MSK Healing and superficial types of injuries/diseases

Primary intention

separation is small

bridge of cells binds ends of wounds together

minor wounds, sutures

secondary intentions

separation is large

tissue must fill space

more scarring, longer healing time

what is considered a normal, physiological response to trauma

inflammation

what is the role of phagocytosis

body ridding itself of debris, foreign material, dying tissue so it can heal itself

what is the goal of phase 1 (inflammation)

to control active inflammation and limit scope of original injury

what can too much inflammation lead to

secondary cell death

for phase 1 (inflammation phase) , what is responsible for clearing debris and bacteria

macrophages

is the lymphatic system active during phase 1 inflammation

it is passive, why elevation is encouraged

what is secondary damage/cell death

damage due to inflammation

what is happening during phase 2 of healing

tissue formation, re-epithelialization, capillarization

how long can phase 2 of healing usually last for?

2-4 weeks

what is the goal of phase 2 of healing

very active phase (controlled movement) and encourage repair

what is considered the longest phase of the healing process

maturation phase (phase 3)

Is chronic inflammation (possible phase 4) beneficial?

no, maturation phase (phase 3) can't normally progress to full recovery

chronic inflammation (possible phase 4)

simultaneous progression of active inflammation, tissue destruction, and healing

what are some systemic factors influencing healing

age, infection or disease, metabolic status, nutrition, hormones, medication, fever, oxygen

what are some local factors influencing healing

type, size, and location of injury

infection

vascular supply

movement/excessive pressure

what is a chronic lesion

repetitive/micro trauma that leads to segment alignment problems and developmental deficiencies

what are acute lesion injuries

high energy trauma and mechanic orgin

what kind of origin is chronic injury, micro-trauma considered?

mechanic origin

avascular necrosis is what type of origin

vascular origin

is a tendon supposed to have a lot of vasculature

no, if so we will see a decrease in strength

how may a tendon become increasingly vascularized

chronic injury

what is the main issue with an open fracture

the high risk of infection

greenstick fracture

bending and incomplete break of a bone; most often seen in children

comminuted fracture

fracture in which the bone is splintered or crushed

what are the stages of fracture healing

inflammation (0-2 wks)

callus formation (2-3 wks)

union (4-6 wks)

consolidation (6-8 wks)

remodeling (1-2 years)

stage 1 treatment of osteoarthritis

conservative approach ~ PT focused

stage 2 treatment of osteoarthritis

pharmacologic non-invasive approach + PT

stage 3 treatment of osteoarthritis

pharmacologic invasive approach (steroid injections)

stage 4 treatment of osteoarthritis

surgery

tendonitis is considered

repetitive trauma to tendons

tendinosis is considered

chronic microtrauma to tendons ~ degenerative disease of tendon's collagen

what is the best kind of exercise for tendinosis and tendonitis

eccentric exercises

chronic disuse disease of muscle

atrophy

metabolic disease of muscles include

cachexia and duchene

cachexia

a condition of physical wasting away due to the loss of weight and muscle mass that occurs in patients with diseases such as advanced cancer or AIDS

spastic/flaccid muscles could be due to...

neurologic disease

contracture

tightening of muscles, tendon, skin, etc

compartment syndrome

increased pressure within a muscle compartment