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Tissue repair
Inflammation and repair
| Question | Answer |
|---|---|
| Physical stress theory | tissues react to forces placed on them in predictable manner |
| Stress Strain Curve | identify tensile load a specific tissue can tolerate before it damages |
| Tensile forces | longitudinal tearing |
| compression forces | stress applied at each end of structure |
| shear forces | occur perpindicular across long axis, transverse fracture or dislocation |
| torsion force | occur with twisting |
| direct blow | blow directly to body part, results in contusion fracture or dislocation |
| primary musculoskeletal injuries | self-inflicted, caused by another individual or entity, or caused by the environment. Acute, Chronic, acute on chronic |
| secondary musculoskeletal injuries | essentially the inflammatory response that occurs with the primary injury |
| principles of tissue healing-Important info | tissue involved, length of immobilization, WB status, surgical procedure, considerations and restrictions, patient goals and pre injury activity, absence of RED flag sx |
| Red flag symptoms | CV-pain or heaviness in chest pulsating pain anywhere, constant & severe pain in LE, Cancer-persistent pain at night, constant pain unrelieved by change in position, GI- frequent or severe abdominal pain, Neuro-frequent or severe headache |
| 3 overlapping events in healing | Inflammation and coagulation(5-7 days), proliferative(2 days-6 weeks), remodeling/maturation(3 wks-18-24 mnths) |
| Inflammatory phase | reaction immediately after wound. defensive events, complete removal of debris marks end. 1-6 days to >6months |
| Coagulation of inflammatory phase | Apart from an initial period of vasoconstriction lasting for 5-10 minutes, tissue injury causes vasodilation, the disruption of blood vessels and extravasation of blood constituents, including platelets |
| inflammation of inflammatory phase | Inflammation is mediated by chemotactic substances, including anaphylatoxins, which attract neutrophils and monocytes |
| 5 cardinal signs of inflammation | redness, swelling, warmth, pain and loss of function |
| Proliferative phase | capillary growth, granulation tissue formation, fibroblast proliferation with collagen synthesis & increased macrophage and mast cell |
| Remodeling phase | conversion of initial healing tissue to scar tissue, lengthy phase of contraction, tissue remodeling and increasing tensile strength |
| Ligament healing | 4 overlapping phases: hemorrhagic(48 hrs), inflammatory(48hrs), proliferation(48-72 hrs) and remodeling (1yr+). 50-70% return of tensile strength |
| Wolff's Law | intermittent physical loads applied to bone stimulates adaptive responses (removal of force does the opposite) |
| Bone remodeling | early WB, Phases: 1 inflammation & hematoma (24-48hrs) 2 chondrocyte formation (2wks) 3 cartilage formation and calcification 4 cartilage removal (4 wks) 5 bone reformation (up to 8wks +) 6 remideling (12-18 mnths) |
| tendinitis | inflammation of structures encased within tendons outer layer, most common at bony attachment, acute: 1-2 weeks |
| tendinosis | degenerative condtion, more prevalent than tendinitis, chronic |
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