Passive Care- Exam 1- Stages of Healing

What are the 4 stages of healing?

1. Hemostasis

2. Inflammatory

3. Proliferation

4. Remodeling/maturaion

What are the phases of healing that we have an impact on?

Inflammatory

Proliferation

Remodeling/Maturation

What stage of healing is in seconds to minutes and is the initial blood clotting to stop the bleeding?

Hemostasis

What stage of healing is hours/days/weeks?

Inflammatory

What stage of healing is weeks/months?

Proliferation

What stage of healing is months/year?

Remodeling/maturation

TRUE or FALSE

The cause of the injury doesn't change the healing process

TRUE

TRUE or FALSE

The timing of the healing varies

True

What are things that can cause timing differences in the healing process?

Tissue type

Severity

Overall health

What is known as the acute phase?

Inflammatory phase

The inflammatory phase is ______to ________

Immediate to a few days

Inflammatory phase is ________but________

Essential but too much can be bad

What type of tissue wont heal well?

Avascular or poorly vascularized

What is the purposes of the inflammatory phase?

Defend against foreign intruders (infection)

Remove damaged tissue and debris

Immobilize area

What are the 5 signs of inflammation?

Heat

Redness

Swelling

Pain

Loss of function

Inflammation stage is characterized by what 3 things?

Vasodilation

Increased capillary permeability

Phagocytosis by neutrophils and macrophages

What inflammatory chemicals cause pain?

Bradykinin

Prostaglandins

Serotonin

How does ice help decrease inflammation?

Decrease temp= decrease enzyme activity and metabolism = decrease inflammation

TRUE or FALSE

Too much inflammation can be bad

TRUE

During a secondary enzymatic injury, ___________ enzymes are released, it is not _________ and ________ tissue is damaged

Lysosomal

Not specific

Heathly

What are some examples of a secondary hypoxia injury?

Hemorrhage

Clotting

Edema

Spasm

Hematoma

Secondary hypoxic injury leads to decreased _____ and _______ with damage to_____________

Oxygen and nutrition

Surrounding uninjured tissues

What are the 2 main goals of the inflammatory phase?

Limit extent of inflammation but not fully prevent it

Preserve ROM

When is PRICE okay to be used?

First 24 hours of passive care done

What is PRICE?

Protect

Rest

Ice

Compress

Elevate

You should rarely ice beyond what time frame?

Beyond 72 hours

You should only do an inch bag, ice bath, gel packs, etc. for how long?

24-48 hrs

What will delay muscle hypertrophy?

Icing immediately after heavy lifting exercise

What is known as the repair phase?

Proliferative phase

What occurs during the proliferative phase?

Angiogenesis= new capillaries

What type of collagen is put down during the proliferative phase?

Type III collagen

Describe type III collagen

Weak

Disorganized

Beginning cross-linking

What other things are involved in the proliferative phase?

Fibroblasts, chondroblasts, osteoblasts

Proteoglycans

What are the goals of the proliferation phase?

Decrease swelling

Decrease pain

Increase pain free range of motion

Begin NON-WEIGHT BEARING proprioceptive training

Encourage and increase proliferation ( proliferate the proliferation)

What happens to proprioception after an injury?

Goes away for a bit

-why sometimes the ankle for example it's unsteady after spraining

What is important to avoid during the proliferation phase?

What is okay to use?

NO ICE

-okay to use heat

What is known as the maturation phase?

Remodeling phase?

When can scar contraction occur? What can it lead to?

Remodeling phase (maturation phase)

-can lead to joint adhesion and loss of motion

What occurs during the remodeling phase?

Type III collagen is replaced by Type I

There is a decrease in__________ during the remodeling phase

Blood vessels

What are the goals of the remodeling phase?

Increase pain free ROM

Progress proprioceptive training

Regain full strength

Normal biomechanics

Protect and strengthen and residual joint instability

What encourages the replacement of Type III collagen by Type I collagen during the remodeling phase?

STRESS

- on the tissue in the way the tissue is used

Tension on connective tissue causes increased what 4 things?

Collagen fibril diameter

Cross linking

Number of collagen fibrils

Collagen fibril packing density

When collagen fibers are aligned in a ___________ fashion it forms the greatest number of cross links and possesses optimal strength

Parallel

During the remodeling phase of healing it should be more (active or passive care)?

Active care