Musculoskeletal disease p1 Flashcards
What is lameness?
- Abnormality of movement caused by pain or dysfunction of the nervous system, musculoskeletal, or cardiovascular system.
- Sign of underlying disease.
Neuroma, what is it?
Abnormal nerve bundle causes lameness through pain as well as dysfunction
How does a horse show lameness? Examples? (4)
Change in movement or stance to compensate for pain or dysfunction.
1. May reduce eliminate motion in a joint resulting in less flexion or extension of a joint.
2. Reducing the total impulse or amount of energy transmitted thru the limb.
3. “Head nod” - shifting body’s weight away from the limb during the stance phase.
4. “Wobbliness” - unable to maintain a normal movement due to neurologic disease-weakness
Lameness examination (7)
- Complete Hx from O
- Observation of a horse at rest
- Close visual inspection
- Observe horse in motion
- Palpation of structures
- Nerve blocks
- Other Dx testing
History collection Q’s (9)
- When did it start?
- What leg seems to be affected?
- Has it become worse? Better?
- Have you noticed any swelling?
- What do you use the hose for?
- Is there a history of previous lameness?
- Have you treated the horse with anything?
- Has the exercise program changed recently?
- Does the horse have shoes on? Was he/she recently shod?
When the horse is at rest, you should observe what far exam? (6)
- BCS
- Posture
- Hoof quality
- Lacerations
- Swelling
- Muscle atrophy
Observing the horse in motion is most advantageous with the ___ due to its symmetry. Exam is done by watching the horse move from the ___, the ___, & ___. Also, ___ the horse or perform figure ___ can accentuate the lameness.
Hard surfaces are best for ___ interpretations and gravel for ___ certain lameness.
- Trot
- Front, side, & behind
- Circling
- Eight
- Audible
- Exaggerate
When performing a movement exam for lameness, look out for… (7)
- Head nodding
- Gait deficits
- Alterations in height of foot flight arc
- Phase of stride
- Joint flexion angle
- Foot placement
- Symmetry in gluteal rise & duration
Lameness Grades 1-5
- Lameness isn’t recognizable at the walk but is evident at the trot.
- Most typical in chronic, non-progressive diseases. - Lameness is barely perceptible in the walk and very apparent at the trot.
- Head movements become obvi at the trot with some head & neck lifting as the lame foot hits the ground. This is an attempt to reduce the weight bearing on affected limb. - Lameness apparent at the walk & trot.
- Head & neck lifting are obvi with the forelimb lameness & with a hindlimb lameness. Head nodding is apparent when the opposite forelimb hits the ground. - Horse won’t place foot completely flat during weight bearing.
- Reluctant to jog. - Non-weight-bearing lameness (NWB)
- Associated with fractures, subsolar abscesses, severe tendonitis, & septic arthritis.
Palp of structures: Hoof
Compare normal hoof and abnormal hoof. Look for abnormal hoof ___, ___ formation, heel bulb ___, hoof wall ___ & ___, and other asymmetries. Palpate the ___ band for heat, ___, & ___ on pressure. Note ___ pulses.
Using a hoof pick & hoof knife, clean out the ___ of the foot and search for any abnormalities. This includes frog ___, ___ footedness, or ____. Use hoof testers on the entire ___ & ___ region of the foot. Localize any hoof ___.
- Wear
- Ring
- Cracks & Swellings
- Coronary band
- Swelling & Pain
- Digital
- Sole
- Atrophy
- Flat footedness or Wounds
- Sole & frog
- Sensitivities
Hoof testers are used as…
“Pinchers” to find areas of pain
Palp of the leg:
Palpate the leg for ___ &/or ___. Compare any suspected abnormalities with the opposite leg. Check for any thickening of the ___ or swollen ____ or muscle ____.
Rotate, ___, & extend the ___ to test for pain.
- Heat
- Enlargements
- Tendons
- Muscles
- Atrophy
- Flex
- Joints
Flexion tests are used to put extra strain on a ____ or surrounding ___ to exacerbate lameness.
Try to separate lameness to a particular ___. Typically held in extreme flexion for at least __ seconds. Horse then trotted off to assess if lameness has ___.
- Joint
- Ligaments
- Joint
- 60 seconds
- Worsened
When using regional anesthesia, determine the specific area and begin with a block at the ___ point of the affected limb.
This will ___ everything below the block, so safest to start ___.
You can choose intraarticular (into ___) or perineural (around ___) nerve block.
After block is placed, the patient is reevaluated for ___ in condition.
When alleviation is achieved, you can proceed with ___ of appropriate region.
- Lowest
- Desensitize
- Distally
- Joint
- Nerve
- Changes
- Diagnostics (ie imaging)
Radiography is useful for evaluation of ___ structures-joints, long ___, ____, etc.
You may not see ___ bony injuries on 1st set of rads. So, ___ views are needed for joints.
This usually requires ___ and specialized equipment.
- Bony
- Bones
- Sesamoids
- Acute
- Multiple
- Sedation
Ultrasound is helpful for looking at the ___ structure of ___ tissues, especially the tendons, and helps evaluate ___.
Tendon problems can be Dx very soon after ___ & usually show up as “___ ___” where the normal central fibers of the tendon have been replaced by ___ & ___.
- Internal
- Soft
- Healing
- Injury
- “Core lesions”
- Blood & fluid
Nuclear scintigraphy looks for new areas of ___ production.
- Bone
MRI can be useful for seeing inside structures such as ___, ligament, ___, and cartilage. It can be used below the ___ & ___ and is very helpful for foot problems.
- Bone
- Tendon
- Carpus & Hock
FINISH SLIDE SHOW GIRLIE!!!
