inflammation

• succession of changes that occur in living tissue when it is injured
• response is to protect and repair tissue
• marked by vascular, chemical, cellular and immune response

• initial response, last 5-10 minutes.
• prevent spreading of bacteria and toxins

WBC migrate to the periphery of the vessel and adhere to the walls of the damaged capillary (pavementing)

leucotaxin

• inc blood flow is followed by inc permeability of the smal blood vessels
• secondary to the direct trauma and chemical mediators such as histamines, serotoni, bradykinnis and leucotaxin

WBC squeeze through the blood vessel wall due to inc permeability

inc in blood bolume and vessel permeability als results in large amount of fluid into the injured area

WBC are guided to the site of injury, more to the areas of greatest bacterial toxins and tissue polysaccharides

WBC at the site of damage or injury recognize, engulf, and digest debris, necrotic tissues, RBC's

trauma, bone fractures, foreign bodies, bacterial invasion, dec blood supply, bacteria and fungi, burns, autoimmune disease (RA, lupus, polymyositis)

• edema
• erythma
• heat
• pain
• loss of function

• caused by vasodilation and inc blood flow
• diagnosed by touch of area compared to other side or to the rest of the body
• elevated temp can cause articular cartilage destruction

• caused by chemical mediation of bradykinnis, histamines, prostglandisn, serotonin
• caused by mechanical mediation by direct trauma or by internal pressure due to swelling

nagging, dull, sharp, radiating

(redness) caused by overexpansion of the interstitial space due to fluid leakage from local blood vessels

• mainly water and dissolved electrolytes, clear in appearance, few cells present
• limited permeability of the microvessels preventing protein and cell escape

more viscous (due to protein) and cloudy (due to leukocytes) results when cells and plasma protein escapes due to increased permeabilty of the microvessels

large number of leukocytes are present in exudate

an excessive amount of tissue fluid in the body tissue and interstitial space

escape of fluid into a part

synovial fluid production due to irritation within the jt or caused by bleeding into the jt

• edema in interstitual space that has been present for sometime
• when pressure is applied indentation is produced which will gradually disappear

• compression for gentle pressure
• cold treatment preferred to heat treatment
• swelling is more common in the extremities
• swelling is not a common sign of the joints of the spine

inc muscle tone or spasm may lead to loss of function

• acute
• subacute
• chronic

• 3-4 of the signs are present
• preferred treatment is cold
• about 2 wks
• rest and gentle therapeutic intervention are preferable

• 2 of the signs are present
• treatment can be cold or hot
• reaction continues about 1 month

• 0-1 signs is present
• treatment heat
• reaction continues for months to years
• active and passive ROM ex and more aggressive intervention are preferable to break down adhesions

• neutorphil
• lymphocytes, monocytes, macrophages

• extent of injury
• edema
• hemorrhage
• poor vascular supply
• separation of tissue
• muscle spasm
• atrophy
• keloids and hypertrophic scars
• infection
• health, age and nutrition

• causes tissue seperation
• reduces neuromuscular control
• reduces tissue nutrition in injured areas

• small damage to capillary can cause bleeding
• produces the same effects on healing as edema

• heals slowly and poorly
• injury can also disrupt blood supply to tissues

inflammatory response is based on the extent of tissue damage

mechanical seperation and the uncontrolled tearing of tissues may necessitate healing by secondary intention resulting in excessive scaring

causes traction on torn tissues and prevents approximation of tissues this may delay healing may also cause tissue ishemia

pain, swellingl loss of function from injury may cause muscle to waste (atrophy)

if rate of collagen formation is greater than rate of collagen breakdown during maturation phase of healing then you have keloids or hyperthrophy of scar tissue

bacteria in wound can delay healing

• aging affects healing
• disease such as diabetes, arteriosclerosis is common

• scurvy
• clotting
• healing process and laks