week 2 stages of healing

Question 1

3 Phases of tissue repair

Answer 1

1. Acute Phase: Inflammatory
2. Subacute Phase: Proliferation
3. Chronic Phase: Remodeling

Question 2

Length of Healing Stage is determined by:

Answer 2

1. Type of tissue
2. Trauma level
3. Blood supply to area
4. Age
5. Comorbidities
6. Lifestyle

Question 3

Acute Phase

Answer 3

-Stage 1
-release of chemical triggers inflammatory response
-24-48 hours- 2 weeks

Question 4

Signs of Acute Inflammatory Response

Answer 4

1. redness
2. swelling
3. pain
4. heat
5. loss of function

Question 5

Goals in the Acute Phase

Answer 5

1. Reduce pain & inflammation
2. Protect from further injury
3. Prevent muscle atrophy

Question 6

Treatment in Acute Phase

Answer 6

1. Education
2. Rest
3. Elevation/Compression
4. Protection
5. Ice
6. Electrotherapy
7. Exercise as tolerated

Question 7

Sub-acute phase

Answer 7

-repair of injured tissue
-re-absorption of inflammatory tissue
-48h-6-12 weeks

Question 8

Goals of sub-acute phase

Answer 8

1. Regain ROM & flexibility
2. Rebuild Strength
3. Prevent reinjury

Question 9

Treatment of sub-acute phase

Answer 9

1. Address inflammation
2. Electrotherapy
3. Protection
4. Education
5. Progressive exercise (Concentric/stretching)

Question 10

Remodeling phase

Answer 10

-Tissue returns to pre-injury state
-tissue can handle more load because of collagen

Question 11

Goals of remodelling phase

Answer 11

-Restore function
-Regain strength/flexibility
-Return to activities

Question 12

Treatment of remodelling phase

Answer 12

• Eccentric exercise
• functional exercise
• Gradual/control return to activity
• education

Question 13

Most common joint injury

Answer 13

Ligament sprain

Question 14

Ligament Injuries

Answer 14

• seen in weight bearing joints (ankles/knees)

Question 15

How do intra-articular ligaments heal?

Answer 15

-not spontaneously
-due to synovial fluid
ex. ACL

Question 16

3 grades of ligament injury

Answer 16

1. Grade 1
2. Grade 2
3. Grade 3

Question 17

Grade 1 ligament injury

Answer 17

• microscopic
  -w/o joint laxity
  -can still walk with discomfort

Question 18

Grade 2 Ligament Injury

Answer 18

• tearing of some fibres
• joint laxity
• lots of pain
• easier to heal

Question 19

Grade 3 Ligament Injury

Answer 19

• complete rupture
• joint laxity/instability
• entire ligament injured
• no pain over the ligament
• surgical attachment

Question 20

Conditions for a Ligament to Heal

Answer 20

• contact of torn ends
• progressive/controlled stress
• protection

Question 21

Bones

Answer 21

• bone is not a static structure
• bone adapt to changing needs

Question 22

Wolffs Law

Answer 22

• Bone grows where there is impact
• where muscles pull on them
• exercise allows bone to get stronger due to weight bearing

Question 23

Fracture

Answer 23

• any abnormal disruption in the anatomic continuity of bone

Question 24

Short hand for charting fracture

Answer 24

#

Question 25

Effects of immobilization

Answer 25

- remodeling process negatively affected - increase osteoclasts - decrease osteoblasts - decrease calcium

Question 26

Osteoclasts

Answer 26

- degrade bone to initiate normal bone remodeling

Question 27

Osteoblasts

Answer 27

- cells that form bone tissue

Question 28

Types of bone fixation

Answer 28

1. External 2. Internal

Question 29

External Bone fixation

Answer 29

- casts -traction - splints

Question 30

Internal bone fixation

Answer 30

- best for displaced fractions -ORIF (open reduction internal fixation)

Question 31

Articular Cartilage

Answer 31

- covers synovial joints - primarily water - type 2 collagen gives tensile strength - Proteoglycans give compressive strength

Question 32

Function of articular cartilage

Answer 32

- durable viscoelastic structure - resistant to wear - nutrients provided to chondrocytes through weight bearing -motion is lotion

Question 33

Vascular supply of articular cartilage

Answer 33

- avascular - cannot organize repair - healing limited

Question 34

Result of immobilization of cartilage

Answer 34

- decreased circulation of synovial fluid - not getting enough nutrients - cartilage atrophy - reduction in synthesis of proteoglycans

Question 35

Disease vs Direct

Answer 35

Disease: internal cause Direct: external force

Question 36

Indirect muscle injuries

Answer 36

- load that is greater than tissue tolerance - load over time

Question 37

Tendinitis

Answer 37

- inflammatory response

Question 38

Tendinosis

Answer 38

- degeneration of tendon

Question 39

Tenosynovitis

Answer 39

- inflammation of tendons synovial membrane