Lecture 4

Question 1

What are the three essential phases of healing?

Answer 1

Inflammatory, Proliferation(fibroblastic repair) and remodeling(maturation

Question 2

How long is the inflammatory phase?

Answer 2

5 days

Question 3

How long is the proliferation phase?

Answer 3

up to 21 days

Question 4

How long is the remodeling phase?

Answer 4

up to one year

Question 5

What should happen during the inflammatory phase?

Answer 5

stabalize and contain injured area

Question 6

What should happen during the proliferation phase?

Answer 6

dispose of dead tissues and restores circulation

Question 7

What should happen during the remodeling phase?

Answer 7

stabalize and reestablish the area

Question 8

What is the immune response to an injury?

Answer 8

response to foreign body, release of antibodies and response is specific to antigen/invader

Question 9

What is the inflammation response to an injury?

Answer 9

used to protect,used to localize, used to rid injurious agent and prepares for healing and repair

Question 10

What is acute inflammation?

Answer 10

short onset and duration, change in hemodynamics, production of exudate and granular leukocytes

Question 11

What is chronic inflammation?

Answer 11

long onset and duration, presence of non-granular leukocytes and extensive scar tissue

Question 12

What are 5 signs of inflammation?

Answer 12

redness, swelling/edema, pain, heat and loss o function

Question 13

What is the purpose of inflammation?

Answer 13

Protect, localize, decrease injurious agents and prepare for healing and repair

Question 14

How can you control swelling?

Answer 14

R.I.C.E

Question 15

What does R.I.C.E.S stand for?

Answer 15

Rest, ice, compression and Elevate and stabalization

Question 16

Why do we use ice?

Answer 16

to reduce the risk the secondary hypoxic injury,

cold=less metabolism=less need for oxygen=less hypoxic damage

Question 17

Why does cold decrease the need for oxygen and nutrients?

Answer 17

slower metabolism

Question 18

what is margination?

Answer 18

neutrophils and macrophages line up against cell wall

Question 19

What are phagocytes?

Answer 19

neutrophyls, macrocytes and leukocytes that ingest micro-organisms, damaged cells and/or foreign particals

Question 20

What is Diapedesis?

Answer 20

movement of WBC out of small arterial vessels

Question 21

What is Exudate?

Answer 21

accumulation of fluid that penetrates cell wall into extravascular space

Question 22

What is Vasoconstriction?

Answer 22

decrease in diamete of blood vessels

Question 23

What are the 8 phases of inflammation?

Answer 23

Injury
Ultrastructural changes
Metabolic (hypoxic) changes
Activation of chemical mediators
Hemodynamic changes
Permeability changes
Leukocyte migration
Phagocytosis

Question 24

In what hour of the Inflammatory response phase does the following happen: Vasoconstriction and coagulation occur to seal blood vessels and chemical mediators are released
Immediately followed by vasodilation of blood vessel

Answer 24

First hour

Question 25

Decreased blood flow, increase in blood viscosity, edema and release of chemical mediators happens in what hour of what phase

Answer 25

second hour of inflammatory response phase

Question 26

How do clots help the healing process?

Answer 26

obstruct lympathic system and localize injury

Question 27

In what phase does Scar tissue form?

Answer 27

Fibroblastic(proliferation) phase

Question 28

What happens during the Maturation phase?

Answer 28

realignment of collagen, increased strength, tissue will start to look normal

Question 29

When does chronic inflammation occur

Answer 29

When acute inflammatory reponse does not eliminate injurious agent

Question 30

Overuse, overload and cumulative micro trauma are associated with which type of Inflammation?

Answer 30

Chronic

Question 31

What factors impede healing?

Answer 31

extent of injury, edema/swelling,hemorrhage, poor vascular suuply, muscle spasm, Atrophy, Smoking, infection, humidity/climate, health, age, smoking and nurition

Question 32

What are four types of tissue?

Answer 32

Muscle, Connective, Epithelial and nerve tissue

Question 33

What is Metaplasia?

Answer 33

transformation from one tissue to another that is not normal

Question 34

What is dysplasia?

Answer 34

abnormal development of tissue

Question 35

What is Hyperplasia?

Answer 35

excessive proliferation of normal tissue in normal cells

Question 36

What is Atrophy?

Answer 36

decrease in size of tissue due to cell death and reabsorbtion or decreased cell proliferatione

Question 37

What is Hypertrophy?

Answer 37

increased size of tissue without increase in the number of cells

Question 38

What has more chronic injuries than acute?

Answer 38

Tendons

Question 39

What is the rate of healing for a nerve?

Answer 39

3-4mm per day

Question 40

What are four things that can modify healing?

Answer 40

Therapuetic exercise, electric modalities, drug utilization and thermal modalities

Question 41

What does electric modalities treat?

Answer 41

Inflammation

Question 42

What are some different types of modalities?

Answer 42

electrical stimulation, microwave, ultra sound

Question 43

What are 5 stages of acute fracture healing?

Answer 43

hematoma formation, cellular proliferation, callus proliferation, ossification and remodeling

Question 44

In what cavity does a hemotoma develop in the first 48 hours of bone healing?

Answer 44

Medullary

Question 45

What is a soft callus?

Answer 45

random network of woven bone

Question 46

What fills calluses to immobilize the site?

Answer 46

Osteoblasts

Question 47

When does hard callus formation begin and for how long?

Answer 47

begins 3-4 weeks and last 3-4 months

Question 48

When is ossification complete?

Answer 48

When the bone has been laid down and excess callus has been resbsorbed by osteoclasts.

Question 49

What are 3 things that interfere with bone healing?

Answer 49

Poor blood supply, infection and poor immobilization

Question 50

What are 3 sites for poor blood supply?

Answer 50

head of femur, navicular of wrist and talus

Question 51

Stress fractures result from what?

Answer 51

cyclic forces, axial compression and tension from muscle pulling

Question 52

What are 4 pain sources?

Answer 52

Cutaneous, deep somatic, visceral and psychogenic

Question 53

What is cutaneous pain?

Answer 53

sharp, bright and burning with fast and slow onset

Question 54

What is deep somatic pain?

Answer 54

originates in tendons, muscles, joints, periosteum and blood vessels

Question 55

What is visceral pain?

Answer 55

begins in organs, may diffuse and then be localized

Question 56

What is psychogenic pain?

Answer 56

emotional pain rather than physical pain

Question 57

What is the difference in acute pain and Chronic pain?

Answer 57

Acute lasts less than six months, Chronic is longer

Question 58

pain which occurs away from the site of injury is?

Answer 58

Referred pain

Question 59

myofascial, sclelotomic and dermatomic are all what type of pain?

Answer 59

Referred Pain

Question 60

What are two ways to control pain?

Answer 60

Modalities, pharamaceutical agents