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Physical Agent Modalities > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

Nerve endings in the dermis

A

Mechanoreceptors for pain, touch, heat, and cold

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2
Q

Soft tissue injuries

A

Trauma or overuse to muscle, tendons, or ligaments

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3
Q

Muscle contusions

A

Bruises
Presents with ecchymosis (tissue discoloration), swelling, formation of hard feeling mass, and hematoma

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4
Q

At what percent stretch do tendons tear?

A

When stretched 5-8% beyond normal length

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5
Q

Sprain

A

Injury involving stretching or tearing of a ligament or joint capsule

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6
Q

First degree sprain or strain

A

No readily observable tissue destruction

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7
Q

Secondary degree sprain or strain

A

Detectable joint instability and muscle weakness

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8
Q

Third degree sprain or strain

A

Severe pain, loss of tissue continuity, decreased ROM, complete joint instability

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9
Q

Cramp

A

Painful, clonic-type muscle pain

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10
Q

Muscle spasm

A

Involuntary contraction of short duration
Trigger points

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11
Q

Myositis

A

Inflammation of muscle connective tissue

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12
Q

Fasciitis

A

Inflammation of sheaths of fascia

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13
Q

Tenosynovitis

A

Inflammation of tendon sheath
Causes pain or swelling with tendon movement

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14
Q

Tendonitis

A

Inflammation of a tendon
Causes pain or swelling with tendon movement

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15
Q

Bursitis

A

Irritation of bursa

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16
Q

Myositis ossificans

A

Accumulation of mineral deposits in muscle
Can occur with a loss of movement

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17
Q

Calcific tendinitis

A

Mineral deposits in tendon

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18
Q

Abrasions

A

Scratches, bruises, and mild burns

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19
Q

Lacerations

A

Tissue is torn open with irregular tearing of skin

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20
Q

Granulation scar tissue

A

Red healthy connective tissue with good blood flow that will continue to heal
Special cells respond to tissue injury by producing a collagenous glue
Matures into a dense fibrous scar

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21
Q

Three sequalae after tissue damage

A

Resolution
- Dead cellular material and debris removed by phagocytosis
- Tissue is left with original architecture in tact

Regeneration
- Lost tissue replaced by proliferation of cells

Repair
- Lost tissue is replaced by fibrous scar

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22
Q

Angiogenesis

A

Process of new cell growth or budding, producing blood vessels during granulation phase of wound healing

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23
Q

Contraction

A

Bringing together wound edges causing the wound size to become smaller

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24
Q

Exudate

A

Fluid from wounds

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25
Ischemia
Loss or deficiency of blood to an area
26
Maceration
Softening, whitening, and breaking down of skin from prolonged exposure to moisture
27
Slough
Nectrotic dead tissue, cream or yellow in color, stringy
28
Eschar
Necrotic dry, black, and hard tissue
29
Wound healing timeline
4 weeks Inflammatory phase (time of injury - 7 days) Proliferative phase (3 days after injury - 3 weeks) Maturation/remodeling phase (2 weeks after injury - 1 year or longer)
30
Inflammatory phase
From time of injury - 7 days Leukocytes, neutrophils, and monocytes are sent to the injured area to decontaminate the wound Blood vessels dilate in response to histamine release to provide increased blood supply for healing Blood flow to area causes are to become red, hot, swollen, and painful Edema surrounds wounds to bind edges together Associated with red, blue, or purple skin color, heat, swelling, pain, and potentially some loss in function Neurovascularization occurs
31
What happens if too much inflammation occurs?
Excessive scar is produced
32
Neovascularization
New circulatory loops fill wound creating highly pink to reddish wound color Immobilization is essential during this phase to permit vascular regrowth and prevent skin breakdown
33
Inflammatory phase intervention
Minimize all factors that can prevent or prolong inflammation by assisting the role of macrophages Antibiotics Debridement Wound cleaning
34
Proliferative phase (Epithelialization or granulation phase)
Lasts 3 days- 3 weeks after injury Damaged area is filled with new connective tissue and covered with new epithelium Granulation tissue fills in the wound site, binding and protecting the area (granulation) Epithelial cells migrate upward and repair the wounded area (epithelization) Wound contraction results in decreased size of wound Scabs form a temporary barrier and should not be disturbed
35
Proliferative phase intervention
Dressings should be kept moist and not permitted to dry out to facilitate epithelization Graded range of motion exercises and functional activities assist in controlled wound contraction and ensure the surrounding skin is supple and mobile
36
Maturation (Remodeling) phase
2 weeks - 1 year or longer after injury Continued fibroblastic activity and collagen synthesis and lysis lead development of a scar with maximum tensile strength Scar formed is dense, disorganized, and may appear rosier Scar formation occurs when collagen synthesis exceeds collagen lysis
37
Hypertrophic scars
Scars within the boundaries of the lesion
38
Keloid scars
Scars that extend beyond the boundary of the wound and appear raised
39
Maturation/remodeling phase intervention
Goal is to influence scar formation by applying controlled stress as scar matures Serial casting Positional heat and stretch Graston & Manual techniques Electrical stimulation/iontophoresis Selective hand activties Low-load prolonged stress
40
Why does low-dosaged pulsed ultrasound help with wound healing?
Decreased infection by disintegrating macrophages
41
Tension theory
Internal and external stresses that are placed on the wound affect and align the fibers during remodeling
42
Tensile strength of skin at 2 weeks
Remodeled skin is 20% of the pre-wound strength
43
Tensile strength of skin at 5 weeks
Remodeled skin is 50% of pre-wound strength
44
Tensile strength of skin at 10 weeks
Remodeled skin is at 80% pre-wound strength Tensile strength is weaker and will never exceed 80%
45
Induction theory
Scar tissue attempts to mimic the characteristics of the tissue it is healing
46
Wound classification based on depth of tissue
Partial thickness wounds Full thickness wounds
47
Partial thickness wounds
Involve the epidermal layer and may include the superficial layer Does not extend through the dermis Wounds are shallow, moist, and painful Wound base appears bright pink or red Heals by epithelialization and may be characterized by a crust or covering consisting of blood and debris particles
48
Full-thickness wounds
Involve the epidermis, dermis, and subcutaneous tissues (muscle, fascia, tendons, and bone) May include necrotic tissue or infection Secondary intention healing (Inflammatory, proliferative and remodeling phase)
49
Wound classification based on color
Red Yellow Black
50
Red wounds
Indicate the wound is clean, healing, and granulating without complications
51
Intervention for red wounds
Provide a moist wound environment to facilitate epithelization and reduce crust/scab formation Minimize any damage to newly formed tissue
52
Yellow wounds
Indicates the wound is possibly infected or contains necrotic tissue Contains devitalized slough or fibrous exudate which can promote bacterial growth and infection
53
Intervention for yellow wounds
Needs debridement and cleaning of the area Remove exudate and debris
54
Black wounds
Indicates that the tissue is necrotic Requires cleaning and debridement of the area
55
Primary closure (intention closure)
Wounds that are closed via surgical incisions occur when full-thickness surgical incisions or acute wound edges are sutured together Most often when there is minimal skin loss and acute wound edges that can be approximated together
56
Secondary closure
Wounds that are left open following surgery to allow for healing Allows for more mobility after healing Used on wounds that are open, large, and full thickeness Allowed to heal by production of connective scar tissue
57
Delayed primary closure (tertiary intention closure)
Wounds that are initially left open for a short period of time followed by approximation and closure of the wound Occurs in complex wounds that may be infected or contaminated
58
Barriers to wound healing
Low blood oxygen content Infection Foreign bodies Lack of perfusion (blood flow)/ arterial insufficiency / venous insufficiency Neuropathy Sustained pressure Malnutrition Systemic disease (diabetes mellitus, artherosclerosis, AIDs) Prescription immunosuppressants
59
Signs of an infected wound
Prolonged or unusual erythema Yellow fibrin slough or necrotic tissue Increased wound pain and tenderness Heat Edema Pus Increased body temperature Pan Purulent drainage Uncharacteristic odor
60
Use of hydrotherapy for wound healing
Can be used to cleanse and debride wound
61
Use of electrical stimulation for wound healing
Assists in debridement and facilitates epithelialization and contraction of the wound
62
Use of ultrasound for wound healing
Promotes wound healing during proliferative and remodeling phase for management of soft tissue inflammation

Physical Agent Modalities (14 decks)

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