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factors that determine length of time for tissues to heal
specific tissue damaged, severity of the damage, overall health of the person
what happens in the inflammatory response phase
release of cellular material, vascular changes, clot formation
clinical signs of the inflammatory response phase (acute stage)
swelling, redness, heat, pain, loss of function
inflammatory response phase is initiated and controlled by
chemical released by cells and activated by plasma proteins
modalities in the acute stage of inflammation help speed recovery by
interrupting pain-spasm cycle, restoring functional ability
increased blood flow causes
redness, warmth at inflammation site, capillaries become more permeable, proteins attract water and causes swelling
inflammatory response lasts until
damaged tissue has been removed, new capillary network has been formed to support tissue repair.
in the inflammatory response phase modalities are used to
decrease circulation, pain, and enzyme activity rate; controlling motion; promoting inflammation progression
clinical signs of the sub acute phase
acute clinical signs are decreased; pain with tissue resistance at end range, developing soft tissue formation
beginning of the sub-acute stage (proliferation stage) is marked by
new blood vessels; granulation tissue; fibroblasts (cells responsible for production of new growth)
sub acute phase: ground substance fills __ and reduces __
fills spaces bt fibers and reduces friction
sub acute phase: fibrous elements
collagen, reticulin, elastin (provides strength and resilience to stress
external signs of the sub acute phase
redness bc of capillaries and water, swelling, pain when stretched
sub acute phase: modalities are used to
increase circulation and enzyme activity rate; promote collagen deposition along lines of stress, progression on inflammation
clinical signs of the chronic stage (maturation-remodeling stage)
no signs of inflammation, may have decreased strength and ROM
fiber allignment improves and links bt fibers become stronger in what phase
chronic (maturation/remodeling phase)
in the maturation-remodeling phase if too much stress is applied too soon
tissue fails (bc it's weak) and re-injury occurs
rate of progression in the maturation-remodeling phase depends on
nature and extent of injury, person's overall fitness, demands of activity returning to
in the maturation-remodeling phase modalities are used to
alter balance of collagen deposition and reabsorption and improve alignment of new collagen fibers
possible reasons for chronic inflammation
excessive mechanical stress due to overly aggressive RX plan, non compliance by pt, infection
causes of inflammation
ST trauma (strains, sprains, contusions), FX (fracture), foreign bodies, autoimmune disease, microbial agents, chemical agents, thermal agents, irradiation
acute stage treatment goals
control edema, spasm, pain, maintain ST and jt integrity, decrease jt. swelling, maintain functional level of associated areas, educate pt.
sub-acute stage treatment goals
promote healing of injured tissue, progressively restor ST and jt mobility, strengthen involved and related muscles, maintain functional level of assoc. areas, educate pt.
chronic stage treatment goals
decrease pain from stress on contractures, adhesions, increase ST and jt. mobility, strengthen all areas, increase endurance, progress to independance, educate pt.
chronic inflammation treatment goals
promote healing, eliminate causes, maintain integrity, progress functional independance, correct environmental factors, develop strong mobile scar, structural balance and support in related areas.
treatment of swelling
elevation (decreases hydrostatic pressure); external pressure (min. oxmotic pressure exerted by free proteins in interstitium); muscle contractions (facilitate lymphatic drainage)
elevation of the feet allows
gravity to pull venous blood toward heart, decrease hydrostatic pressure at venule, promotes interstitial drainage
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