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6th MELEAH Sur-Gur-RAYYY final lezzzz ace dis shit > Elbow > Flashcards

Elbow Flashcards

1
Q

Elbow dysplasia signalment? Often uni or bilateral?

A
  • Biphasic meaning (young and old)
  • Large giant breeds
  • bilateral
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2
Q

When we say elbow dysplasia it can either be due to these 2 things?

A
  • Medial compartment disease
  • ununited anconeal process
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3
Q

What 3 conditions can patients with medial compartment disease (elbow dysplasia)?

A
  • Fragmented medial coronoid process
  • Osteochondritis dissecans
    • medial humeral condyle
  • Joint incongruity
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4
Q

Which condition is a condition with ununited anconeal process and medial compartment disease?

A
  • Incongruity
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5
Q

When we get DJD, where is the first place we will see osteophytes?

A

Anconeal process

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6
Q

OCD is most commonly on the ____ ____ ____

A

medial humeral condyle

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7
Q

FCP most commonly involves ____ ____ ____

A

medial coronoid process

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8
Q
  • A mismatch in articular surfaces is known as ______
  • Involves
    • ______ discrepancy (radius vs ulna)
    • ______ discrepancy (humeral condyle vs trochelear notch)
    • _____ or _____ (radius during weight bearing)
A
  • A mismatch in articular surfaces is known as incongruity
  • Involves
    • Length discrepancy (radius vs ulna)
    • Diameter discrepancy (humeral condyle vs trochelear notch)
    • Static or Dynamic (radius during weight bearing)
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9
Q

In terms of uneven joint surface, it changes the _____ distribution acorss joint and focused _____ leads to pathology

A
  • weight
  • stress
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10
Q

In terms of a normal stance in the thoracic limb, is the radius or ulna the main weight bearing bone?

A
  • radius
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11
Q

German shepherds are especially predisposed to this elbow dysplasia problem?

A

Ununited anconeal process

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12
Q

In terms of Age for development of ortho dz and elbow dysplasia

  • Young dogs - pain due to ______ in _____ ____
  • Old dogs- pain due to _______
A
  • Young dogs - pain due to defect in joint surface
  • Old dogs- pain due to osteoarthritis
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13
Q

Development of ortho dz and elbow dysplasia is fequently _______(uni or bilateral) 35% of the time. Is it heritable or not (what should we avoid if so?)

I

A
  • bilateral
  • it is heritable don’t breed!
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14
Q

For development of ortho dz and elbow dysplasia:

Large and giant breeds

  • _______breeds especially are noted for UAP
  • ______(males or females are predisposed)
A
  • GSD
  • Males
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15
Q

For development of ortho dz and elbow dysplasia, what age is this most frequent in? Also state the type of lameness which is often aggravated by _____

A
  • 5-12 months of age
  • Chronic progressive lameness aggravated by activity
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16
Q

For development of ortho dz and elbow dysplasia, _______(uni or bilateral) disease may DELAY presentation

A
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17
Q

Do you often get pain upon manipulation of the joint with elbow dysplasia?

A

Yes!

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18
Q

In terms of pain with elbow dysplasia

  • UAP: pain on _______ (anconeal pressure)
  • MCD: _______ + _______ (medial compartment)
A
  • UAP: pain on extension (anconeal pressure)
  • MCD: flexion + supination (medial compartment)
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19
Q

With elbow dysplasia there is a characteristic posture mostly seen with this type of elbow dysplasia?

A

MCD

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20
Q

We often hear ______ wth osteoartritis bc of osteophytes

A

crepitus

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21
Q

What postural abnormality do you see with MCD?

  • “_____ ____”
  • Elbow ______(abducted or adducted)
    • offloads the _______ compartment
  • External _____of limb
A
  • “Toed out”
  • Elbow adducted
    • offloads the medial compartment
  • External rotation of limb
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22
Q

What condition is this in and name the posture?

A
  • Toed out
  • MCD posture
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23
Q

Often incongruity is a proposed etiology with UAP and FCP: state whethere it is short or long radius or ulna?

A
  • UAP:
    • SHORT ULNA
    • LONG RADIUS
  • FCP
    • Short radius
    • Long ulna
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24
Q
  • With radioulnar incongruity it’s often a _______ discrepancy
    • shortened ____ displaces ______ proximally
    • Excess force on developing _____ _____
    • Focused _____ result in separation
A
  • With radioulnar incongruity it’s often a length discrepancy
    • shortened ulna displaces humerus proximally
    • Excess force on developing anconeal process
    • Focused stress result in separation
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25
Q

Can standard OCD occur without incongruity?

A

YEP

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26
Q

With UAP incongruity, a short ____ displaces _____ _____ proximally, causing a failure to _____ and stress on _____ _____

A

With UAP incongruity, a short ulna displaces humeral condyle proximally, causing a failure to fuse and stress on anconeal process

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27
Q

What breed is often seen with UAP, causing a separation of the _____ center of ossification

A

LORETTA :-(

anconeal

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28
Q

True facts about UAP:

  • Normally uses to ulna at ___-___ weeks
  • If the anconeal process has not fused by ____ weeks = UAP
A
  • Normally uses to ulna at 16-20 weeks
  • If the anconeal process has not fused by 24 weeks = UAP
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29
Q

Proposed etiologies of FCP is a error in _____ _____, current _____presumed to be caused by _____

A

Proposed etiologies of FCP is a error in endochondral ossification, current microtrauma presumed to be caused by incongruity

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30
Q

FCP incongruity is caused by short _____ displacing the _____(state bone) ______(prox or distal?). You get stress on _____ _____ and _____ results from added stress

A

FCP incongruity is caused by short radius displacing the humerus(state bone) distally prox or distal?). You get stress on coronoid process and fragmentation results from added stress

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31
Q

Failure of endochondral ossification causes ____

A

OCD

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32
Q

What radiographic view is highly diagnostic for UAP?

A
  • flexed lateral view
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33
Q

OCD is often well positioned and best viewed on _______ view for radiographs.

A

craniocaudal

34
Q

With FCP, ______ may be the only sign we see

A

sclerosis (abnormal hardening)

35
Q

With FCP, what is seen in the lateral view versus craniocaudal view of rads?

A
  • Coronoid overlies radial head (lateral view)
  • Coronoid lies partially over ulna (craniocaudal)
36
Q

What imaging modality is excellent for FCP?

A

CT scan

37
Q

In general, _________ has largely replaced CT

A

arthroscopy

38
Q

What is the gold standard viewing modality for elbow dysplasia?

A

Arthroscopy

39
Q

90% of the time, OCD is ossiciated with _____

A

FCP

40
Q

What do we do for surgical treatment of UAP? (2)

A
  1. Fragment excision
  2. Osteotomy (of ulna) + Fixation (screw)
41
Q

With UAP fragment excision (sx tx)

  • IS it acceptable for older dogs eith DJD
  • ______ remains
A
  • yes it’s acceptable
  • instability
42
Q

How is the prognosis wth UAP fragment excision for a pet versus a athletic working dog?

A

Guarded to fair for function as a pet (long terms)

Guarded for athletic working dog

43
Q

With a osteotomy + fixation with UAP surgical treatment:

Osteotomy allows distraction of _____

  • Restoration of _____: _____ lengthens
  • Encourage ____ of _____ process
  • Fragment may not ___ long term

Prognosis:

  • _____
A

Osteotomy allows distraction of ulna

  • Restoration of congruity-ulna lengthens
  • Encourage union of anconial process
  • Fragment may not fuse long term

Prognosis:

  • excellent
44
Q

What is the gold standard treatment for FCP/OCD

A
  • Arthroscopic
45
Q

Can medical management be used alone for elbow dysplasia? What is the best chance for these guys?

A

No! It should always be paired with something. Best chance for a good prognosis is early dx and tx, medical managment is used long term due to DJD but the best is ARTHROSCOPY > arthrotomy + MM

46
Q

True or False:

TX via arthrotomy is better than arthroscopy for elbow dysplasia?

A

FALSE

Arthrotomy is worse than arthroscopy

47
Q

With elbow dysplasia we said the earlier the dx the better the prognosis, if dx early can we prevent DJD?

A

NO!!!! Early prevention does not prevent DJD

48
Q

What is expected long term in terms of treatment for elbow dysplasia: _____ _____

A

medical management

49
Q

Is it better to have a dog with hip dysplasia or elbow dysplasia in large breeds?

A

hip dysplasia, eventually elbow dysplasia needs to be euthanized

50
Q

In terms of treatment for elbow incongruity what do we know?

A

dvanced training needed for surgical treatment, so refer it

51
Q

Incomplete ossification of the humeral condyle results from failure of this?

A

failure of union between the medial and lateral portions of the humeral condyle

52
Q

Union of the medial and lateral portions of the humeral condyle are complete by _____ weeks

A

12

53
Q

What breeds, gender, and age are predisposed to incomplete ossification of humeral condyle, is it usually uni or bilateral?

A
  • Spaniel breeds most common
  • males
  • usually young to young adult
  • Bilateral but may only show clinically as a unilateral**
54
Q

Are there often clinical signs seen with IOHC, if so state them.

A
  • NO CS often incidental finding
55
Q

Describe the type of lameness for IOHC

  • Mild lameness indicates ______
    • worse after ______
    • state whether or not weight bearing??
  • Acute lameness indicates ______ _____\_
    • state whether or not weight bearing??
A
  • Mild lameness indicates micromotion
    • worse after activity
    • indicates weight bearing
  • Acute lameness indicates pathological fracture
    • Non weight bearing lameness
56
Q

IOHC 90% of the time is ______(uni or bilateral) which why you always have to check the _____ _____

A

IOHC 90% of the time is bilateral which why you always have to check the contralateral limb

57
Q
  • What is the preferred treatment for IOHC?
    • if no fracture: _____ only
  • Which one is contraindicated?
  • Prognosis?
A
  • Surgery (preferred tx)
    • if no fracture: single large lag screw only
  • Medical therapy contraindicated
  • Prognosis with tx: excellent
58
Q

90% of traumatic elbow luxations are ______(medial or lateral) due to this anatomical aspect?

A

lateral due to large medial epicondyle

59
Q

For elbow luxation: normal mediolateral motion is _____

  • Constrained by _____ _____ in flexion
  • Constrained by ______ in extension
A

For elbow luxation: normal mediolateral motion is minimal

  • Constrained by collateral ligaments in flexion
  • Constrained by olecranon in extension
60
Q

For traumatic luxation

  • Dogs : _____ ______ minimum
  • Cats: both ______ ______
A
  • Dogs : lateral collateral minimum
  • Cats: both collateral ligaments
61
Q

With traumatic luxations, always take radiographs in this view because it shows the direction of the luxation?

A
  • craniocaudal
62
Q

For tramatic luxation, what type of reduction is idea for acute luxation of a normal joint or chronic luxation attempt

A

closed reduction

63
Q

For tramatic reduction, concurrent fractures and unsuccessful attempts at previously correcting a luxation or recurrent luxations cause us to do an ______ reduction

A

open

64
Q

In a closed reduction for tramatic luxation we can access the collateral ligaments by performing this test?

A

Cambells test

65
Q

For the cambells test we compare it to the contralateral limb:

  • the elbow and carpus is put at ___ degrees.
  • _____ takes place with lateral collateral ligament
  • _____ takes place with medial collateral ligament
A

For the cambells test we compare it to the contralateral limb :

  • the elbow and carpus is put at 90 degrees.
  • Supination takes place with lateral collateral ligament
  • Pronation takes place with medial collateral ligament
66
Q

With a closed reduction, why do we flex and extend through ROM?

  • to move the ______
A

to move hematoma

67
Q

With traumatic luxation if the jont is unstable we do a ______ reduction

A

open

68
Q

What type of reduction is the best reduction in cats?

A
  • open reduction
69
Q

For traumatic luxation post, the leg is maintained in _______. The _______ provides stability.

  • Spica splint __-__ weeks (stable closed reduction)
  • Flexible ESF __-__ weeks (open/unstable reduction)
A

For traumatic luxation post, the leg is maintained in extension. The olecranon provides stability.

  • Spica splint 2-3 weeks (stable closed reduction)
  • Flexible ESF 3-4 weeks (open/unstable reduction)
70
Q

After the traumatic luxation, after apparatus is removed

  • Exercise restriction __-__ weeks
  • physical therapy
A
  • 4-6 weeks
71
Q

This splint maintains the limb in standing position

A

Spica splint

72
Q

For tramatic luxation the prognosis is good to excellent after a stable ______ reduction versus fair with an _____ reduction (better for thse types?)

A
  • Good to excellent: closed
  • Fair: open reduciton (better for small or less ctive dogs)
73
Q

TER stands for?

CUE stands for?

both are _____ procedures

A
  • TER: total elbow replacement
  • CUE: canone unicompartmental elbow
  • salvage
74
Q

CUE: canone unicompartmental elbow is a _____ joint replacement. _____ joint resurfacing. Primarily for end stage _____. 90% ______

A

CUE: canone unicompartmental elbow is a partial joint replacement. Medialjoint resurfacing. Primarily for end stage MCD. 90% improved

75
Q

These are used in what procedure for what?

A

Canine unicompartmental elbow (resurfacing in the medial compartment region)

76
Q

What does a total elbow replacement replace? what 3 components?

A

parts of the jumerus, ulna, and radius

77
Q

This salvage procedure is technically challenging , require extensive preoperative planning, costly and only done at Iowa state

A

Total elbow replacement

78
Q

What are 2 examples of potentially catastophic complications for total elbow replacement?

A
  • Fracture Joint luxation
  • Infection Implant loosening
79
Q

Complete fusion of joint at standing angle requires an elbow ______

A

arthrodesis

80
Q

______ contraindicated with severe contralateral disease

A

Amputation

81
Q

When you do elbow arthrodesis it can leave the with a limited fucntion “____ ____”

A

peg leg

82
Q

What correction is this to the elbow?

A

Elbow Arthrodesis

6th MELEAH Sur-Gur-RAYYY final lezzzz ace dis shit (15 decks)

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