Phases of wound healing

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

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

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

Coagulation or blood clotting

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

Localized tissues respond initiate by pathology or injury

Formation of new and immature repair tissues to replace damaged tissue

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

Formation of new fibrous tissue

Formation of new blood vessels

First phase of healing

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

Resistance vessels

Known for vasodilating and vasoconstricting

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

Transport oxygenated blood from high pressure to low pressure

Arterial circulation is maintained by

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

Artery layers

Pressure in arterial system

Capacitance vessels

Thinner walls

Greater number

Transport dark, unoxygenated blood from tissues back to the heart

One way valves to prevent backflow

Influenced by muscle contraction, gravity and respiration

Deep veins accompany arteries, while superficial do not

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

Arterioles + venules =

Exchange of nutrient and fluids between blood and tissues

Walls are thin and permeable

Lymphatic organs

Drains lymph from bodily tissyes and returns it to venous circulation

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

Lymph travels from

Important for regulation of relative volumes of blood and interstitial fluid

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

Promote filtration

Promote reabsorption

Generated by pumping of heart

Main pressure promoting reabsorption fluid

Balance between BHP+IFOP+BCOP = NFP

BHP+IFOP+BCOP =

Loss of NFP balance =

IFOP

BHP

BCOP

IFHP

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

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

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

Edema can be caused by excess filtration due to

Factors affecting blood flow

Blood flows from regions of hight pressure to low pressure

MAP

Low lumen

High viscosity

Increased length

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

Amount of blood that the heart can pump per beat

Excessive build up of fluid in body’s tissues

Primarily ib extracellular space

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

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

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

Amount is determined by the degree of imbalances in fluid exchange

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

Excess fluid in a cavity

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

Placement of limb in anti gravity position to facilitate drainage

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

Through the use of massage

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

Influence of muscle contraction to increase venous return

Increased pressure on sensory nerves leading to pain

Increased pressure that blocks blood flow to tissues

May cause tissue necrosis

Decreased ROM

Disturbance of joint function

Predisposition to infection

Predisposition to thrombosis or pulmonary embolism