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Equine Rehab > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What is the benefit of MRI

A

Detailed evaluation of osseous and soft tissue structures, can evaluate cartilage and fluid in the bone , can tell active vS silent problems

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2
Q

Describe low field MRI

A

Lower quality image, longer scan times so increased risk of motion artifacts , thicker slices, no risk of general anesthesia

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3
Q

Describe high field MRI

A

Greater signal emission , thinner slices, under general anesthesia, size limitation, harder to position the horse, greater quality

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4
Q

The medullary cavity of the bone would be - on MRI because-

A

Hyperechoic because of the fat

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5
Q

Describe a TI weighted MRI

A

Less contrast between tissues , fluid / cortical bone hypointense , fat hyperintense , muscle in the middle

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6
Q

Describe a T2 weighted MRI

A

Cortical bone hypointense , fluid/fat hyperperintense, muscle in the middle

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7
Q

Differentiate between a T2 weighted image and a proton density (pd) image

A

T2 - hypo intense cortisol bone, hyper intense fluid and fat
PD- hypointense cortical bone, hyper intense fluid , fat is intermediate (the difference)

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8
Q

On a Pd image , tendon will be - and a lesion in a tendon will be -

A

Tendon will be hypointense and a lesion in the tendon will be hyperechoic

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9
Q

Describe a stir image - short time inversion recovery

A

Cortical bone is hypointense, fluid is hyperperintense - low spatial resolution (grainy appearence ) I suppresses fat to highlight fluid

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10
Q

What is nuclear scintigraphy

A

Bone scan

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11
Q

Describe the basic principles of a bone scan

A

IV injection of radionuclide that concentrates in metabolically active bone (abnormal bone turnover and osteoblastic activity

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12
Q

What are benefits of nuclear scintigraphy over rads

A

Whole horse picture , very sensitive to bone remodeling and turnover, precursor to radiographic change / able to image areas that are hard to radiograph

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13
Q

What are the phases of imaging of a bone scan

A

Vascular in 90 seconds, soft tissue in 10 - 20 minutes, bone imaging in 2- 3 hours , take quickly after injecting

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14
Q

What is the danside to a bone scan

A

Spatial resolution is poor so yw con see the bore is not but not exactly where, need to do xrays to confirm

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15
Q

What is chiropracture

A

Relationship between structure (musculoskeletal system) and function (nervous system)

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16
Q

Chiropractor is a- therapy that uses - to cause a healing response in _

A

Manual therapy , uses specific location, direction and controlled force to cause a healing response via a change in joint structure , muscle function, neuro reflexes

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17
Q

What are the core chiropractic values

A

The body will heal itself, the nervous system is king, interference/ disruption happens, chiropractors job is to restore communication

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18
Q

Describe AB large myelinated fibers (gate theory)

A

Involved wl proprioception , fast signals, stimulates the interneurons that are inhibitors ramp down the proprioceptive pathway

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19
Q

Describe C fibers in the gate theory pathway

A

Small unmyelinated fibers , largely involved in pain stimuli, slow conduction, inhibit the interneurons (the inhibitors) which allows the pain pathway to ramp up

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20
Q

Define subluxation to a chiropractor

A

Joint not moving as well as it should (vertebral segment dysfunction )

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21
Q

In chiropractic, you assess thoracic bones - and lumbar bones -

A

Thoracic - side to side
Lumbar - top to bottom

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22
Q

Chiropractic goes along with _ as therapy to improve strength and stability

A

Core training exercises

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23
Q

What is most important with restabilization of the multilidus muscles

A

More important to restore stability and muscle strength than to increase flexibility

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24
Q

Define massage

A

Manipulation of soft tissue (not joints like in chiropractic)

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25
Q

Define trigger points

A

Hyper irritable spots in skeletal muscle - palpable nodules in tight muscles, twitch response can lead to good pain

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26
Q

What can cause trigger points to develop

A

Muscle injury or strain, structural imbalances , rapid growth, systemic infections , arthritic joints, poor nutrition, lack of exercise, stress

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27
Q

Describe active trigger points

A

Painful, referred pain that spreads down limbs, decreased ROM and circulation, secondary trigger points associated with

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28
Q

Describe latent trigger points

A

Not currently painful, cause restriction of motion and maybe decreased circulation can become active

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29
Q

What affect do trigger points have on performance

A

Limit stretch of affected music which alters gait, reflex relaxation of opposing side increasing risk of injury I decreased circulate due to waste buildup in muscle I decreased mobility

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30
Q

How can you treat trigger points

A

Massage (firm direct pressure for 30 seconds) , aquapuncture, stretch muscle through full ROM and active/passive stretching

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31
Q

What is collagen

A

Main constant of connective tissue keeps things inline and in bundles , align along lines of stress

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32
Q

Describe the 2 types of collagen fibers

A

Type 1 - gives support and resistance to tension
Type 2 - supports endothelial cells

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33
Q

Describe the stress strain curve

A

Elongation will not be permanent up to the elastic limit or yield point, complete rupture occurs at pmax (the maximum load point)

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34
Q

What causes the stress strain curve

A

Collagen fibers are oriented in the direction of stress and the curve occurs when longitudinal stress is applied to collagen, causing tissue elongation and permanent deformation

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35
Q

How does massage affect the stress strain curve and the collagen within the connective tissue

A

Low repetitive loads that causes elongation by creep , also elongation by relaxation

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36
Q

How can massage benefit the lymphatic system

A

Can increase lymph flow, increase interstitial fluid pressure and more find from limbs to core body

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37
Q

How can massage benefit the circulatory system

A

Replenish tissue fluid and remove inflammatory products

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38
Q

How can massage benefit injury to connective tissue

A

Stretch shortened tissues, mobilize and soften adhesions

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39
Q

How can massage benefit muscles

A

Change muscle plasticity by increasing extensibility and strength, reduce soreness, improve recovery after exercise

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40
Q

How does massage affect pain and sensation

A

Can stimulate nerves and mechanoreceptors, reducing sensitivity increasing pain thresholds, reduce response to stretch

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41
Q

What are general benefits of massage therapy

A

Pain relief by reducing pain thresholds, improved locomotor function, improve circulation, relaxing, restoring balance and Qi flow

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42
Q

Describe stroking and effleurage techniques

A

Stroking - opening or closing to assess tissues and cause relaxation
Effleurage - milk find up though lymphatics , decrease swelling, relaxation

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43
Q

Describe petrissage and compression massage techniques

A

Petrissage- deep pressure to compress underling tissues (kreading, wringing, ete) to mobilize tissues
Compressions - pressure applied over the muscle for 15 seconds in areas with increased muscle tore to soften and increase circulation

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44
Q

Describe holding/ placing and percussion

A

Holding - light touch held in place to warm, relax, support
Percussion - cupped hand in area to hear a hollow sound over large muscle bellies to improve circulation and promote relaxation

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45
Q

Describe friction and passive movement techniques

A

Friction - contact rapidly applied over an area to warm tissues and alter blood flow , use with scar tissue to break up adhesions (deep cross fiber pressure)
Passive - ROM at end of treatment when muscles warmed and relaxed, identity areas of continued restriction

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46
Q

Describe myofacial release

A

Fascia surrounds muscles and connects to tendons/ligaments , simulate areas along facial lines using massage (hands on or instrument assisted pressure)

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47
Q

What is the goal of tui-na

A

Restore balance and homeostasis in the body, keep Qi in abundance

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48
Q

What are the functions of tui-na

A

Similar to massage - warming, more accumulation, dispel masses, sedation, correct malpositions (chiropractic)

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49
Q

Describe kinesiology tape

A

Elasticity gently lifts skin from tissues below allowing space to improve blood and lymphatic flow _ goal is to support mobile and relieve pain, reduce swelling, increase mobility without limiting Rom

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50
Q

Describe T touch

A

Combo of training and touch massage

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51
Q

Describe the masterson method

A

Integrated massage modality , lets the horse actively participate in process of releasing tension

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52
Q

Describe reiki

A

Light touch technique to reduce stress, restriction and improve relaxation - channel energy into patient by means of touch

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53
Q

Describe yin and yang in TCVM

A

Yin - cold, slow, calm, parasympathetic
Yang - bright, hot, sympathetic
Endless cycle when balanced, pathologic imbalanced

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54
Q

What are the 5 elements of acupuncture and what organs do they represent

A

Wood - liver / gallbladder
Fire - heart, small intestine, tongue
Earth - spleen, stomach, muscle, digestion
Metal - lung, large intestine, skin
Water - kidney, bladder

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55
Q

What is zang fu in relation to acupuncture

A

The 2 organs of each element - zang is related to yin (interior) and fu is related to Yang (exterior)

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56
Q

What is acupuncture

A

Stimulation of specific locations in body to enact an energetic change, changing nerve conduction I hormone release, etc through meridians and acupoints

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57
Q

What are back shu points

A

Along bladder channel, where Qi moves internal to external

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58
Q

What are front mu points

A

Alarm points on chest and abdomen, where Qi gathers

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59
Q

Stagnation of qi leads to

A

Pain - use points to more Qi

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60
Q

Stress leads to (in termsof acupunchre)

A

Liver disharmony - use points that target the liver

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61
Q

For acupuncture, bone →, tendon/ligament → , muscle →

A

Bone → kidney
Tendon ligament → liver
Muscle → spleen

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62
Q

What are likely mechanisms of action of acupuncture

A

Nerve stimulation, local counter irritation, microtrauma , resulting in altered blood now and immune response

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63
Q

What are local effects of acupuncture

A

Activation of complement cascade and coagulation cascade, mast cell degranulation, results in increased blood flow to the area 1 local immune response and relaxation of muscles

64
Q

What are systemic effects of acupuncture

A

Activate sensory nerves (pain or proprioceptive pathways), analgesic effect (endorphin release)/serotonin release

65
Q

Describe tens units - transcutaneous electrical stimulation and its goal

A

Electrical current applied via surface electrodes to stimulate peripheral nerves for pain modulation - goal is to stimulate inhibitory interneurons at spinal cord to stop pain cycle and release endogenous endorphins within the CNS

66
Q

What are the 2 modes of the tens unit

A

Conventional - acute pain, frequencies over 100, lower pulse duration
Acupuncture - chronic pain, frequencies less than 20, longer pulse duration, attached to acupuncture needles in large or focal muscle groups

67
Q

What are indications for the tens unit

A

Acute or chronic musculoskeletal pain, stimulation of denervated muscles

68
Q

What is the protocol for tens unit

A

30 minutes 2-3 times daily over painful region or electroacupuncture once daily 3 times a week

69
Q

What is NMES - neuromuscular electrical stimulation; what is the goal

A

Lower frequency longer pulse duration with targeted depths of 6-8 inches deep - goal is to achieve full contraction and relaxation of larger muscle groups , stimulate sensory and motor nerves

70
Q

Differentiate between a tens unit and a NMES unit

A

Tens - stimulates sensory nerves, can focus on focal areas
NMES - stimulate sensors and motor nerves, larger muscle groups

71
Q

FES (functional electrical stimulation) is a form of NMES that does what

A

Electrodes placed diagonally in pairs across large muscle groups (back, neck, pelvis) - contract and relaxI hanging power supply

72
Q

What are indications of NMES

A

Acute and chronic musculoskeletal pain, stimulation of denervated muscles , chronic muscle wasting, muscle spasticity

73
Q

How often do you treat with nmes

A

2 treatments in 48 hours then 1 treatment once a week

74
Q

What are contraindications for tens / NMES

A

Cardiac issues, pregnancy, treatment over the thoracic cavity

75
Q

What PEMF - pulsed electromagnetic therapy

A

Uses electrical currents through a coiled wire to generate a magnetic field that produces secondary electrical currents in tissues that stimulates a cellular repair response - low frequency with short phase and short pulse duration to avoid heat generation

76
Q

What are benefits of PEMF

A

Increase in nitric oxide to decrease information, reduce pain, stiffness improved function -increase vasodilation and blood flow

77
Q

What are indications for PEMF

A

Increase blood now in superficial and deep tissues, decrease pain and muscle spasm , muscle relaxation I chronic or nonunion fractures / osteoarthritis

78
Q

What is the protocol for PEMF

A

Range from 5-20 minutes per site

79
Q

What contraindications for PEMF

A

Pregnancy , open wounds, cancer, infection I cardiac issues - we wouldn’t want to increase metabolic activity in these tissues

80
Q

What is WBV - whole body vibration therapy

A

Uses vertical and horizontal vibrations (oscillations) at law frequency and low amplitude to mimic natural movement - used in astraunots to prevent osteoporosis and muscle wasting

81
Q

What are risks to whole body vibration therapy

A

Prolonged exposure to high frequency and high amplitude vibrations can have deleterious effects (muscle fatigue , reduced muscle contraction force)

82
Q

What are indications for WBV

A

Maintenance of fitness, promotion of blood flow, postoperative strength training, balance, proproception, core training, tendon and ligament injuries

83
Q

How often do you do WBV

A

10 - 30 mins, 1-2x daily

84
Q

What are contraindications for WBV

A

Acute fractures, laminitis - don’t want anything unstable on the plates

85
Q

Describe cold therapy, when is it indicated, what are the goals

A

Indicated during the acute injury phase (first 24-48 hours), therapeutic effects occur when tissue temps are 10-15 °C - causes peripheral vasocastriction and decreased soft tissue perfusion to reduce edema, decrease nerve induction velocity to diminish pain, decrease metabolic rate of tissues to inhibit information

86
Q

What is the protocol for cold therapy

A

20 -30 minutes every 2-3 hours for first 48 hours following surgery a injury, don’t do it over 30 minutes

87
Q

What is most effective at lowering temperature to therapeutic levels

A

Continuous circulation of ice water slurry

88
Q

Describe a saltwater spa

A

Supersaturated sea salt solution - combines anti inflammatory analgesic effects of cold with osmotic effects salt ( draw edema out) , compression of water has a hydrostatic effect to promote venous return and lumphahi drainage for reduced edema

89
Q

What are the risks of saltwater spa

A

Risk of reduction of core temperature if water levels rise above the elbow

90
Q

How often do you use saltwater therapy

A

15 - 20 mins 1-3 times a day until swelling has resolved

91
Q

What are indications for cold water therapy

A

Acute information (heat, swelling, pain), acute soft tissue or muscle injury / post exercise

92
Q

What are contraindications for cold water therapy

A

Prolonged application that lowers tissue temp to less than 50 its contraindicated

93
Q

Describe heat therapy - when are therapeutic effects reached

A

Indicated after the acute inflammatory period, most helps prior to exercise - increases local circulation of tissues encouraging mile relaxation and tissue extensibility, increases oxygenation of tissues and metabolic rate - transpectic effects at 40-45 C

94
Q

What is the risk of heat therapy

A

Over 45 can cause thermal injury and damage

95
Q

For every 10° in temp we increase , we increase the metabolic rate -

A

2-3 times

96
Q

What are the 2 forms of heat therapy

A

Superficial - less than 1 cm, hot pack, hot water hosing, etc
Deep - 3.5cm, continuous wave therapeutic ultrasound

97
Q

Describe therapeutic ultrasound

A

Only generates heat et continuous form - absorption of sound waves results in transfer of energy to surrounding tissues and a localized increase in temp

98
Q

Who is therapeutic ultrasound ideal for

A

Those with high protein or collagen content or tissue interfaces

99
Q

What are the indications for heat therapy

A

Treat injury after acute inflammatory phase, increased local circulation of target tissues, chronic soft tissue or muscle injury, muscle relaxation, preexercise

100
Q

When is heat therapy contraindicated

A

During acute inflammatory phase or if it hill raise temp over 45 C

101
Q

Describe extra corporal shockwave therapy (eswt)

A

High energy sound waves, outside the body - defined by a high transient peak pressure (rapid rise for short duration) followed by a negative pressure drop

102
Q

Describe the profile of a shockwave

A

Direct shear effects come from the compressive phase while indirect cavitation effects come from the tensile phase rapid rise to peak pressure

103
Q

What is acoustic impedance

A

Resistance a sound wave encounters as it passes through tissues - can travel relatively unchanged through fluids and soft tissues but can’t pass through bone

104
Q

Differentiate between shock wave and ultrasound

A

Shockwave - lower frequency (less than 20) higher peak pressures, minimal tissue absorption and no thermal effects
Ultrasound - higher frequency (over 20), lower peak pressures, some have thermal effects

105
Q

What are benefits of eswt

A

Analgesia, neovasularization, stimulates tissue repair, increased growth factor and cellular activity osteogenesis, fibroblastic stimulation

106
Q

Number of shock wave pulses influences the

A

Amount of energy delivered

107
Q

What are indications for eswt

A

Pain relief, stimulation of tissue healing, osteoarthritis, subchondral bone pain, desmitis, tendonitis, back pain

108
Q

What are contraindications of ESWT

A

Gas or air filled structures due to cavitation effects and during the acute inflammatory phase (like with heat therapy)

109
Q

What is photobiomodulation

A

Form of northermal light therapy that elicits photochemical and photophysical events

110
Q

Differentiate between lasers and led

A

Lasers - coherent, high power, deep absorption / collimated light
LED - noncoherent, divergent light, low power

111
Q

Which classes of lasers are therapeutic

A

3B and 4B

112
Q

Which penetrates tissues better - lasers or LED

A

Lasers, LED less able to penetrate

113
Q

What are benefits of laser therapy

A

Analgesic, accelerated tissue repair, reduced scar tissue formation, accelerated nerve cell regeneration

114
Q

Which classes of laser are an optical hazard

A

Class 3 and 4, over 500 mw

115
Q

Differentiate between class 3 and class 4 lasers

A

Class 3 - up to 500, optical hazard, trespectic laser
Class 4 - greater the 500, optical and thermal hazard, trespectic and surgical laser

116
Q

Describe very simply how lasers work

A

Excite electrons which emit photons that escape a partially reflective mirror to reach patients

117
Q
  • Tissue targets require - wavelength
A

Deeper tissue targets requires higher wavelengths

118
Q

What is the therapeutic window of laser wavelength

A

800 - 1000; law wavelengths used for superficial areas, longer wavelengths for deeper areas

119
Q

Wavelength alters - and -

A

Degree of penetration and absorption

120
Q

Describe bluelight (465 wavelength)

A

Superficial skin depths, wounds, antibacterial

121
Q

Describe red light (620 wavelength)

A

Subcutaneous depths, wounds, superficial edema , acupressure points

122
Q

What wavelengths do deeper tissues require

A

Near infrared light over 800

123
Q

What is the ideal equine patient for laser therapy

A

Pink skin with SDFT injury

124
Q

Differentiate between power output and dose of a laser

A

Power output - rate that energy is emitted , high power loses deliver same energy in less time
Dose - precise amount of photos delivered to an area (impacted by weight, body type, skin color, etc )

125
Q

Does pulsing the laser limit energy penetration

A

No - just prevents thermal damage

126
Q

Higher energy from the laser reduces- but may cause-

A

Reduces treatment time but may case undesired effects if used incorrectly

127
Q

When shard uw be laser on contact? Off contact?

A

On contact for musculoskeletal, off contact for wounds

128
Q

Differentiate between point to point and repetitive laser techniques

A

Point to point- stationary over target area until full dose administered
Repetitive - scorning horizontally and vertically over and over

129
Q

What are the 3 phases of laser treatment? Describe

A

Induction - aggressive series of treatment until clinical response is noted
Transition - gradually reduce frequency of treatment to see nav offer is needed to maintain clinical response
Maintenance - long term series of treatments to maintain clinical response

130
Q

What are contraindications for laser therapy

A

Pregnancy, active physis, hemorrhage, testicles, thyroid gland, malignancy, locally injected medication

131
Q

Describe pneumatic compression therapy

A

Active pneumatic compression device with forward airflow to alleviate edema and enhance lymphatic flow, designed to target the lymphatic system of the upper and lower limb (hoof to stifle/elbow)

132
Q

Why was the pneumatic compression device created

A

Because the lack of musculature in the limbs en impede lymphatic return in cases of edema

133
Q

What is the protocol for the pneumatic compression device

A

60 minty for 60 minutes daily

134
Q

What are indications for the EQ press

A

Prevention or treatment of standing limb edema during layup, cellulitis, lymphangitis, recovery post exercise

135
Q

Describe equine blood flow restriction

A

Used to reduce muscle atrophy or stimulate muscle hypertrophy - low impact exercises performed with BFR Are equivalent to high impact exercise , increases blood supply to affected area in distal limb for faster healing

136
Q

What are benefits of water therapy

A

Reduce ground reaction forces and unload tendons, joints, etc to reduce stress on musculoskeletal system I helps increase range of motion and fitness when and exercise is contraindicated - improves side length / postural stability, muscle tone and function

137
Q

What are contraindications of water therapy in horses

A

Skin infections, open wounds, unstable fractures, fresh surgical sites, heart disease

138
Q

Are horses natural swimmers

A

No - distressed I extend neck and have extreme lordosis of their back (make sure no back pain or upper limb lameness before swimming )

139
Q

What are benefits of linear pools over circular pools

A

Linear gives the horse a break, circular is nonstop

140
Q

Describe buoyancy as a benefit of water therapy

A

Lifting force that reduces axial loading of joints by minimizing vertical ground reaction forces - the feeling of weightlessness in the water / unweights soft listen, joints and bones

141
Q

Depth of water is inversely related to

A

Vertical ground reaction forces - the deeper the water the less ground reaction forces

142
Q

Describe the influence of viscosity in water therapy

A

Viscosity is the resistance of fluid to motion, influenced by temp, turbulence and drag - the lower the temp the higher the viscosity and the move turbulence / drag the higher the viscosity

143
Q

How does viscosity influence rehab

A

Increased resistance results in increased muscle activation and improves muscle strength motor control and joint stability

144
Q

Describe hydrostatic pressure in water therapy

A

Sum pressure exerted on all surfaces of the body immersed in water at a given depth las depth increases so does the hydrostatic pressure

145
Q

How does hydrostatic pressure benefit the horse

A

Enhances neuromuscular function, increase joint stability and protect the joint from abnormal loads / circumferential compression promotes venous return and lymphatic damage

146
Q

What are risks of excessive hydrostatic pressure

A

On cause respiratory distress Or compromise (deeper water affects lung volume)

147
Q

How is thermoregulation in water different than air

A

Can’t dissipate heat by sweating, heat conductance in water is 25 times greater than air and core temps are easily influenced by water

148
Q

Older temps lead to

A

Peripheral vasoconstriction that decreases perfusion and nerve conduction to cause an analgesic effect

149
Q

Warmer temps lead to

A

Vasodilation, increased tissue perfusion and analgesia

150
Q

What water temps are optimal for different exercises

A

Lower temps for high activity, higher temps for low activity

151
Q

Describe water osmolality in water therapy

A

Number of solute particles per kg of solvent - high osmolatily (higher solute) has antinflammatory ,osmotic and analgesic effects, pulls water from tissue to reduce edema - like with saltwater spas

152
Q

How does water depth affect stride length and qualify

A

As depth increases , stride number decreases and stride length increases (fewer longer strides)

153
Q

At what water depth should you walk horses to improve stride quality and strength

A

Walk at carpus or ulna heights

154
Q

How does water therapy affect horses with carpal OA

A

Anti inflammatory effects

155
Q

Describe the acclimation period of water therapy

A

1-2 dans, start with no water, slowly add little water, then to the treadmill

156
Q

Describe the first week of water therapy

A

Once a day for 5 working minutes 3-5 times a week, water level target, slow speeds

157
Q

Describes weeks 2+ of water therapy

A

Increase speed by I each week and add 5 mins each week

Equine Rehab (3 decks)

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