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ACVN - SURGICAL NURSING > Elbow Dysplasia - advanced nursing > Flashcards

Elbow Dysplasia - advanced nursing Flashcards

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1
Q

what is the most common cause of forelimb lameness in dogs?

A

elbow dysplasia or developmental elbow disease (DED)

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2
Q

what does developmental elbow disease include?

A

abnormalities including fragmented medial coronoid process, osteochondritis, joint incongurity and anconeal process

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3
Q

when do dogs show signs of elbow dysplasia?

A

from 5 months old

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4
Q

what are the signs of elbow dysplasia?

A

lameness, elbow swelling, decreased range of motion and joint pain

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5
Q

what imagingviews would you do?

A

cranio-caudal. medio-lateral and flexed lateral

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6
Q

what breed does ununited anconeal process usually occur in?

A

german sheperds

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7
Q

when should the anconeal pocess fuse to the proximal ulna?

A

4-5 months of age

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8
Q

what do patients with ununited anconeal prcess usually have?

A

a short ulnr relative to the legnth of the radius

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9
Q

what does the procedure proximal dynamic ular osteotomy do?

A

allows lengthening of ulna as the radius grows and removes the stress of the anconeal process, which allows it to reunite with the ulnar metaphysis

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10
Q

what is elbow incongruity and short radius syndrome?

A

cartilage wear and fragmentation of the medial coronoid process due to shortened radius relative to the length of the ulna

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11
Q

how do you improve congruity of the elbow?

A

dynamic partial ulnar ostectomy

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12
Q

what happens during a dynamic partial ulnar ostectomy?

A

A small portion of the ulna is excised, allowing improved humeroradial contact

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13
Q

what does OsteoChondritis Dissecans affect?

A

the medial humeral condyle and it usually seen as a subchondral bone defect on a craniocaudal or caudocranial elbow radiograph

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14
Q

what can OsteoChondritis Dissecans also be seen with?

A

fragmented coronoid process

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15
Q

how does OsteoChondritis Dissecans appear?

A

a thickened partially detached flap of cartilage overlying a subchondral bone defect

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16
Q

how do you treat Osteochondritis Dissecans?

A

flap removal and abrasion arthroplasty or microfracture of the subchondral bone

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17
Q

what area of gragmentation is most common in fragmented medial coronoid process?

A

medial coronoid process of the ulna adjacement to the radial head

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18
Q

how can underlying necrotic bone and fragments be removed?

A

arthroscopically or arthrotomy

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19
Q

how can the subchondral bone be treated?

A

burring the bone by abrasion arthroplasty and microfracture to encourage fibrocartilaginous repair

20
Q

what will all dogs with developmental elbow disease /elbow dysplasia have?

A

osteoarthritis

21
Q

what is the goal of treatment of osteoarthritis?

A

debridement of necrotic cartilage, removal of sclerotic bone, neovacularization, and recruitment of pluripotential mesenchymal cells

22
Q

how can you debride exposed subchonral bone?

A

using abrasion arthroplasty or micropick technique

23
Q

how is abrasion arthroplasty performed?

A

hand burr or power shaver burr inserted through instrument portal or arthrotomy incision, burr spun to remove subchondral bone over area of lesion, joint lavaged if blood seen and removes remaining bone debris

24
Q

how is microfracture performed?

A

angled micropick pressed against subchondral bone surface, bleeding checked by stopping inflow of fluid

25
Q

what does sliding humeral osteotomy aims for?

A

transfering weight bearing from medial aspect of the joint to the lateral

26
Q

why is proximal dynami ulna osteotomy performed?

A

for medial compartment disease, radioulnar incongruence or ununited anconceal process treatment

27
Q

when is elbow arthroscopy indicated?

A
  • Exploration of joints for diagnosis through observation, biopsy and culture
  • Removal of loose bodies
  • Topical treatment of OA – microfracture and abrasion arthroplasty
  • Joint debridement and lavage
  • Arthroscopic assisted joint stabilization or fracture repair
28
Q

what are the advantages of elbow arthroscopy?

A
  • Decreased morbidity
  • More rapid recovery than arthrotomy
  • Decreased complications
  • Improved outcomes
  • Decreased surgery, anaesthesia and hospitalization times
29
Q

what are the disadvantages of elbow arthoscopy?

A
  • High level of skill required
  • Long learning curve
  • High cost of equipment
  • Increased cost to client
30
Q

what is the diameter of the scope used for elbow arthroscopy?

A

1.9-2.7mm

31
Q

what is the lens angle for the arthroscope?

A

30 degrees

32
Q

what is the working length for the arthroscope?

A

short 8.5cm or long 13cm

33
Q

what does the camera mount do?

A

attaches to camera with the image projected on a screen. A high definition camera is best for arthroscopic images

34
Q

what is the flat screen monitor for?

A

require good quality monitor otherwise it’s a waste of time having a HD camera. It is useful to keep a record of the procedure by saving photos or video clips during arthroscopy

35
Q

what is the light post of the arthroscope for?

A

for connecting the light source and illuminating the joint

36
Q

what is the light source used in arthroscopy?

A

halogen and xenon

37
Q

what are the functions of the cannula on the arthroscope?

A
  • Maintains arthroscope portal
  • Protects the arthroscope
  • Ingress of fluid
38
Q

what does irrigation do?

A

keeps the joint inflated and removes debris and blood

39
Q

what pressure is fluid pushed in during irrigation?

A

60mmHg

40
Q

what is egress systems?

A

a source for removal of lfuid

41
Q

what are instrumental cannulas?

A

have a rubber seal that allows insertion of instruments without allowing egress of fluid

42
Q

what type of power tools are used during arthroscopy?

A

shavers are available for removal of soft and hard tissue e.g. the fat pad, synovial membrane or medial coronoid

43
Q

what is elctrocautery or radiofrequency used for?

A

used to generate heat for cauterization of vessels or shrinking of tissues

44
Q

how would you prep a patient for elbow arthroscopy?

A
  • aseptic clip and prep around the entire elbow and enough space for conversion to open
  • hang leg
  • draping (waterproof drapes)
  • positioning (dorsal or lateral recumbency and distract the joints ver sandbag or edge of table
45
Q

why might a patient require arthroesis?

A

if the patient has unilateral lameness, pain relief but gait abnormality

46
Q

what area of the humerus is usually most affcted in dogs with elbow dysplasia?

A

medial compartment

47
Q

how would you treat ununited anconeal process?

A
  • conservative
    -removal of anconeal process
  • proximal dynamic ulna osteotomy
  • lag screw fixation

ACVN - SURGICAL NURSING (17 decks)

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