Injury, Inflammation, and Healing in Physical Therapy

Cardinal Signs of Inflammation

Heat, pain, redness, swelling, and decreased function.

Reversible Cell Injury

Transient injury allowing cellular adaptation and recovery.

Chronic Cell Injury

Sustained stress leading to stable cellular adaptation.

Intracellular Accumulations

Increased lipids, proteins, or pigments due to overload.

Irreversible Cell Injury

Cell death via apoptosis or necrosis.

Apoptosis

Programmed cell death, genetically mediated.

Necrosis

Pathological cell death, often resulting in gangrene.

Acute Inflammation

Sudden onset, short duration response to injury.

Inflammatory Process

Removes injurious agents and initiates healing.

Healing Process

Includes regeneration, repair, or combination of both.

Regeneration

Regrowth of original tissue after injury.

Repair

Formation of connective tissue scar after injury.

Outcome of Inflammation

Determined by degree and persistence of inflammation.

Physical Therapy Implications

Understanding injury essential for managing patient recovery.

Acute Inflammation Triggers

Infections, tissue necrosis, foreign bodies, immune reactions.

Swelling in Inflammation

Caused by exudation and leukocyte infiltration.

Increased Temperature in Inflammation

Due to arteriolar vasodilation during acute response.

Pain in Inflammation

Pressure from edema on peripheral nerves.

Decreased Function in Inflammation

Result of pressure from edema on nerves.

Termination of Inflammation

Occurs when injurious agent is removed.

Impact on Physical Therapy

Influences management across various healthcare settings.

Tonsillitis

Inflammation of the tonsils, often due to infection.

Myositis

Inflammation of muscle tissue, causing pain.

Epicondylitis

Inflammation of the tendons at the elbow.

Vasodilation

Widening of blood vessels to increase blood flow.

Vasoconstriction

Narrowing of blood vessels to reduce blood flow.

Endothelial cells

Cells lining all blood vessels, regulating permeability.

Serum

Clear fluid remaining after blood coagulation.

Plasma

Liquid component of blood, includes serum and proteins.

WBC

White blood cells, key players in immune response.

RBC

Red blood cells, responsible for oxygen transport.

Platelets

Cell fragments aiding in blood clotting.

Laminar blood flow

Smooth, layered flow of blood in vessels.

Hyperemia

Increased blood content in tissues, causing redness.

Fluid Exudate

Plasma leaking into tissues due to inflammation.

Stasis

Slowed blood flow and pooling in small vessels.

Pavementation

WBCs adhering to endothelial cells during inflammation.

Diapedesis

Migration of WBCs out of blood vessels.

Resolution

Removal of fluid and cells by lymphatics.

Histamine

Chemical mediator causing vasodilation and permeability.

Bradykinin

Induces blood vessel dilation and pain sensation.

Prostaglandins

Mediators of inflammation, pain, and fever.

Lactic acid

Byproduct of metabolism, accumulates during inflammation.

Acute Inflammation

Body's immediate response to injury or infection.

Protection

First line of defense against harmful agents.

Fluid Exudate

Fluid accumulation at injury site for healing.

Cellular Exudate

White blood cells involved in immune response.

Swelling

Result of fluid accumulation in tissues.

Serum

Liquid component of blood, aids in healing.

Antibodies

Proteins that provide immunity against pathogens.

Fibrin

Protein that forms clots to prevent damage spread.

Opsonins

Substances that enhance phagocytosis of pathogens.

Phagocytosis

Process of engulfing and digesting foreign materials.

Pyrogens

Substances that induce fever during inflammation.

Immune Response

Body's defense mechanism against infections.

Serous Inflammation

Clear fluid exudate, often seen in blisters.

Fibrinous Inflammation

Characterized by fibrin formation, seen in pericarditis.

Hemorrhagic Inflammation

Presence of red blood cells in exudate.

Catarrhal Inflammation

Inflammation of mucous membranes with clear mucus.

Pseudomembranous Inflammation

Necrotic tissue with exudate, appears as coating.

Gangrenous Inflammation

Infection of dead tissue, leading to necrosis.

Suppurative Inflammation

Presence of pus due to infection.

Abscess

Localized collection of pus surrounded by tissue.

Chronic Inflammation

Prolonged inflammation that can cause tissue damage.

Healing Process

Restoration of tissue integrity following inflammation.

Inflammation Agent Removal

If removed, inflammation resolves and healing occurs.

Persistent Inflammation

If not removed, inflammation can become chronic.

Cardinal Signs of Inflammation

Pain, heat, swelling, redness, loss of function.

Pain Measurement

Utilizes pain scales to assess severity.

Heat Assessment

Compare temperature between affected sides.

Swelling Measurement

Use tape measure and volumetrics for assessment.

Redness Evaluation

Compare color changes between affected sides.

Loss of Function Assessment

Evaluate weight bearing and goniometry.

RICED Protocol

Rest, Ice, Compression, Elevation, Drugs for treatment.

Rest in RICED

Allows tissue healing without complete inactivity.

Ice Application

Reduces hyperemia through vasoconstriction.

Compression Techniques

Controls fluid formation and increases tissue tension.

Elevation Purpose

Facilitates drainage and reduces swelling via gravity.

Drugs in RICED

Includes anti-inflammatories like aspirin and ibuprofen.

Wound Healing Process

Involves contraction and complex tissue repair mechanisms.

Local Factors in Healing

Blood supply and tissue breakdown influence recovery.

Patient Factors in Healing

Age, nutrition, and genetics affect healing outcomes.

Chronic Inflammation Characteristics

May follow acute inflammation and cause scar tissue.

Chronic Inflammation Treatment

Heat application is typically contraindicated.

Chronic Inflammation

Persistent inflammation that does not resolve over time.

Necrosis

Cell death due to injury or disease.

Fluid Exudate

Fluid that leaks from blood vessels during inflammation.

Cellular Exudate

Accumulation of immune cells at inflammation site.

Myofibroblasts

Cells that aid in wound healing and tissue repair.

Chronic Suppurative Inflammation

Inflammation characterized by pus formation.

Pyogenic Agent

Bacteria that produce pus during infection.

Granulomatous Inflammation

Inflammation with heavy macrophage infiltration.

Tuberculosis

Infectious disease causing granulomatous inflammation.

Hansen's Disease

Also known as Leprosy, causes chronic inflammation.

Crohn's Disease

Chronic inflammatory bowel disease with granulomas.

Chronic Peptic Ulcer

Ulceration in the stomach or duodenum due to inflammation.

Hemoptysis

Coughing up blood from bronchial tubes.

Chronic Fibrosis

Excessive connective tissue formation in chronic inflammation.

Stenosis

Narrowing of a bodily passage or opening.

Delayed Wound Healing

Prolonged recovery time for tissue repair.