Musculoskeletal

Question 1

What comprises the musculoskeletal system?

Answer 1

muscles
bones
tendons
ligaments
joints
cartilage

Question 2

What are potential presenting complaints for musculoskeletal system?

Answer 2

1. lameness
2. recumbancy
3. syncope
4. weakness
5. wobbly

Question 3

What are to non-exclusive types of problems with the musculoskeletal system?

Answer 3

1. generalized

2. localized

Question 4

What are two points of confusion that may make an issue seem muskuloskeletal when it isn’t?

Answer 4

1. neurological disorders

2. pain

Question 5

What are important points in a history?

Answer 5

1. get full history
2. ask specifics:
   a. problem,
   b. progression,
   c. previous treatments and response

Question 6

What are important points in a history?

Answer 6

1. get full history
2. ask specifics:
   a. problem,
   b. progression,
   c. previous treatments and response

Question 7

Why do you need to do a general physical exam?

Answer 7

1. to rule out other body systems

2. to look for problems to support differentials

Question 8

What are two problems with gait evaluation?

Answer 8

1. requires experience

2. need to reproduce the problem–it may not be apparent at a walk–can be subtle

Question 9

What two things need to be done in a specific physical exam?

Answer 9

1. palpation

2. manipulation

Question 10

What must you know and look for with palpation

Answer 10

1. must know normal
2. must look for
   a. pain
   b. different morphology
   c. changes in tone
   d. swelling

Question 11

What do you have to manipulate? What do you look for?

Answer 11

1. manipulate every joint
2. check:
   a. range of motion
   b. smoothness of motion
   c. pain

Question 12

Is a neurological exam always done? Why is it done?

Answer 12

1. not always done

2. need to rule out possibility of neuro cause

Question 13

How can you localize discomfort?

Answer 13

1. nerve blocks

3. joint blocks

Question 14

What direction do you work with nerve/joint blocks?

Answer 14

distal to proximal

Question 15

What can be run on the blood?

Answer 15

1. CBC–infectious?

2. chemistry panel–Ca/P; Ck/AST for muscle damage

Question 16

What are disadvantages of imaging?

Answer 16

1. expensive
2. time consuming
3. potentially dangerous
4. difficult to interpret
5. need to know where you are looking
6. need to have some idea what looking for

Question 17

What are disadvantages of imaging?

Answer 17

1. expensive
2. time consuming
3. potentially dangerous
4. difficult to interpret
5. need to know where you are looking
6. need to have some idea what looking for

Question 18

What are 3 special tests that can be done?

Answer 18

1. Biopsy (muscle, bone, joint)
2. EMG
3. Myasthenia gravis testing
4. Genotyping

Question 19

What is signalment?

Answer 19

1. species
2. age
3. breed
4. sex
5. activity
6. environment

Question 20

Why is signalment important?

Answer 20

Some of the disease are very specific to the species, age, breed, sex, activity, environment

Question 21

Radiography is good for seeing what 4 things in bones?

Answer 21

1. fractures
2. density
3. irregularity of growth
4. can help with joints (but can’t see cartilage)

Question 22

What is ultrasound good for?

Answer 22

1. soft tissue (tendon, joint capsule, abnormalities in muscle)
2. can image surface of bone (e.g. pelvic fracture)

Question 23

What is CT good for?

Answer 23

1. can get a 3D image so can get a better view of complex lesions
2. can see some soft tissue lesions

Question 24

What is MRI good for?

Answer 24

1. very good for soft tissue
2. can image cartilage
3. limited use for bone

Question 25

What is scintigraphy and what can it be used for?

Answer 25

1. dynamic imaging | 2. can be used to look for lesions in soft tissue and bone

Question 26

What are problems with scintigraphy?

Answer 26

1. have to give a radioactive

Question 27

What are problems with scintigraphy?

Answer 27

1. have to give a radioactive compound and that goes into urine and stall 2. usually doesn't help much?

Question 28

What is scintigraphy mostly used for?

Answer 28

spine lesions in horses (kissing spines)

Question 29

What is arthrocentesis and what can it diagnose?

Answer 29

sample synovial fluid of joint. Can diagnose inflammation (potentially infeciton, can help ID cause of inflammation)--however remember fluid is often negative for bacteria b/c in synovial membrane

Question 30

What are the advantages and disadvantages of muscle biopsy?

Answer 30

advantages 1. relatively easy to do 2. many options beyond simple histopath disadvantages 1. samples need to be handled carefully 2. may need specialized lab services

Question 31

What are the advantages and disadvantages of bone biopsy?

Answer 31

advantages 1. can be a good tool for diagnosis disadvantages 1. need specialized tools (very specific needles) 2. results delayed while sample is decalcificied

Question 32

What can EMG be used to do?

Answer 32

1. generally more of a neurology test | 2. can ID certain muscle disorders due to abnormal electrical activity (e.g. myotonia)

Question 33

What is an example of a muscle disorder that has a genetic basis?

Answer 33

Hyperkalemic periodic paralysis

Question 34

What does GIN AND TONIC stand for?

Answer 34

``` G-genetic I-infectious N-non known cause A-allergic/autoimmune N-nutritional D-degenerative T-traumatic O-oncologic N-endocrine I-intoxication C-congenital ```

Question 35

What is a toxicology example that involves the musculoskeletal system?

Answer 35

monensin

Question 36

what are miconutrients that might be involved with muscle pathology?

Answer 36

Vit E and Se