Chapter 10 (Healing process)

What do the mast cells release?

-Histamine -Serotonin

What is going on during the Maturation Phase? (3)

-Realignment of collagen fibers -Decreased fibroblastic activity -Increased organization of the extracellular matrix

After inflammatory stage, _______ formation and repair will begin 48 hours after injury to form scar tissue but can take up to ___-___ weeks.

-Scar -4 to 6

What does vasoconstriction do and how long does it last?

-causes local anemia (loss of blood) -5 to 10 minutes

Granulation has fibroblasts begin to make collagen in a random fashion to create a ______. What type of pattern is this collagen typically?

-scar -Criss cross

What is released from a damaged cell and when does it begin/end?

-thromboplastin -Begins 12 hours after injury and ends 48 hours after injury

Inflamamtion phase

1. Alters cellular metabolism 2. Mast cells release chemical mediators 3. Vascular reaction 4.

T or F, bone heals the same as skin or tissue.

False

Do we want a clot?

YES!!!

Serotonin

causes blood vessels to constrict and reduce the amount of blood loss

Histamine

causes vasodilation which increases cell permeability that will swell and separate the tissues

Type 1 collagen

Bones, skin, tendons, ligaments, cartilage, fascia

Vitamin C does what for the healing process?

Collagen syntehsis

T or F, the removal of debris by macrophages and granulocytes is discontinued by this stage.

FALSE it is continued

What is the second phase of the healing process?

Fibroblastic and Proliferation Phase

What tissue starts to form now?

Granulation

What chemical mediator kicks off the healing process?

HISTAMINE

_____ phase is CRITICAL to the healing process.

Inflammation

Vitamin K does what for the healing process?

It stops our bleeding by forming a clot

3rd phase of the healing process?

Maturation/Remodeling Phase

Type 3 collagen

Nerves, skin, blood vessels & smooth muscles

What is then freshly formed that will bring in oxygen and nutrients to the tissue for regeneration.

New capillaries

______ & ______ go together.

Pain & inflammation -Even if you can't see inflammation you can still have it (internal)

What do leukotrienes and prostaglandins

adhere to the cell walls and increase permeability

Why does this happen?

because of initial loss of oxygen

Injury to the tissues results in injury at the ______ level

cellular

These increases cause fibroblasts to.....

decrease and that will signal phase 3

What happens when these steps do not occur or occur properly?

healing is delayed

What do cytokines do?

help attract phagocytes that will eat debris/bacteria @ end of phase

Why would chronic inflammation occur?

if the acute response is not effectively processed or if the body does NOT go through the ENTIRE healing process

What does vasodilation do?

increases blood flow and capillary

Why is there increased organization of the extracellular matrix?

its recognizing so it can be as strong as it can

There is no definitive end or beginning of each phase, they all ______ one another.

overlap

We need ___ to heal the womb.

scars

This phase can last up to ______ years.

several

Longer collagen is laid down= _______ increases

tensile strength

How does a plug form?

the injury will exposes collagen fibers and this will allow the platelets to stick/create a sticky matrix on the vascular wall

3 steps of the healing process

1. Inflammation 2. Proliferation 3. Remodeling

Inflammation Process- step by step (6)

1. Injury to cell 2. Chemical mediators arrive (histamine, leukotrienes, cytokines) 3. Vascular reaction (vasoconstriction, vasodilation, exudate creates statis) 4. Platelets/leukocytes adhere to vascular wall 5. Phagocytosis 6. Clot formation (stick spot is where clot is formed by platelets and leukocytes)

Signs of the inflammation phase?

1. Pain (due to chemicals released) 2. Pressure (on nerve endings due to swelling causing pain) 3. Discoloration- black (ruptured blood vessels) 4. Redness (increased blood flow to the area= heat) 5. Chronic inflammation (acute response is not effectively process though)

What is the vascular reaction?

1. Vasoconstriction 2. Vasodilation 3. Form a plug 4. Form a clot

What are the factors that impede healing? (12- do the best you can)

1. extent of injury 2. edema 3. Hemorrhage 4. Poor vascular supply 5. Muscle spasm 6. Atrophy 7. Cortiocosteriods 8. Keloids and Hypertrophic scars 9. Infection 10. Humidity, climate and oxygen 11. Health, age, nutrtion 12. Seperation of tissues

How long does it take to fully form a clot?

2 days

Inflammation phase lasts ____ to ___ days.

2 to 4

Around week ____ a scar will exist.

3

How long does this phase last?

4 to 6 weeks

Type 1 collagen makes up _____-_____% of the human makeup.

80-90%

_______ and regenerative activity lead to scar formation/repair.

Proliferative

We need to be working what during this phase? And why? (3 reasons)

ROM -Pain and swelling have decreased -We are stronger here than before -Tissues are realizing so we need to practice ROM

What is extremely IMPORTANT in this phase?

ROM because scar tissue/adhesions form

Why do we want to keep our wound moist in a bandage?

This allows the debris to go to the surface and get off the body fast

T or F, A scar is not as strong as the original tissue.

True

T or F, each cell has a metabolism.

True

Type 2 collagen

Vertebral discs