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Year 4 equine > Limb Exams > Flashcards

Limb Exams Flashcards

1
Q

What are you feeling for on limb palpation

A

Heat
Swelling
Pain
Bony changes

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2
Q

What is the most proximal carpal join called

A

Antebrachiocarpal

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3
Q

What is the proper name for the check ligament

A

Accessory ligament of the deep digital flexor tendon

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4
Q

What should you look for on your distant exam

A

Both sides
Confirmation
Asymmetry
Muscle wastage
Swelling

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5
Q

What are the correct terms for swayback and roachback

A

Spondylosis and lordosis

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6
Q

Where does tendon sheath effusion stay

A

Behind the suspensory branch

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7
Q

What is a bone spavin

A

Boney swelling at distal tarsal joint

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8
Q

What is a big spavin

A

Effusion in tibial tarsal joint

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9
Q

What nerve do you block with a DP

A

palmar distal

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10
Q

What is the physiology of a bounding digital pulse

A

Injury to foot leading to inflammation and swelling/increased blood flow
As the hoof can’t expand the BP in the digital artery increases causing a bounding pulse

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11
Q

Where do you find the digital pulse

A

The abaxial margin of the lateral and medial sesamoid bones with finger and thumb on either side

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12
Q

What is normal for the digital pulse

A

Faint and hard to feel

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13
Q

What is important to do with hoof testers

A

Use with two hands and work systematically around the hoof and across the heals

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14
Q

How can you further examine the hoof

A

Remove shoe, repeat hoof testing, par the food
Assess discolouration, discharge and white line deviation

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15
Q

How should you manage a suspected fracture

A

Appropriate stabilisation - RJ/cast

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16
Q

AO principles of fracture repair

A

Fracture reduction and fixation to restore anatomical
Fracture fixation providing absolute/relative stability
Preservation of blood supply to soft tissue
Early/safe mobilisation of injured part and patient

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17
Q

What do lag screws do

A

Bridge 2 bone parts into compression, cartilage contour returned as close as possible to normal

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18
Q

Lag screws technique

A

Drill through chip with bit the same size as screw place drill sleeve
Counter sink the screw
Reach far cortex and measure length
Screw into the tapped area in the bone

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19
Q

Position screws

A

Hole drilled to core diameter then screw inserted and thread cuts in

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20
Q

What are the types of plate screw

A

DCP - dynamic compression plates
LC-DCP - limited contact dynamic compression plates
LCP - locking compression plates (screw locks into bone and plate)

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21
Q

Preparation for emergency radiography

A

Restraint
Analgesia
Sedation
Remove bandages
Tail bandage out the way
Find appropriate radiography location - stable area you can guard

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22
Q

Complications of fracture repair

A

Osteomyelitis
Screw loosening
Implant failure
Delayed/non union
Ring sequestrum
Support limb laminitis

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23
Q

First aid of tendon/ligament injuries

A

Reduce inflammation
Provide stability
Reduce tendon loading

24
Q

First aid for the inflammatory phase of tendon injury

A

Nsaids
Steroids
External support
Cold therapy
Confinement

25
Q

When can you use intralesional therapies

A

Only when a hole/space is present to improve speed)quality of healing

26
Q

How is stem cell therapy used in tendon injury

A

Autologous graft of mesenchymal stem cells cultured in laboratory and differentiate into tenocytes to promote healing

27
Q

What is platelet rich plasma

A

Autologous graft of platelets in plasma stimulates angiogenesis and proliferation of tissues

28
Q

What is bone marrow aspirate concentrate (BMAC)

A

Autologous graft of fluid and cells from bone marrow. Centrifuged to concentrate cells injected under ultrasound guidance
Single cell procedure

29
Q

Surgery of tendons

A

Exposed fibres treated by arthroscopic removal
Few lesions amenable to surgical treatment
Palmar/plantar annular ligament desmitis - PAL desmotomy
SDFT tendonitis - superior check ligament desmotomy
Manica flexoria tear - removal
DDFT tear - DDFT debridement

30
Q

When should you start exercise after tendon injury

A

End of inflammatory/start of proliferative phase

31
Q

What is the use of shockwave therapy

A

Treatment of the junction between bone and soft tissue
Temporary lameness improvement with no effects in structure or function

32
Q

Clinical application of shockwave

A

Variables - number and intensity of shocks - no evidence basis
Protocol - weekly/fortnightly for 4-6 weeks
Delivered non weight bearing

33
Q

Use of laser

A

Class 4
Reduces lesions size, increases Doppler signal, changes collagen deposition and improves US fibre pattern
No evidence yet of reduced reinjury

34
Q

Contraindications for laser use

A

Eye exposure
Neoplasia
Haemorrhage
Pregnancy/sec glands

35
Q

Whole body rehab

A

Water treadmill
Swimming
Ridden/in hand work with poles etc

36
Q

What are the sections of tendon loading curves

A

Straightening of crimp
Elastic deformation
Non-elastic deformation
Failure/rupture

37
Q

What is comp

A

Cartilage oligometric metrix peptide
Correlates with tendon elasticity - vary within a tendon

38
Q

What are GAGS

A

Glycosaminoglycans
Components of the extracellular matrix linking collagen fibrils

39
Q

What happens to comp with age

A

Metacarpal comp decreases with age - up to 5
Metacarpophalangeal comp increases - up to 5

40
Q

Where are inferior check lesion injuries normally most palpable

A

Lateral side of the proximal third of the forelimb metacarpus

41
Q

What symptom is characteristic of SDFT injury

A

Palmar bow

42
Q

Clinical signs of tendon injury (inflammatory phase)

A

Lameness
Pain on palpation
Heat
Swelling
Pathology
Haemorrhage/inflammation/neutrophils/increased blood flow/oedema

43
Q

Clinical signs/pathology of reparative phase

A

Reduction of lameness
Resolution of inflammation
Palpable enlargement
Pathology - angiogenesis, fibroplasia, fibroblasts, type 3 collagen, small fibril formation

44
Q

Remodelling/maturation phase signs

A

Size decreases, tendon less pliable, contracture
Collagen transforms 3-1
Cross linking and collagen fibrils

45
Q

Where is strain likely to occur when a tendon has been previously injured

A

Proximal and distal to the previous injury
Cross links are very strained

46
Q

Synoviocenthesis of DIP

A

Proximal edge of DIP 2cm lateral or medial of midline needles inserted distally

47
Q

Synoviocenthesis of PIP

A

Difficult
1cm distal to line of medial and lateral eminences for attachment of collateral ligaments

48
Q

Digital flexor tendon sheath synoviocenthesis

A

Enter on palmar aspect of the pasterns between proximal and distal annular ligaments

49
Q

Metacarpophalangeal/metatarsophalangeal synoviocenthesis dorsal approach

A

Insert needle under lateral edge of the common digital extensor at or slightly above palpable joint space directed medially parallel to frontal plane of the joint

50
Q

Metacarpophalangeal/metatarsophalangeal synoviocenthesis palmar approach

A

Needles must be dorsal to suspensory branch distal end of forth metacarpal/metatarsal bone

51
Q

Carpus synoviocenthesis

A

Must be flexed sample either side of extensor carpal radialis either into radiocarpal or intercarpal joint

52
Q

Synoviocenthesis of tarsocural

A

Distal to the medial malleolus of the tibia just medial or lateral to the saphenous vein 45° toward joint

53
Q

Tarsometatarsal synoviocenthesis

A

Planterolateral approach inserted above the head of the 4th metatarsal directed dorsomedial

54
Q

Femoropatella compartment of stifle

A

Between the middle and medial patella ligaments between the middle and lateral patella ligaments proximal to the palpable aspect of the tibial tuberosity

55
Q

Medial femorotibial synoviocenthesis

A

Needle inserted in to indentation between medial patella ligament and the tendon of the sartorius muscle proximal to the tibial plateau parallel to the ground

56
Q

Lateral femorotibial synoviocenthesis

A

Immediately cranially, caudally or through the long digital extensor muscles proximal to tibial plateau

Year 4 equine (20 decks)

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