Tissue Healing and Repair

Chapter 5 or 6

Injury Mechanisms

Force and Its Effects

Load Deformation Yield Point Elastic Limit

Forces

Axial Force Compressive Force Tensile Force Shear Force Stress

Skin Tissue

Epidermis Dermis Subcutaneous Layer

Skin Injury Classification

Abrasions Blisters Skin Bruises Incisions Lacerations Avulsions Punctures

Tendons, Ligaments, and Aponeuroses

Tendons

Connect muscle to bone Connect bone to bone

Ligaments

Made up primarily of collagen and elastin

Muscles

Epimysium Perimysium Endomysium Fasciculus

Muscle Fibers Myofibrils

Soft Tissue Injury Classification

Contusions (1st, 2nd, 3rd degree)

Ecchymosis (Superficial bleeding) Hematoma (Hardening of the blood)

Strains (1st, 2nd, 3rd degree) Sprains (1st, 2nd, 3rd degree) Cramps and Spasms Myositis and Faciitis

Soft Tissue Injury Classification cont.

Tendinitis and Tenosynovitis Myositis Ossificans Calcific Tendinitis Bursitis

Muscle Bruises- Grading

1st degree- Little or no range of motion loss. 2nd degree- Noticeable loss or range of motion. 3rd degree- Severe restriction of range of motion. Fascia may be ruptured causing muscle tissue to protrude.

Sprains and Strains Grading

1st degree- Limited pain, only microtearing of the collagen fibers, no loss of function. 2nd degree- More intense pain, partial tearing of the tissue, joint instability and muscle weakness. 3rd degree- Severe pain, complete tearing, loss of ROM, complete instability.

Soft Tissue Healing

Inflammatory Phase (0-6 days) Proliferation Phase (3-21 days) Regeneration and Maturation Phase (up to 1+ year)

Acute Inflammatory Response

Vasoconstriction

1st Response Exudate

2nd Response Platelets

Axon Reflex

Serum Protein

Serotonin Complement Cascade

Catecholamines Granular Leukocytes

Adrenaline Kinin Cascade

Serotonin

Noradrenaline

Histamine

ATP

Bones

Calcium Carbonate Calcium Phosphate Collagen Water

Bone Injury Classification

Fractures

Closed Compounded Transverse Comminuted Oblique Epiphyseal

Spiral Greenstick Avulsion Impacted Depressed

Nerves

Afferent Nerves (Affectors) Efferent Nerves (Effectors)

Nerve Injury Classification

Tensile forces cause stretching of the nerve fibers.

Grade I: Neurapraxia: temporary loss of sensation and/or motor function. Grade II: Axonotmesis: significant motor and mild sensory losses. Grade III: Neurotmesis: motor and sensory losses persisting for up to one year.