Exam # 3 StudyGuideExam 3 Key TermsSkin- Is liable, has basement membrane and regenerates throughout life- Regeneration potential decreases throughout life- Layers of epidermis : stratum corneum, stratum granulosum, stratum germinativum- Contains elastic, collagen, reticular fibers- Epidermiso Avascular, innervated, regenerated normally, stratified squamous epitheliumo Stratum germinativum are only living cellso Active mitosis at night when loss of top layer- Dermiso Dermal papilla holds layer in placeo Langer lines for natural stretch direction, incisions along lineso Regenerated normally - Hypodermis and subcutaneouso Density and arrangement determines skins mobilityo Composed of fat and areolar tissueCompartment Syndrome- When hemorrhage within a closed muscle unit pressure increases (intramuscular hematoma)- Can cause ischemia, necrosis then gangrene- Fascia relese surgery within 12 hours can reduce damage- Signs: pain tightness and shiny skin appearanceHypoxia- Occurs in tissues during 2nd phase of laceration/abrasion/ puncture healing- Combined with GF leads to capillary buds AKA angiogenesisTissue Plasminogen Activator- Enzyme involved with breakdown of blood clots- Found in endothelium of blood vessel- Treat strokes, embolisms or ischemic attacks- Plays role in tissue remodeling- Changes plasminogen to plasmin to fibrinPlasmin- dissolve fibrin blood clots- activates collagenases, some mediators of the complement system- cleaves von Willebrand factorStress FracturesPSYC 3510 1st EditionExam # 3 StudyGuide- due to intensity/ volume of work- Complete defect or crack in bone, callus deposition- Causes: repetitive torque, impact, low bone density, poor alignment- Types: Oblique and transverse (are most common and most dangerous), Longitudinal, Compression- Signs: pain, swelling, atrophy- Do not show well in x rays, show as hot spot in bone scan- Tibia and humerus are common sitesTalofibular Ligament Sprain- Anterior is involved with inversion ankle sprain, most common sprain (with calcaneofibular)- Posterior is involved in severe sprains- Grade 1 is no instability, 2 is some in stability, 3 is gross instability- Re-injury can be worse, important to preventACL- Typically result in surgery being required- Full tensile strength not restored, less collagen cross linksScar tissue- Can be avoided with incisions along the langer lines- Type III collagen- disorganized- Heling by first intention decreases scar tissue- Not as vascular, flexible, elastic, or strong- Can inhibit function or cause adhesion of organs- Can cause contractures of skin or joint- Stretch marks are common formIntramuscular hematoma- More severe than intermuscular hematoma- Bleeding within fascia of enclosed muscle bundle- Bleeding is confined and inflammatory response is multiplied- Increases risk of myositis ossificans, scarring, and compartment syndromeMyositis Ossificans- Injury to the muscle - Edema causes inappropriate differentiation of fibroblasts to osteoblasts- Made worse by heatTendonitis- Inflammation of the tendon or the sheath (rare)PSYC 3510 1st EditionExam # 3 StudyGuide- Inflammation of sheath= tenosynovitis or paratenonitis- Can occur with tendinopathyTendinosis- degeneration and changes in the tendon without swellingTendionpathy- Disease of tendon referring to tendonitis or tindinosis- Accompanied by necrosis and vascular abnormalities- Disorganized collagen and fiber separation by fat or mucoids- Contributes to tendon rupture- Diminished tendon strength and function- Causes unknown but suspect overload, compressive forces, steroids, malnutrition, eccentricMucoid- Part of matrix ground substance that separates collagen and fibers in tendinopathy- Deposits in patellar tendonitis and Achilles tindinosis - Greenish brown color- Appears with tendon degenerationFibrinous Adhesions- Chronic tendinopathy leads to fibrinous adhesions- Cause decrease in tissue function and strengthEccentric Contractions- Possible etiology of tendinopathy- Negative direction on force velocity curve- Plyometrics possibly included- Can stimulate collagen alignment in late stage remodeling- Can cause disturbances in calcium homeostasis and lead to cell death- Cells can adapt for future boutsBone Scans- Can show early stage stress fracture- Shows stress reaction- above average remodeling- Superior to x ray for stress injuriesSimple Fractures- Heal in about 6 to 8 weeks- Involve little or no bone displacementInductionPSYC 3510 1st EditionExam # 3 StudyGuide- Stimulus for bone regeneration- Caused by decreases in oxygen leading to hypoxia or necrosis- Disrupts and creates new bioelectric potentials- Part of fracture healing hematoma and inflammation phase- Influenced by electronegativity in areas of growth and repairCallus Formation- Fibrocartilagenous tissue- lasts for 3 weeks forms within 2-3 days- Osteoblasts secrete woven bone distal end, chondrocytes secrete hyaline cartilage proximal end,fibroblasts secrete collagen in hematoma- Serves to splint bone, forms in and around fracture- Osteoblasts in outer part lay down hard bone, inner lays down trabecular- If not immobilized, has poor vascularization and incomplete repair- Replaced by bony callus- Inhibited by use of Tabaco- Primary fractures heal without external callusFracture Healing- Hematoma and Inflamationo Bleeding from bone and tissue forms hematoma and starts inflammationo Induction stimulates regenerationo Inflamatory response  mediated by cytokines and prostaglandins, the neutrophils macrophages and lysosomes clean up fibrin mesh formed around site Capillaries grow in and bring fibroblasts- Fibrocartilagenous Callus Formation- Bony Callus formation and Ossificationo Temporary collagen, cartilage and woven bone replaced by osteoblastso Callus replaced by lamellar boneo If not immobilized, more cartilage laid downo Bone remodels for a long timeo Stable at 40 days, strength in 3 to 6 monthsOsteoblasts- Fill bone into callus scaffolding- Secrete woven bone- Secrete alkaline phosphatase during ossification- Arrive from periosteum or endosteum in adultsTrabecular bone- Laid down by osteoblastsPSYC 3510 1st EditionExam # 3 StudyGuide- Porous bone, replaces woven boneBioelectric Effects- Electronegative in areas of bone growth and repair, allow inductance to trigger regeneration- Stimulates osteoblasts- Compression increases electronegativity- Direct relation to rate of hard bone deposition- Can be used to stimulate non union