Tissue Healing & Inflammation – Exam Review

30 question-and-answer flashcards covering the lecture’s key concepts: stages of healing, inflammatory mediators, drug actions, cryotherapy/heat use, tissue mechanics, overuse, manual therapy, systemic factors, and clinical decision-making.

What are the three primary stages of normal tissue healing?

Inflammation, Proliferation (or Fibroblastic/Repair), and Remodeling (or Maturation).

Why should the inflammatory phase NOT be stopped or skipped?

Because it initiates clotting, recruits leukocytes, sets up proliferation, and is essential for normal healing.

Which two leukocytes arrive first at an acute injury site?

Neutrophils (early) followed by macrophages (later).

What is leukocyte diapedesis?

The process by which leukocytes exit capillaries through widened endothelial gaps to reach damaged tissue.

Name two chemical mediators released by mast cells during inflammation.

Histamine and prostaglandins (among others such as serotonin, heparin, leukotrienes).

What are the classic cardinal signs of inflammation (Latin terms)?

Rubor (redness), Calor (heat), Tumor (swelling), Dolor (pain), and Functio laesa (loss of function).

Differentiate edema vs effusion.

Edema is fluid accumulation in interstitial (third-space) tissue; effusion is fluid within a joint capsule or synovial cavity.

Why are NSAIDs contraindicated in acute fractures?

They inhibit the prostaglandin-mediated inflammatory response needed for early bone healing and may impair callus formation.

Compare Tylenol (acetaminophen) to ibuprofen.

Tylenol is an analgesic/antipyretic with minimal anti-inflammatory action; ibuprofen is an NSAID that reduces inflammation by inhibiting cyclo-oxygenase enzymes.

Which over-the-counter drug is considered the ‘kingpin’ NSAID and also limits platelet aggregation?

Aspirin (acetylsalicylic acid, ASA).

What is Celebrex (celecoxib) prescribed for?

It is a COX-2–selective NSAID used to reduce pain and inflammation while sparing gastric mucosa compared with non-selective NSAIDs.

How do corticosteroid injections impact the arachidonic acid cascade?

They block phospholipase A2, shutting down the entire cascade (both COX and lipoxygenase pathways), thereby powerfully suppressing inflammation.

Give two primary reasons clinicians apply ice to an acute ankle sprain.

Pain modulation (numbing) and secondary swelling control—not to ‘stop’ the necessary inflammatory reaction.

After roughly what time frame can prolonged icing begin to inhibit M2 macrophage arrival and delay healing?

After the first 24 hours (approx.); extended cryotherapy beyond that period may slow the transition to proliferation.

Explain ‘creep’ in viscoelastic tissues.

Progressive deformation (lengthening) of tissue when a constant load or stretch is applied over time.

Why are systematic rest and recovery critical during repetitive training?

To prevent cumulative micro-trauma that outpaces tissue repair, thereby avoiding stress reactions, tendonitis, and other overuse injuries.

Define macro-trauma vs micro-trauma with one example each.

Macro-trauma: single, high-force event (e.g., ACL tear). Micro-trauma: repetitive sub-threshold loading over time (e.g., shin splints).

What is chronic ankle instability and its most common precursor?

Recurrent giving-way of the ankle due to mechanical and/or functional deficits, most often resulting from inadequately rehabilitated initial sprains.

Which medical condition markedly slows clot formation and initial healing?

Hemophilia (deficient clotting factors).

What is arthrogenic muscle inhibition (AMI)?

Reflex shutdown of a muscle (often quadriceps) caused by joint swelling/pain, leading to early atrophy and impaired rehabilitation.

List two manual techniques used to realign disorganized scar tissue during the proliferative phase.

Cross-friction massage and instrument-assisted soft-tissue mobilization (e.g., Graston).

Why might a ‘lysis of adhesions’ procedure be required after a total knee replacement?

If early ROM milestones (≈90° flexion) are not reached, dense scar adhesions can lock the joint, necessitating surgical breakup under anesthesia.

Give one advantage and one disadvantage of heat application in acute injury care.

Advantage: ↑ blood flow and tissue extensibility during later stages. Disadvantage: Early heat can increase bleeding/edema and delay initial clotting.

What does the mnemonic PEACE & LOVE emphasize that RICE neglects?

Early Protection, Education, Avoiding anti-Inflammatories, Compression, Elevation & later Load, Optimism, Vascularization, Exercise—highlighting active rehab and patient mindset.

Why is the lymphatic system important after injury, and how can clinicians assist it?

It drains excess interstitial fluid/proteins (edema); gentle compression, elevation, and manual lymphatic drainage facilitate this process.

Which inhaled medications address the two components of an asthma attack?

Albuterol (bronchodilator/β-agonist) for airway constriction and inhaled corticosteroids for airway inflammation.

Explain why bone often heals stronger after a fracture whereas cartilage healing is limited.

Bone forms a thick callus and remodels to original strength; cartilage is avascular, leading to limited cell supply and poor regenerative capacity.

How does psychological state influence tissue healing in athletes?

Stress, fear, or poor adherence decrease rehab participation, alter pain perception, and can physiologically slow healing via hormonal pathways.

What is exertional rhabdomyolysis and one key prevention strategy?

Acute muscle breakdown releasing myoglobin that can block kidneys; prevention includes progressive training loads and adequate rest/hydration.

Once an athlete suffers a concussion, how does risk for a subsequent concussion change?

Risk approximately doubles after one concussion and climbs further (≈4–5×) after two, emphasizing need for full recovery before return to play.