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Small animal (fourth year) > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

what causes rickets?

A

vitamin C deficiency

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2
Q

is the first metacarpal/tarsal medial or lateral?

A

medial (count outwards)

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3
Q

what is the first metacarpal/tarsal also known as?

A

dew claw

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4
Q

does distal limb lameness tend to appear worse on a smooth surface or gravel surface?

A

gravel

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5
Q

what are the main conditions seen in the foot?

A

fractures
joint luxations
pad injury - corns…
foreign bodies
nail injuries

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6
Q

what breed gets sesamoid disease of the foot?

A

Rottweilers

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7
Q

what is a footpad corn?

A

focal area of hyperkeratosis causing a thickened/harder pad

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8
Q

how are footpad corns treated?

A

cutting the superficial flexor tendon (tendonectomy) so dog doesn’t walk on it and corn grows out

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9
Q

what breeds are footpad corns most commonly seen in?

A

greyhounds

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10
Q

how are single fractures of the metacarpal/tarsal bones fixed?

A

external coaptation

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11
Q

how are multiple fractures of the metacarpal/tarsal bones fixed?

A

internal fixation

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12
Q

what shaped is used for toe amputation?

A

Y shaped to allow preservation of the footpad

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13
Q

what are the clinical signs of panosteitis?

A

shifting lameness (mild to non-weight bearing)
acute onset
usually forelimb

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14
Q

what dogs is panosteitis most commonly seen in?

A

young large breed dogs with no abnormalities on clinical exam

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15
Q

how is panosteitis treated?

A

self-limiting - exercise control and analgesia

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16
Q

what dogs is metaphysical osteopathy seen in?

A

young large breeds

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17
Q

what is the cause of metaphysical osteopathy?

A

idiopathic

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18
Q

what are the clinical signs of metaphyseal osteopathy?

A

mild to severe lameness
pyrexia, anorexia, depression

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19
Q

what are the radiographic signs of metaphyseal osteopathy?

A

radiolucent line in metaphysis parallel to physis
slightly widened epiphysis and growth plate

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20
Q

how is metaphyseal osteopathy treated?

A

self-limiting - supportive and analgesia

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21
Q

what breed does craniomandibular osteopathy occur in?

A

west highland white terriers

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22
Q

what are the clinical signs of craniomandibular osteopathy?

A

mandibular swelling/thickening
inability to open mouth (anorexia)
salivation
pain when eating

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23
Q

what are the radiographic signs of craniomandibular osteopathy?

A

bilateral palisading proliferation of mandible and tympanic bullae

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24
Q

how is craniomandibular osteopathy treated?

A

self-limiting - supportive and analgesia

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25
Q

what is hypertrophic osteopathy?

A

paraneoplastic syndrome causing palisading new bone formation on distal limbs

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26
Q

what are the clinical signs of hypertrophic osteopathy?

A

slowly developing lameness
firm swelling along distal extremities
painful

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27
Q

what is the aetiology of nutritional secondary hyperparathyroidism?

A

puppies/kittens fed high phosphorous or low calcium diets of purely meat leading to hypocalcaemia and increased parathyroid hormone inducing skeletal demineralisation

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28
Q

what are the clinical signs of nutritional secondary hyperparathyroidism?

A

lameness
skeletal pain
swollen metaphysis
pathological fractures

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29
Q

what are the radiographic signs of nutritional secondary hyperparathyroidism?

A

decreased bone density and thinned cortex
mushroom shaped metaphysis

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30
Q

how is nutritional secondary hyperparathyroidism treated?

A

rest
diet correction
oral calcium
NSAIDs

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31
Q

what occurs with renal osteodystrophy?

A

impaired phosphate excretion leads to hyperphosphataemia causing a hypocalcaemia leading to increased parathyroid hormone secretion and bone demineralisation

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32
Q

what are the clinics signs of renal osteodystrophy?

A

rubber jaw
loose teeth
skeletal pain
pathological fractures

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33
Q

how is renal osteodystrophy treated?

A

reduce phosphate intake
phosphate binder
calcium supplementation

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34
Q

what are the possible fracture forces?

A

bending
axial compression
torsion
high energy/comminuted

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35
Q

what side does the implant need to go onto a fracture?

A

tension side (node compression side)

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36
Q

what is the only type of fracture bandaging alone should be used for?

A

transverse

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37
Q

what are avulsion fractures?

A

pull of muscle/ligament tears away the cartilage link to bone in young dogs

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38
Q

what is the only way to fix avulsion fractures?

A

surgery

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39
Q

what are the three main categories of implants?

A

plates/screws
external skeletal fixators
pins/wires

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40
Q

what are the two types of plates?

A

dynamic compression paltes
locking plates

41
Q

what is a transverse fracture?

A

a fracture up to 30 degrees

42
Q

how fast would a fracture be expected to heal in a young dog (under 6 months old)?

A

4 weeks

43
Q

what are the advantages of locking plates?

A

good in young dogs and poor quality bone
less contouring
improved vascularity

44
Q

what is the appearance of a cortical screw?

A

small threads

45
Q

what is the appearance of a cancelous screw?

A

large thread (better in soft bones)

46
Q

how can screws be placed?

A

positional
lag

47
Q

what is positional screw placement?

A

both pieces of bone have the screw thread in so it simply holds it in place

48
Q

what is the function of a lag screw?

A

gives compression

49
Q

what are the two types of pins?

A

negative thread
positive thread (wider than the shaft)

50
Q

what is a negative thread pin?

A

the thread is cut into the shaft of the bone

51
Q

do connecting bars of an external fixator need regular tightening?

A

no (should need to be tightened)

52
Q

how are external frames described?

A

number of planes its in
how many times it goes through the skin

53
Q

what are the advantages of IM pins?

A

good resistance to bending forces
inexpensive
can be used with other fixations devices

54
Q

what are the distadvanatges of IM pins?

A

poor resistance to rotation and sheer
interferes with medullary blood supply
difficult to place in chondrodystrophic dogs

55
Q

why are IM pins generally better used in cats?

A

they have straighter legs than dogs

56
Q

what are cerclage wires used for?

A

long oblique fractures

57
Q

what are the four As of fracture repair assessment?

A

apparatus (implants)
alignment (joint alignment)
apposition (fracture compression)
activity

58
Q

what is the most common cause of hip luxation?

A

trauma

59
Q

what are the two directions a hip can luxate?

A

craniodorsal
caudoventral

60
Q

what is the most common direction of hip luxation?

A

craniodorsal

61
Q

why is craniodorsal the most common hip luxation?

A

weight bearing on foot
pull from gluteal muscle

62
Q

what are the two causes of craniodorsal hip luxation?

A

trauma
hip dysplasia

63
Q

what cause caudoventral hip luxation?

A

animal does the splits

64
Q

what are the clinical signs of craniodorsal hip luxation?

A

internal rotation of limb
non-weight bearing
greater trochanter higher than normal

65
Q

what are the three boney landmarks associated with the hip region?

A

greater trochanter
ischiadic tuberosity
ileal wing

66
Q

what is the technique for non-surgical reduction of craniodorsal hip luxation?

A

GA/sedation plus epidural
lateral recumbency (affected limb uppermost)
towel/rope around inguinal region (stability)
externally rotate limb to release femoral head
traction caudodistally
internally rotate when femoral head is distal to dorsal acetabular rim

67
Q

what should be done one hip luxations have been non-surgically reduced?

A

xray and bandage (before moving patient)

68
Q

what type of bandage is used for craniodorsal luxations?

A

ehmer sling (keep limb inwardly rotated)

69
Q

what are the signs of mandibular physical separation?

A

mandibular canine misaligned
excess movement

70
Q

what are the possible treatment options for mandibular physical separation?

A

muzzle
wire - metal and PDS (surgery)

71
Q

how are mandibular physical separation fixed with wire?

A

place widest gauge needle through just caudal to mandible and pass wire through it, repeat on the other side and then tighten wire outside mouth

72
Q

what animals will naturally correct carpal extension?

A

very young dogs who have had a bandaged fracture and have tendon laxity due to this

73
Q

can carpal hyperextension be treated by bandaging?

A

no

74
Q

what can cause a carpal hypertension?

A

high rise falls
degeneration (border collie…)
collateral ligament rupture
inflammation (NAD seen on radiograph)

75
Q

what factors drive how carpal/tarsal hyperextension is managed?

A

degree of lameness
dysfunction
exercise tolerance
load bearing angle of the carpus (take care with skin ulceration)

76
Q

what is the treatment for traumatic carpal hyperextensions?

A

surgery

77
Q

what radiographic views need to be taken for carpal hyperextension?

A

mediolateral
dorsopalmar
stressed views of these

78
Q

what is almost always the treatment option for tarsal instability?

A

surgery

79
Q

what size dog is gastrocnemius enthesopathy seen in?

A

large breeds

80
Q

what is gastrocnemius enthesopathy?

A

marked thickening of the gastrocnemius (achilles) tendon causing a partial/complete plantigrade stance (crabbed toes)

81
Q

what is always the treatment option for gastrocnemius enthesopathy?

A

surgery (bandaging won’t work)

82
Q

where does the achilles (gastrocnemius) tendon insert?

A

calcaneus

83
Q

why does gastrocnemius enthesopathy cause toes to curl?

A

as the calcaneus/hock drops the superficial digital flexor tendon has to travel further

84
Q

what does the management of digit luxation depend on?

A

whether is is stable or unstable
which joint luxates

85
Q

how are stable digit luxations treated?

A

surgical stabilisation
digit amputation

86
Q

if securing stable P2/P3 luxations with a split, what should be done?

A

cut nail short
ungunal crest ostectomy
(nail acts as a lever to luxate the joint again)

87
Q

what are the weight bearing digits?

A

3 and 4

88
Q

how many digits can be removed from the foot?

A

1

89
Q

when is it best to do the dynamic assessment of an animal?

A

after getting a clinical history

90
Q

what are the ways of subjective gait analysis?

A

visual analogue scale
numerical rating systems
descriptive systems

91
Q

what are the features of a thoracic limb lameness on dynamic assessment?

A

head position - shifts weight caudally, head rise when lame leg on floor
short stance distance on lame leg
fast swing on non-lame leg

92
Q

what is the position of the head on dynamic assessment of the thoracic limbs?

A

head rise when lame limb is down (throw weight off of limb)

93
Q

what are the features of a pelvic limb lameness on dynamic assessment?

A

head position - shifts weight cranially, hip rise when lame leg on floor, head drop when lame leg on floor
short stance phase on lame leg
fast swing phase on non-lame leg

94
Q

what is the position of the head/hip on dynamic assessment of the pelvic limbs?

A

hip rise when lame leg on floor
head drop when lame leg on floor
(throw weight cranially)

95
Q

why is the dynamic assessment done before the physical examination?

A

so you can determine which limb is lame and leave the examination until last (painful)

96
Q

what needs to be assessed on physical examination of the lame limb?

A

soft tissue - muscle mass/symmetry, joints, tendons
long bones
joints - motion, thickening, crepitus

97
Q

what are the four considerations for managing the lame patent non-surgically?

A

exercise modification
physiotherapy
analgesia
weight management

98
Q

what is standard analgesia for lame dogs?

A

NSAIDs and paracetamol (possibly gabapentin)

Small animal (fourth year) (26 decks)

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