Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CVNT2 > Equine Lameness and Orthopaedics > Flashcards

Equine Lameness and Orthopaedics Flashcards

1
Q

what background information is important to obtain when getting a history of a horse with a lameness issue?

A

signalment

use

duration of ownership (awareness of history)

recent management (work/exercise, feeding, housing, shoeing)

previous medical problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what problem-specific information is important to obtain from the owner of a horse presenting with lameness?

A

limb/limbs affected

timing and nature of onset of signs
progression of signs since onset

associated events/incidents

any swelling/heat/pain

treatments/management employed

current state of problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the aims of the initial lameness workup?

A 
decide if lame or sound 
identify limbs affected 
score the severity of lameness 
try to identify the source/cause 
implement treatment plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the steps of the initial lameness workup?

A

physical examination

focused exam of musculoskeletal system

gait evaluation (walk/trot/lunge)

flexion tests

further examination of affected limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is involved in the physical examination of the horse? (5)

A

general clinical exam and body condition

conformation of body/limbs/feet

posture and weight bearing on the limbs

skeletal and soft tissue symmetry

localised swelling/thickenings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is involved in a detailed evaluation of the limbs?

A

inspection, palpation and manipulation of the limbs/joints

palpating the soft tissue

applying pressure to see response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what do we want to establish with a gait evaluation?

A

is there a gait abnormality?

is this due to lameness or something else e.g.
neurological

degree of lameness, which limbs are affected

what exacerbates the lameness?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do you perform a gait evaluation in a horse?

A

different surfaces - soft/hard
start with walk - if obviously lame at walk then won’t trot
trot up in a straight line
move on to lunging - soft and hard surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what PPE should you wear in order to lead/trot up a horse?

A

hat
boots
gloves
overalls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what equipment is required for leading/trotting up a horse?

A

headcollar

lead rope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the considerations for trotting up?

A

appropriate PPE

location - safe, flat surface, weather
contained?

how lame - is it appropriate

temperament of the horse

restraint - headcollar +/- bridle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how can you assess forelimb lameness?

A

assess as the horse is walking/trotting towards you

will be a head nod if lame - head lifts UP as the LAME leg hits the ground

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how can you assess hindlimb lameness?

A

assess as horse is walking away from you

“hip” of the lame limb will rise and fall through a greater range of motion than the sound side

hindquarters as a whole pushed up by sound limb and sink during stance phase of the lame limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the other aspects of gait evaluation?

A

relative lengths of phases of stride
arc of foot flight
path of foot flight (medial/lateral)
foot placement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a lameness locator?

A

technology to aid lameness evaluation - sensors worn by horse (poll, foot and rump) - helps identify asymmetry in stride
not a replacement for standard evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is lameness graded? why grade it?

A

out of 10 (more common) or out of 5

useful for the individual clinician to assess improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the uses of provocative (flexion) tests?

A

to demonstrate occult lameness in a “sound” horse
to exacerbate mild lameness
to aid localisation of the source of lameness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how is a flexion test performed?

A

limb held in flexion for about 1 minute - horse trotted away as soon as limb released
allowed a few lame strides - does lameness continue longer than expected?
horse should be standing ready to trot away
attempt to only flex joints being tested

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the limitations of flexion tests?

A

lack of specificity to site
inconsistency
lack of hard criteria for “positive” (allowed lame strides)
false positives and negatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how does lunging help diagnose lameness?

A

lameness often exacerbated on a circle due to leaning in (suspected lame leg on inside)
hard ground more evident than soft usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what PPE/equipment is required for performing lunging?

A

PPE - hat, steel toe capped boots, gloves, overalls

equipment - lunge line, lunge whip, bridle/lunging cavesson, boots for horse?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the other considerations when lunging a horse?

A

soft vs hard lunge (surfaces)
does the horse lunge well?
flat, large enough arena, appropriate surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are nerve/joint blocks?

A

perineural, intrasynovial or local infiltration of local anaesthetic - anaesthetises areas of the limb progressively to identify area of source of lameness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what LA is used for nerve blocks?

A

intra epicaine (mepivacaine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how are nerve blocks perfomed?
start distally and work up clean area with clorhex and spirit +/- clipping usually unsedated (need to test movement) left 10 mins then trot up to check for improvement
26
what are the common nerve block sites?
1. palmar/plantar digital 2. abaxial sesamoid 3. low 4 point
27
what size needles/syringes are used for nerve blocks?
23-25G, 5/8" needles | 2ml syringes
28
which nerve block site is this?
palmar/plantar digital
29
which nerve block site is this?
abaxial sesamoid
30
which nerve block site is this?
low 4 point - medial and lateral (4 needles)
31
how is a joint block performed?
intrasynovial administration - sterility is key sterile skin prep - clorhex and spirit evaluated at 10 mins and then later
32
when is diagnostic imaging performed?
once an area of source of lameness has been identified
33
what are radiographs useful for?
identifying bony change
34
why are diagnostic ultrasounds useful?
distinguishes tendon/ligament injuries from peritendonous swelling defines which tendon/ligament is injured evaluates type and degree of damage monitors healing
35
how do you prep a limb for ultrasound?
clip if required clean to remove dirt apply gel to area may require sedation to keep still
36
what are we looking for during ultrasound?
``` increase in tendon/ligament size change in internal architecture loss of longitudinal fibre alignment indistinct margination peritendinous fluid in tendon sheaths ```
37
what are hyperechoic core lesions (US)?
black hole in tendon centre
38
what is diagnostic arthroscopy?
direct visualisation of joint cavities, including articular cartilage, synovial membrane, intra-articular ligaments and menisci
39
what are the limitations of diagnostic arthroscopy?
requires GA - risk and cost | inability to examine most joints in their entirety
40
what is MRI useful for?
allows simultaneous demonstration of bone and soft tissue structures- good for hoof
41
how is nuclear scintigraphy performed?
technetium 99m linked to methylene diphosphate injected IV, taken up into mineral bone lattice emits gamma radiation (6 hours) which is detected by gamma camera
42
which lesions can be detected by nuclear scintigraphy?
stress fractures arthropathies enthesiopathies (connective tissue around joints) (binds to increased metabolism/rapid turnover areas of bone)
43
how can uptake be increased for nuclear scintigraphy?
lunge/exercise horse beforehand
44
how must a horse be managed after nuclear scintigraphy?
will be radioactive - must be kept in isolation until no longer radioactive (no handling, mucking out etc) urine will need to be collected during image acquisition
45
what is synovial sepsis?
bacterial contamination of a synovial structure - causes septic arthritis and chronic lameness of not treated
46
how can we investigate synovial sepsis?
synoviocentesis and analysis of synovial fluid may inject sterile saline into joint and check for egress contrast radiography?
47
what does checking for egress with saline mean?
checking if fluid comes out of wound | shows communication between joint and wound
48
what is the most important part of arthrocentesis?
maintaining sterility
49
how do you prep for arthrocentesis?
sterile prep with clorhex 5 min minimum wipe with surgical spirit horse usually sedated
50
what is the role of the nurse during arthrocentesis?
prepping site non-sterile assistant during arthrocentesis have equipment and spared ready (needles, syringes, sterile gloves, tubes/pots for collection) monitoring for lameness/deterioration of lameness in post 48 hours (plus heat)
51
how might an arthrocentesis sample be analysed?
cytology - TNCC and neutrophil % protein concentration lactate (slow to rise in first 24hrs) may also take blood sample for serum amyloid A
52
what is laminitis?
inflammation of the laminae/lamellae in the hoof | leads to dermal/epidermal separation and structural changes in the foot - rotation and sinking of P3
53
what is the main issue with laminitis?
causes structural changes/failure in the foot (rotation/sinking of P3)
54
what is the developmental phase of laminitis?
between the trigger and onset of clinical signs
55
what are the phases of laminitis?
developmental acute subacute chronic
56
what is the acute phase of laminitis?
onset of clinical signs (72 hours) | may become chronic or subacute after this
57
what is the subacute phase of laminitis?
from 72 hours | will require 2-3 months repair
58
what is the chronic phase of laminitis?
structural failure
59
what are the clinical signs of laminitis?
``` stilted, pottery gait increased, bounding digital pulses leaning back on heels recumbency worse on hard ground struggle to turn due to foot placement reluctance to pick up feet ```
60
what are some of the causes of laminitis?
``` endocrinopathies (PPID, EMS) excessive carbohydrates excessive weightbearing endotoxaemia/SIRS corticosteroids (? anecdotal) ```
61
what are the underlying endocrinopathies which can contribute to laminitis?
equine metabolic syndrome | pituitary pars intermedia dysfunction
62
what is the pathophysiology of endocrinopathic laminitis?
not known but likely hyperinsulinaemia and insulin toxicity
63
what are the other causes of laminitis?
hospital setting supporting limb laminitis (excessive weightbearing, fractures, cellulitis) endotoxaemia (secondary to colic/colitis/retained foetal membranes)
64
what are the risk factors for laminitis?
``` history of laminitis obesity endocrinopathies (PPID, EMS) age insulin resistance season (pasture-related) heavy horses native ponies excessive weightbearing or carbohydrates ```
65
how can we manage laminitis in the developmental stages?
``` consider management for at-risk horses cold therapy - ice boots NSAIDs to reduce inflammation support for feet - frog supports, deep shavings bed treat underlying endocrinopathies ```
66
how can we manage laminitis in the acute stage?
strict and complete box rest/restricted movement deep shavings bed frog supports/styrofoam pads NSAIDs - analgesia and anti-inflammatory increase perfusion - ACP? treat underlying cause address diet if endocrine related - care w/ colic farriery once more comfortable
67
how can we manage laminitis in the subacute phase?
gradually withdraw treatment as long as improving | keep on strict box rest
68
how can farriery help laminitis?
shorten toe needs doing over time remedial shoeing - heart bars (support frog), silicone, glue on shoes
69
what radiography considerations are there for laminitis patients?
lateromedial and dorsopalmar/plantar projections measure rotation and sinking (prognostic indicators) comfort - pick up feet and stand on blocks metal marker on dorsal hoof wall for measurement
70
how can we try and prevent laminitis occurring in those with endocrinopathies?
treat underlying endocrinopathy weight loss/promote ideal BCS exercise if possible to increase insulin sensitivity diet - restrict carbohydrates, soaking hay restricted grazing - muzzles, strip grazing
71
what will change for the horse on box rest?
limited exercise no turnout behaviour - boredom, stable mates, lack of exercise reduction in eating time
72
what are the main concerns with a horse put on box rest?
colic impaction behaviour issues gastric ulcers
73
why might box rest increase the risk of gastric ulcers? how can this be avoided?
reduction in eating time due to boredom (eating faster) | omeprazole, smaller holed haynets/toys to keep occupied for longer consider what is laminitis appropriate
74
what nursing considerations are there for horse on box rest?
monitor faecal output, colic signs, appetite, signs of stress consider mirrors, company watch out for behaviour - may be more keen to escape, difficult to handle
75
what considerations need to be made when a horse is coming off box rest?
gradual changes in management, gradual change in diet behaviour when turned out - may require sedation/small field for gradual return slow reintroduction to work

CVNT2 (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions