Locomotion 3 Flashcards
What is the developmental process that is usually responsible for arthrogryposis and what do the affected joints look like once they are opened post mortem?
primary central or peripheral nervous system insult that causes inadequate muscle development in utero
- only in severe forms are there any associated deformities of the articular surfaces
what species is patella subluxation or luxation common
common in dogs and also seen in horses
medial luxations predominate in dogs, especially small breeds
What are the key abnormalities in canine hip dysplasia
○ small pelvic muscle mass relative to pelvis size (with the discrepancy exacerbated by feeding for maximal growth rate) -> lack of conformity between the femoral heads and the acetabula (acetabulum too shallow) -> laxity and subluxation of the coxofemoral joints - movement of femoral heads out -> DJD
What is the key difference between degenerative joint disease and arthritis
inflammation is primary in degenerative it is secondary
what are the 3 ways infectious agents get into joints and What is the most common route of entry?
1) haematogenously - the most common route
2) by direct extension from an infectious focus in adjacent soft tissues or bones
3) via a penetrating wound (including pressure sores and iatrogenic infections)
In which species is infectious arthritis commonly diagnosed? What age of animal is most commonly affected
infectious arthritis is especially common in livestock, especially young animals
What are the major differences (grossly and prognostically) between fibrinous arthritis and suppurative arthritis?
Grossly - the earliest change is oedema and hyperaemia of the synovium +/- petechiation
- the volume of synovial fluid increases and the fluid becomes slightly turbid and floccular
yellow-grey fibrin deposits may be present over the synovium, articular cartilages or in joint recesses
- complete lesion resolution most common
Grossly - marked enlargement of the joint area +/- abscessation or fistulation to the skin surface
prog - chronic
What are the 2 forms of immune-mediates arthritis pathogenesis, lesions and prognosis
1) Erosive - the antigen triggering inflammation is persistent in the synovium -> erosion of the synovium
- subluxation/luxation +/- ankylosis
- flamboyant synovial villous hyperplasia
2) non-erosive – the primary disorder is extra-articular in location and may be transient,
- usually minimal or no synovial villous hyperplasia
What are the major forms of immune-mediated arthritis seen in domestic animals? Which of these are erosive and which are non-erosive
Erosive
e.g. rheumatoid arthritis of dogs - chronic
Non-erosive
- systemic lupus erythematosus
In which species is articular/periarticular gout common? What does it look like grossly?
- occurs in humans, birds and reptiles (species that lack the enzyme uricase)
- urate deposits (tophi) are white, caseous or pasty and periarticular and may be grossly visible
What are hte 2 most serious forms of bursitis in horses and where found
1) Fistulous withers - involves the supraspinous bursa between the nuchal ligament and the spinous process of thoracic vertebra
2) “poll evil” - involves the atlantal bursa between the nuchal ligament and the dorsal arch of the atlas
What is the typical behaviour of a synovial sarcoma and which other aggressive tumour can develop around joints in dogs
- most synovial tumours are malignant and destroy and cross the joint, penetrating the bones and causing bone lysis and periosteal reactivity
- less common tumours arising from synovium of joints or tendon sheaths in domestic animals include benign and malignant giant cell tumours
Horse Hooves what occurs during compression
○ Caudal thinner than the cranial part of the hoof
○ Cranial is so it can land and take the force of the bones
○ Soft tissue in the palmar surface acts as cushion (as get faster land more palmar than toes)
§ To tip on the toes -> use flexors such as the deep flexor (inserts onto P3)
What is the hoof and the 4 major regions
The Hoof is the hard keratinised covering of the third phalanx Major regions of the hoof 1) Periople (and bulbs) 2) Wall (heels and bars) 3) Sole 4) Frog
describe the wall and sole of the hoof
Wall of the hoof Toe + quarters (medial and lateral) + heel
Sole - between frog and the wall - epidermis forms pigmented intratubular and tubular horn
Describe the frog of the hoof
- elastic material triangular in shape with a base and an apex
- Base is expanded and covered in periople which forms the bulb of the heels
- Groove marked by central groove and collateral (paracuneal) grooves separate frog either side from bar and sole
Describe the bar and the white line of the horse hoof
Bar - where the wall folds back on itself -> similar material to the wall
- Either side of the frog (there are two)
White line - between the sole and the wall of the hoof - Region where infection can track up the hoof
JUNCTION BETWEEN - important when shoeing a horse
- Sensitive tissues - laminar dermis and Non-sensitive hoof - horn of stratum internum and stratum medium
Describe the periople and coronet of the horse hoof
Periople - band of soft tubular and intratubular horn located between the normal skin of the left and the wall of the hoof
- Perioplic epithelium overlies the perioplic dermis which forms the horn of the stratum externum
○ Spreads a short way down the hoof forming a thin waterproof coating
Coronet/corona - the region where the haired skin meets the hoof
Hoof wall what is the composition
- Tubular and intertubular horn produced by epidermis covering the coronary dermis
- Inner surface of the wall comprises fine leaves of lamina horn produced by epidermis of the laminar dermis covering the external surface of P3
What are the 3 layers of the hoof wall and characteristics
1) Stratum externum - thin layer generated by the periople (tubular and intertubular horn)
2) Stratum medium - the major component of the wall (tubular and intertubular horn)
- Generally pigmented, inner wall isn’t where it becomes continuous with the laminar epithelium (that produces the str. Internum)
3) Stratum internum - fine leaves of keratin running parallel to the surface of the wall towards the ground (laminar horn)
What are the 2 dermal regions associated with the hoof wall and what do they form
1) Coronary dermis - forms the stratum medium (main hoof wall)
2) laminar dermis - forms the stratum interum
Coronary dermis what does it form and how
forms the stratum medium (main hoof wall)
- Forms the long papillae pointing towards the ground and supports the epithelium that produces the tubular and intertubular horn of the str. Medium
Concave proximal boarder of stratum medium is the coronary groove and contains coronary dermis in life
Laminar Dermis what does it form and how
- Shaped into laminae which run parallel to the surface of the hoof wall and towards the ground
- Laminae have smaller secondary laminae (tissue dermis) arising from their lateral surfaces
- Overlaying epithelium forms non-pigmented horn of the stratum internum which grows downwards at the same rate as the horn of the stratum median
○ Similar growth rates means high integrity and strong union between them and the dermis (sensitive tissues) is maintained
can the hoof regrow
Horn can heal and grow over the end of the hoof after removed as long as have dermis, blood supply and no infection
List 4 differences between Cow and Horse
1) Periople is much wider
2) The sole is a narrow rim of horn adjacent to the wall and gradually merges caudally with the bulb
3) Coronary papillae are much smaller
4) The str. Internum is less extensive and bears no secondary lamellae
What are the 4 steps in the systemic approach to reading MSK radiographs
1) Alignment -> limbs, bones, joint surfaces -> are they in contact - luxation
2) Bone loss and new bone production -> where occurring
3) Cartilage -> joint space and physes -> normally radiolucent, width, contour, contrast radiography may be needed
4) soft tissue -> swelling, atrophy or change in opacity
List 6 advantages of using radiology for examining joints
1) readily available
2) inexpensive
3) relatively easy to perform
4) global ‘overview’ of lesions
5) detects many common lesions
6) monitor progress with follow-up examinations
List 5 disadvantages of radiology for examining joints
1) limited evaluation of soft tissue
2) subtle pathology may not be visible
3) significant bone loss required before lesions are visible - need to lost 70% before see
4) lesions may not be visible on ‘standard’ views
5) superimposition of structures may make interpretation difficult
List 5 advantages of ultrasound for evalulation of joints
1) readily available
2) portable
3) evaluation of soft tissue structures
4) detect some lesions when radiographs are normal
5) monitor progress with follow-up examinations
List 5 limitations of ultrasound for evaluation of joints
1) high quality equipment required - high frequency
2) excellent knowledge of joint anatomy required
3) can be difficult to image curved or ‘knobbly’ structures
4) limited information about bone lesions
5) not as sensitive as MRI for soft tissue lesions
What is the advantage and disadvantage of scintigraphy for bone
Ad - sensitive at detecting areas of bone activity
Dis - is not specific for the disease process
KNOW WHERE THE LESION IS NOT WHAT IS IT
List 4 Indications for computed tomography of the musculoskeletal system
1) sensitive detection of bone lesions
2) understand complex lesions in 3 dimensions
3) evaluate intra-articular structures eg. CT arthrography
4) evaluate relationship of bone lesion to surrounding soft tissue
List 4 limitation of computed tomography of the musculoskeletal system
1) limited availability
2) expensive
3) uses radiation
4) soft tissue contrast - better than radiographs, not as good as MRI
List the 3 indications for magnetic resonance imaging of the musculoskeletal system
1) Any MSK injury!
2) Joint lameness localised to a specific area, but other modalities do not show the lesion
3) Lameness localised to an area difficult to access by other means (eg. equine distal limb)