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Equine Studies > Foot balance, Foot pain, Foot penetrations, Diagnostic analgesia > Flashcards

Foot balance, Foot pain, Foot penetrations, Diagnostic analgesia Flashcards

1
Q

What is a “broken back” HPA?

What does this to do forces in the foot?

A

Long toes and low heels

Increases forces through the DDF and navicular apparatus

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2
Q

What is a “broken forward” HPA?

What does this to do forces in the foot?

A

Boxy and upright feet

Puts stress on joints and associated structures

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3
Q

What is a common presentation of the medial and lateral walls of the foot?
What does this do to the coronary band?
What can this cause?

A

Medial side more upright
Lateral side more flared
Coronary band slopes down from medial to lateral side
Shunting of the medial heel

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4
Q

What is “toe in” and “toe out”?

What ligaments does it put stress on?

A

Rotational abnormalities of the foot
Toe in: inward rotation
Toe out: outward rotation
Increased stress on collateral ligaments

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5
Q

Where are the bars?

What are they formed by?

A

On either side of the frog

Formed from hoof capsule folded in on itself

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6
Q

What is the strongest part of the foot?

A

Bars

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7
Q

Where is the centre of the foot?

A

1cm back from the point of the frog

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8
Q

What is tracking?
What is over-tracking?
What is the problem with this?

A

When the hindfeet step into where the front feet have been

Where the hindfeet step more forward than where the front feet have been, Can interfere with the heel of the front feet

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9
Q

What is plaiting?
What is forging?
What are the problems each of these gaits may cause?

A

Walking in a narrow fashion, can interfere with contralateral limb
Stab forwards with hindfeet, may injure limb in front

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10
Q

What do horses land first on?

A

Lateral heel

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11
Q

What is the farrier treatment for broken back HPA?

A

Raise the heel (short term option)

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12
Q

What is the treatment for broken forward?

A

Lower heels and toe extension

May need to severe the accessory ligament of the DDFT (inferior check ligament) to reduce opposing tension

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13
Q

What is laminitis?

A

Detachment of the pedal bone from the hoof apparatus

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14
Q

What type of support should you provide in acute laminitis?

What should you NOT do?

A

Frog pressure
E.g. lilypads, styrofoam, dental impression material
Walk or remove shoes

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15
Q

What treatment should you provide in after the acute period of laminitis has passed?

A

Trim hoof

Fit heart bar shoe

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16
Q

What is a founder/sinker

A

The majority of the attachment of P3 to hoof is gone

Foot sinks through the hoof due to weight of horse

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17
Q

What is the founder distance?

A

Distance between coronary band and extensor process of P3

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18
Q

What clinical signs would you see in a founder/sinker?

What is the treatment if there is evidence of P3 protrusion?

A

Depression in coronary bank
Thin, bulbous sole
Sole may extrude serum on digital pressure
Euthanasia

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19
Q

What is dorsal wall resection?
What analgesia should be used and why?
What is the disadvantage of it?

A

Removal of damaged hoof wall and drainage
Use sedation not nerve blocks
Important to determine margins between live sensitive tissue and dead necrotic tissue
Long recovery (12 months) and significant input required from owner (dressing)

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20
Q

Why are toe abscesses frequent in chronic laminitis?

Which hoof wall tends to overgrow and what does this cause?

A

Poor quality of laminae at toe
Lateral wall
Medial shunting of foot
“Corkscrewing”

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21
Q

Where is the corn in the foot?

A

Next to the bars

22
Q

Which is the most common direction of hoof crack?

A

Proximo-distal (with horn tubules)

23
Q

What is “nail bind” and “shoeing prick”?

What can “shoeing prick” develop into?

A

Nail CLOSE to sensitive structures, pain around nail
Nail INTO sensitive structures, immediate blood/pain
Subsolar abscess

24
Q

What are 4 clinical signs of subsolar abscessation?

What is the treatment?

A
  1. Acute severe lameness “pointing” the limb
  2. Increased digital pulse
  3. Increase hoof temperature
  4. Sensitive to hoof testers
    Drainage of the foot - pare foot, follow tracts and remove necrotic/underrun horn
25
Q

What poultice would you use for subsolar abscessation?

A

Magnesium sulphate

26
Q

What is the treatment for food penetrations involving synovial structures?

A

Debridement and removal of necrotic tissue
Flushing of synovial structures
Antibiotics (systemic, intra-synovial, PMMA beads in tract)
Bandaging
Hospital plate
NSAIDs

27
Q

What is the prognosis for food penetrations involving synovial structures?

A

Fair prognosis

Guarded return to function (due to involvement of DDFT, navicular bursa)

28
Q

What are 4 underlying causes of chronic hoof abscessation?

A
  1. PPID
  2. Keratoma
  3. Laminitis (poor quality laminae)
  4. Sequestrum (bone or cartilage)
29
Q

What is a quittor?

What is the main clinical sign?

A

Infection of the collateral cartilages (acts as a sequestrum)
Swelling or chronic discharge

30
Q

What is a keratoma?
What would you see in discharging tracts?
What would you see on radiography?

A

Benign tumor of the hoof/solar wall
Circular area of abnormal keratinisation
Smooth, radiolucent defect in P3 (P3 reabsorption)

31
Q

What is a canker?
What bacteria is often linked?
What does it result in?

A 
Chronic condition
Hypertrophy of the germinal layer of the epithelium of the frog
Fusobacterium/Bacteriodes spp
Dyskeratosis of keratin-producing cells
Abnormal hyperkeratotic horn 
Keratolysis
Fronds of unconnected tubular horn
32
Q

What is an astringent?

What are they used in?

A

Chemical that shrinks or constricts tissues

Cankers

33
Q

What is the treatment for canker (early/mild cases and advanced/severe cases)

A 
Early/mild:
Improve environment
Debridement
Metronidazole bandages
Astringents

Advanced/severe cases:
Aggressive surgical debridement

34
Q

What is white line disease?
What deficiency can cause it?
What is a risk of the disease?

A

Progressive, crumbling, poor quality hoof wall
Separation at the white line
Biotin/methionine/zinc/selenium
Bacterial infection

35
Q

Which two local anaesthetics are used in diagnostic analgesia?
Which lasts has the longer duration, which one has the quicker onset?

A

Mepivicaine (quicker onset)

Bupivicaine (longer duration)

36
Q

What are the 3 contraindications for use of diagnostic analgesia?

A
  1. Suspect fracture
  2. Cellulitis
  3. Uncooperative horse
37
Q

What are 4 reasons for poor response to local anaesthesia?

A
  1. Severe pain (e.g. subsolar abscessation, P3 fractures)
  2. Poor technique/inadequate volume
  3. Pain originating more proximal
  4. Neurological problem
38
Q

What is the main differences in the structures desensitised between a PDNB and abaxial sesamoid nerve block (ASNB)?

A 
ASNB is same as PDNB but rest of digit
\+ DIP and PIP joint and collateral ligaments
\+ Lamellar corium 
\+ Coronary band
\+ Digital extensor tendon
\+ Suspensory ligament
39
Q

Which 3 structures does a DIPJ nerve block desensitise?

A
  1. DIP joint (+/- collateral ligaments)
  2. Navicular bone/bursa
  3. Toe region of sole (NOT heel)
40
Q

How do you perform a navicular bursa nerve block?

A

Between bulb of heels
Weight bearing
Spinal needle

41
Q

If you wanted to desensitise the heel region of the sole, which two nerve blocks could you use?
What if you wanted to desensitise the DDFT and SDFT?

A
  1. Abaxial sesamoid
  2. Palmar/plantar digital nerve block

Same

42
Q

What nerve block would you chose to desensitise the coronary band and entirety of the digit?

A

Abaxial sesamoid

43
Q

What are the two different ways of taking a dorsoproximal-palmarodistal oblique of the P3?

A 
Upright-pedal (truer image as beam is perpendicular to the plate)
High coronary (easier to perform as horse standing on cassette, slight elongation of the foot)
44
Q

What is a “skyline” view?

A

Palmaroproximal-palmarodistal oblique

Leg back and foot on cassette tunnel, centre between bulbs of heels (45 degrees)

45
Q

What is the problem with using a DIPJ nerve block to diagnose DIP disease?

A

Its non-specific

Blocks DIP joint but also navicular apparatus

46
Q

What reduces the prognosis in pedal bone fractures?

A

Articular involvement

47
Q

What is a PD neurectomy used for?

A

Surgical treatment

Non-healing wing fracture (type I and II)

48
Q

What is Pedal Osteitis?
What is it often associated with?
What is the radiographic appearance?

A 
Radiographic changes in P3 with chronic foot soreness
Foot balance
Demineralisation "moth eaten" appearance
Widening of vascular channels
Irregular margination
49
Q

What does navicular disease present with?

What foot confirmation is it associated with?

A

Chronic BILATERAL forelimb lameness
Often intermittent lameness, worse on a hard surface, exacerbated in a circle
Stumbling, unwilling to go forward
“Broken back” HPA (low heel, long toe)

50
Q

What are 5 examples of pathology associated with navicular disease?

A
  1. Thinning of fibrocartilage
  2. Degenerative joint changes (DIP, NB)
  3. Medullary lysis and replacement with highly vascularised CT
  4. New bone formation along collateral sesamoidean ligament
  5. DDFT damage (roughening, adhesions, lesions)
51
Q

Give 4 examples of the management of navicular disease

A
  1. Farriery (balance foot, engage frog, improve heel support)
  2. Intra-articular corticosteroids
  3. Bisphosphonates
  4. Neurectomy
52
Q

What are bisphosphonates used for in management of navicular disease?

A

Slow down bony absorption

Equine Studies (15 decks)

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