Musculoskeletal Flashcards
What comprises the musculoskeletal system?
muscles bones tendons ligaments joints cartilage
What are potential presenting complaints for musculoskeletal system?
- lameness
- recumbancy
- syncope
- weakness
- wobbly
What are to non-exclusive types of problems with the musculoskeletal system?
- generalized
2. localized
What are two points of confusion that may make an issue seem muskuloskeletal when it isn’t?
- neurological disorders
2. pain
What are important points in a history?
- get full history
- ask specifics:
a. problem,
b. progression,
c. previous treatments and response
What are important points in a history?
- get full history
- ask specifics:
a. problem,
b. progression,
c. previous treatments and response
Why do you need to do a general physical exam?
- to rule out other body systems
2. to look for problems to support differentials
What are two problems with gait evaluation?
- requires experience
2. need to reproduce the problem–it may not be apparent at a walk–can be subtle
What two things need to be done in a specific physical exam?
- palpation
2. manipulation
What must you know and look for with palpation
- must know normal
- must look for
a. pain
b. different morphology
c. changes in tone
d. swelling
What do you have to manipulate? What do you look for?
- manipulate every joint
- check:
a. range of motion
b. smoothness of motion
c. pain
Is a neurological exam always done? Why is it done?
- not always done
2. need to rule out possibility of neuro cause
How can you localize discomfort?
- nerve blocks
3. joint blocks
What direction do you work with nerve/joint blocks?
distal to proximal
What can be run on the blood?
- CBC–infectious?
2. chemistry panel–Ca/P; Ck/AST for muscle damage
What are disadvantages of imaging?
- expensive
- time consuming
- potentially dangerous
- difficult to interpret
- need to know where you are looking
- need to have some idea what looking for
What are disadvantages of imaging?
- expensive
- time consuming
- potentially dangerous
- difficult to interpret
- need to know where you are looking
- need to have some idea what looking for
What are 3 special tests that can be done?
- Biopsy (muscle, bone, joint)
- EMG
- Myasthenia gravis testing
- Genotyping
What is signalment?
- species
- age
- breed
- sex
- activity
- environment
Why is signalment important?
Some of the disease are very specific to the species, age, breed, sex, activity, environment
Radiography is good for seeing what 4 things in bones?
- fractures
- density
- irregularity of growth
- can help with joints (but can’t see cartilage)
What is ultrasound good for?
- soft tissue (tendon, joint capsule, abnormalities in muscle)
- can image surface of bone (e.g. pelvic fracture)
What is CT good for?
- can get a 3D image so can get a better view of complex lesions
- can see some soft tissue lesions
What is MRI good for?
- very good for soft tissue
- can image cartilage
- limited use for bone
What is scintigraphy and what can it be used for?
- dynamic imaging
2. can be used to look for lesions in soft tissue and bone
What are problems with scintigraphy?
- have to give a radioactive
What are problems with scintigraphy?
- have to give a radioactive compound and that goes into urine and stall
- usually doesn’t help much?
What is scintigraphy mostly used for?
spine lesions in horses (kissing spines)
What is arthrocentesis and what can it diagnose?
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
What are the advantages and disadvantages of muscle biopsy?
advantages
- relatively easy to do
- many options beyond simple histopath
disadvantages
- samples need to be handled carefully
- may need specialized lab services
What are the advantages and disadvantages of bone biopsy?
advantages
1. can be a good tool for diagnosis
disadvantages
- need specialized tools (very specific needles)
- results delayed while sample is decalcificied
What can EMG be used to do?
- generally more of a neurology test
2. can ID certain muscle disorders due to abnormal electrical activity (e.g. myotonia)
What is an example of a muscle disorder that has a genetic basis?
Hyperkalemic periodic paralysis
What does GIN AND TONIC stand for?
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
What is a toxicology example that involves the musculoskeletal system?
monensin
what are miconutrients that might be involved with muscle pathology?
Vit E and Se
