Week 1- Physiology of Human Recovery Flashcards
Main factors affecting tissue healing
- Patient
- Tissue
- Injury
Patient characteristics affecting healing
- Genetics
- Age
- Nutrition
- General fitness
- Medical comorbidities
- Psychosocial/socioecological status
- Patient characteristics
Nonmodifiable factors
- Cannot change
- Genetics, age, etc
Modifiable factors
- Factors under control of the patient
- Nutrition, fitness, etc
Healing characteristics of muscle
- Excellent healing potential
- Uniformity of injury
Healing characteristics of tendon
- Excellent healing potential
- Uniformity of injury
- Slower rate than muscle
Healing characteristics of extra-articular ligament
- Excellent healing potential
- Excellent blood supply
- Good environment
Healing characteristics of intra-articular ligament
- Lower healing potential
- Poor blood supply
- Hostile environment
Healing characteristics of articular cartilage
- No blood supply
- Heals as fibrocartilage
Healing characteristics of fibrocartilage
- Blood supply varies by location
- Repairs are technically difficult
Injury characteristics affecting healing
- Mechanism of injury
- Quantity of tissue involved
- Quality of injury site
Mechanism of injury
Gives appreciation for involvement of surrounding tissue
Quantity of tissue involved
Time needed for healing
Quality of injury site
Healing potential of tissue
Considerations for bone injury
- Requires period of immobilization
Post-immobilization: - ID impairments (weakness/atrophy, ROM, pain)
- ID functional status and activity level
Possible effects of peripheral nerve injury
- Sensory loss
- Motor loss
- Sympathetic function loss
- Pain
What is unique about pain with peripheral nerve injuries?
- Nerves are not innervated
- Damage to surrounding tissue may cause sensing pain
Factors affecting healing of peripheral nerves
- Age
- Motivation of patient
- Nature of injury
- Level of injury
- Timing/technique of surgery
- Regenerative potential of involved nerve
Seddon Classifications of nerve injury
- Neuroproaxia
- Axonotmesis
- Neurotmesis
Neuroproaxia
- Result of mild ischemia from compression or traction
- Recovery is usually complete
Axonotmesis
- Result of prolonged compression or stretch
- Causes infarction and necrosis
- Recovery is usually incomplete
Neurotmesis
- Result of laceration, avulsion, or rupture
- Poor prognosis w/o surgery
Phases of managing nerve injuries
- Acute phase
- Recovery phase
- Chronic phase
Acute phase for nerve injuries
- Immobilization
- Limit movement
- Splinting or bracing
- Patient education
Recovery phase for nerve injuries
- Motor retraining
- Desensitization
- Discriminative sensory reeducation
- Patient education
Chronic phase for nerve injuries
- Occurs in cases of poor or incomplete healing
- Compensation strategies
- Preventative care
Relationship b/t tissue damage and pain
Tissue damage is neither sufficient or necessary for pain
What happens as patients are educated about the nature of pain?
Pain levels decrease
How does word choice affect pain levels
Words perceived as threatening (annular tear, bulging disc, degenerative arthritis, etc) have been shown to increase fear and disability
