TOPIC 1.2

82問 • 1年前

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Phases of wound healing

homeostasis, inflammatory, proliferative, remodeling

Body’s emergency response to injury or pathology with the aim is to prevent hemorrhage

homeostasis

Lasts a few seconds or in the case of moderate to severe pathologies that involve multiple well-vascularized tissues up to several minutes

homeostasis

Occur within seconds after the blood vessel trauma include vessel constriction and the development of a temporary hemostatic plug in the damaged vessels

initial homeostatic mechanism

Coagulation or blood clotting

secondary homeostatic mechanism

Aim is to clean the wound of its cellular debris, preparing it for the deposition of new repaired and regenerated tissues

inflammatory

Localized tissues respond initiate by pathology or injury

inflammatory

Formation of new and immature repair tissues to replace damaged tissue

proliferative

May last for weeks or months depending on tge severity of pathology and type of soft tissue affected

proliferative

Formation of new fibrous tissue

fibroplasia

Formation of new blood vessels

angiogenesis

First phase of healing

remodeling or maturation

Lasts months to years depending on the severity of the pathology and type of soft tissue affected

remodeling or maturation

Resistance vessels

arteries

Known for vasodilating and vasoconstricting

arteries

Controlled by small amount of muscles arranged in a helical pattern in the tunica media

vasomotor tone

Transport oxygenated blood from high pressure to low pressure

arteries

Arterial circulation is maintained by

heart pump

Influenced by ELASTICITY and EXTENSIBILITY of vessel wall, and by peripheral resistance, amount of blood in the body

arteries

Artery layers

tunica externa or adventitia, tunica media, tunica intima

Pressure in arterial system

90-100 mmHg in large vessels, decreases by 25-35 mmHg in arterioles

Capacitance vessels

veins

Thinner walls

veins

Greater number

veins

Transport dark, unoxygenated blood from tissues back to the heart

veins

One way valves to prevent backflow

veins

Influenced by muscle contraction, gravity and respiration

veins

Deep veins accompany arteries, while superficial do not

true

Small blood vessels that connects the ends of arteries with the beginning of veins, forming anastomosing network

capillaries

Arterioles + venules =

anastomosing network

Exchange of nutrient and fluids between blood and tissues

capillaries

Walls are thin and permeable

capillaries

Lymphatic organs

lymph nodes, tonsils, spleen, thymus, thoracic duct

Drains lymph from bodily tissyes and returns it to venous circulation

lymphatics

Collect cellular debris and bacteria, remove excess fluid, blood waste, protein molecules and produce antibodies

lymph nodes

Lymph travels from

lymphatic capillaries, lymphatic vessels, ducts, left subclavian vein

Important for regulation of relative volumes of blood and interstitial fluid

bulk flow

Pressure-driven movement of fluid and solutes from blood capillaries into interstitial fluid

filtration

Promote filtration

bhp, ifop

Promote reabsorption

bcop

Generated by pumping of heart

bhp

Main pressure promoting reabsorption fluid

bcop

Balance between BHP+IFOP+BCOP = NFP

sterling’s law of capillaries

BHP+IFOP+BCOP =

NFP

Loss of NFP balance =

edema

IFOP

0 mmHg

BHP

16-35 mmHg

BCOP

26 mmHg

IFHP

0.1-5 mmHg

Not usually detectable in tissues until interstitial fluid volume rises to 30% above normal

edema

Result if filtration > exceeds reabsorption = abnormal increase in interstitial fluid volume

edema

Can be caused by inadequate reabsorption due to decrease plasma protein concentration

edema

Edema can be caused by excess filtration due to

increased capillary bp, increased permeability of capillaries

Factors affecting blood flow

bp, vascular resistance, venous return, velocity of blood flow

Blood flows from regions of hight pressure to low pressure

true

MAP

diastolic bp + 1/3 (systolic bp-diastolic bp)

Low lumen

high resistance

High viscosity

high resistance

Increased length

high resistance

Ability of tissue to automatically adjust its blood flow to match its metabolic demands

autoregulation

Amount of blood that the heart can pump per beat

cardiac stroke volume

Excessive build up of fluid in body’s tissues

edema

Primarily ib extracellular space

edema

Occurs because of excessive accumulation of extravascular and extracellular fluid in tissue spaces due to disruption of fluid regulation as a result of water protein imbalance across capillary membrane

edema

Hapoends when small blood or lymphatic vessels leak into nearby tissues causing abnormal accumulation of fluid in the interstitial space

edema

Medication, infection, pregnancy and other medical conditions may cause edema

true

Amount is determined by the degree of imbalances in fluid exchange

edema

Occurs in reponse to inflammation, fluid imbalance, vascular impairments and as a result of systemic issues and comorbidities

edema

Excess fluid in a cavity

effusion

Accumulation of interstitial fluid due to an obstruction in lymph channels that prevents reabsorption of proteins from the interstitium

lymphedema

Placement of limb in anti gravity position to facilitate drainage

elevation

Application of non elastic or low stretch bandage or an intermittent, sequential pneumatic compression pump to facilitate shrinkage of edema

compression

Through the use of massage

manual drainage

Application of ice packs to slow local blood flow and reduce fluid accumulation

cold application

Influence of muscle contraction to increase venous return

pumping exercises

Increased pressure on sensory nerves leading to pain

low albumin

Increased pressure that blocks blood flow to tissues

allergic reactions

May cause tissue necrosis

allergic reactions

Decreased ROM

critical burns

Disturbance of joint function

heart disease

Predisposition to infection

kidney disease

Predisposition to thrombosis or pulmonary embolism

pregnancy

ROM

Kyla Rafols · 71問 · 2年前

ROM