Lecture 20: Lameness Flashcards
Why do flexion tests
Irritates the nerve ends in the FIBROUS JOINT CAPSULE and exaggerates lameness
What is the best gait to evaluate lameness
Slow trot
What is the best surface to evaluate a lameness
Asphalt
What is a grade 1 lameness
Lameness is difficult to observe and is not consistently apparent
What is grade 2 lameness
Difficult to observe at walk or when trotting in straight lighten but consistent when weight-carrying, circles, incline, hard surface
What is a grade 3 lameness
Lameness is consistently observable at trot under all circumstances
What is a grade 4 lameness
Lameness is obvious at a walk
What is grade 5 lameness
Minimal weight bearing in motion and/or at rest or complete inability to move
what is this and what is it commonly attributed to
Club foot typically problem with upper forelimb- shoulder or elbow
Shoulder OCD
Head goes down on what leg
Sound
Up on lame limb
Which leg lameness increases in a circle
Inside leg
In a circle normally which limb lands harder
Outside
For hindlimb lameness what happens to lame hip
Goes higher and drops faster
With hindlimb lameness what happens on contralateral front limb
Will land harder
Ex: horse is RH lame what front limb is landing harder
Left
For multi limb lameness what should you observe in forelimbs
Straight and in circle
Bilateral stride is short and stiff
For hindlimb multi limb lameness what should you watch
Straight, going by, stride shortens, bilateral back pain
What imaging technique is very useful for multi limb lameness
Scintigraphy
How can you evaluate heel pain
Stand frog on hoof knife handle for 30 seconds and pick up other limb
What flexion tests are these
left: digital flexion test
Right: carpus
what flexion tests are these
Left: elbow
Right: shoulder
what is this flexion test testing
Hip, stifle, digits, sacroiliac joint
what flexion tests are these
Left: extension of stifle/SI
Right: abduction of stifle/SI
When blocking joints or peripheral nerves you start ___ and move ___
Distal, proximal
What are the two common meds used to block joints/ nerves
Mepivicaine
Bupuvicaine- longer acting
what does this show
Suspensory ligament desmitis
what does this show? Which is normal vs abnormal
Left: Normal
Right: proximal sensory ligament desmitis
what imaging technique is this and how does it work
Scintigraphy- inject radioactive isotope that has propensity for bone
What block is this and where do you inject
Palmar/planter digital nerve block
Block at level of collateral cartilages at digital sheath
What structures are blocked with palmar digital nerve lock
Sole, digital cushion, navicular bone, navicular bursa, navicular suspensory apparatus, insertion of DDFT
What do these pictures show
Let: navicular disease- lollipops- heel pain
Right: DDFT injury
What block is this
abaxial sesamoid block
What structures does the abaxial sesamoid block and not block
Blocks: dorsal hoof wall, coronary band, coffin joint, sesamoidean ligaments
Misses Pastern joint/ front of foot
What common injury takes place in proximal interphalangeal joint/ pastern joint that does not get blocked by abaxial sesamoid
High and Low ring bone- osteoarthritis of pastern and coffin joints
What is wrong here
High and low ringbone- osteoarthritis of pastern and coffin joints
What is wrong here
Coffin bone cyst
What is wrong here
High and low ringbone- OA of pastern and coffin joints
What are C and D
C: straight sesamoidean ligament
D: oblique sesamoidean ligament
What block is this
Low 4 point block
What structures does low 4 point block
Fetlock joint, sesamoid bones, insertion of suspensory ligament on sesamoid bones
And other things blocked in abaxial and palmar/plantar blocks
Where do you insert needle for low 4 point block
Distal button of splint bone
what block is this
High 4 point block
What structures are blocked in high 4 point block
Cannon bone, STF, DDFT, suspensory ligament
In the hindlimb in addition to the high 4 point block what must you do and to block what
Ring block to block dorsal metatarsal nerves
What is wrong
Suspensory ligament desmitis
What wrong
cannon bone fracture
what block is this and what are you blocking
Wheat block
Blocking lateral palmar nerve, suspensory ligament, ulnar nerve
what block is this
Tibial and peroneal block
What does tibial and peroneal blocks block
Hock and distal
Do not do ___with horse when doing tibial and peroneal blocks
Circle/turn
what joint block is this
Coffin
What joint block is this
Pastern/PIP
what joint block is this
Fetlock- palmar/plantar pouch
What joint block is this
carpus
what block is this
Elbow- cranial
what block is this
Elbow-caudal
What block is this
shoulder
what block is this
Tarsometatarsal
what block is this
Tibiotarsal
What block is this
medial femorotibial
what block is this
Femoropatellar
What block is this
Lateral femorotibial joint