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65 terms

161 tissue injury, inflammation and repair

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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
inflammation occurs in
vascularized tissue
inflammation causes
symptoms
3 phases of inflammation
acute, repair, maturation
inflammatory response phase
initial phase of injury
inflammatory response phase lasts
4-6 days
what happens in the inflammatory response phase
release of cellular material, vascular changes, clot formation
purpose of modalities
to make the environment better for inflammation to progress
clinical signs of the inflammatory response phase (acute stage)
swelling, redness, heat, pain, loss of function
inflammatory response phase removes
debris
inflammatory response phase allows for growth of
new capillaries
inflammatory response phase is initiated and controlled by
chemical released by cells and activated by plasma proteins
inflammatory response phase stimulates
free nerve endings. pain causes spasms
muscle spasm starts the
pain cycle
modalities used for RX of
acute injuries and persistent pain (pain at rest)
modalities in the acute stage of inflammation help speed recovery by
interrupting pain-spasm cycle, restoring functional ability
chemical mediators cause opening of
capillary beds
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.
purpose of acute inflammation
clears neurotic tissue, builds new capillaries
in the inflammatory response phase modalities are used to
decrease circulation, pain, and enzyme activity rate; controlling motion; promoting inflammation progression
fibroplastic repair phase aka
sub acute phase
scar fomation occurs during what phase
sub acute (fibroplastic repair phase)
sub-acute stage lasts
10-17 days
breakdown of clots happen during
sub-acute phase (fibroplastic repair phase)
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)
length of the sub-acute phase depends on
size and site of injury, type of tissue involved
matrix has 2 components
non fibrous element (ground substance)
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
sub acute phase: type III collagen is
weak and thin
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
maturation-remodeling phase is aka
chronic phase
maturation-remodeling phase lasts
months/years
reallignment of collagen fibers happens in what stage
chronic (maturation/remodeling phase)
collagen is easier ro remodel when it is
immature
clinical signs of the chronic stage (maturation-remodeling stage)
no signs of inflammation, may have decreased strength and ROM
in the chronic stage, as healing takes place type III collagen is replaced by
type I
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
focus of rehab in the maturation-remodeling phase
functional activities and return to activity
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
chronic inflammation increases
immature collagen production (type III)
chronic inflammation degenerates
mature collagen (type I)
clinical signs of chronic inflammation
increased pain and swelling hours after activity
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.
ice does not
slow bleeding
swelling at time of injury increases
cell permeability
swelling is caused by
increased proteins in interstitium and osmotic pressure of proteins
treatment of swelling
elevation (decreases hydrostatic pressure); external pressure (min. oxmotic pressure exerted by free proteins in interstitium); muscle contractions (facilitate lymphatic drainage)
joint effusion
excessive amt of fluid produced when synocial is irritated
joint effusion cause
loose bodies, torn meniscus
joint effusion impairs
function, normal mechanics of a jt.
swelling in the lower extermity due to venous insufficiency can cause
chronic swelling
1 way valves in veins fail with
increased age
elevation of the feet allows
gravity to pull venous blood toward heart, decrease hydrostatic pressure at venule, promotes interstitial drainage
function of compression stockings
increase interstitial resistance to fluid loss and help control edema