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Tissue Healing and Repair

Chapter 5 or 6

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Injury Mechanisms

Force and Its Effects

Load

Deformation

Yield Point

Elastic Limit

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Forces

Axial Force

Compressive Force Tensile Force

Shear Force

Stress

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Skin Tissue

Epidermis

Dermis Subcutaneous Layer

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Skin Injury Classification

Abrasions

Blisters Skin Bruises

Incisions

Lacerations Avulsions

Punctures

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Tendons, Ligaments, and

Aponeuroses

Tendons

Connect muscle to bone Ligaments

Connect bone to bone

Made up primarily of collagen and elastin

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Muscles

Epimysium

Perimysium Endomysium

Fasciculus

Muscle Fibers

Myofibrils

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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

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Soft Tissue Injury Classification

cont.

Tendinitis and Tenosynovitis

Myositis Ossificans Calcific Tendinitis

Bursitis

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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.

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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, lossof ROM, complete instability.

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Soft Tissue Healing

Inflammatory Phase (0-6 days)

Proliferation Phase (3-21 days) Regeneration and Maturation Phase (up to 1+

year)

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Acute Inflammatory Response

Granular

Leukocytes

Protein

1st Response

Exudate

Serotonin

Catecholamines

Serum

ATP

Histamine

Noradrenaline

Adrenaline

Serotonin

2nd Response

Platelets

Kinin

Cascade

Complement

Cascade

Axon Reflex

Vasoconstriction

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Bones

Calcium Carbonate

Calcium Phosphate Collagen

Water

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Bone Injury Classification

Fractures

Closed

Compounded

Transverse

Comminuted

Oblique

Epiphyseal

Spiral

Greenstick

Avulsion

Impacted

Depressed

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Nerves

Afferent Nerves (Affectors)

Efferent Nerves (Effectors)

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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.