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Surgery 3 > Lecture 1: Orthopedic Exam & Diagnostic Tools (Exam 1) > Flashcards

Lecture 1: Orthopedic Exam & Diagnostic Tools (Exam 1) Flashcards

1
Q

What are the 4 dx test that are specific for dx lameness

A
  • Gait analysis
  • Visual inspection of body & conformation
  • Palpate
  • Lacalization
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2
Q

What should be asked/found out during Hx

A
  • General& presenting complaint
  • Anorexia, fever, depression?
  • What leg & how severe
  • When 1st noticed? Acute v. chronic
  • Progression & response to meds?
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3
Q

What kind of questions should be asked when taking Hx

A

Open ended questions

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4
Q

T/F: You should switch up how you do a complete PE everytime

A

False; keep it the same everytime

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5
Q

What is proprioception

A
  • Knowing where a part of the body is in space
  • Putting my arm behind my back (know that it is behind my back)
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6
Q

What is normal proprioception

A

When you flip the paw onto the metacarpus/tarsal region and they flip it back

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7
Q

What is abnorm proprioception

A
  • Px doesn’t know where limb is placed
  • Px knows where limb is placed but can’t correct
  • PX knows where limb is placed but is unwilling to correct
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8
Q

Where should you perform a gait analysis

A
  • On the floor w/ traction
  • Examine w/ owners NOT present
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9
Q

What gaits should be analyzed

A
  • Walk
  • Trot
  • Pace
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10
Q

Describe a norm walk

A

2,3, or 4 legs support @ any one time

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11
Q

Describe a norm trot

A
  • Body is supported by 2 legs on opp sides (contralateral)
  • Most impt gait to eval lameness
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12
Q

Describe a norm pace

A

limbs of the same side (ipsilateral) sym support the animal

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13
Q

T/F: Evaluate the gait towards & away from you

A

True

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14
Q

What should you see if there is forelimb lameness

A
  • “head bob”
  • Head lifts when lame leg bears weight
  • Head drops when weight bearing on norm limb
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15
Q

What should you see if there is hindlimb lameness

A
  • Stride length shortened on lame leg
  • Norm limb reaches forward faster than lame leg
  • Oscillating motion during locomotion (towards the norm side)
  • Hip hike on lame leg
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16
Q

0 degrees of lameness =

A

No lameness

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17
Q

1 degree of lameness =

A

Mild weight-breaing lameness

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18
Q

2 degrees of lameness =

A

Moderate weight-bearing lameness

19
Q

3 degrees of lameness =

A

Severe weight-bearing lameness

20
Q

4 degrees of lameness =

A

Non-weight bearing lameness

21
Q

What is favoring

A

Using that limb less

22
Q

What should be looked for if lameness is bilateral

A
  • May not be obvious
  • Weight shifting while standing (sometimes forward)
  • Shortened stride
  • Bilateral muscle atrophy
  • Bilateral compensatory hypertrophy of unaffected limbs
23
Q

What should be known about breeds for ortho

A
  • Breed conformation
  • Abnorm body condition
  • Breed differences (like how they stand)
24
Q

What should be observed during visual inspection

A
  • Examine posture (body symmetry & areas of muscle atrophy)
  • Hyperflexion or hypextension of joints
  • Muscle atrophy
  • Angular limb deformities (varus or valgus)
25
Q

What all should be palpated

A
  • General body palpation w/ animal standing
  • Neck (Deep palpation, ventral & lateral flexion, extending the neck)
  • The back
  • Lumbosacral region (Dorsally do lumbosacral jt w/o loading or extending the hips)
  • Medial aspect of knee
26
Q

How should the back be palpated

A

Apply pressure to spinous processes down the entire length of the spine

27
Q

Why is the medial aspect of the knee joint

A
  • Swelling
  • “medial buttress” found on the medial aspect of the stifle
  • Indicator of cranial cruciate ligament rupture
28
Q

Describe how to do localization

A
  • W/out sedation to allow pail localization
  • Neuro exam done along w/ then ortho exam
  • lateral recumbency
  • Start @ most distal part of leg
  • Move ea. joint through full range of motion
  • Apply stress to joint medially & laterally (check for excess laxity)
  • Palpate bones & joints
  • Isolate the joint
29
Q

What are the rules of localization

A
  • Always perform @ end of eval
  • Palpate lame leg last b/c it is the most painful
30
Q

Do we check joint angles w/ goniometry often

A

Not really

31
Q

What should be done by palpating bones of joints

A
  • Long bone pain
  • Palpate each joint for pain, heat, swelling, & instability
  • Joint effusion
32
Q

What are the four main things you should be looking for when palpating

A
  • Pain
  • Heat
  • Swelling
  • Instability
33
Q

What should be noted when palpating

A
  • Asymmetry btw/ limbs
  • Abnorm ROM
  • Crepitation
34
Q

how is ortolani sign performed

A
  • Grasp flexed stifle & apply pressure dorsally
  • Apply counter pressure w/ other hand dorsal to pelvis
  • Abduct the limb slowly
35
Q

What does ortolani sign mean if it is positive

A

Movement is felt as the femoral head reduces back into the acetabulum

36
Q

What is the ortolani used to dx

A

Hip dysplasia

37
Q

Describe the ortolani maneuver (dorsal)

A
  • Positioned in dorsal recumbency
  • Place hands over stifles
  • Hold femurs parallel
  • Subluxate femoral head (pushing the stifle toward the pelvis, maintain pressure, abduct the limb)
  • There is a click when the femoral head returns to the acetabulum
38
Q

Describe the cranial drawer test

A
  • Both hands (one on tibia & one on fibula)
  • Move tibia cranially w/ respect to femur
39
Q

Where should each finger be placed on the femur when doing a cranial drawer test

A
  • Thumb - lateral fabella
  • Index finger - patella
  • Thumb - fibular head
  • Index finger - tibial tuberosity
40
Q

What does a positive cranial drawer test mean

A
  • > ~1 to 2 mm of movement
  • Dx for CCLR
41
Q

Describe the tibial compression test

A
  • Tarsus flexed w/ force
  • Tibia translates cranially w/ CCLR (tibial thrust)
42
Q

Describe the luxate patella manually

A
  • Stifle extended (medial MPL)
  • Stifle slightly flexed (Lateral LPL)
43
Q

What is the objective of an ortho exam

A
  • Lameness localization
  • R/O other condition/neuro disease
  • Help determine other dx needs
44
Q

What should be done for in a therapeutic plan

A
  • Discussion w/ the owner regarding orthopedic exam & all dx results
  • Include surgical & medical tx as pertains to the case
  • Discuss possible complications & prognosis

Surgery 3 (1 decks)

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