Equine soft tissue injuries of the distal limb Flashcards

1
Q

What is strain

A

the amount a tendon elongates for amount of stress put into it

Curve not linear

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2
Q

Sections of stress strain graph

A

1 = straightening of tendon crimp, don’t get much deformation
2 = elasticc deformation; tendon absorbs lots of strain before deforming and returns elastic energy
3 = non-elastic deformation; potential for microdamage here
4 = failre/rupture

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3
Q

What safety factor do most equine soft tissues have

A

only 1.2

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4
Q

What is COMP

A

Cartilage oligometric matrix peptide
Involves in organising collagen into efficient systems; high early in life esp in middle of SDFT where it needs to be more elastic

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5
Q

What age is COMP high i.e window to make a difference with tendon education

A

<3 years

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6
Q

Difference in collagen in DDFT between mid metacarpal region and fetlock

A

In mid metacarpal region, more elastic with lots of type 1 collagen

In fetlock region, it is changing direction and needs to be resistant to compreeion; more type II colagen

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7
Q

What is chondroid metaplasia

A

Where there is more type II collagen in a tendon so it is more ike cartilage
See this where tendons change direction
Also after injury

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8
Q

What has suspensory ligament evolved from

A

interosseus muscle; so it has some muscle fibres and fat

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9
Q

Where do most SDFT injuries happen

A

Mid metacarpal region; mostly forelimb

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10
Q

Where do most DDFT injuries happen

A

Where it changes direction i.e around fetlock within tendon sheath or around navicular bone wihtin hoof

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11
Q

Where do suspensory ligament injuries tend to happen

A

At prox origin + insertion onto prox sesamoid bones

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12
Q

Where do check ligament injuries happen and how do they present

A

IN prox third of forelimb metacarpus on lateral side
Get a pathognomic lateral swelling

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13
Q

What are common soft tissues around stifle that get injured

A

Cruciate ligament
Medial meniscus

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14
Q

When does most tendon education happe

A

in the foal so want foal to be active

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15
Q

Why should we refrain from training horses at competition standard too often

A

Because this puts them in stage 3 of stress/strain graph i.e above threshold for microdamage of tendons

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16
Q

What are the advantages/disadvantages of overreach boots and when should we use them

A

can stop overreach injuries
But contributes to physiologcal heating effect in tendons so can cause denaturaiton

Only use in horses that tend to overreach

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17
Q

What happens in the remodelling phase o tendon injury

A

Tendon size decreases
Transformation back to springy type I collage from type III

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18
Q

Why do scar tissue lesions in tendons tend to extend proximally and distally over same cross sectinoal area

A

Because this section is non-compliant so during tendon stretch there is pulling on the parallel fibres above and below the lesion

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19
Q

What structures are within the digital flexor tendon sheath

A

DDFT
SDFT
MAnica flexoria
Palmar/plantar annular ligament

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20
Q

what is the manica flexoria

A

Part of SDFT which forms a tunnel for DDFT to travel through

21
Q

What is the annular ligament and what happens when it gets injured

A

= ligament that holds DDFT/SDFT in canal
Very uncompliant tissue

When it is injured and heals, it shortens causing constriction of the tendon sheath, this leads to effusions around flexor tendons and even more compression and inflammaiton
= compartment-like syndrome

22
Q

How do treat palmar annular ligamnet syndrome

A

Cut the palmar annular ligament

23
Q

Characteristics of ultrasound as a diagnostic device for soft tissue injuries

A

High specificity
Low sensitivity

24
Q

Why is it. agood idea to do tenoscopy and removal of torn manica flexoria parts

A

Because they drive tneon injury

25
Q

What do we see with a peroneus tertius tear

A

Reciprocal apparatus breaks down
Can extend the tarsus without extending stifle

26
Q

What is peroneus tertius the antagonist of

A

SDFT

27
Q

What horses is locking stifle seen most in

A

Miniature horses

28
Q

How to treat locking stifle in mild vs severe cases

A

mild = rehab
severe = medial patellar ligament desmotomy

29
Q

Which meniscus is more commonly injured and which aspect

A

Medial meniscus as cranial aspect

30
Q

How to diagnose meniscal injuries

A

arthroscope
U/S can be used for severe ones

31
Q

What kind of lameness is cruciate ligament injury associated with

A

Acute, severe lameness rather than degeneration

32
Q

What can we do to treat refractory cases of soft tissue injury in tarsal region

A

Neurectomy of deep branch of lateral plantar nerve
+ plantar fasciotomy to allow ligament to swell out

33
Q

What is a contraindication for neurectomy of lteral plantar nerve for lameness in tarsal region

A

marked ligament degeneration because the neurectomy can accelerate degeneration

34
Q

What sort of injuries would be candidates for biological therapies

A

Need something to inject into
e,g tendon core lesion
injuries within synovial structures

35
Q

Are bone marrow or adipose derived stem cells better

A

Bone marrow e.g from sternabrae

36
Q

How good is platelet rich plasma in soft tissue injury

A

Seems to heal quicker but just as likely to re-injur so less populat now

37
Q

What is the only consistently proven practctice to improve soft tissue injuries

A

Controlled exercise programH

38
Q

How to do a controlled exercise program

A

Start early with walking in hand
Increase work gradually over 6-12 weeks
Don’t turn out free until up to canter level work in school

39
Q

What type of laser has the best effect in soft tissue injury

A

Class 4

40
Q

Difference between water treadmill and swimming

A

Water treadmill provides stress for bones and soft tissue to make them heal
Adds resistance

vs swimming good for aerobic fitness

41
Q

What sedatino choice would be good for scanning a horse

A

detomidine; gives 45 mins sedation
+ butorphanol

42
Q

What frequency probe do we use for tendon scanning

A

High freq linear probe
This gives good tissue detail (traded off against low depth but this isn’t needed)

43
Q

What is a lameness with thickening on lateral aspect of prox third of metacarpu s likely to be

A

Check ligament injury e.g split injury

44
Q

Large swelling on back of tarsus/carpus localises to where

A

Digital flexor tendon sheath

45
Q

Swelling over lateral aspect of distal metacarpu s might be injury to what structure

A

suspensory ligament (this is where it inserts on prox sesamoids)

46
Q

Why is the fibre pattern in a torn tendon so poor

A

Because it is not under tension
See similar finding when a non-weight bearing tendon is scanned

47
Q

How should shockwave threapy be delivered for best results; weight bearing or not

A

Non-weight bearing

48
Q
A