Type I (bones, tendons, and mature scars) Type II (cartilage) Type III (new scars, skin, blood vessels) Type IV (basement membrane)

Week 2 Flashcards by Wayne Ayerscreech

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

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What is the inflammatory response to parasite infection?

Release of Eosinophilia

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What is the role of a physical therapist in the maturation phase of healing?

Stretch tight scar tissue
Address impairments

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What tissues contain permanent cells?

Brain
Heart Muscle

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What does the appearance in granulation indicate?

This means the wound is healing

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What is the anterolateral system responsible for?

Pain
Temperature
Touch
Conscious level

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What is regeneration in tissue healing?

The regrowth of parenchymal cells and stroma

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What growth factors contribute to healing?

Epidermal Growth Factor (EGF)
Vascular Endothelial Factor (VEGF)
Platelet-derived growth factor
Fibroblast growth factor

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What are the phases of wound healing?

Hemostasis & Coagulation
Inflammation
Proliferative & Migration
Remodeling

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Why do 3rd-degree burns typically result in scarring?

3rd degree burns typically damage the basement membrane leading to scaring

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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)

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What is referred pain?

pain perceived at a location other than the site of the painful stimulus/ origin

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Collagen types

Type I
- (bones, tendons, and mature scars)
Type II
- (cartilage)
Type III
- (new scars, skin, blood vessels)
Type IV
- (basement membrane)

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What is Allodynia?

The sensation of pain in things not traditionally believed to be painful.

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What is Lymphadenopathy

Swollen Lymph nodes

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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

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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?

1. Fibroblasts disappear 2. Balance Synthesis/Lysis 3. Collagen fibers become organized 4. Blood vessels disappear 5. 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?

1. **Re-epithelialization** —► Wound closure * **Contact inhibition** —► stops from growing when they touch 2. **Fibroplasia** —► Collagen production 3. **Wound contraction** * ******Myoblasts** —► these contract to pull the wound together 4. **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