Presentation on theme: "Injury/ Trauma Injury occurs when local stress or strain exceeds the ultimate strength of bones and/ or soft tissues. The rate of injury or tissue deformation."— Presentation transcript:
1Injury/ TraumaInjury occurs when local stress or strain exceeds the ultimate strength of bones and/ or soft tissues.The rate of injury or tissue deformation also contributes to the degree of injury
2Trauma/ InjuryAn injury includes mechanical failure and destruction of the cells and tissues.
3The Phases of Healing There are 3 phases of healing: Acute Inflammatory ResponseThe Proliferation PhaseThe Maturation Phase
4Acute Inflammatory Response Mechanical trauma, such as a sprain, strain, disc injury, amputation or burn, results in damaged cells;Damaged cells initiate the inflammatory response;The sudden and extended release of inflammatory mediators is necessary to initiate the healing response.
5The Inflammatory Response Attracts precursors for cell growth, andEncourages repair mechanisms.The buildup of fluids causes chemical irritation and mechanical pressure on the nerve receptors.Chemical irritation and mechanical pressure stimulates pain receptors, which serve a protective purpose, causing patients to limit motion around the damaged tissue.
6The Inflammatory Response Other effects of the inflammatory response include:Clogging of the vasculature which results in further cell death due to cell oxygen deprivation;Muscle spasm occurs due to the pain and lack of oxygen, andThe patient moves less due to pain and muscle spasm.
7Inflammation Necessary part of the healing process However, if the inflammatory response is prolonged or particularly intense, it may lead to chronic inflammation which can be debilitatingThrough use of therapeutic modalities, we can influence the inflammatory response promote healing
8Cardinal Signs of Inflammation HeatRednessSwellingPainLoss of Function
9Measuring Inflammation Measure the amount of swelling compared to the opp0site sidePoint tenderness on palpationJoint range of motion as compared to the opposite side
10Typical Presentation in Acute Inflammatory Response Phase SwellingLoss of Range of MotionMuscle guardingSplinting postures
11Duration of the Acute Inflammatory Response Begins immediately following injuryPersists until the stimulus is removed/ mediators dissipatedMay last a few seconds or a few months
12Proliferation PhaseThe number and size of fibroblasts increase allowing for the collection of ground substance and collagen to collect in preparation for tissue repair.Growth of new tissueDevelopment of new blood vesselsDevelopment of fibrous tissueWound contractionFormation of collagen matrix
13Proliferation PhaseRemoval of debris and temporary repair tissue formed by the inflammatory response phaseDevelopment of new, permanent replacement tissuesDevelopment of new vascular framework to supply repairing tissues with oxygen and nutrients and cells needed to restore the area
14Proliferation PhaseThought to begin approximately 72 hours after injuryMay last 3 weeks
15Maturation PhaseCollagen and Fibroblasts attempt to align themselves in the original tissue orientation, although this does not always occur.Main focus is:Deposition of permanent tissuesReturn to normal function
16Return to normal function The Injury ResponseTraumaIschemiaCell DeathSecondary TraumaInflammationPhagocytosisContain InjuryClogging of Blood FlowBleedingSwellingBlood ClottingRevascularizationPain, spasm, atrophyWound ContractionLoss of FunctionTissue RepairWound RemodelingReturn to normal function