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Eq SX Musc Skel Exam > Foot (Morton-from slides) > Flashcards

Foot (Morton-from slides) Flashcards

1
Q

Forelimb weight bearing

A

60% of weight

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2
Q

95% of forelimb lameness originates

A

distal to the carpus

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3
Q

Hindlimb weight bearing

A

35-40% of weight

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4
Q

80% hindlimb lameness probably originates from

A

Hock or stifle

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5
Q

Role of forelimbs versus role of hindlimbs

A

Fore: shock absorption
Hind: propulsion

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6
Q

Most common causes of lameness are

A

OA and soft tissue injuries

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7
Q

Structures of the foot

A
  1. Proximal phalanx
  2. Middle phalanx
  3. Distal phalanx
  4. DDFT
  5. Navicular suspensory ligament
  6. Navicular bone
  7. Impar ligament
  8. Digital cushion
  9. Sensitive laminae
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8
Q

Synovial spaces of the foot

A
  1. Distal interphalangeal joint (DIPJ)
    - dorsal pouch
    - palmar recess
  2. Digital Flexor Tendon Sheath (DFTS)
  3. Navicular bursa

*T ligament-separates the 3 synovial structures

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9
Q

Low ringbone

A

OA of coffin joint

-chronic, low-grade, progressive lameness

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10
Q

High ringbone

A

OA of PIPJ

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11
Q

Distal interphalangeal OA DX

A

PE
-Effusion of DIPJ
-Dorsal/palpable exostosis
LE
-Positive resp DIPJ IA anesth
-Partial response PD n. block, w/dorsal branch
-May require AS n. block to eliminate lameness

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12
Q

DIPJ OA and rads

A
  • May be unrewarding
  • May not correlate to dz
  • Osteophytes/enthesophytes
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13
Q

Osteophyte

A

bony projection at joint space

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14
Q

Enthesiophyte

A

Bone projection at attachment of tendon or ligament

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15
Q

DIPJ OA TX (conservative)

A
  1. Rest and controlled exercise
  2. Chondroprotective therapies
    - PSGAG (Adequan)-IM
    - Hyaluronic acid (Legend)-IV
    - Oral glucosamine/chondroitin
  3. NSAIDS PRN
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16
Q

DIPJ OA IA TX

A
  1. Hyaluronic acid
  2. Corticosteroids
    - triamcinolone
    - betamethasone
  3. Biologics/regenerative tx
    - stem cells
    - PRP
    - ACS
17
Q

DIPJ OA SX

A
  1. Arthroscopy-limited success but diagnostic
  2. Arthrodesis-end stage/salvage
    - rarely performed (orientation of joint access difficult)
18
Q

DIPJ OA arthrodesis techniques

A
  1. cartilage debridement, screws and PMMA

2. cartilage debridement, bone graft

19
Q

DIPJ OA prognosis

A
  1. Variable, related to degree of osteoarthrosis
  2. Degree of IA analgesia response indicative of response to IA tx
  3. Progressive
  4. Arthrodesis is salvage, limited performance
20
Q

DIPJ Collateral ligament Desmitis

A
  • Affects show jumpers, dressage horses, WBs

- Increased stress placed on CLs when horse moves in a circle (OUTSIDE LEG)

21
Q

DIPJ Collateral ligament Desmitis etiology

A

Asymmetric foot placement more stress

  • foot imbalance, varus/valgus, uneven footing, sliding/rotation
  • primary ligament degeneration
  • acute trauma-not common, protected by hoof wall
22
Q

DIPJ Collateral ligament Desmitis DX

A
  1. MRI gold standard
    - lesions often distal in hoof capsule
    - VERY position dependent (magic angle artifact)
  2. Rads-solar margin view
    - remodeling of COLLATERAL FOSSA on proximal PIII
23
Q

DIPJ Collateral ligament Desmitis TX

A
  1. Rest and controlled exercise
  2. Corrective trimming/shoeing
  3. NSAIDS
  4. ESWT
  5. Intralesional biologic/regenerative therapies
    - imaging guided
24
Q

DIPJ Collateral ligament Desmitis prognosis

A

28-79% return to previous level activity
Often concurrent DIPJ OA
Presence concurrent lesions decreases prognosis

25
Q

Type of phalanx fractures

A
  1. wing fx
  2. articular wing fx
  3. midline from solar margin to joint fx
  4. extensor process fx
  5. comminuted fx
  6. chip fx
  7. foal and I dunno fx
26
Q

Etiology P3 fx

A
  1. majority are at high speed
    - sometimes kicking wall or bad step
  2. standardbreds over-represented
27
Q

CS P3 fx

A
  1. Acute, relatively severe lameness
  2. Fore/hind limb
  3. Positive to hoof testers
  4. Increased digital pulses
  5. Heat in hoof wall
  6. DIPJ effusion (if articular)
28
Q

DX P3 fx

A
  1. Rads-may need to wait 7-10 days
  2. Don’t do blocks if you suspect fx
  3. CT most useful advances imaging
29
Q

Type 1 P3 fx

A

Abaxial/wing fx, non-articular
TX: food cast, rest
Prog: Good, radiographic non-union common

30
Q

Type 2 P3 fx

A

Abaxial/wing fx, articular
TX: Foot cast, rest or screw fixation
Prog: fair/good, radiographic non-union common, OA likely

31
Q

Type 3 P3 fx

A

Axial/Sagittal fx
TX: Screw fixation or conservative
Prog: Guarded unless < 2 yrs old, OA develops

32
Q

Type 4 P3 fx

A

Extensor process fx, may also be a form of OC
TX: fragment removal
Prog: Good; depends on frag size and presence OA

33
Q

Type 5 P3 fx

A

Comminuted fx
TX: Foot cast, rest
Prog: Poor

34
Q

Type 6 P3 fx

A

Solar margin fracture
TX: rest
Prog: Good

35
Q

Type 7 P3 fx

A

Solar margin fracture in a foal
TX: rest
Prognosis: good

36
Q

Side bone

A 
Ossification of collateral cartilages
More common in
-medial to lateral hoof imbalance
-common interference
-older age
-drafts
37
Q

Side bone tx

A
  1. Therapeutic shoeing (hoof balance, bar shoe +/- pads)
  2. Local corticosteroid injection
  3. NSAIDS
  4. Evaluate CLs of DIPJ and treat if desmitis

Eq SX Musc Skel Exam (20 decks)

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