasts lay down cancellous bone, replace cartilage
  • crystallization of callus, remodeling begins
  • less than ideal immobilization makes cartilaginous union instead of bony
34
Q

ossification

A
  • complete when bone is laid and callus is absorbed by osteclasts
  • adapt to applied stress (Wolff’s Law)
  • 3-8 wks (depend on severity, site, age, extent)
35
Q

acute fracture management

A
  • immobilized until x-rays reveal the presence of a hard callus
  • fractures can limit participation for weeks or months
  • Factors that interfere with healing:
    poor blood supply, poor immobilization, infection

Z -AET 272 Midterm 1 (6 decks)

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