Week 2 Flashcards
What are the INDIRECT pathways of the anterolateral system and what sensations responsible for?
-
Spinoreticulothalamic
- diffuse, poorly localized, achy pain, multiple projections from reticular formation to other brainstem sites then to thalamus
What is the inflammatory response to parasite infection?
Release of Eosinophilia
What is the role of a physical therapist in the maturation phase of healing?
- Stretch tight scar tissue
- Address impairments
What tissues contain permanent cells?
- Brain
- Heart Muscle
What does the appearance in granulation indicate?
This means the wound is healing
What is the anterolateral system responsible for?
- Pain
- Temperature
- Touch
- Conscious level
What is regeneration in tissue healing?
The regrowth of parenchymal cells and stroma
What growth factors contribute to healing?
- Epidermal Growth Factor (EGF)
- Vascular Endothelial Factor (VEGF)
- Platelet-derived growth factor
- Fibroblast growth factor
What are the phases of wound healing?
- Hemostasis & Coagulation
- Inflammation
- Proliferative & Migration
- Remodeling
Why do 3rd-degree burns typically result in scarring?
3rd degree burns typically damage the basement membrane leading to scaring
What are the characteristics of A Delta Fibers?
- Small diameter myelinated fibers that carry fast pain and temperature information to the spinal cord.
- Not blocked by opiates
- quick onset
- short-lasting
- Pain felt (sharp, stabbing, pricking)
What is referred pain?
pain perceived at a location other than the site of the painful stimulus/ origin
Collagen types
- Type I
- (bones, tendons, and mature scars)
- Type II
- (cartilage)
- Type III
- (new scars, skin, blood vessels)
- Type IV
- (basement membrane)
What is Allodynia?
The sensation of pain in things not traditionally believed to be painful.
What is Lymphadenopathy
Swollen Lymph nodes
What factors interfere with wound healing?
- Infection
- Poor nutrition
- Catabolic interventions (corticosteroids, chemotherapies & radiation)
- POOR VASCULAR SUPPLY
- Smoking and alcohol
- Foreign objects & mechanical forces
- Aging
Where do A delta fibers, C fibers , & Aß fibers terminate?
Either on the dorsal gray matter on either interneurons or T (transmission) cells
What tissues contain labile cells?
- Bone marrow
- Epidermis
- Gastrointestinal epithelium
- Bronchial epithelium
What tissues contain stable cells?
- Liver
- Kidney
When does peak remodeling influence occur?
Between weeks 1-8
What internal mechanisms interfere with wound healing?
- Cancer
- Diabetes
- Chronic Heart Failure
- HIV
- Stress
What is the purpose of collagen in tissue healing?
- Provides support and tensile strength to the tissue
- Makes up the extracellular matrix
What two key components do you need for regeneration?
- Stem cells
- Stromal framework
What is the specificity theory of pain?
The idea is that sensation (pain) was attributed to a specific type of receptor.
What occurs during the remodeling phase?
- Fibroblasts disappear
- Balance Synthesis/Lysis
- Collagen fibers become organized
- Blood vessels disappear
- H2O content decreases
What produces collagen?
Fibroblasts and epithelial cells
What are the components of healing?
- Fibronectin
- Proteoglycans and Elastin
- Collagen
What is hyperalgesia?
An increased sensitivity to feeling pain and an extreme response to pain
What is the role of a physical therapist in the proliferation phase of healing?
Enhance proliferation and strengthen tissue
What are the characteristics of C-Fibers?
- Nonmylinated
- small diameter
- carry noxious crudely localized pain and temperature information to spinal cord
- slow onset of firing
- conduct slowly
- accompanied by autonomic responses
- nausea
- sweating
- increased HR and BP
- dull
- throbbing
- Emotional response
What are the two DIRECT pathways of the anterolateral system and what sensations responsible for?
-
Lateral spinothalamic
- fast, noxious mechanical pain and temperature
-
Anterospinothalamic
- Crude touch & pressure, itch, prolonged achy pain, some brainstem collaterals
What occurs during the proliferative phase?
-
Re-epithelialization —► Wound closure
- Contact inhibition —► stops from growing when they touch
- Fibroplasia —► Collagen production
-
Wound contraction
- Myoblasts —► these contract to pull the wound together
-
Neovascularization
- Endothelial buds & capillary loop
How is 2nd intension healing different compared to 1st intension?
- Larger scab
- More inflammation
- Larger amounts of granulations
- Involves wound contraction
- Myoblasts are a larger contributor to healing
What is the pattern theory of pain?
The belief that stimuli (pain) is recognized by the brain through the increasing intensity and frequency of action potential firing and that the summation of this information is sent to the brain which then determines what is perceived.
What is the inflammatory response to bacterial infection?
Acute inflammation is the result of neutrophilic release
What is a pyogenic granuloma?
- Highly vascular granulation tissue as a result of arrest of healing
- Lose Inflammatory infiltrate & edema
What is repair in tissue healing?
The partial or no regeneration with the formation of scar (fibrous fiber)
What is the inflammatory response to viral infection?
Release of Lymphocytosis
What is the role of a physical therapist in the acute phase of healing?
To limit excessive or prolonged inflammation
What are the characteristics of A-ß fibers?
- Large myelinated axons
- Sense
- Vibration
- Stretching of skin
- Mechanoreceptors
How might you reduce excessive scar formation like that found in Hyperplastic Scarring?
Compression of the area during healing
What are the two pathways from the spinal cord to the thalamus?
Direct and Indirect
