Injury Response Process Part I

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Injury Response ProcessPart I
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Modalities

• NO modality can accelerate the healing of an
  injury.
• Modalities attempt to provide the best
  environment for the healing process.
• We, as clinicians, try to prevent the healing
  process from being hindered by regulating the
  environment and the function of the cells.
  (Starkey, 2nd ed., p. 1)

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General Adaptation Syndrome

• Alarm State flight or fight response
• Stage of Resistance
• Stage of Exhaustion

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Alarm Stage

• Bodys reaction to change
• Increased blood supplies are brought to areas in
  need
• Cortisol (steroid hormone secreted by adrenal
  cortex) is released into the blood
• Proteins break down into amino acids (potential
  energy source)

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Stage of Resistance

• Bodys adaptation plateau
• Body wants to remain in homeostasis
• Longest phase
• Physical fitness is achieved in this stage

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Stage of Exhaustion

• One of the bodys systems cannot tolerate the
  stress fails
• Point of distress - injury

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Wolff Law

• Bones remodel adapt to the forces placed on
  them.
• Every change in the form and the function of a
  bone (or its function alone) is followed by
  certain definite changes in its internal
  architecture secondary alterations in its
  external conformation. (Stedmans Concise Med.
  Dict., 4th ed., p. 1069)

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Tissue Types

• Epithelial
• Adipose
• Connective
• Muscular
• Nervous

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EPITHELIAL TISSUE

• Line the skin, heart, blood vessels, hollow
  organs, glands, external openings, other organs
• Secretes absorbs various substances
• Devoid of blood vessels
• High potential to regenerate
• Prevents many external substances from getting
  into the body system
• Most commonly injured tissue
• Modality use
• Thermal agents lose/gain heat CONDUCTION
• Ultrasound passes relatively easily
• E-stim resists due to dead cells
• Medications must find hair follicle/sweat gland
  portals

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ADIPOSE TISSUE

• High water content
• Insulator against cold
• Modality use -
• Good for Ultrasound
• Thermal agents effectiveness decreased over thick
  layers

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CONNECTIVE TISSUE

• Support Cells
• Most abundant in body
• Collagen protein-based CT
• 11 types found throughout body (Table 1-6, p.
  10)
• Found in highly vascular areas except meniscus
• Collagen can be elongated through stretching
• Modality use -
• Thermal modalities assists with warming up the
  tissues for elongation

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MUSCULAR TISSUE

• Little or no ability to regenerate
• Can actively shorten passively lengthen
• Classified by function of nerve
• Smooth m. involuntary control
• Cardiac m. pumps blood
• Skeletal m. movement of bodys joints

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MUSCULAR TISSUE

• Type I (slow-twitch)
• Produce low intensity, long duration contraction
• Uses aerobic energy system
• Postural muscles
• Slow to fatigue
• What type of person performing physical activity
  has this type of muscle fiber make-up?

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MUSCULAR TISSUE

• Type II (fast-twitch)
• Uses anaerobic energy system
• High intensity, short duration contraction
• Can generate high amount of force in a short time
• Predominant in explosive m. contractions
• Subcategories
• Type IIA both Type I Type II traits
• Type IIB all anaerobic
• What type of person performing physical activity
  has this type of muscle fiber make-up?

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MUSCULAR TISSUE

• Modality use -
• Some direct electrical current can cause m.
  fibers to short, but stimulation of motor nerves
  commonly produces therapeutic muscular
  contractions

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NERVOUS TISSUE

• SAME
• Has ability to conduct afferent efferent
  impulses
• - Dendrites transmit impulse TOWARDS a cell
  body
• - Axon transmits impulse AWAY from the cell
  body
• - Synaptic junctions chemical or electrical
• - Presynaptic Neurons transmit info TOWARDS a
  synapse
• - Postsynaptic Neurons transmit an impulse
  AWAY from a synapse

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NERVOUS TISSUE

• Speed
• Myelinated n. faster impulses, more efficient
• Unmyelinated n. slower impulses
• Diameter
• Wide faster
• Small slower although small myelinated are
  faster than large unmyelinated nerves

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Synaptic Junctions

• Electrical gap junction
• Allows n. impulse to be transferred directly to
  next n. in sequence.
• Chemical synaptic cleft separates pre
  postsynaptic n.
• Chemical neurotransmitter is released from
  presynapse n. diffuses across cleft binds into
  a receptor site on postsynapse n.

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Injury to Nervous Tissue

• Damaged CNS cells are not replaced functions
  are lost
• N. cells damaged in the PNS possess some ability
  to regenerate functions may also be restored by
  a collateral system
• Modality use -
• E-stim can result in activation of sensory,
  motor, and pain nerves
• Electrical stimulus causes a depolarization

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INJURY PROCESS

• Primary Response tissue destruction directly
  associated with traumatic force cant change
  amount of initial damage
• Secondary Response occurs from cell death caused
  by a blockage of O2 supply can assist to keep
  minimum damage to other tissues
• Injury Response Cycle pain-spasm-pain cycle
• (Chemicals stimulate free n. endings cause pain
  which causes m. spasm triggers bodys
  protective mechanism.)