Large Animal Musculoskeletal Exam Flashcards
what are you evaluating for on musculoskeletal palpation? (5)
- areas of sensitivity
- areas of heat
- obvious soft tissue swelling
- joint effusion
- ASYMMETRY in pain, effusion, or swelling/thickening
name the major gaits of the horse used for the musculoskeletal exam
- walk: four beat gait, lateral and symmetric, biphasic movement of head/stride (head should make a symmetric figure 8), little trunk movement, marked flexion and extension of the neck, head down on weight baring and up during protraction normally
- trot: majority of the dynamic exam!
-a 2 beat symmetric gait, trot is diagonal, pace is lateral, head neck and withers move together, head is down during weight baring and up during suspension normally - canter/lope: 3 beat asymmetric gait; rocking type motion through hind-end and then fore-end; if turning, inside hindlimb and inside forelimb should land first (inside lead)
- gallop: not often used in ortho exam; 4 beat asymmetric gait
describe the AAEP lameness scale
5: non-weightbearing lame
4: lame at the walk
3: consistently lame at the trot under all circumstances
2: consistently lame at the trot under certain circumstances (circling, different circumstances, after flexing)
1: inconsistently lame at the trot under certain circumstances
can modify with mild, moderate, or severe before above number scale (mild 3, moderate 4, etc.)
what does the surface type the ortho exam is being performed on tell you?
if horse is lamer on hard surfaces due to increased concussive forces, it suggest bone/joint pain or foot pain
if horse is lamer on soft surfaces due to increased stretch of soft tissue, it suggests soft tissue pain
describe the goals of performing flexions during the lameness exam
identify and describe signs of forelimb lameness in the horse (3 plus so background info)
(background info) with forelimb lameness, pain causes the horse to try to decrease the load on the painful limb, which causes decreased flexion of the trunk and head when the affected limb is hitting the ground, leading to decreased descent of the trunk, so
- with forelimb lameness, looking for head nod (will move down on the sound limb, and seem raised on the affected limb hitting the ground in comparison)
- stance versus swing phase lameness: stance more common, but swing phase can occur with caudal cervical or shoulder pain
- circling:
-if in circling, the lameness is worse when the affected limb is on the inside, issue is commonly in the foot or the most distal joints
-if in circling, the lameness is worse when the affected limb is on the outside, the issue is likely in the suspensory ligament, the shoulder, the elbow, the neck, or the medial aspect of the joint
identify and describe signs of hindlimb lameness in the horse (6)
- increased gluteal excursion
-hip drop on impact or
-hip hike on push-off - lunging: can help by exacerbating the lameness, look for:
-shortened cranial phase of the stride
-axial placement of the hind limb
-slow to advance the hind limb
-reduced stance duration - canter:
-lack of dissociation of the hindlimbs (bunny hopping)
-lack of flexion through lumbosacral region
-incorrect lead that cannot be corrected even if horse is trained - attitude: reluctance to go forward, head shaking, tail swishing
- if when circling:
-hindlimb lameness worse when affected limb is inside, issue is in hocks
-if worse when affected limb on outside, issue is in suspensory or stifles
-variable- soft tissue injury - if lameness is worse at the canter than at the trot, issue in stifles, sacroiliac region, or back pain
explain the law of sides
- phantom lameness that typically occurs with moderate to marked primary lameness and the phantom is usually a grade less severe than the primary lameness
- with primary forelimb lameness:
-can typically see contralateral hindlimb impact lameness (hip drop) or
-ipsilateral push-off lameness (hip hike) - with primary hindlimb lameness will typically see ipsilateral forelimb lameness
