Locomotor Flashcards
Clinical exam
Observation from a distance
Symmetry, posture, conformation (poor conformation doesn’t necessarily mean lameness)
Significant variations are usually obvious
Clinical exam
Gait observation
Patient moving away, towards and across you
Possibility of circling and turning to exaggerate abnormalities
Which limb? Characterise and score problem
Clinical Exam
Manipulation of joints
Moving the joint and limb in a controlled fashion to determine:
- Range of movement/abnormal movement
- Pain related to movement
- Load or unload specific structures in the limb
Safety factor
Maximum stress a structure withstand until breakage
OVER
Stress it is most likely to undergo during its lifetime
Factors of failure
Force/stress: magnitude, frequency, speed of loading, duration of loading
Influenced by: body mass, speed, gait
Constraints during locomotion
Need to support against gravity, force only produced when limb in contact with ground
Increase in speed - shorter stance, higher force
Ligaments in equine distal limb
Superficial digital flexor tendon SDFT
Deep digital flexor tendon DDFT
Distal accessory ligament DAL
Suspensory ligament SL
Flexor tendon muscles
Highly pennate
Muscle fibres about 1cm
Limited capacity for length change
Tendons
7% energy release as heat (horses)
Gallop tendons about 45 degrees C
Kills some cells but not tendon cells
Predilection for tendon core injuries
Joints - function
Relative movement of limb segments
Shock absorbers
Joints - horse
Reduction of phalanges, fusion of bones -> movement in sagittal plane only Interlocking configuration (ridges/grooves) - collateral ligaments -> restriction of movement without muscular control -> decrease in metabolic cost
Hoof (equine)
Horn capsule - protection but no expansion
Mechanical function - shock absorption, support and grip, propulsion
Constraints - resistance to abrasion, protection of senstive structures
Hoof (equine) - protective mechanisms
Shape of solar surface allows heel movement
Suspension of distal phalanx: forces transferred via distal border of hoof wall
Digital cushion: shock absorption and frog movement
Hoof sliding
Rotation and translation of the DIP joint
Duty factor
Ratio of stance and stride time
All stance phases critical to injury
1st impact: large accelerations, low forces
- likely to result in bruising to the soft tissues
- ‘vibrations’ good for bones??
2nd impact: low acceleration, high forces
- important to allow for a natural braking action
Support: large vertical force
- up to 2.5x body weight per limb
- excessive dorsiflexion of the fetlock means tendon stress
Force usually acts parallel to the long bones
Very tight safety factors in equine limb
High speed exercise
Increase tendon strain:
- reduced fatigue life
- potent stimulus for changes in structural properties
Trade off:
- providing stimulus and exceeding the mechanical capacity
- estimated fatigue life of around 10,000 cycles
Shifting of the PZM (point of zero movement)
Increase of moment around DIP
Increase in stress by the DDFT on navicular bone
Compensatory decrease in fetlock extension - unloading of the DDFT
Hindlimb: also point of force laterally in late stance -> shortening of moment arm around DIP
Mediolateral imbalance
Mediolateral wedge (6mm wide) moves PZM towards elevated side of the foot
Lateral extensions, trailer shoes in bone spavin:
- horses attempt to unload the dorsomedial aspect of small tarsal joints by redistributing weight to plantarolateral aspect of the foot
Assumed mechanism: redistribution of weight by rotating the foot or by helping the horse weight-bear on the lateral side of the foot
Alternate explanation: horse forced to move ‘normally,’ no unloading of painful tissues - eliciting the repair process
Heel wedges
Move PZM towards the heels
Reduce DIP moment arm, unloading DDFT and navicular bone (NB)
Give longer support through stance
Increase DIP joint pressure
Shift articular contact area dorsally
Increase in pressure may directly result in pain, can cause damage by changing vascularisation to the synovium and cartilage function triggering a cascade of detrimental pathways
Collapsed/underrun heels
Tubules start bending when grown distal to the distal phalanx
Impairment of natural hoof deformation and blood flow
Application of carbon fibre patches beneficial
Cow Lameness
History questions
Which lactation? How long calved? Previous (foot) problems? How long has she been lame? Treatment? Is she pregnant? Is she milking?
Cow Lameness
Score 0
Walks with even weight bearing and rhythm on all four feet with a flat back
Long fluid strides possible
Cow Lameness
Score 1
Steps uneven (rhythm or weigh bearing) or stride shortened affected limb(s) not identifiable immediately
Cow Lameness
Score 2
Uneven weight bearing on a limb that is immediately identifiable and/or obviously shortened strides (usually with an arch to the centre of the back)