1. 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
  2. vasoconstriction
    • initial response, last 5-10 minutes.
    • prevent spreading of bacteria and toxins
  3. margination
    WBC migrate to the periphery of the vessel and adhere to the walls of the damaged capillary (pavementing)
  4. chemical mediatior for margination
  5. vasodilation
    • 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
  6. diapedesis
    WBC squeeze through the blood vessel wall due to inc permeability
  7. inc intersitial fluid
    inc in blood bolume and vessel permeability als results in large amount of fluid into the injured area
  8. chemotaxis
    WBC are guided to the site of injury, more to the areas of greatest bacterial toxins and tissue polysaccharides
  9. phagocytosis
    WBC at the site of damage or injury recognize, engulf, and digest debris, necrotic tissues, RBC's
  10. common cause of injury producing inflammation
    trauma, bone fractures, foreign bodies, bacterial invasion, dec blood supply, bacteria and fungi, burns, autoimmune disease (RA, lupus, polymyositis)
  11. signs of inflammation
    • edema
    • erythma
    • heat
    • pain
    • loss of function
  12. heat
    • 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
  13. pain
    • caused by chemical mediation of bradykinnis, histamines, prostglandisn, serotonin
    • caused by mechanical mediation by direct trauma or by internal pressure due to swelling
  14. different types of pain
    nagging, dull, sharp, radiating
  15. erythema
    (redness) caused by overexpansion of the interstitial space due to fluid leakage from local blood vessels
  16. transudate
    • mainly water and dissolved electrolytes, clear in appearance, few cells present
    • limited permeability of the microvessels preventing protein and cell escape
  17. exudate
    more viscous (due to protein) and cloudy (due to leukocytes) results when cells and plasma protein escapes due to increased permeabilty of the microvessels
  18. pus
    large number of leukocytes are present in exudate
  19. edema
    an excessive amount of tissue fluid in the body tissue and interstitial space
  20. effusion
    escape of fluid into a part
  21. jt swelling or edema can be caused by
    synovial fluid production due to irritation within the jt or caused by bleeding into the jt
  22. pitting edema
    • edema in interstitual space that has been present for sometime
    • when pressure is applied indentation is produced which will gradually disappear
  23. clinical implications for edema
    • 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
  24. loss of function
    inc muscle tone or spasm may lead to loss of function
  25. stages of inflammation
    • acute
    • subacute
    • chronic
  26. acute
    • 3-4 of the signs are present
    • preferred treatment is cold
    • about 2 wks
    • rest and gentle therapeutic intervention are preferable
  27. subacute
    • 2 of the signs are present
    • treatment can be cold or hot
    • reaction continues about 1 month
  28. chronic
    • 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
  29. cell types in the acute phase
    " " chonic phase
    • neutorphil
    • lymphocytes, monocytes, macrophages
  30. factors that may impede healing
    • extent of injury
    • edema
    • hemorrhage
    • poor vascular supply
    • separation of tissue
    • muscle spasm
    • atrophy
    • keloids and hypertrophic scars
    • infection
    • health, age and nutrition
  31. edema effect on healing
    • causes tissue seperation
    • reduces neuromuscular control
    • reduces tissue nutrition in injured areas
  32. hemorrhage effect on healing
    • small damage to capillary can cause bleeding
    • produces the same effects on healing as edema
  33. poor vascular supply effect on injury
    • heals slowly and poorly
    • injury can also disrupt blood supply to tissues
  34. extent of injury
    inflammatory response is based on the extent of tissue damage
  35. seperation of tissue effect on healing
    mechanical seperation and the uncontrolled tearing of tissues may necessitate healing by secondary intention resulting in excessive scaring
  36. muscle spasm effect on healing
    causes traction on torn tissues and prevents approximation of tissues this may delay healing may also cause tissue ishemia
  37. atrophy effect on healing
    pain, swellingl loss of function from injury may cause muscle to waste (atrophy)
  38. keloids and hypertrophic scar effect on healing
    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
  39. infection effect on healing
    bacteria in wound can delay healing
  40. health, age, and nutrition
    • aging affects healing
    • disease such as diabetes, arteriosclerosis is common
  41. Vitamin C
    Vitamin K
    Vitamin A
    Vitamin E
    amino acids
    • scurvy
    • clotting
    • healing process and laks
Card Set