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VET 433a - Small Animal Stream 1 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

Musculoskeletal

1
Q

Rehabilitation impact on tissues (bone)

A
  • exercise increases bone metabolism and healing
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2
Q

Rehabilitation impact on tissues (cartilage)

A
  • rest protects injured cartilage
  • rigid immobilization damages articular cartilage
  • controlled remobilization enhances cartilage recovery
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3
Q

Rehabilitation impact on tissues (ligaments)

A
  • protected exercise boosts ligaments recovery rate
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4
Q

Rehabilitation impact on tissues (muscle)

A
  • exercise strengthens, stretches, increases balance, alleviates pain, increases function, decreases depression
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5
Q

10 Parts to Rehabilitation (Why bother…)

A
  1. Assessing patient more completely
  2. Protecting Patients (from slipping, falling, etc)
  3. Assisting Patients (slings, harness)
  4. Relieving Pain
  5. Providing nursing care
  6. Strengthening
  7. Stretching
  8. Provide (non-noxious) sensory stimuli
  9. Training and education (everyone)
  10. Identifying and managing high-risk patients
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6
Q

5 points to decreasing pain during rehab

A
  1. anti-inflammatory measures
  2. edema control
  3. gate control theory
  4. dec. healing tissue stress
  5. improving posture and locomotion
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7
Q

Candidate for physical rehab? ( 7 points)

A
  1. non-ambulatory
  2. potential to become non-ambulatory
  3. potential to lose joint motion (contracture, etc)
  4. potential for irreversible changes to musculoskeletal system
  5. require specific form of protection ( not available to or managable by owner)
  6. severely overweight
  7. missing limbs
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8
Q

Recovery states of wound healing

A
  1. hemostasis (~hours)
  2. inflammatory (~days)
  3. repair/ proliferation (~weeks)
  4. remodeling/ maturation ( ~months)
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9
Q

Perthe’s Disease

A
  • aseptic necrosis of the femoral head
  • young small breed dogs
  • severe lameness and limb disease
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10
Q

Canine Hip Dysplasia

A
  • highly prevalent, osteoarthritic disease
  • mild to severe pain
  • hip laxity leads to clinical signs and progressive hip OA
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11
Q

What is the #1 risk factor for developing hip OA later in life

A
  • passive hip laxity
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12
Q

Functional hip laxity influenced by:

A
  • increased volumes of joint fluid
  • thickened ligament of head of femur
  • pelvic muscle mass
  • hormonal
  • weight and growth rates
  • nutrition ( high Ca, Ph, Vit C)
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13
Q

T/F: there is no medical or surgical cure for Canine Hip Dysplasia… only palliative treatment

A

T

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14
Q

What is the best method to reduce frequency and severity of CHD?

A
  • selective breeding
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15
Q

T/F: CHD is expressed on a scale from normal to severely abnormal

A

T

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16
Q

T/F: checking the dog at 2 years of age is an effective method to rule out hip OA later in life

A

F, hip OA arises progressively through life on a linear scale so looking at 2 years of age is not very helpful

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17
Q

T/F: CHD has a biphasic distribution

A

False

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18
Q

When testing for laxity, what does a finding of ‘no laxity’ indicate

A
  • simply that you can’t find it on exam

- does not indicate that it is not present in the patient

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19
Q

Ortolani Sign

A
  • the small click heard when the hip is abducted

- indicates reduction of the joint

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20
Q

Barlow Sign

A
  • the glide or step felt when the hip is adducted

- indicates sub-luxation

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21
Q

How to read the difference between Ortolani and Barlow Signs

A

Barlow - Ortolani = 20-30*

- increased angle is an indicator of worse disease

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22
Q

danger of hip extension radiographs for hip OA

A
  • has potential to hide laxity
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23
Q

Hip Disease (Clinical Signs)

A
  • mild-severe lameness
  • usuallly chronic and insidious lesions
  • stiffness on rising and gait
  • Bunny-hopping gait
  • exercise intolerance
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24
Q

Hip Disease (Physical Exam)

A
  • muscle atrophy
  • protrusion of greater trochanter dorsal and lateral
  • pain on hip extension or hip movement
  • decreased hip range of motion
  • crepitus
  • ortolani signs
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25
Q

Hip Disease (medical/ Conservative treatment)

A
  • weight management is the best
  • exercise modification programs
  • physical rehab
  • essential fatty acids
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26
Q

Do dietary supplements or stem cells help treat Canine Hip Disease?

A
  • no evidence to support that and they can actually be harmful
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27
Q

CHD - Exercise modification program examples

A
  1. cold and heat therapy
  2. maintain mobility and circulation
  3. inclines
  4. hydrotherapy
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28
Q

2 surgical options for CHD

A
  1. total hip replacement

2. femoral head and neck excision

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29
Q

Total Hip Replacement (indications)

A
  • any disability from hip OA
  • failure to achieve activity level desired by dog or o
  • failure of medical management
  • no skin bacterial disease
  • no UTI
  • no dental fractures
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30
Q

Total Hip Replacement (non-cemented adv.)

A
  • no bone cement complications ( infection, immune rxn, breakage, neuropraxia)
  • longer life span on implants
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31
Q

Total Hip Replacement (cemented adv.)

A
  • less precise measurements preop
  • implant stable as soon as cement cures
  • technically easier
  • no subsidence in straight femures
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32
Q

Total Hip Replacement (outcomes)

A
  • can return to n function
  • complication at 10-40%
  • many mistakes are surgical mistakes or poor owner compliance
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33
Q

Femoral Head and Neck Excision

A
  • gait will not be normal

- very good at removing pain

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34
Q

Femoral Head and Neck Excision (indications)

A
  • femoral head and neck fractures
  • aseptic necrosis of femoral head
  • acetabular fractures
  • hip luxations
  • failed THR
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35
Q

Femoral Head and Neck Excision (Ostectomy)

A
  • hold femur at 90
  • cut caudal angle 35-45
  • muscle flaps not helpful
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36
Q

Femoral Head and Neck Excision (outcome)

A
  • correct ostectomy (no neck left, torchanter left intact)
  • rehab. plan per owner
  • limb use before surgery
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37
Q

Aseptic Necrosis of Femoral Head

A
  • usually unilateral
  • small dogs
  • Etiology - heritable (toy poodle, terriers)
  • Pathogenesis - blood supply is disrupted (circumflex femoral vain)
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38
Q

Aseptic Necrosis of Femoral Head (Clinilal presentation, tx, rec)

A 
Clinical Presentation:
- mild trauma @ 4-12 months of age
- non-partial weight bearing
Tx and Rec:
- conservative doesn't work
- FHO or THR
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39
Q

Hip Dysplasia in Cats

A
  • 1.2% were clinical
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40
Q

Best preventative for Hip Disease

A
  • don’t breed and keep thin
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41
Q

T/F: conservative treatment is only effective for less than half of hip disease.

A

F; conservative is good for ~75%

42
Q

T/F: THR can restore normal function but is technical and has higher rates of complications

A

T

43
Q

T/F: FHO can be successful but is ideal for smaller and requires rehabilitation

A

T

44
Q

How to treat a dog with congenital/ traumatic elbow luxation?

A
  • Severe OA? –>
    Yes = Salvage via arthrodesis/ amputation
    No
    –> Avulsion frx? Articular frx? > 48-72hrs?
    Yes = open reduction, lig reconstruction, fx repair
    No = Closed Reduction
    –> Stable
    Yes = temp stabilization in extension
    No = back to open reduction
45
Q

How long to splint a dog treated for elbow luxation?

A

5-7 days

46
Q

T/F: congential and traumatic elbox luxation are treated the same way

A

T

47
Q

Signalment and History for Incomplete Ossification of Humeral Condyle (IOHC)

A

Signalment: spaniel breeds, 90% bilateral
History: front limb lameness and SH type 4 frx caused by minor/ no trauma

48
Q

4 components of elbow dysplasia

A
  1. Elbow incongruence
  2. OCD of medial humeral condyle
  3. Fragmented coronoid process
  4. Ununited anconeal process
49
Q

Treatment of Elbow Dysplasia (OC/ OCD)

A
  • debridement –> defect will fill w/ fibrocartilage; resurfacing via osteochondral autograph
50
Q

Treatment of Elbow Dysplasia (Elbow Incongruence)

A
  • ulnar osteotomy

- controlled distraction surgery

51
Q

Treatment of Elbow Dysplasia (Anconeal Process)

A

minimally displaced fragment –> proximal ulnar osteotomy

old or highly displaced frag –> removal of fragment

52
Q

Treatment of Elbow Dysplasia (Coronoid Process)

A

fragment removal via arthroscopy

53
Q

3 functions of cranial cruciate

A
  1. prevents cranial translation of tibia
  2. prevents medial patellar luxation
  3. prevents hyperextension of stifle
54
Q

2 pathognomonic ortho exam findings for confirming CCL

A
  1. Drawer’s test

2. Tibia compression test (indirect drawer)

55
Q

3 (maybe 4) most common surgery treatment methods for cranial cruciate repair

A
  1. Lateral Sutures (static)
  2. Tightrope (static)
  3. Tibial Plateau Leveling Osteotomy (TPLO)
  4. Tibial Tuberosity Advancement (TTA)
56
Q

Lateral Sutures

A
  • suture around fabella and through a hole in tibia
57
Q

Tightrope

A
  • much stronger suture than lateral, but braided

- potential for infection d/t braided

58
Q

2 Reasons why medial meniscus more likely to be damaged than lateral meniscus?

A
  1. mid-body of meniscus attached to the MCL

2. caudal meniscal tibial ligament holds meniscus in place so no stretch/ less than lateral

59
Q

Function of the meniscus

A
  1. force redistribution

2. joint stability

60
Q

Rational behind meniscal release

A
  • for an intact meniscus
  • prevent future meniscal injury
  • gets rid of hammock function
61
Q

Rational behind meniscectomy

A
  • for a torn meniscus
  • remove source of pain
  • save as much normal tissue as possible
62
Q

2 radiographic views for CHD needed for surgery

A
  • cross-table cranial-caudal

- open leg lateral

63
Q

Shoulder OCD (common location, diagnosis, treatment, prognosis)

A
  • inherited condition, usually bilateral
  • caudomedial humeral head
    Diagnosis: rads, CT, Arthroscopy
    Treatment: conservative not helpful if OCD; flap removal and debridement via arthroscopy
    Prognosis: good - excellent following surgery
64
Q

Glenoid Dysplasia (signalment, clinical signs, treatment)

A
  • toy breed dogs
  • luxation usually medially
    Clinical Signs: lameness, atrophy
    Treatment:
    –> Stabilization surgery doesn’t seem to work
    –> Salvage procedure has fair prognosis (arthrodesis or excision arthorplasty)
65
Q

Incomplete Ossification of Caudal Glenoid

A
  • usually incidental finding
  • may cause pain and lameness but usually d/t other conditions
  • may see resolution after removal of fragment
66
Q

Biceps Brachii Tendinopathy (signalment)

A
  • adult, active large breed
67
Q

Biceps Tendon ( origin, insertion)

A

origin - supraglenoid tubercle

insertion - prox. radius and ulna

68
Q

Biceps Brachii Tendinopathy ( Diagnosis)

A
  • pain @ biceps tendon
  • (+) biceps test – flex shoulder, extend elbow
  • shoulder drawer test
  • biceps retraction test
69
Q

Biceps Brachii Tendinopathy ( radiography and US)

A
  • not super useful

- US only useful on lateral

70
Q

Biceps Brachii Tendinopathy ( Treatment)

A
  • medical for mild lameness ( rest and NSAIDs)

- surgical: tenodesis or biceps brachii transection

71
Q

Supraspinadus tendinopathy

A
  • mineralization of supraspinatus
  • large breeds
  • Diagnosis: low grade lameness, pain on palpation
  • Treatment: NSAIDs, rest, Surgery for removal of tendon
72
Q

Infraspinadous contracture

A
  • active hunting dogs w/ acute onset distal limb abduction and foot circumduction
  • Treatment: transection of tendon
  • Prognosis: good - excellent
73
Q

Medial - Joint Instability

A 
- tearing of medial glenohumeral ligament, subscapular muscle, joint capsule 
Clinical Signs and Diagnosis: 
- lameness, pain on abduction
- increased abduction
- atrophy
- measure angle of abduction
74
Q

What is the most common cause of shoulder lameness in the young, large dog

A

OCD

75
Q

T/F: incomplete ossification of the glenoid rarely needs treatment

A

T

76
Q

T/F: Glenoid Dysplasia can become clinical at any age and requires arthrodesis or glendoid excision arthroplasty

A

T

77
Q

What is the most common soft tissue injury in dogs?

A

Biceps Brachii Tendinopathy

78
Q

Tibial Plateau Leveling Osteotomy (TPLO)

A
  • change direction of joiint surfaces to change direction of joint contact force
79
Q

Tibial Tuberosity Advancement (TTA)

A
  • change direction of quadriceps pull to change direction of trans-articular force
80
Q

Panosteitis (risk factors/ signalment)

A
  • young, male, >23kg, during summer and fall
81
Q

Panosteitis ( pathogenesis)

A
  • fat necrosis in bone marrow
  • vasc proliferation and local bone formation at nutrient foramen ( increase intraosseous pressure)
  • further bone formation from congestion
82
Q

Panosteitis (Clinical Signs and Dx)

A
  • shifting leg lameness

- Rads: smoke in the chimney ( may look normal / thickened periosteum )

83
Q

Panosteitis ( Tx)

A
  • palliative only, good prognosis
84
Q

Hypertrophic Osteodystrophy (HOD) (signalment)

A
  • young, rapidly growing, male, large breeds
85
Q

HOD ( pathogenesis)

A
  • zone of abnormal trabeculae bone in metaphysis

- hemorrhage , inflammation, necrosis, and fibrosis

86
Q

HOD ( clinical signs and diagnosis)

A
  • exam = metaphyseal swelling, lameness, systemically ill, fever
  • Rads = lucent line metaphysis, excessively enlarged meatphysis
87
Q

HOD ( tx and prognosis)

A
  • supportive only

- self limiting condition but can cause 2* growth deformities

88
Q

OC (Risk factors)

A
  • young, large - giant, males
  • heritable
  • overfeeding –> rapid growth
  • high Ca and Vit. D
89
Q

OC ( Pathogenesis)

A
  • ischemia to certain location of subchondral bone causing death
90
Q

OC ( Osteochondrosis Lesion)

A
  • fate depends on size, vascularized?, extent of attachments
    Reattach: only in animals <25 weeks of age
    Detach: flap/ joint mouse –> OCD
91
Q

OC ( Locations)

A
  • Femur = condyle, head
  • Humerus = medial condyle, head
  • Tarsus = talus
92
Q

OC ( Diagnosis)

A
  • exam for joint effusion, pain on joint manipulation

- rads, ct, mri

93
Q

OC (treatment)

A
  • medical
  • surgical:
  • -> Palliative (currettage, abrasion arthoplasty)
  • -> Restorative (osteochondral transplants, grafts, implants)
94
Q

OC (prevention)

A
  • selective breeding

- control of energy and diets while young

95
Q

Retained Ulnar Cartilagenous Core

A
  • core of cartilage from distal metaphysis into diaphysis of ulna
  • 3-4 month old, large-giant breed
  • dx on rads
  • tx not necessary
  • prg depends on degree of growth retardation
96
Q

Swimmer Syndrome

A
  • poorly understood
  • 1-2 weeks of age
  • decreased muscle tone forces sternal recumbency
  • causes sternal and limb range of motion changes
  • tx supportive
  • prognosis good if treated aggressively with PT be <3-4 weeks of age
97
Q

Carpal Laxity Syndrome

A
  • either hypoextension or hyperextension of carpus
  • 6-16 weeks in large breed dogs
  • pathogenesis unknown
  • tx: resolves spontaneously post 2 weeks… do not splint the limb
98
Q

5 Signs of an Aggressive Bone Lesion on rad

A
  1. pattern of osteolysis
  2. cortical lysis
  3. irregular periosteal reaction
  4. long zone of transition
  5. quick rate of change
99
Q

Normal coxo-femoral joint

A
  1. 50% coverage of dorsal acetabulum

2. parallel subchondral bone margins

100
Q

Radiographic features of DJD

A
  1. increased synovial mass
  2. Periarticular new bone formation
  3. Decreased joint space
  4. Subchondral bone sclerosis

VET 433a - Small Animal Stream 1 (10 decks)

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