Modalities: Ch3 Inflammation And Tissue Repair Kuyabic

Front 1

What is the ultimate goal of Inflammation and repair?

Back 1

Restore function and promoting regeneration of normal tissue structure

Front 2

Treat inflammatory conditions. Three treatment types.

Back 2

Physical agents (modalities)

Therapeutic exercise

Manual techniques

Front 3

What are the three phases of Inflammation and healing?

Back 3

Inflammation phase

Proliferation phase

Maturation phase

Front 4

The phases of Inflammation and healing. What is the purpose of the Inflammation phase and when does it occur?

Back 4

Prepares wound for healing

Days 1 to 6

Front 5

Phases of Inflammation and healing. What is the purpose of the proliferation phase and how long does it last?

Back 5

Rebuilds damaged structures and strengthens the wound

Days 3 to 20

Front 6

Phases of Inflammation and healing. What is the purpose of the maturation phase and when does it occur?

Back 6

Modifies the scar tissue into its mature form

Day 9 onward

Front 7

Which phase of Inflammation begins when the normal physiology of tissue is altered by disease or trauma?

Back 7

Phase I: Inflammation

Front 8

Which phase of Inflammation is necessary for healing?

Back 8

Phase I: Inflammation

Front 9

Which phase of Inflammation can become inappropriate, such as in autoimmune diseases, causing damage and excessive scarring?

Back 9

Phase I: Inflammation

Front 10

What are the five Cardinal signs of Inflammation?

Back 10

Heat

Redness

Swelling

Pain

Loss of function

Front 11

How is bleeding stopped?

Back 11

Hageman factor (clotting factor XII)

Hint 11

factor

Front 12

What cell converts into macrophages in the tissue space during the cellular response?

Back 12

Monocytes

Front 13

Which leukocyte converts to macrophages and predominates for 24 to 48 hours after injury?

Back 13

Monocyte

Front 14

Which cell is most effective when oxygen is present and engulfs large debris?

Back 14

Macrophage

Front 15

Which cell activates cells to make antibodies during the immune response?

Back 15

Macrophage

Front 16

What are the four simultaneous processes that occur during the proliferation phase?

Back 16

Epithelialization

Collagen production

Wound contraction

Neovascularization

Front 17

What makes collagen?

Back 17

Fibroblasts

Front 18

What is the purpose of epithelialization? (2)

Back 18

Re-establish epidermis

Provide protection

Front 19

How do fibroblasts align themselves to the capillaries?

Back 19

Perpendicular

Front 20

Collagen production day 7. (2)

Back 20

Significant increase in collagen

Tensile strength of injured area increases

Front 21

Collagen production day 12.

Back 21

Type 1 collagen replaces type 3

Front 22

Collagen production day 21.

Back 22

Maximal collagen production

20% wound strength

Front 23

Collagen production six weeks.

Back 23

80% of long term strength

Front 24

Which phase is the longest phase of healing?

Back 24

Maturation phase

Front 25

What decreases during the maturation phase? (5)

Back 25

Fibroblasts

Macrophages

Myofibroblasts

Capillaries

Water content

Front 26

What is the goal of the maturation phase?

Back 26

Restore prior function of tissue

Front 27

Examples of type 1 collagen. (4)

Back 27

Bone

Skin

Tendon

Mature scars

Front 28

Example of type 2 collagen.

Back 28

Cartilage

Front 29

Examples of type 3 collagen. (3)

Back 29

Gastrointestinal tract

Uterus

Blood vessels

Front 30

Is type 1 or type 3 collagen stronger?

Back 30

Type 1

Front 31

Increased collagen production is due to inhibition of...

Back 31

Lysis

Front 32

Keloid and hypertrophic scarring is due to...

Back 32

Inhibition of lysis increasing collagen production.

Front 33

How long does collagen synthesis and lysis last after an injury?

Back 33

12 to 24 months

Front 34

What does it mean when the scar is more red than other tissue?

Back 34

Remodeling is still occurring

Front 35

What are the two theories regarding collagen orientation?

Back 35

Induction theory

Tension theory

Front 36

Can skeletal muscle cells proliferate?

Back 36

No

Front 37

What are the four stages of bone healing?

Back 37

Inflammation

Soft callus

Hard callus

Bone remodeling

Front 38

What is impaction?

Back 38

Dissipation of energy from an insult

Front 39

Induction is the least understood bone healing stage. What is it?

Back 39

Cells with osteogenic properties activate

Front 40

What four things happen during the inflammation stage of bone healing?

Back 40

Fibrous union

Fracture hematoma

Oxygen tension decrease

pH decrease

Front 41

What six things happen during the soft callus stage of bone healing?

Back 41

Increased vascularity

Increased cell proliferation

Capillary growth

pH normalizes

Hematoma has fibrous tissue added

Osteoclasts remove bone fragments

Front 42

What happens during the hard callus stage of bone healing?

Back 42

Fracture healing

Front 43

When does the remodeling stage of bone healing begin and end?

Back 43

Begins when fracture is healed

Ends when bone returned to normal state

Front 44

What two things happen during remodeling stage of bone healing?

Back 44

Fibrous bone converts to lamellar bone

Medullary canal revised

Front 45

When does the soft callus stage begin and end?

Back 45

Begins when pain and swelling subside

Ends when bony fragments are united by fibrous tissue

Front 46

When does the hard callus stage begin and end?

Back 46

Begins when hard callus covers ends of fracture

Ends when new bone unites with fragments

Front 47

When does the inflammation stage of bone healing begin and end?

Back 47

Begins shortly after impact

Ends with fibrous union

Front 48

Why does cartilage have a limited ability to heal? (3)

Back 48

Lacks lymphatics, blood vessels, and nerves

Front 49

What are some adjuncts to promote wound healing? (5)

Back 49

Negative-pressure wound therapy

Hydrotherapy

Biological dressings containing silver

Silicon-based wound dressings

Immunonutrition

Front 50

What four systemic factors affect wound healing?

Back 50

Age

Disease

Medication

Nutrition

Front 51

What are some local factors that affect wound healing? (5)

Back 51

The injury itself

Infection

Vascular supply

External forces (modalities)

Movement

Front 52

The simultaneous progression of active inflammation, tissue destruction, and healing.

Back 52

Chronic inflammation

Front 53

Active inflammation follows acute inflammation and can be the result of:

Back 53

Cumulative trauma or other interference with normal healing

Front 54

Tissue destruction related to chronic inflammation may be the result of:

Back 54

Immune response or autoimmune disease

Front 55

If acute inflammatory phase lasts longer than 4 weeks, this is known as:

Back 55

Subacute inflammation

Front 56

How long does chronic inflammation last?

Back 56

Months to years

Front 57

Increased fibroblast proliferation, which increases collagen production and ultimately increases scar tissue and adhesion formation is a result of:

Back 57

Chronic inflammation

Front 58

What do humoral and neural mediators do?

Back 58

Control inflammatory phase

Front 59

What two types of cells predominate immediately after injury?

Back 59

Platelets and neutrophils

Front 60

Vascular response of inflammation:

What happens during vasoconstriction?

Back 60

Damaged blood vessels constrict to minimize blood loss. Mediated by norepinephrine. Lasts 5 to 10 minutes.

Front 61

Vascular response of inflammation:

What happens during vasodilation?

Back 61

Blood vessels near injury dilate and increase permeability causing edema. Mediated by histamine, bradykinin, prostaglandins, serotonin, hageman factor, and complement fractions. Leukocytes attracted to histamine via chemotaxis. Lasts up to an hour.

Front 62

Vascular response of inflammation:

What happens when Hageman Factor touches negatively charged surface of endothelial lining of damaged vessels?

Back 62

Activates coagulation system to stop bleeding. Vasoconstriction and increased vascular permeability. Produces kallikrein and plasmin. Plasmin activates more Hageman factor. Complement system activates.

Front 63

Hemostatic response of inflammation:

What happens during this response?

Back 63

Immediately after injury, platelets release fibrin to stimulate clotting to control blood loss

Front 64

Cellular response of inflammation:

What happens during this response?

Back 64

Monocytes convert to macrophages and predominate for 24 to 48 hours after injury

Front 65

Immune response of inflammation:

What happens during this response?

Back 65

Macrophages activate cells to make antibodies. Foreign antigens presented to T-cells. T-cells activate B-cells. Phagocytosis occurs.

Front 66

What does plasmin do?

Back 66

Augments vascular permeability and activates Hageman factor

Front 67

What are kinins?

Back 67

Peptides that are inflammatory substances derived from plasma and trigger the immune system

Front 68

What are prostaglandins?

Back 68

Produced by nearly all cells in body and released when cell membrane is damaged

Front 69

What are thought to be responsible for sensitizing pain receptors and hyperalgesia?

Back 69

Pro-inflammatory prostaglandins

Front 70

What is transudate?

Back 70

Fluid that first forms edema

Has electrolytes and water

Front 71

What is exudate?

Back 71

Cloudy fluid with high lipid and cellular debris content

Front 72

Leukocyte migration from blood vessels into perivascular tissues is known as:

Back 72

Emigration

Front 73

Epithelialization of proliferation phase:

What happens during epithelialization?

Back 73

Basal cells detach from basement membrane. Cells migrate toward the wound. Contact inhibition occurs. Basal cells proliferate.

Front 74

What is healing by primary intention?

Back 74

Wound can heal without wound contraction

Front 75

What is healing by secondary intention?

Back 75

Wound must undergo wound contraction to heal

Front 76

What is healing by delayed primary intention?

Back 76

Later suturing or skin grafting can reduce wound contraction

Front 77

Neutrophils squeezing through vessel walls after margination is known as:

Back 77

Diapedesis

Front 78

Sequence of events in the journey of neutrophils in the wound transmigrating across the capillary endothelial cell walls is known as:

Back 78

Extravasation

Front 79

Collagen production of the proliferation phase:

What happens during collagen production?

Back 79

Fibroblasts make collagen and align perpendicular to capillaries. Cross-linking strengthens injury. Granulation tissue is formed. Type 3 collagen converts to Type 1 collagen. Strength of wound reaches 80% strength.

Front 80

Wound contraction of the proliferation phase:

What happens during wound contraction?

Back 80

Contraction starts at day 5 and peaks day 14. Wound is pulled together by myofibroblasts.

Front 81

Neovascularization of the proliferation phase:

What happens during neovascularization?

Back 81

Angiogenisis results in development of new blood supply

Front 82

The scar attempts to mimic the characteristics of the tissue it is healing is known as:

Back 82

Induction theory

Hint 82

theory

Front 83

Internal and external stresses placed on the injury during the maturation phase determine the final tissue structure is known as:

Back 83

Tension theory

Hint 83

theory