Orthopaedic examination

Question 1

Stance

Answer 1

• assymetry
• inward, outward pointing of paw
• scoliosis (lateral curvature)
• frequent sitting (pelvic limb lameness)
• frequent lying down - thoracic limb lameness

Question 2

Gait

Answer 2

• shortened stride length
• abnormal joint movement
• head movement
• head bobbing
• scuffing of nails
• ataxia

Question 3

Ataxia

Answer 3

Pelvic limb icoordination

Question 4

Paraparesis

Answer 4

Neurological deficits but motor function present

Question 5

Paraplegia

Answer 5

Neurological deficits with absent motor function

Question 6

Bunny hopping

Answer 6

Hip pain

Question 7

Bobbing head

Answer 7

Thoracic limb lameness, “sink on the sound side”

Question 8

Degrees of lameness - 0

Answer 8

Normal, no lameness

Question 9

Degrees of lameness - 1

Answer 9

Off weight bearing at a stance, no lameness noted at a walk/trot

Question 10

Degrees of lameness - 2

Answer 10

Mild lameness at a trot, non at a walk

Question 11

Degrees of lameness - 3

Answer 11

Moderate lameness at a walk/trot

Question 12

Degrees of lameness - 4

Answer 12

Places foot when standing, intermittently carries limb when trotting, “toe touching”

Question 13

Degrees of lameness - 5

Answer 13

Non-weight bearing lameness

Question 14

Distribution of weight in thoracic and pelvic limbs in %

Answer 14

Thoracic limbs carry 60% of the body weight, pelvic limbs carry 40%

Question 15

Centre of gravity

Answer 15

Behind the elbow

Question 16

Technology which can help us with gait analysis

Answer 16

• force plate
• pressure plates
• pressure-sensitive walkway
  -pressure or force-sensitive treadmill
• kinematic analysis
• activity trackers

Question 17

Observation of a patients stance - SAW

Answer 17

Symmetry
Angular limb deformity
Weight bearing

Question 18

Brief neurological exam

Answer 18

• spinal pain
• proprioceptive defects
• withdrawal reflex
• neck ROM
  Any findings warrant full neurological examination

Question 19

How do you differentiate between hip pain and lower back pain

Answer 19

• apply firm direct pressure to the lower back area
• in lateral recumbancy, flex hips and extend lower back
• extend hips and apply pressure to the lumbosacral area
• tail lift

Question 20

palpation of standing animal

Answer 20

• assymetry
• swelling
• muscle atrophy
• joint effusion
• abnormal conformation (joint, bones)
• compare limbs

Question 21

Palpation of joints - CRISP

Answer 21

• Crepitus
• Range of motion
• Instability
• Swelling/effusion
• Pain

Question 22

Examination of limbs - SAP

Answer 22

• Swelling (bone or soft tissue)
• Atrophy of muscles (disuse, neurogenic)
• Pain (bone or soft tissue)

Question 23

Cranial drawer test

Answer 23

Index finger on patellar and tibial crest; move tibia and fibula cranially, hold femur still.
May be negative due to collateral ligament resisting forward motion of the tibia when joint is fully extended

Question 24

Tibial compression test/tibial thrust

Answer 24

One hand on cranial aspect of distal femur with first finger on tibial tuberosity, other hand on food, keep stifle still and flex the hook

Question 25

Ortolani test

Answer 25

Hip dysplasia test
Sedated/anesthetized
Lateral recumbancy, thumb on greater trochanter, hand on femur, push up towards spine and abduct - if click = positive

https://www.youtube.com/watch?v=zFbBUMZvPa8

Question 26

Bardens test (hip lift)

Answer 26

Sedated/anesthetized
Lift up femur from hip - if more than 0,5cm then probably abnormal

Question 27

Thumb displacement test

Answer 27

in traumatic luxation
Place thumb in depression between greater trochanter and ischial tuberosity, externally rotate the hip, if thumb is displaced then hip is NOT luxated.

Question 28

Hip luxation - limb length

Answer 28

shorter limb is the abnormal one

Question 29

Problem list

Answer 29

All presenting complaints that represent a problem for the animal - may be interrelated