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PTI 3 - Final > Stages of Tissue Healing and Interventions - Class 6 > Flashcards

Stages of Tissue Healing and Interventions - Class 6 Flashcards

1
Q

stages of tissue healing

A

acute stage

subacute phase

chronic stage

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2
Q

acute stage

A

inflammatory response

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3
Q

subacute phase

A

proliferation

repair

healing

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4
Q

chronic stage

A

maturation and remodeling

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5
Q

acute stage consists of

A

vascular changes

exudation of cells and chemicals

clot formation

phagocytosis/neutralization of irritants

early fibroblastic activity

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6
Q

what is present during the acute pahse

A

signs of inflammation

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7
Q

signs of inflammation

A

swelling

redness

heat

pain at rest

loss of fxn

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8
Q

acute phase –> ROM

A

painful w/ guarding before the completion of the range

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9
Q

what is pain d/t in the acute phase

A

altered chemical state irritating nerve endings

increased tissue tension

guarding

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10
Q

why is there pain in the acute phase

A

body’s way of protecting the injury

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11
Q

how long does the acute phase last

A

4-6 days

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12
Q

goals and interventions of acute stage

A

protection phase

control effects of inflammation

manage pain

prevent negative effects of rest

education

general movement

pain…

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13
Q

prevent negative effects of rest

A

nondestructive movement

PROM

massage

muscle setting

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14
Q

education

A

on expected duration

what they can do

what to expect

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15
Q

general movement is

A

beneficial

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16
Q

pain

A

during movement in this phase is generally ill advised

but at low levels may be ok

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17
Q

subacute phase involves

A

removal of noxious stimuli

growth of capillary beds into area

collagen formation

granulation tissue resulting in very tenuous, easily injured tissue

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18
Q

when does inflammation decrease

A

2-4 days after injury

colt begins to resolve

repair begins

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19
Q

how long is the subacute phase

A

14-21 days after injury

but can last 6 weeks

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20
Q

defining characteristic of the subacute phase

A

synthesis and deposition of collagen

21
Q

what is there a significant increase in –> subacute phase

A

presence and activity of fibroblasts

myofibroblastic activity begins around day 5 –> resulting in scar shrinkage

22
Q

connective tissue –> subacute

A

immature

thin and unorganized

extremely fragile

23
Q

tensile loading –> subacute

A

appropriate tensile loading can stimulate growth and alignment

24
Q

subacute phase goals and interventions

A

controlled motion phase

develop a mobile scar

promote healing

continue to educate

asses response and sxs

gradually transition into active strengthening and endurance exercise

can implement stretching

be on the lookout for signs of excessive stretch

25
Q

develop a mobile scar –> subacute

A

selective stretching/mobilization

26
Q

promote healing –> subacute

A

nondestructive active, resistive, open and closed chain stabilization exercise

muscular endurance

cardiopulmonary exercise to increase circulation

27
Q

continue to educate –> subacute

A

about expectation

encourage return to normal activities that do not exacerbate sxs

begin more involved HEP

28
Q

assess response and sxs –> subacute

A

generally slow progression

29
Q

gradually transition into active strengthening and endurance exercise –> subacute

A

submax isometrics

AROM

building endurance w/ repetition/low intensity exercise

protected weight bearing exercise

30
Q

what should we avoid in the subacute phase

A

heavy eccentrics

high resistance exercises that may overstress the area

31
Q

can implement stretching –> subacute

A

to minimize decreased flexibility

help with alignment of developing scar

32
Q

signs of excessive stretch (1)–> subacute phase

A

soreness that persists longer than 24 hrs after exercise

increased intensity and earlier onset of pain

progressively increased feelings of stiffness/decrease ROM over several sessions

33
Q

signs of excessive stretch (2)–> subacute phase

A

swelling, redness, warmth in affected tissue

progressive weakness over several sessions

decreased fxnal use of involved body part

34
Q

chronic stage involves

A

maturation of connective tissue

contracture of scar tissue

remolding of scar

collagen aligns to physical stress

35
Q

when is scar retraction typically complete

A

after 21 days

scar stops decreasing in size

36
Q

when does the process of maturation begin

A

late subacute phase

persists for several months

37
Q

what happens to the collagen fibers in the maturation phase

A

thicken and reorient

based on physical stress placed through connective tissue

38
Q

what is remodeling time influenced by

A

factors that affect the density and activity of fibroblasts

39
Q

factors that affect the density and activity of fibroblasts –> chronic stage

A

time of immobilization

location of the lesion

stress placed on tissue

vascular supply

40
Q

healing time depends on

A

size of injured structure

degree of injury/pathology

healing with increasing tensile quality

41
Q

healing may occur for

A

12-18 months

42
Q

what happens to immature collagen fibers –> chronic

A

adhere to surrounding tissue

can be easily remodeled through physical stress for 10 weeks after the injury

43
Q

what happens if the area isnt properly stressed –> chronic

A

collagen will begin to adhere to surrounding tissue

forming a restricting scar

44
Q

what happens at 14 weeks –> chronic

A

scar is unresponsive to remodeling

required adaptive lengthening of the surrounding tissue or surgical release

45
Q

chronic stage goals and intervention

A

return to fxn phase

increase tensile quality of scar

develop fxnal independence

educate the pt

lean into progressive resistance exercises

may need to isolate certain muscle/muscle groups

transition into high demand activities that stimulate specific tasks

46
Q

increase tensile quality of the scar –> chronic

A

through progressive strengthening and endurance exercise

47
Q

develop fnxal independence –> chronic

A

through fxnal exercise and specificity drills

48
Q

educate the pt

A

safe progression of resistance exercises and how to monitor for signs of excessive stretch

est clear guidelines/criteria on return to affected activities

recommend progressions or modifications of exercises

recommend modifications to activities as necessary

49
Q

isolate certain muscle/muscle groups –> chronic

A

b/c of inhibition or learned disuse

PTI 3 - Final (11 decks)

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