Anesthesia of lameness evaluation (Hindlimb)

Question 1

2 other nerves innervated on the pelvic limb

Answer 1

Medial and lateral metatarsal nerves that innervate the dorsal MTP region
Blocked by the low 6-point NB

Question 2

Communicating branch of thoracic limb v. Pelvic

Answer 2

Its rudimentary or nonexistent in the pelvic limb
If present then its more distant than the branch in the forelimb
Can be ignored with plantar nerve blocks

Question 3

Which nerves do the lateral plantar nerve give off + area innervated?

Answer 3

The form the medial and lateral plantar metatarsal nerves
Sensation to the proximal portion of the suspensory ligament

Question 4

Complication for anesthetizing the deep branch of the lateral plantar nerve

Answer 4

Inadvertent injection of the tarsal sheath adn the TMT joint

Question 5

Which nerves desensitize the limb from the tarsus distally

Answer 5

The tibial and peroneal nerve blocks

Question 6

Which nerves does the tibial nerve give off + area desensitized

Answer 6

Medial and lateral plantar nerves
Deep branch of the lateral plantar supplies suspensory ligament → improves lameness caused by prox suspensory desmitis with block

Question 7

Complications of the tibial nerve block

Answer 7

Fails to penetrate the deep crural fascia between subcutis and the nerve
Violent reaction after nerve struck

Question 8

What area does the peroneal nerve innervate

Answer 8

Distal joints of the tarsus

Question 9

Anesthesia issue of differentiating suspensory desmitis from osteoartitrisits of the distal tarsal joints

Answer 9

Difficult to distinguish between the lameness caused by either the desmititis (TMT joint) or osteoarthritis (deep lateral n.) (doing peroneal and tibia block separately differentiates)

Question 10

T/ F: lameness caused by suspensory desmitis may improve after anesthesia of the TMT joint

Answer 10

TRUE

Question 11

T/F: Lameness caused by osteoarthritis of the distal tarsal joints may improve after anesthesia of the deep branch of the lateral plantar nerve

Answer 11

TRUE

Question 12

Complication of anesthetizing the peroneal nerve

Answer 12

Extensor muscle paralysis: horse may buckle @ the MTP joint, dorsal MTP region strikes the ground

Question 13

Which joints do the tarsocrual joint communicate with?

Answer 13

Always communicates directly with the proximal intertarsal (PIT) and talocalcaneal joints

Question 14

Direct communication between the distal intertarsal and tarsometatarsal joints

Answer 14

8.3-70%
Communicate functionally (diffusion) when mepivacaine HCl or methylpred acetate injected into he TMT joint

Question 15

Medial approach of the distal intertarsal joint

Answer 15

Distomedial aspect of tarsus with limb bearing weight
Needle inserted where distal border of cunean tendon crosses the horizontal depression between proximal and distal rows of tarsal bones
Gap formed by junction of fused 1st and 2nd then 3rd and central tarsal bone

Question 16

Disadvantage of medial approach of the distal intertarsal joint

Answer 16

Places the clinician in a vulnerable position for injury

Question 17

Dorsolateral approach of the distal intertarsal joint

Answer 17

2-3 mm lat. to the long digital extensor tendon, 6-8mm proximal to line perpindicular to axis of MTIII

Question 18

Disadvantages of the distal intertarsal joint block

Answer 18

Medial approach laces the clinician in a vulnerable position for injury
Both have high incidence of inaccuracy accessing the joint

Question 19

Why the gait of some horses with lameness caused by proximal suspensory desmittis or stress remodeling of the plantar cortex of MTIII nay improve after injecting anesthetic solution into the tarometatarsal joint

Answer 19

Local anesthetic may leak from the needle puncture of diffuse from the medial and lateral outpouching of the joint

Question 20

Joint compartments of the stifle joint

Answer 20

Femoropatella (largest)
Lateral femorotibial
Medial femorotibial

Question 21

Communication of the femoropatellar and the femorotibial joints

Answer 21

Direct communication (65%) with medial femorotibial joint, rarely with the lateral

Question 22

Intrapatellar ligament approach of the femoropatellar joint

Answer 22

Between the middle and medial patella ligs
Between the middle and lateral patella ligs
2.5-4 cm prox to the tibial tuberosity

Question 23

Lateral cul-de-sac approach of the femoropatellar joint

Answer 23

5 cm prox to the lateral tibial condyle
Caudal to the lateral patellar lig
Directed lateromedially
Contacts the abaxial surface of the lateral trochlear ridge of the femur then retracted

Question 24

First approach of the medial femorotibial joint

Answer 24

Btwn medial patellar lig and medial collateral FT lig
Prox to the palpable proximomedial edge of the medial meiscus

Question 25

Second approach of the medial femorotibial joint

Answer 25

Btwn medial patellar lig and tendon of the sartorius muscle 2.5 cm prox to the tibial plateau Not directed to medial meniscus or articular cartilage

Question 26

Lateral femorotibial joint

Answer 26

Centesis of the LFT bursa of the long digial extensor tendon Distal to proximolateral edge of the tibia through center of the tendon of the long digital extensor muscle until bone

Question 27

Advantage of the lateral femorotibial joint

Answer 27

Performing @ the diverticulum avoids contact to meniscus, avoiding pain assoc. with trauma