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A. Equine and Camelid Medicine and Surgery > Foundational Laminitis > Flashcards

Foundational Laminitis Flashcards

1
Q

what is the stratum externum?

A

thin, outermost layer

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2
Q

cell of stratum spinosum differentiate into cells of _____________________

A

stratum corneum

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3
Q

what does the dermis of the hoof provide?

A

blood supply and nutrients to epidermis

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4
Q

what is the blood supply of the hoof?

A

palmar digital arteries and veins

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5
Q

what innervates the hoof?

A

palmar digital nerve

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6
Q

what is the most common type of laminitis?

A

endocrinopathic laminitis

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7
Q

what conditions are associated with endocrinopathic laminitis?

A

equine metabolic syndrome
pituitary pars intermedia dysfunction
exogenous corticosteroid administration
pasture-associated

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8
Q

how does hyperinsulinemia cause microvascular damage?

A

activation of complement and platelets

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9
Q

what are some common disorders associated with sepsis/SIRS?

A

gastrointestinal disease
pneumonia
metritis
grain overload

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10
Q

what is the least common type of laminitis?

A

supporting limb laminitis

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11
Q

who does supporting limb laminitis occur in?

A

patients with painful musculoskeletal conditions

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12
Q

are radiographic or structural changes evident during the acute phase (first 72 hours) of laminitis?

A

no

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13
Q

what are some hoof-associated changes in laminitis (on exam)?

A

elevated digital pulses
hoof warmth
sensitivity to hoof testers
altered hoof appearance

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14
Q

what might be necessary to take radiographs in a painful patient?

A

local anesthesia

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15
Q

where is contrast injected for a digital venogram?

A

palmar digital vein

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16
Q

what are the three prongs to treating laminitis?

A

biochemical support
analgesia
treat underlying cause

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17
Q

what can you do during the acute phase to promote load-sharing by recruiting the solar surface?

A

soft bedding
deformable/impression material
removable boots with an insert

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18
Q

what is a surgical treatment for biochemical support?

A

deep digital flexor tenotomy

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19
Q

what side effects are we worried about with horses on NSAIDs?

A

nephrotoxic
damaging to GI tract

20
Q

what can opioids do that may predispose horses to colic?

A

decrease gastrointestinal motility

21
Q

how is oral bioavailability of gabapentin in horses?

A

poor: 16%

22
Q

what effects does lidocaine have?

A

analgesic
anti-inflammatory

23
Q

what temperature should the hoof be below to achieve effective hypothermia in digital cryotherapy?

A

10 degrees C

24
Q

where does growth begin of the epidermis?

A

coronary segment

25
Q

what makes up the two-layered stratum germinativum?

A

cells of stratum basale migrate into stratum spinosum

26
Q

what are the layers of hard keratins in the stratum corneum?

A

stratum externum
stratum medium
stratum internum

27
Q

what does the stratum internum feature?

A

featured epidermal lamellae: primary and secondary

28
Q

what provides the critical connection between the hoof wall and the distal phalanx?

A

dermal papilla interdigitate with epidermis: primary and secondary dermal lamellae

29
Q

what is the terminal arch?

A

anastomosis in solear canal of palmar digital arteries and veins

30
Q

where does the dorsal branch of the palmar digital nerve innervate?

A

dorsal 1/3 of hoof

31
Q

what forces act upon the digit?

A

weightbearing
support of frog and sole
pull of deep digital flexor tendon
lamellar attachments
pull of extensor tendon

32
Q

is endocrinopathic laminitis inflammatory?

A

no

33
Q

what does insulin do in endocrinopathic laminitis?

A

activates insulin-like growth factor-1 receptor
mitosis lamellar cells
dysregulation cellular adhesions

34
Q

how does sepsis/SIRS cause laminitis?

A

injury to basement membrane: separation of dermal and epidermal lamellae

35
Q

what causes loss of lamellar cellular adhesions in supporting limb laminitis?

A

protracted alteration in weightbearing leads to decreased perfusion of food and decreased oxygen/nutrients
ischemia and negative energy balance

36
Q

where is sensitivity to hoof testers most common with laminitis?

A

toe region

37
Q

which radiographic views are taken for laminitis?

A

lateral-medial
dorsal-palmar/plantar
+/- dorsoproximal-45 degree palmaro/plantarodistal oblique

38
Q

why is heel elevation useful in treatment?

A

decreases tension from deep digital flexor tendon on dorsal laminae
decreases compression of solar corium and circumflex artery

39
Q

why is a rocker component of a shoe useful?

A

allows patient to adjust breakover

40
Q

what are the indications for deep digital flexor tenotomy?

A

continued rotation of distal phalanx
progressive/persistent vascular deficits in venogram
no hoof growth despite mechanical intervention

41
Q

what are the non-selective COX inhibitors?

A

phenylbutazone
flunixin meglumine

42
Q

how does gabapentin work?

A

mimics neurotransmitter GABA

43
Q

what can ketamine be combined with?

A

alpha-2 agonist
opioids
lidocaine

44
Q

what can lidocaine be combined with?

A

alpha-2 agonist
opioids
ketamine

45
Q

what is the duration of bupivacaine (abaxial sesamoid perineural block)?

A

120-240 minutes

46
Q

what can be used in an epidural?

A

local anesthetic
opioid
alpha-2 agonist

47
Q

what effects does digital cryotherapy have?

A

vascular effects
analgesic effects
anti-inflammatory effects
metabolic effects

A. Equine and Camelid Medicine and Surgery (46 decks)

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