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Injury Response Process Part I

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

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Injury Response Process Part I

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    1. Injury Response Process Part I

    2. 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)

    3. General Adaptation Syndrome Alarm State – “flight or fight response” Stage of Resistance Stage of Exhaustion

    4. Alarm Stage Body’s 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)

    5. Stage of Resistance Body’s adaptation plateau Body wants to remain in homeostasis Longest phase “Physical fitness” is achieved in this stage

    6. Stage of Exhaustion One of the body’s systems cannot tolerate the stress & fails “Point of distress” - injury

    7. 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.” (Stedman’s Concise Med. Dict., 4th ed., p. 1069)

    8. Tissue Types Epithelial Adipose Connective Muscular Nervous

    9. 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

    10. ADIPOSE TISSUE High water content Insulator against cold Modality use - Good for Ultrasound Thermal agents effectiveness decreased over thick layers

    11. 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

    12. 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 body’s joints

    13. 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?

    14. 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?

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

    16. 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

    17. 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

    18. 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.

    19. 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

    20. INJURY PROCESS Primary Response: tissue destruction directly associated with traumatic force; can’t 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 body’s protective mechanism.)

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