Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ACVN - MEDICAL NURSING > Orthopaedic Exam > Flashcards

Orthopaedic Exam Flashcards

1
Q

How would you plan a lameness examination?

A
  • signalment and presenting complaint
  • history
  • gait examination
  • physical examination
  • differential diagnosis and diagnostic exam
  • ancillary aids to diagnosis
  • arthrocentesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is part of the signalment and presenting complaing section of the lameness examination?

A

breed, age and sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What would knowing the breed, age and sex of the patient help you with?

A

can provide important cues with regard to the nature of the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are you looking for when taking a history?

A
  • patient medication
  • duration of lameness
  • onset
  • progression
  • continuous or intermittent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If the patient is on medication for lameness what are you asking?

A
  • the duration of the treatment
  • how they responded to the treatment
  • when the treatment course finished
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What else do you want to find out when taking a history from a lame patient?

A
  • duration of lameness
  • the onset, whether it was gradual or acute, if there was an initiating trauma
  • whether the lameness is static or progressive, deteriorating or improving
  • is it continuous or intermittent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What might intermittent lameness be associated with?

A

could be a flare up or overuse of an arthritic joint or due to intermittent patella luxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What might progressive worsening lameness be caused by?

A

neoplastic condition, osetoarthritis can cause continuous lameness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are you looking at when observing the lame patients stance?

A

symmetry, weight bearing, if there is angular deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are you looking for specifically with symmetry of the stance?

A
  • the paw of the limb taking the most weight will be flatter and more difficult to lift this limb in the standing patient
  • inward and outward pointing of the paw
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are you looking for specifically if a patient is weight bearing differently?

A

if they are shifting weight from pelvic to thoracic limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a kyphotic stance?

A

the back is curved upwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is scoliosis?

A

lateral curvature of the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What might frequent sitting be a sign of?

A

pelvic limb lameness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What might frequenct lying down be a sign of?

A

thoracic limb lameness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are you looking for when doing a gait analysis?

A
  • stride length
  • head nodding
  • scuffing of nails
  • ataxia, paraperesis, paraplegia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is ataxia?

A

pelvic limb incoordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is paraperesis?

A

hind limb neurological deficits but motor function is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is paraplegia?

A

hind limb neurological deficits with absent motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does circumducted mean?

A

swung out from the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why might a limb be circumducted?

A

prevents stifle flexion, preventing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a lateral sway?

A

when hip pain causes the spine to be introduced in walking which minimises hip motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does bunny hopping occur?

A

when both hindlimbs are moved forward together and is also associated with hip pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why might head bobbing occur?

A

if there is thoracic limb lameness, and there is a sink on the sound side when the dog throws weight on the good leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the lameness grading 0-10?
0 - sound 1 - occasionally shifts weight 2 - mild lameness at slow trot, none whilst walking 3 -mild lameness whilst walking 4 - obvious lameness whilst walking, placing foot when standing 5-8 - degress of severity 9- places toe when standing, carries limb when trotting 10 - unable to weight bear
26
What might exercise intolerance be a cause of?
cardiac or metabolic problem
27
What are you palpating the standing animal for?
- asymmetry - swelling - msucle atrophy - joint enlargement - abnormal conformation
28
When examining joints, what is SPIRM?
Swelling, joint effusion Pain Instability Range of motion Manipulation
29
Why might you examine a patient in lateral recumbency?
so that you can work from the toes upwards and easier to examine all 4 limbs
30
Which limb would you examine first for a lameness check?
the unaffected limb so that it is easier to compare normal to abnormal and range of motion
31
What is important to remember when checking for swellings or joint effusion?
differentiate between fibrous swelling and an acumulation of joint fluid
32
What is important to rememeber when checking for pain during the orthopaedic exam
joints are often painful on manipulation especially at extremes of range of motion
33
What types of joints are often most painful on extension?
diseased joints
34
What is important to remember when checking for instability?
aplly varus and valgus stresses to assess collateral ligaments or assess draw movement with ccruciate disease
35
What is varus stressors?
distal limb moved medial
36
What is valgus stressors?
distal limb moved lateral
37
What is important to remember when checking the range of motion?
they often decrease in painful swollen or chronically affected joints - an increase in range of motion may indicate ligamentous or tendinous injury
38
What is important to remmeber when mainpulating a limb?
- place your hand over the joint whilst moving it to assess for crepitus or clunking
39
What is crepitus?
grating associated with loss of cartilate, NOT referred from another joint
40
Why might a joint 'clunk'?
if the hip is subluxating
41
What are you checking for when examining the limbs?
swelling, muscle atrophy and pain
42
What other problems might lame dogs present with?
neurological problems
43
What neurlogical problems might dogs with hip dysplasia also have?
lumbosacral disease
44
What is involved in a screening neurlogical exam?
- conscious proprioception - spinal reflexes (patella, withdrawal, perineal reflexes)
45
How do you differentiate between hip pain and lower back pain?
1 - with dog standing apply firm direct pressure to the lower back 2 - wiith the dog in lateral recumbency flex the hips and the extend the lower back 3 - if dog doesn't resent hip extension then stand behind dog extend the hips, the apply pressure to the lumbosacral area
46
What does a cranial draw test for?
integrity of the cranial cruciate ligament
47
How do you perform a cranial draw test?
1 - patient in lateral 2 - hold femur and tibia and try to move tibia cranially with respect to the femur 3 - repeat test with stifle at different angles or flexion/extension
48
What is a tibia compression test (or tibial thrust test) for?
tests cranial cruciate ligament integrity
49
How do you perform a tibial compression test?
1 -hand over distall femur, firt finger on the tibial tuberosity, other hand on foot 2 - keep stifle still whilst flexing the hock 3 - tibial tuberosity displaces cranially if ligament ruptured
50
What species usually get medial patella luxation?
dogs and cats
51
What does luxate mean?
dislocate
52
How do you luxate the patella?
1 - have the stifle extended 2 - shift the patella medially and laterally
53
What does the ortolani test for?
hip laxity
54
How would you perform the ortolani test?
1 - patient in dorsal recumency 2 - subluxate the hips by pressuign towards back 3 - abduct the femurs (they would click as hip reduces, check angle of reduction) 4 - adduct hips (would click as hip reluxated, check angle of subluxation)
55
What is the angle of luxation?
angle from the verticle to hip luxation
56
What are the ancillary aids to diagnosis?
- diagnositic imaging: ultrasound, radiology, CT, MRI - arthrocentesis - EMG
57
What are the indications for arthrocentesis?
- persistent or cyclical fever - lameness localised to a joint
58
How would you prepare the patient for an arthrocentesis?
- GA or sedation - patient in lateral recumbency - if ill and large patient may be bale to aspirate concious or with local anaesthesia
59
What will you need to ensure strict apseptic technique is carried out when preparing the patient?
- clip an adequat sized area - clean with chlorhexidine or povidone iodine - finish with surgical spirit
60
What equipment will you need to perform an arthrocentesis?
- sterile hypodermic and spinal needles 20-25G, 5/8ths - 2.5" in length - 2.5-5ml syringes
61
What is important not to do when taking the arthrocentesis sample?
do not move the needle as can aspirate tissue and contaminate the sample
62
What tube would you place a large volume of arthrocentesis fluid in?
EDTA for cytology - Plain pot for protein - blood culture media
63
What is a normal amount of joint fluid to aspiration when tapping a normal joint?
less than 0.2ml
64
What does synovial fluid mean?
syn - similar to ova - egg white
65
What does normal synovial fluid look like?
viscous, clear and small volume
66
What does 'tap' mean?
to obtain
67
What does arthrocentesis mean?
surgical puncture and aspiration of a joint
68
What equipment would you need for a scapulohumeral joint tap?
5ml syringe 1.5-2.5" length needle 20-21G spinal needle
69
Tips for tapping a scapulohumeral joint
- insert needledistal to acromion, direct perpendicular and slightly dorsal and medial - withdraw if bone is felt - gentle traction from assistant can help open the shoulder joint
70
What equipment would you need for a cubital (elbow) joint tap?
- 5ml syringe - 1.1.5" length needle - 23G needle
71
How to tap cubital (elbow) joint?
-flex elbow 45 degrees - needle started from point level and perpendicular to epicondylar crest alongside aconeal process
72
What equipment would you need for tapping a carpal joint?
- 2-5ml syringe - 5/8ths length neelde - 23-25G needle
73
What degree should you flex thecarpus for tapping?
90
74
What should you avoid when tapping the carpaljoint?
neurovascular bundle
75
What equipment do you need for tapping the MCP/MTP/IP joints?
- 1-2ml syringe - 5/8ths length needle - 25G spinal needle
76
What equipment do you need for a coxofemoral joint tap?
- 5-10ml syringe - 1.5"-2.5" length needle 20G spinal needle
77
What equipment do you need for a stifle joint tap?
- 5ml syringe - 1-1/5" length needle - 21-23G needle
78
What equipment do you need for a tarsal joint tap?
- 2.5-5ml syringe - 5.8-1" length needle - 23-25G needle
79
What should you do if there is effusion during tarsal joint tap?
push don't aspirate

ACVN - MEDICAL NURSING (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions