Study PTA (Review of Tissue Healing) Flash Cards

 
Pile Management Card
PTA (Review of Tissue Healing)

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Articular cartilage is?
ANEURAL-AVASCULAR
What does articular cartilage require in order to maintain it's unique environment?
REQUIRES PHYSIOLIGICAL STRESS
What % of chrondrocytes is in articular cartilage?
5%
What % of proteoglycans is in articular cartilage?
10-15% (RESPONSIBLE FOR BEARING THE COMPRESSIVE STRENGTH)
% of type II collagen in articular cartilage?
20% (TENSILE STRENGTH)
% of water in articular cartilage?
65%-80%

ALLOWS FOR LOAD DEFORMATION (CREEP)
What are two interventions used to retard muscle atrophy?
-ISOMETRIC CONTRACTIONS
-ELECTRICAL STIMULATION
What does mechanical bone healing depend on?
SOFT-TISSUE ATTACHMENTS TO BONE
What does biological bone healing depend on?
AGE, NUTRITIONAL STATUS, CIGARETTE SMOKING, ETC...
What are the factors that influence bone healing?
-BIOLOGICAL: (AGE, NUTRUITIONAL STATUS, CIGARETTE SMOKING)

-MECHANICAL: (SOFT TISSUE ATTACHMENTS TO BONE)
Used for displaced fractures?
INTERNAL FIXATION
If screws have to be removed in an ORIF, how long will it take to regain normal strength in the bone?
1 YEAR
Involves surgically exposing the fx site to reduce, approximate and align the bone fragments?
INTERNAL FIXATION
Internal fixation?
-INVOLVES SURGICALLY EXPOSING THE FX SITE TO REDUCE, APPROXIMATE AND ALIGN THE BONE FRAGMENTS
-USED FOR DISPLACED FRACTURES
-COMBINATION OF SCREWS, PINS, NAILS
-IF SCREWS HAVE TO BE REMOVED, IT TAKES UP TO 1 YEAR TO REGAIN NORMAL STRENGTH IN THE BONE
What are the advantages of external fixation?
-ALLOWS FOR MODIFICATION OF STIFFNESS AND RIGIDITY DURING FRACTURE HEALING
-DYNAMIZATION (CAN BE ADJUSTED)
-THE MORE RIGID THE FIXATION, THE EARLIER THE RADIOGRAPHIC CONFIRMATION OF BONE UNION
What kind of bone injury and repair involves surgery?
PRIMARY (DIRECT)
Non-operative fracture management entails?
SECONDARY OR INDIRECT PERIOSTEAL CALLUS
Rigid anatomic fixation results in?
PRIMARY OR DIRECT CORTICAL RECONSTRUCTION
Malunion?
HEALING RESULTS IN A NONANATOMIC POSITION
Nonunion?
HEALING PROCESS HAS STOPPED
Delayed union?
HEALING OCCURS AT A SLOWER RATE
What are the complications of bone healing?
-DELAYED UNION
-NONUNION
-MALUNION
Immobilization of fractures is a _____________?
TWO-BLADED SWORD
Secondary bone healing?
INDIRECT
Primary bone healing?
DIRECT
This kind of bone repair involves immobilization with a cast/no surgery?
SECONDARY HEALING (INDIRECT)
Noted for external periosteal soft-tissue callus bridging between fracture fragments?
SECONDARY (INDIRECT)
Rigid internal fixation is used to achieve cortical healing. Devoid of periosteal soft callus?
PRIMARY REPAIR (DIRECT)
What are the two kinds of bone healing?
-PRIMARY (DIRECT)
-SECONDARY (INDIRECT)
What does trauma do to bone?
-DISRUPTS THE BIOLOGICAL
-MECHANICAL
-STRUCTURAL
-ARCHITECTURAL
-HISTEOCHEMICAL ENVIRONMENT OF BONE
Bone regeneration involves what?
-BONE MARROW
-BONE CORTEX
-PERIOSTEUM AND EXTERNAL SOFT TISSUES
Any abnormal disruption in the normal anatomic continuity of bone?
FRACTURE
Intermittent pysiologic loads applied to bone stimulate adaptive responses?
WOLF'S LAW
This is a life long process in response to mechanical stress?
BONE REMODELING
Inside of bone (looks like sponge candy)?
CANCELUS BONE
What are the goals of fracture management?
-FRAGMENT REDUCTION
-MAINTENANCE OF ALIGNMENT
-PRESERVATION AND RESTORATION OF FUCTION
What are the negative effects of immobilization?
-JOINT STIFFNESS
-SHORTENING OF DENSE CONNECTIVE TISSUE
-DECREASED WATER CONTENT
-DECREASED LIGAMENT STRENGTH
-LOSS OF BONE
-WEAKENING OF CARTILAGE AND TENDONS
-MUSLCE ATROPHY
How are grades I and II ankle sprains treated?
TREATED WITH PROTECTIVE BRACING AND STRENGTHENING TO PROVIDE DYNAMIC MUSCULAR SUPPORT
Grade III ankle sprain?
COMPLETE RUPTURE WITH PROFOUND INSTABILITY AND LAXITY
Grade II ankle sprain?
TEARING OF FIBERS WITH MODERATE LAXITY
Grade 1 ankle sprain?
MICROSCOPIC TEARING AND NO LAXITY
Sprains are always associated with what kind of injury?
LIGAMENT INJURIES
What are 3 key conditions that must exist for ligaments to heal well?
-ENDS MUST BE IN CONTACT WITH EACH OTHER
-PROGRESSIVE, CONTROLLED STRESS MUST BE APPLIED TO THE HEALING TISSUES TO ORIENT SCAR TISSUE FORMATION
-PROTECTION
Ligaments heal by what process?
BY THE INFLAMMATORY PROCESS BECAUSE THEY HAVE A GOOD BLOOD SUPPLY
True/False

Ligaments have a poor blood supply
FALSE
How to intra-articular ligaments heal?
DO NOT HEAL SPONTANEOUSLY
(EX: ACL)
How do extra-articular ligaments heal?
IN A HIGHLY STRUCTURED, ORGANIZED AND PREDICTABLE FASHION
(EX: MCL)
Ligament healing occurs in one of two ways?
-EXTRA-ARTICULAR
-INTRA-ARTICULAR
Interface between muslces and bones?
SHARPEY FIBERS
Ligaments will attach to bones in one of two ways. Describe what they are?
-DIRECT: GRADUAL CHANGE FROM SPECIFIC LIGAMENT FIBERS, FIBROCARTILAGE, CALCIFIED FIBROCARTILAGE, BONE

-INDIRECT: SUPERICIAL LAYERS ATTACH TO THE PERIOSTEUM, DEEP FIBERS TRANSITION TO BONE BY WAY OF SHARPY'S PERFORATING FIBERS
This connective tissue is rich in sensory innervation, propioception and pain?
LIGAMENTS
What determines the overall strength of a ligament?
THE RATIO OF ELASTIN TO COLLAGEN
What will an alteration in the ECM do to connective tisue?
-INFLUENCES NORMAL ARCHITECTURE
-IMPAIRS ORGAN FUNCTION
-CHANGES THE MECHANICAL PROPERTIES OF THE TISSUES
Tissues with a high proteoglycan content, combinded with a network of collagen fibers, withstand what kind of force?
COMPRESSION
Tissues with a high collagen-fiber content and low amounts of proteoglycans will resist what kind of forces?
TENSILE
The ability of connective tissue to function properly is determined by the _________________ of the matrix components?
PROPORTIONS
This fibrous component of the ECM is responsible for facilitating the exchange of water, oxygen, cells, and gases?
GROUND SUBSTANCE
This fibrous component is responsible for the compressive strength of cartilage?
-PROTEOGLYCANS AND GLYOAMINOGLYCANS (GAGS)
This fibrous component is the most abundant component in the ECM?
COLLAGEN
Can elongate about 70% without undergoing fiber disruption?
ELASTIN
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