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thermod notes

in informed consent person should be informed of: diagnosis or findings of physical examination recommendaed treatment procedures and rehab plan prognosis if the recommended treatment is administered or rehab plan is complete
components of informed consent risks and benefits of the recommended treatment and rehab reasonable alternatives to proposed plan, with potential risks, benefits and prognosis prognosis if not treatment is administered
Components of a comprehensive, progressive plan of care 1. control pain and swelling, protect injury 2. restore ROM 3. restore neuromuscular control and muscular endurance 4. restore strength and power 5. resume sport specific training 6. return to physical activity
Tissue types epithelial, connective, muscle, nervous
Epithelial tissue coversl all internal and external structures, skin, outer layer of internal organs and inner lining of blood vessel
Types of injury to epithelial tissue lacerations, abrasions, punctures and avulsions
Connective Tissue types tendons, ligaments, cartilage, adipose, bone, blood and lymph
Connective Tissue supports and protects the body
Injuries to connective tissue sprains, strains, contusions, overuse syndromes and ruptures
Types of muscle tissue skeletal, cardiac, smooth
Skeletal muscle responsible for movement of boney levers Made up of muscle fiber units that are grouped into bules called fascicli
Types of Skeletal muscle slow twitch-type 1 intermediate fibers type II A fast twitch type II B
Types of injuries to skeletal muscle contusions, strains, myositis ossificans, infection
Nerve tissue Provides communication between the CNS and muscles, Basic cell is the neuron
Types of injury to nerve tissue paraplegia, quadriplegia, compression
bone Tissue Cancellous or spongy bone Cortical or compact bone
Signs of inflammation Redness, heat, swelling, pain, loss of function
Redness blood vessels dialate (arteriole sphincters)
Chemical mediators histamine, bradykinins, prostaglandins, seratonin
Histamine causes vasodilation, heat and redness
Bradykinins increase capillary permeability, increase sensitivity to pain receptors, pain and swelling
Prostoglandins increase capillary menbrane permeability, increase sensitivity to pain, pain and swelling
Seritonin increases capillary membrane permeability, swelling
Heat increase blood flow to the injured area increases heat, chemical activity increases metabolic activity
Pain GOAL is to releive athlete of noxious stimulous=physical, chemcial and cell anoxia
Physical pain from the trauma to the area
Chemcial Pain from the trauma to the tissue, bradykinin and prostoglandinds make pain receptors more sensitive to painful stimuli
Cell anoxia death of cells interfereswith normal blood flow
Swelling secondary to the increased blood flow to the area and broken blood vessels, exudate, tranudate
Exudate an infection by product of an increase in the number of WBC
transudate blood cells marginate and blood volume and capillary pressure increases
Causes of Swelling torn blood vessels cell death-increases osmotic extracellular pressure(drives fluid from capillaries) increaded protien gravity chemical mediators-alters cell permeability to protien and fluid
Loss of Function secondary to the pain and inflammation of the joint or tissue
Phases of Tissue Healing and duration of phase inflammation(injury to 4 days), proliferation/fibroblastic(4 days to 3 weeks), remodelling(3 weeks to one year)
Goal of the inflammation phase to clean wound and to minimize all factors tht can prolong inflammation
Inflammation Phase Tissue injury Vasoconstiction-increase in sympathetic actiivity(shock lasts for 5 sec-10 min), decreases blood flow so clotting can occur release of chemical mediators by mast cells-increases bf, vasodilation, block lymph channels to prevnt systemic inf
Inflammation phase cells PMNL-polymorpho nuclear luekocytes-leukocytes(macrophages and neutrophils)-chemotaxis occurs Diapedesis-movement of WBC and other substances through damaged cessels into the tissue phagocytosis
Chemotaxis movement of an organism or cell along a chemical gradient
phagocytosis Neutrophils-clean up dead cells-kill off other cells in the process Macrophages-form lysomes to destroy and increse phagocytosis
Treatment during inflammation phase NSAIDS Antibiotics debridement RICE proper positioning
Goals of proliferation/fibroblastic phase impart strength to wound increase epitheliazation increase collagen production increase healing
Proliferation/fibroblastic phase New capillary system forms though endothelial cell regeneration cappilaries bring O2 & nutrients(AA, sugars, vitamins & enzymes) to the injured area fibroblast activity increase collagen production scar tissue formation
Modalities that effect proliferation phase US-helps increase fibroblastic activity
Proliferation phase(collagen) as collagen is being synthesized, the lytic process of the enzyme collagenase, which is produced by macrophages and granulocytes is also breaking it down. this occurs predominately in the 1st two weeks after tissue injury and results is tensile strength
Treatment for prolifertation phase NSAIDs Antibiotics debridement RICE proper positioning early motion-make sure that collagen fibers do not line up in a shortened position, early movement allows collagen fibers to properly align
Remodelling phase Goal final healing orientation and arragement of collagen fibers
Remodeling phase regeneration of new cells Reduction in fibroblast, macrophages Type III collagen coverting to type I reduction of capillaries
Treatment of Remodelling phase Controlled motion-motion of the injured tissue will influence thier strucures when they heal Modalities-STM, ultrasound, lazer Exercise
Created by: jwebst1
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