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Locomotor > Equine External Coaptation and Emergencies > Flashcards

Equine External Coaptation and Emergencies Flashcards

1
Q

Assorted layers of bandaging?

A
  • vet gammgee (padding)
  • non adherent wound dressing
  • orthopeadic padding
  • cohesive bandage tape
  • conforming bandage
  • adhesive bandage
  • white tape
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2
Q

What types of limb bandage can be applied to horses?

A
  • lower limb bandange
  • foot bandage
  • full limb (fore/hind)
    > start with lower limb and then add another section higher up, then cover both
  • RObert-Jones (fx support before surgery/if sugery not possible)
    > multiple layers of thick padding, getting tighter -> provides support
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3
Q

How is a lower limb CAST applied?

A
  • minimal orthopeadic padding
  • cotton stockingette
  • fix cast felt to proximal mrgin
  • apply casting tape
  • apply heel wedge
    +- encorporate Gigli wire (facilitates easy cast removal)
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4
Q

What is transfixation casting? Indications?

A

> transosseal pins cemented in cast

  • repaired or conservatively treated distal limb fx that is unstable under axial loading
  • fetlock breakdown
  • often salvage
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5
Q

How can setting time of cast be altered?

A
  • hotter the water, faster it sets
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6
Q

What is a large animal external fixator also known as?

A

Walking cast

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7
Q

What Hx must be found out about the Fx patient?

A
  • what happened? How long ago ?
  • was the trauma observed?
  • has the horse been moved since?
  • did it have to be caught after the trauma?
  • did the horse lose a lot of blood?
  • did the horse sweat excessively?
  • has any medication been given?
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8
Q

Kit necessities to be prepared for fx

A 
> bandage material 
- wound dressing
- conforming gauze
- sheet cotton 
- casting tape
- duct tape
> splints
- 2"x4" slats, boards
- light metal rods
- PVC pipes
- Kimzey leg saver splint 
> Chemical restraint 
- Xylazine 
- detomidine
- romifidine
- butorphanol 
> Abx
- Procaine Penicillin G 
- K-Penicillin 
- Gentamicin 
> other
- flunixin 
- bute
- tetanus toxoid vax
- IV fluids
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9
Q

Initial steps to tx of emergency patient?

A 
> take charge
> assess condition
- shock 
- blood loss
> localise and assess damage
- tx v euthanasia
> correct immobilisation 
- always 1st, before radiographs etc. 
> radiographs
> referral
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10
Q

Which drugs can be used for chemical restraint inthe mergency situation? Which should not be used?

A 
> A2s
- xylazine 0.2-1.1mg/kg IV
- detomidine 10-25ug/kg IV
- romifidine 0.05mg/kg IV
> A2 + Narcotic
- detomidine 
\+ Butorphanol 0.020.1mg/kg IV 
- never use narcotics alone -> excitement
> AVOID ACP d/t hypotensive effects in the presence of circulating catecholamines
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11
Q

Outline initial examination of an injured limb

A 
> visual 
- deviation axial/abaxial 
- hyperextension 
- swelling/haematoma
- open wound
> palaption 
- crepitus
- fx fragments
- open wound/moist spot
- stress tests 
-> localisation and classification of fx 
- incomplete v complete
- simple v comminuted 
- closed v open 
- articular v non-articular
- tendon/lig disruption? 
- status of soft tissue
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12
Q

Outline classification of a fracture. LEARN THIS FOR ROTTIONS!!

A
  • closed/open
  • incomplete/complete
  • simple/comminuted
  • articular/nonarticular
  • tendon/ligament disruption?
  • status of surrounding soft tissues
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13
Q

How do the biomechanics of a limb change when fx?

A
  • muscles acting over a fx bone exert different action to what they are intended to do
    > eg. digital extensors and flexors in proximal radius -> abduction
    > passive action structures counter their action
  • suspensory aparatus
  • reciprocal apparatus
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14
Q

Outline the ideal splint

A
  • neutralises forces
  • not too cumbersoe (pendulum effect)
  • applicable under difficult circumstances (no GA)
  • economical and accessible
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15
Q

What are the functional divisions of the equine limb?

A
  1. Coronary band to distal MC / MT
  2. Distal MC/MT to distal radius/proximal MT
  3. Distal radius/prox MT to elbow/stifle
  4. elbow/stile to distal scapula/hip
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16
Q

What biomechanical acts on division 1 of the forelimb? What effect does this have clinically and so what are the goals of immobilisation?

A 
> angle of the fetlock 
- suspensory apparatus
- flexor tendons 
- bending focus over fx site 
> counteract bending forces
> axial alignment of dorsal cortices
17
Q

What immobilisation technique would be appropriate for division 1 forelimb fx?

A

debatable
- padded bandage/cast bandage with dorsal splint
- Kimzey leg saver splint
- can keep up on tippytoe but some argue immobilisation of the fetlock in flexion is counterproductive, can result in displacement of a fx that is otherwise stable under axial loading eg. condylar fx 3rd MC/MT, proximal phalanx fx
- rigid external coaptation with limb weight bearing may be better
> avoid excessive padding
- slipping
- pendulum effect

18
Q

What biomechanical acts on division 2 of the forelimb? What effect does this have clinically and so what are the goals of immobilisation? Methods of immobilisation?

A
  • use bones proximal and distal to attach splints bridging fx site
    > immobilisation
  • RObert Jones bandage (2/3x diameter of limb @ fx site, multiple layers of individually confoming padding)
    + rigid splints up to elbow laterally and caudally
19
Q

What biomechanical acts on division 3 of the forelimb? What effect does this have clinically and so what are the goals of immobilisation? Methods?

A
  • digital extensors and flexors act as abductors of the limb (prox radius)
  • inadequate stabilisation with RJB splints up to elbow
    > goal of immobilisation
  • prevent abduction and soft tissue damage on medial aspect of the limb
    > methods
  • RJB with extended lateral splint
20
Q

What biomechanical acts on division 4 of the forelimb? What effect does this have clinically and so what are the goals of immobilisation?

A
  • triceps apparatus disabled -> dropped elbow (cannot be flexed for weight bearnig)
  • but humerus, radius and ulna (bones affected) are well protected by soft tissue so no need for direct protection
    > goal
  • splint carpus in extended position to allow for weight bearing and blanace
    > method
  • padded bandage
  • splint caudally orcranially over carpus
  • walking may be difficult and foals may be too weak to ambulate
    > may not require immobilisation
21
Q

What biomechanical acts on division 1 of the hindlimb? What effect does this have clinically and so what are the goals of immobilisation?

A

debatable as for forelimb - maintain in extension or flexion?
- reciprocal apparatus
- plantar cortices easier aligned
> method
- bandage/cast bandage with plantar splint
- ANGLED Kimzey leg aver splint

22
Q

What biomechanical acts on division 2 of the hindlimb? What effect does this have clinically and so what are the methods of immobilisation?

A

> angulation of tarsus
- prox tarsus difficult to bandage and splints difficult to apply
immobilisation
- RJB with spints to tuber calcaneous (lateral and plantar)
- usually less voluminous than forelimb to allow movement!

23
Q

3 main purposes of bandages?

A
  • cover wounds protected by dressing
  • prevent swelling/oedema
  • immobilisation (+splinting)
24
Q

What biomechanical factor acts on division 3 of the hindlimb? What are the components of this? Effects clinically? Immobilisation technique?

A

(prox metatarsal to stifle)
> reciprocal apparatus
- peroneus tertius m.
- fllexor digitalis superficialis m.
- gastrocnemius m.
> overriding at fx site instead of hock flexion
+ stifle joint cannot be immobilised
+ muscles laterally over tibia act asabductors
> RJB with extended lateral splint up to coxofemoral joint (wide board splint, light metal [modified Schroeder-Thomas without groin bar]
- prevents lower limb instability
- angulation at tarsus and stifle prevents paplication of cranial or caudal splint

25
Q

How are fx of division 4 of the HL treated? Clinical signs? Prognosis?

A

(femur and pelvis, stifle to coxofemoral joint)
> non-weight bearing lameness
- limb remains controllable d/t more distal muscle insertions
- impossible to stabilise by external means
- poor prognosis (unstable fx, fx involving acetabulum)

26
Q

See lecture for good summary of tx of each division

A 
> FL
1. dorsal splint
2. RJB caudal and lateral splint
3. RJB with extended lateral splint
4. caudal splint to lock carpus in extension/no immobilisation necessary
> HL 
1. plantar splint
2. RJB with plantar and lateral splint
3. RJB with extended lateral splint
4. no immobilisation necessary
27
Q

What are the best ways to transport a fx patient?

A

> shorten the distance to get to trailer
use goose neck trailers or large vans
- put sound legs at the FRONT to allow them to compensate for breaking forces
limit space to allow for leaning
leave head and neck free
young foals will travel recumbent

Locomotor (29 decks)

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