Exam 2 - LA fracture, tendons, joints

Question 1

functional categories for fracture stabilization:
category 4 - shoulder/stifle/humerus & femur

Answer 1

no immobilization necessary

Question 2

functional categories for fracture stabilization:
category 3 - radius/ulna & tibia/fibula

Answer 2

robert jones bandage with extended lateral splint

Question 3

functional categories for fracture stabilization:
category 2 - metacarpal/metatarsal “cannon bone”

Answer 3

robert jones bandage with lateral and caudal/plantar splint

(caudal to lock carpus in extension)

Question 4

functional categories for fracture stabilization:
category 1 - hoof/coffin bone

Answer 4

dorsal splint (forelimb)
plantar splint (hindlimb)
includes tendon injuries

Question 5

what does emergency first aid management include

Answer 5

sedation
initial wound management
fracture stabilization
analgesia/anti-inflam (NSAIDs, opioids, caudal epidural)
antimicrobial prophylaxis (broad spectrum IV)
IV fluids
careful safe transport

Question 6

transportation for LA fractures

Answer 6

minimize walking distance/need to use fx limb
use ramp with minimal slope & non-slip surface
lateral support to body wall
want “fracture in the back” so hindlimb fracture face forward and forelimb fracture face backward
caution with braking, acceleration and turns
unload using sound limbs first

Question 7

how would you stabilize a forelimb phalangeal fracture?

Answer 7

dorsal splint

Question 8

how would you stabilize an olecranon fracture “dropped elbow”?

Answer 8

caudal splint to lock carpus in extension - from elbow to fetlock

Question 9

management for an olecranon fracture

Answer 9

internal fixation
strict stall rest for older horses or nondisplaced fractures

Question 10

what is the prognosis for an olecranon fracture

Answer 10

good-excellent
if open - fair to good

Question 11

tendon composition breakdown

Answer 11

cells
extracellular matrix 30%
- collagen (86%) + ground substance
water 60-80%

Question 12

what type of collagen are tendon primarily made of

Answer 12

type I collagen

Question 13

what makes up ground substance

Answer 13

elastin
proteoglycans
glycosaminoglycans
glycoproteins

Question 14

describe the blood supply to tendons

what is their blood supply affected by?

Answer 14

avascular (long healing)

age (decreased with age)
exercise (increases)
injury (increases)

Question 15

what collagen are ligaments made up of

Answer 15

type III collagen

Question 16

tendons heal slowly due to ____

Answer 16

low blood supply (relative hypoxia)

Question 17

healed tendons lack ______

Answer 17

elasticity and strength compared to healthy tendons

Question 18

why do tendon injuries have a high incidence of recurrence?

Answer 18

due to impaired elasticity/strength due to increased collagen III vs I and reduced strength of scar tissue

Question 19

contributing factors of tendon injuries

Answer 19

conformation
shoeing
fatigue related incoordination during performance
aging
exercise

Question 20

predispositions in tendon injury

Answer 20

flexors > extensors
SDFT > DDFT because more external, smaller CSA and less vascular
forelimbs > hindlimbs

Question 21

what does injury to the SDFT alone cause

Answer 21

mild hyperextension

Question 22

what does injury to the SDFT and DDFT cause

Answer 22

moderate hyperextension
elevation of the toe off ground

Question 23

what does injury to the SDFT, DDFT and suspensory ligament cause

Answer 23

complete loss of fetlock joint support

Question 24

what suture patterns should you use for flexor tendon lacerations

Answer 24

three loop pulley
interlocking loop (not as strong)

Question 25

treatment for flexor tendon lacerations what % return to athletic function?

Answer 25

debride suture distal limb cast 6-8 weeks 55% return to athletic function

Question 26

what is articular cartilage

Answer 26

central structure constituting joint function provides frictionless movement of joints

Question 27

articular cartilage lacks what?

Answer 27

vascular, lymphatic and neural suuply

Question 28

articular cartilage depends on what?

Answer 28

diffusion for nutrients and waste removal

Question 29

what does articular cartilage consist of

Answer 29

chondrocytes extracellular matrix

Question 30

articular cartilage has limited ability for what

Answer 30

shock absorption

Question 31

what are the 5 zones of articular cartilage which one is the most?

Answer 31

superficial/tangential zone intermediate/transitional zone (MOST) deep/radiate zone calcified zone tidemark

Question 32

what collagen is articular cartilage made of

Answer 32

type II collagen

Question 33

indications for arthroscopy

Answer 33

diagnostic osteochondral fragments intra-articular fractures debride OCD/cystic lesions synovectomy/lavage for sepsis

Question 34

benefits of arthroscopy

Answer 34

less invasive visualize more articular surface

Question 35

arthroscopic closure... tissue? pattern?

Answer 35

skin only simple interrupted or cruciate pattern

Question 36

arthrotomy indications

Answer 36

large intra-articular fragments large intra-articular fractures sepsis

Question 37

arthrotomy closure... tissue? pattern?

Answer 37

synovial layer use small diameter absorbable suture & simple continuous ligaments - large diameter absorbable or non-absorbable suture + simple interrupted or vertical mattress skin - interrupted or continuous