Week 1- Physiology of Human Recovery

Question 1

Main factors affecting tissue healing

Answer 1

• Patient
• Tissue
• Injury

Question 2

Patient characteristics affecting healing

Answer 2

• Genetics
• Age
• Nutrition
• General fitness
• Medical comorbidities
• Psychosocial/socioecological status
• Patient characteristics

Question 3

Nonmodifiable factors

Answer 3

• Cannot change

- Genetics, age, etc

Question 4

Modifiable factors

Answer 4

• Factors under control of the patient

- Nutrition, fitness, etc

Question 5

Healing characteristics of muscle

Answer 5

• Excellent healing potential

- Uniformity of injury

Question 6

Healing characteristics of tendon

Answer 6

• Excellent healing potential
• Uniformity of injury
• Slower rate than muscle

Question 7

Healing characteristics of extra-articular ligament

Answer 7

• Excellent healing potential
• Excellent blood supply
• Good environment

Question 8

Healing characteristics of intra-articular ligament

Answer 8

• Lower healing potential
• Poor blood supply
• Hostile environment

Question 9

Healing characteristics of articular cartilage

Answer 9

• No blood supply

- Heals as fibrocartilage

Question 10

Healing characteristics of fibrocartilage

Answer 10

• Blood supply varies by location

- Repairs are technically difficult

Question 11

Injury characteristics affecting healing

Answer 11

• Mechanism of injury
• Quantity of tissue involved
• Quality of injury site

Question 12

Mechanism of injury

Answer 12

Gives appreciation for involvement of surrounding tissue

Question 13

Quantity of tissue involved

Answer 13

Time needed for healing

Question 14

Quality of injury site

Answer 14

Healing potential of tissue

Question 15

Considerations for bone injury

Answer 15

• Requires period of immobilization
  Post-immobilization:
• ID impairments (weakness/atrophy, ROM, pain)
• ID functional status and activity level

Question 16

Possible effects of peripheral nerve injury

Answer 16

• Sensory loss
• Motor loss
• Sympathetic function loss
• Pain

Question 17

What is unique about pain with peripheral nerve injuries?

Answer 17

• Nerves are not innervated

- Damage to surrounding tissue may cause sensing pain

Question 18

Factors affecting healing of peripheral nerves

Answer 18

• Age
• Motivation of patient
• Nature of injury
• Level of injury
• Timing/technique of surgery
• Regenerative potential of involved nerve

Question 19

Seddon Classifications of nerve injury

Answer 19

• Neuroproaxia
• Axonotmesis
• Neurotmesis

Question 20

Neuroproaxia

Answer 20

• Result of mild ischemia from compression or traction

- Recovery is usually complete

Question 21

Axonotmesis

Answer 21

• Result of prolonged compression or stretch
• Causes infarction and necrosis
• Recovery is usually incomplete

Question 22

Neurotmesis

Answer 22

• Result of laceration, avulsion, or rupture

- Poor prognosis w/o surgery

Question 23

Phases of managing nerve injuries

Answer 23

• Acute phase
• Recovery phase
• Chronic phase

Question 24

Acute phase for nerve injuries

Answer 24

• Immobilization
• Limit movement
• Splinting or bracing
• Patient education

Question 25

Recovery phase for nerve injuries

Answer 25

- Motor retraining - Desensitization - Discriminative sensory reeducation - Patient education

Question 26

Chronic phase for nerve injuries

Answer 26

- Occurs in cases of poor or incomplete healing - Compensation strategies - Preventative care

Question 27

Relationship b/t tissue damage and pain

Answer 27

Tissue damage is neither sufficient or necessary for pain

Question 28

What happens as patients are educated about the nature of pain?

Answer 28

Pain levels decrease

Question 29

How does word choice affect pain levels

Answer 29

Words perceived as threatening (annular tear, bulging disc, degenerative arthritis, etc) have been shown to increase fear and disability