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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 – Ligaments – Connect muscle to bone Connect bone to bone 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 Serum Axon Reflex Serotonin Protein Complement Cascade Catecholamines Adrenaline Granular Leukocytes 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.