Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Locomotor > Equine Tendon and Ligament Dz > Flashcards

Equine Tendon and Ligament Dz Flashcards

1
Q

What are the most common sites of tendon injury?

A
  • SDFT
  • Suspensory
  • Accessory ligament of the DDFT
  • DDFT
    (in that order)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of tendon injury?

A 
> percutaneous
- laceration/penetration 
> subcutaneous (most common)
- not associated with direct external trauma
- strain, displacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cause of over-strain injuries?

A 
> sudden overextension
- ?DDF
> preceding tendon degeneration + sudden oveextension 
- SDFT, SL 
(working close to limit of strain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the tendon sheath affect the physiology of tendon?

A
  • outside sheath, paratenon surrounds the tendon
  • in sheath, healing slower and poorer
  • adhesions can form here
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a bowed tendon?

A
  • SDFT injury

- usually extrathecally ( outside tendon sheath)

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

Hx of tendon injury?

A
  • intense excercise

- signs can be delaed

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

clinical exam findings with tendon/lig injuries?

A

> lameness
- can be temporary
- or can persisnt chronically (DDFT/SL)
MCP joint overextension
- decrreased with reduced weight bearing (so weigh up lameness with overextension)
- fibrosed (stiff) tendon
elevating toe
- PATHOGNOMONIC with DDFT (sole flexor of distal interphalangeal joint)
palpation
- limb lifted (apply pressure ID pain) and weight bearing (location)
- may be bilaterally affected just one worse than the other
- prox SL in HL and pastern difficult to palpate
- assess pain, oedema, suppleness of tendons

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

When can ultrasound be used for assessing severity of tendon injuries?

A
  • ~7d

- and give prognosis

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

Type of equipment used for ultrasounding tendons?

A
  • high frequency 7.5MHz and linear transducer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical exam findings with SDFT tendinopathy/tenditis?

A

> palmar metacarpal swelling

  • initial lameness (variable)
  • pain on palpation
  • core lesion with surrounding healthy tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hx and PE findings of PROXIMAL suspensory ligament desmitis?

A

> conformation (straight hock and hyperextension of the felock)
- pdf or result?
Hx: lameness variable, acute or insiduous onset
- worse on outside circle, soft
PE: medial palmar veain distension
- pain on palp
- diagnostic anaglesia
- imaging (US, radiograph, scintigraphy, MRI

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

What is the strangulation technique?

A

pushing SDFt and DDFt to palapte underlying SL in proximal canon

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

Where is the lameness worse on lameness workkup with proximal suspensory disease?

A
  • OUTSIDE circle

- soft surface

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

Ultrasound/radiographic findings with suspensory body and branch desmitis?

A 
(ligamentous origin) 
- image from medial and lateral (both branches) 
- focal/gneeralised lesions poss
- enlargement 
- periligamentar fibrosis very common 
- bilateral involvement common 
> radiographpy
- concurrent bony abnormlaities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PE finding with desmitis of the accessory ligament of DDFT (Inferior check)

A
  • swelling prox metacarpal region
  • dorsal SDFT
  • lamess often ABSENT
  • ultrasound : generalised enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which is the rarest tendinopathy?

A

DDFT
- commonly within digital sheath or navicular bursa (never really in metacarpal region)
> mid-substance disruption v border tears
- usually lateral

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

Which intra-thecal tendon tears are most common in fore and hindlimbs?

A 
> DDFT
- lateral border
- forelimbs
> manica flexoria
- usually HL 
> ultrasound diffficult 
- lateral or medial echogenic material 
- MF instability in longitudinal view
- distended flexor tendon sheath
18
Q

What are windgalls?

A

Bilat symmetrical, tenosynovitis -> idiopathic distnesion of the digital sheath
No need for tx if non painful and bilateral (common ponies)

19
Q

How does tenosynovitis affect lexor tendon region?

A
  • important consequences for associated soft tissues and bone
20
Q

Causes of digital sheath tenosynovitis?

A
  • idiopathic (widngalls)
  • non-septic (1* or mostly 2* )
  • penetrating injuries -> sepsis
21
Q

What is ALS? PE?

A

> annular ligament syndrome

  • milkd-mod lameness
  • minimally responsive to rest
  • occasionally irregular gliding of tendons
  • distended digital sheath with notch at level of PAL
22
Q

Further dxx findigns with ALS?

A 
> digital sheath analgesia
- usually + but may not be 100% 
- ?mechanical element to lameness? 
> Ultrasound 
- >2mm thickness
23
Q

What are the 3 phases of tendonitis?

A 
> acute
  inflammaotry
> subacute 
fibroplasia
> chronic
- remodelling 
(over ~1yr, SL quicker, tendons slower)
24
Q

Historical tx for tendonitis?

A
  • many tx advocated n the past
  • many no effect, some deleterious
  • little evidence base
25
Q

What clinical signs and pathology is associated with the inflammatory phase? (first 2 weeks)

A 
> PE 
- lamenss (dt inflam) 
- pain on palp 
- heat and swelling
> Path 
- hameorrhage
- inflam (neutrophils, macrophages, monocytes, ^ blood flow, oedema, proteolytic enzymes)
26
Q

Rational tx of inflammmaory phase of tendopathy?

A 
= minimise inflammation 
> physical therapy
- cold
- compression 
- MCP joint support 
- rest
> Meds
- short acting steroids (only within 24-48hrs, systemic or PERItendinosly, risk laminitis or apparnet resolution and over working!) 
- NSAIDs (analgesia too) 
> surgery
- percutaneous tendon splitting 
- poss combined with intrateninour medication 
- minimal evidence
27
Q

Clinical signs and pathology associated with subacute reparative phase (1 week-6months)

A

> clinical signs
- reduction/abscence of lameness
- resolution of inflame
- tendon still palpably enlarged and soft
- signs of re-injury if exercised too early
path
- angiogenesis
- fibroplasia (++ fibroblasts, collagen III, small collagen fibrils formed)

28
Q

Tx in subacute phase (1week-6 months)

A

> mobilisation
- early
- prgressive (introduce trotting after 3 months for SDFT)
regular ultrasound monitoring
- every 2-3months
- excercise based on cross sect area of tendonds (

29
Q

3 main regenerative medicines for tendiopathy? Aims of regenerative medicine?

A

= aims are to induce regeneration cf. repair (-> scar)
> scaffolds
- ACell (lyophilised pig bladder submucosa)
> growth factors
- PRP (platelet rich plasma)
> cell therapy
- mesenchymal stem cells

30
Q

Outline mesenchymal stem cell protocol?

A
  • locate bone marrow in sternum, heparinise
  • recover nucleated adherent stem cell population (one passage??)
  • resuspension in citrated supernatant of BM
  • implantation under ultrasound guidance (standing)
  • 48 week rehab programme
    > shown to be effective in racers and sports horses
31
Q

Clinical signs and pathology associated wih chronic remodelling phase (3-18 months)

A 
> clinical signs 
- tendon size decreases 
- tendon less pliable 
- reduced fetlock extension 
- contracture
> path
- collagen transformation from III-I 
- cross-linking
- thicker collagen fibrils
32
Q

Rational Tx in chronic phase?

A

= promote remodelling and prevent re-injury
> controlled ascending excercise (lower excercise level)
- with ultrasound monitoring
> surgery
- desmotomy of the accessory ligament of the SDFT (“superior check ligament”)
-> ^ incidence of suspensory dismitis?
- carpal sheath approach (tenoscopic)

33
Q

What is the fetlock joint?

A

Metacarpophalangeal

34
Q

What specific txx are indicated for proximal suspensory ligament desmitis ?

A

> extracorporeal shock wave therapy
- forelimb PSD 50% @ 6 months for chronic cases, 90% for conservative management of acute cases
- hindlimb PSD 40% @ 6 months for chronic, 10% for acute/0% chronic cases with conservative management only
fasciotomy and neurectomy
- for hindlimb PSD failed to improve after first 2 tx

35
Q

Specific txx for intrathecal tendon/ligament lesions?

A
  • medication? tenoscopy/arthroscopy?
  • intrasynovial location = poor healing
    > H/L manica flexoria tears
  • good prog with removal (80%)
    > F/L DDFT tears
  • debridement but poor prog (20-40%)
36
Q

Give egs. of developmental tendon diseases

A

= FLexural limb deformities
- congenital (uterine malpositiioning/CDET extensor rupture) or acquired (DOD, pain -> v loading)
> carpal flexural deformity
- congenital
> DIP flex deform
- aquired ~6mo
- type 1 =hoof can still sit flat on floor (can be loaded normally)
- type 2 =hoof past the vertical (breaker point)
- pain related? NSAIDs
- in adults: chronic lameness (FLs) or ALDDFT desmitis (HLs) can look the same
> MCP flex deform
- can occur 2* to chronic SDFT tendinopathy in adults too

37
Q

Tx carpal limb deformity

A
  • tx: exercise, physio, tube casts, surgery? if sx needed, prog too poor
38
Q

Tx DIP deformity

A 
> type 1
- exercise, physio
- toe extension shoe
- surgery: ALDDFT desmotomy /DDFT tenotomy 
> type 2 
- usually surgery 
- ALDDFT desmotomy/DDFT tenotomy
39
Q

Which structure is responsible for flexing the DIP?

A

DDFT§

40
Q

Tx MCP flex deform?

A
  • ALDDFT/ALSDFT desmotomy

- SDFT tenotomy last resort

41
Q

Causes of tendon laxity? Tx?

A
  • congenital
  • acquired 2* to casting
    > Tx: corrective farreiry/shoeing/ casts?? Not sure

Locomotor (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions